An Anatomical Study of Incisive Canal and its Foramen

2021 ◽  
Author(s):  
Beatriz Quevedo ◽  
Beatriz Sangalette ◽  
Ivna Lopes ◽  
João Vitor Shindo ◽  
Jesus Carlos Andreo ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Oral Cavity ◽  
Nasal Cavity ◽  
Anatomical Study ◽  
Clinical Applications ◽  
Incisive Canal ◽  
Average Area ◽  
Incisive Foramen ◽  
Morphology And Morphometry ◽  
The Right

Abstract Introduction: Anatomically, the incisive canals start on the nasal fossa floor, close to the septum, and open at the incisive foramen of the maxillary palatine process. The nasopalatine nerve passes through the incisive foramen as well as the septal artery and the sphenopalatine vein. Also, there may be accessory canals. Typically, the incisive foramen has two incisive canals. This work aimed to analyze the morphology and morphometry of the foramen and incisive canals in the macerated cephalic skeletons. Material and methods: For this purpose, we selected 150 samples of adult individuals, with no distinctions of sex and ethnicity. We analyzed the frequency of incisive canals in the foramen was analyzed as well the area, diameter, and communications of incisive canals with the fossa and nasal cavity. Results: The cephalic analysis results showed that most incisive foramina have at least two canals that communicate the nasal cavity with the oral cavity. The right-side canal had an average of 1.975mm² in area and 1.281mm in diameter. Also, the left-side canal had an average of 1.468mm² in area and 1.182mm in diameter. The average area and total diameter of the incisive foramen were 8.148mm² and 3.101mm, respectively.Conclusion: Hence, understanding anatomy and its variations is essential for clinical applications, as it may alter surgical technique and prognosis. Besides, it can be said all incisive canals have communication with the nasal cavity.

scholarly journals Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

2021 ◽  
Author(s):  
Sergey Dydykin ◽  
Friedrich Paulsen ◽  
Tatyana Khorobykh ◽  
Natalya Mishchenko ◽  
Marina Kapitonova ◽  
...  
Keyword(s):  
Prone Position ◽  
Anatomical Study ◽  
Structural Features ◽  
Posterior Mediastinum ◽  
Visual Navigation ◽  
Anatomical Landmarks ◽  
Video Assisted ◽  
Before And After ◽  
Human Cadavers ◽  
The Right

Abstract Purpose There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum’s fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. Methods The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. Results For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. Conclusion The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

Anatomical Study of the Medialis Pedis Flap and its clinical applications in Asian Singaporean Patients

Injury ◽  
2021 ◽  
Author(s):  
Priya Tiwari ◽  
Khong Yik Chew ◽  
Bien Keem Tan ◽  
Shian Chao Tay ◽  
Beng Hai Lim
Keyword(s):  
Anatomical Study ◽  
Clinical Applications

MINI OPCAB Operation: Surgical Technique

2021 ◽  
Author(s):  
Federico Benetti ◽  
Natalia Scialacomo ◽  
Gustavo Mazzolino
Keyword(s):  
Surgical Technique ◽  
Large Scale ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Off Pump ◽  
Internal Mammary ◽  
Hybrid Revascularization ◽  
Pump Coronary Artery Bypass ◽  
The Right

Introduction: We describe how to perform left internal mammary artery (LIMA) bypass to the left anterior descending (LAD) artery, the so-called MINI Off-pump Coronary Artery Bypass (MINI OPCAB). Materials and Methods: We included patients with a demonstrated predominant ischemia related to the LAD territory. Of 70 patients who were operated upon at the Benetti Foundation, 10 received hybrid revascularization. Surgical Technique: The patient is prepared as for a standard coronary bypass operation through sternotomy. The sternum is opened to the 3rd or 4th intercostal space depending on the anatomy, and a retractor is put in place. The left mammary artery is generally dissected to about 8 cm and isolated without the veins. Importantly, the angle of the superior part, where the mammary artery is attached to the sternum, needs to be below 20% to avoid any potential kinking. The pericardium is cleaned to identify the area of the pulmonary artery. The pericardium is opened to the apex and towards the right to around 5 to 6 cm initially. In most cases, the area of the LAD can be seen and the potential area of the anastomosis is defined. The patient is heparinized and the LAD is occluded with 5-0 Proline. A mechanical stabilizer is put in place and the anastomosis is performed. When the bypass is finished, and before sutures are tied, the stitches of 5-0 polypropylene around the artery are released, along with the clamp of the mammary artery; the anastomosis is then tied. The mechanical stabilizer is removed, the stitches of the pericardium are released and the flow of the graft is measured, while ensuring that there is no kinking. If the flow and Pulsatility and Resistance (PR) are acceptable, the mammary is fixed with 2 stitches of 7-0 polypropylene on both sides around 1 cm from the anastomosis. The heparin is reverted with protamine and a drain is put in place, while taking care to avoid any chance of touching the mammary artery or the anastomosis. The sternum is closed with 1 or 2 wires. Results: Operative mortality in this series was 0%; one patient was converted to sternotomy off-pump (1.4%). None of the grafts were revised after measurement with a Medistim system (Medistim ASA, Oslo, Norway). Fifty five patients (79%) were extubated in the operating room The average hospitalization stay was 60 hours (SD 17, 95% CI). Sixteen patients who underwent the LIMA-to-LAD procedure were restudied, with 100% patency. At 144 months, 82% of the patients were alive and 68% were asymptomatic. Conclusion: Additional clinical experience is required to be able to reproduce this operation on a large scale and expand the MINI OPCAB operation in hybrid revascularization.

Salivary peptide histatin 1 mediated cell adhesion: a possible role in mesenchymal-epithelial transition and in pathologies

2018 ◽  
Vol 399 (12) ◽  
pp. 1409-1419 ◽  
Author(s):  
Irene A. van Dijk ◽  
Enno C.I. Veerman ◽  
Eric A.J. Reits ◽  
Jan G.M. Bolscher ◽  
Jan Stap
Keyword(s):  
Cell Adhesion ◽  
Oral Cavity ◽  
Potential Function ◽  
Clinical Applications ◽  
Epithelial Barrier ◽  
Salivary Peptide ◽  
Mesenchymal To Epithelial Transition ◽  
Mesenchymal Epithelial Transition

Abstract Histatins are histidine-rich peptides present in the saliva of humans and higher primates and have been implicated in the protection of the oral cavity. Histatin 1 is one of the most abundant histatins and recent reports show that it has a stimulating effect on cellular adherence, thereby suggesting a role in maintaining the quality of the epithelial barrier and stimulating mesenchymal-to-epithelial transition. Here we summarize these findings and discuss them in the context of previous reports. The recent findings also provide new insights in the physiological functions of histatin 1, which are discussed here. Furthermore, we put forward a possible role of histatin 1 in various pathologies and its potential function in clinical applications.

Level I to III craniofacial approaches based on Barrow classification for treatment of skull base meningiomas: surgical technique, microsurgical anatomy, and case illustrations

2011 ◽  
Vol 30 (5) ◽  
pp. E5 ◽  
Author(s):  
Emel Avcı ◽  
Erinç Aktüre ◽  
Hakan Seçkin ◽  
Kutluay Uluç ◽  
Andrew M. Bauer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Skull Base ◽  
Surgical Anatomy ◽  
Microsurgical Anatomy ◽  
Middle Point ◽  
The Mean ◽  
The Right ◽  
Skull Base Meningiomas ◽  
Supraorbital Foramen ◽  
Ethmoidal Foramen

Object Although craniofacial approaches to the midline skull base have been defined and surgical results have been published, clear descriptions of these complex approaches in a step-wise manner are lacking. The objective of this study is to demonstrate the surgical technique of craniofacial approaches based on Barrow classification (Levels I–III) and to study the microsurgical anatomy pertinent to these complex craniofacial approaches. Methods Ten adult cadaveric heads perfused with colored silicone and 24 dry human skulls were used to study the microsurgical anatomy and to demonstrate craniofacial approaches in a step-wise manner. In addition to cadaveric studies, case illustrations of anterior skull base meningiomas were presented to demonstrate the clinical application of the first 3 (Levels I–III) approaches. Results Cadaveric head dissection was performed in 10 heads using craniofacial approaches. Ethmoid and sphenoid sinuses, cribriform plate, orbit, planum sphenoidale, clivus, sellar, and parasellar regions were shown at Levels I, II, and III. In 24 human dry skulls (48 sides), a supraorbital notch (85.4%) was observed more frequently than the supraorbital foramen (14.6%). The mean distance between the supraorbital foramen notch to the midline was 21.9 mm on the right side and 21.8 mm on the left. By accepting the middle point of the nasofrontal suture as a landmark, the mean distances to the anterior ethmoidal foramen from the middle point of this suture were 32 mm on the right side and 34 mm on the left. The mean distance between the anterior and posterior ethmoidal foramina was 12.3 mm on both sides; the mean distance between the posterior ethmoidal foramen and distal opening of the optic canal was 7.1 mm on the right side and 7.3 mm on the left. Conclusions Barrow classification is a simple and stepwise system to better understand the surgical anatomy and refine the techniques in performing these complex craniofacial approaches. On the other hand, thorough anatomical knowledge of the midline skull base and variations of the neurovascular structures is crucial to perform successful craniofacial approaches.

Neurovascular structures adjacent to the lumbar intervertebral discs: an anatomical study of their morphometry and relationships

2011 ◽  
Vol 14 (5) ◽  
pp. 630-638 ◽  
Author(s):  
Mehmet Arslan ◽  
Ayhan Cömert ◽  
Halil İbrahim Açar ◽  
Mevci Özdemir ◽  
Alaittin Elhan ◽  
...  
Keyword(s):  
Nerve Root ◽  
Lumbar Disc ◽  
Anatomical Study ◽  
Intervertebral Discs ◽  
Nerve Roots ◽  
Disc Space ◽  
Anatomical Knowledge ◽  
The Mean ◽  
The Right ◽  
Neurovascular Structures

Object Although infrequent, injury to adjacent neurovascular structures during posterior approaches to lumbar intervertebral discs can occur. A detailed anatomical knowledge of relationships may decrease surgical complications. Methods Ten formalin-fixed male cadavers were used for this study. Posterior exposure of the lumbar thecal sac, nerve roots, pedicles, and intervertebral discs was performed. To identify retroperitoneal structures at risk during posterior lumbar discectomy, a transabdominal retroperitoneal approach was performed, and observations were made. The distances between the posterior and anterior edges of the lumbar intervertebral discs were measured, and the relationships between the disc space, pedicle, and nerve root were evaluated. Results For right and left sides, the mean distance from the inferior pedicle to the disc gradually increased from L1–2 to L4–5 (range 2.7–3.8 mm and 2.9–4.5 mm for right and left side, respectively) and slightly decreased at L5–S1. For right and left sides, the mean distance from the superior pedicle to the disc was more or less the same for all disc spaces (range 9.3–11.6 mm and 8.2–10.5 mm for right and left, respectively). The right and left mean disc-to-root distance for the L3–4 to L5–S1 levels ranged from 8.3 to 22.1 mm and 7.2 to 20.6 mm, respectively. The root origin gradually increased from L-1 to L-5. The right and left nerve root–to-disc angle gradually decreased from L-3 to S-1 (range 105°–110.6° and 99°–108°). Disc heights gradually increased from L1–2 to L5–S1 (range 11.3–17.4 mm). The mean distance between the anterior and posterior borders of the intervertebral discs ranged from 39 to 46 mm for all levels. Conclusions To avoid neighboring neurovascular structures, instrumentation should not be inserted into the lumbar disc spaces more than 3 cm from their posterior edge. Accurate anatomical knowledge of the relationships of intervertebral discs to nerve roots is needed for spine surgeons.

Discomallear and malleomandibular ligaments: anatomical study and clinical applications

2003 ◽  
Vol 25 (2) ◽  
pp. 152-157 ◽  
Author(s):  
F. Cheynet ◽  
L. Guyot ◽  
O. Richard ◽  
W. Layoun ◽  
R. Gola
Keyword(s):  
Anatomical Study ◽  
Clinical Applications

scholarly journals Dynamic anatomical study of cardiac shunting in crocodiles using high-resolution angioscopy

1996 ◽  
Vol 199 (2) ◽  
pp. 359-365 ◽  
Author(s):  
M Axelsson ◽  
C E Franklin ◽  
C O Löfman ◽  
S Nilsson ◽  
G C Grigg
Keyword(s):  
High Resolution ◽  
Connective Tissue ◽  
Right Ventricle ◽  
Anatomical Study ◽  
Systemic Circulation ◽  
Outflow Tract ◽  
Aortic Valves ◽  
Aortic Blood Pressure ◽  
The Right

Prolonged submergence imposes special demands on the cardiovascular system. Unlike the situation in diving birds and mammals, crocodilians have the ability to shunt blood away from the lungs, despite having an anatomically divided ventricle. This remarkable cardiovascular flexibility is due in part to three anatomical peculiarities: (1) an 'extra' aorta (the left aorta) that leaves the right ventricle and allows the blood from the right ventricle to take an alternative route into the systemic circulation instead of going to the lungs; (2) the foramen of Panizza, an aperture that connects the right and left aortas at their base immediately outside the ventricle; and (3) a set of connective tissue outpushings in the pulmonary outflow tract in the right ventricle. Using high-resolution angioscopy, we have studied these structures in the beating crocodile heart and correlated their movements with in vivo pressure and flow recordings. The connective tissue outpushings in the pulmonary outflow tract represent an active mechanism used to restrict blood flow into the lungs, thus creating one of the conditions required for a right-to-left shunt. We observed that the foramen of Panizza was obstructed by the medial cusp of the right aortic valve during most of systole, effectively differentiating the left and right aortic blood pressure. During diastole, however, the foramen remained open, allowing pressure equilibration between the two aortas. Contrary to current theories, we found that the left aortic valves were unable to cover the foramen of Panizza during any part of the cardiac cycle, supporting the reversed foramen flow hypothesis. This would ensure a supply of blood to the coronary and cephalic circulation during a complete shut-down of the left side of the heart, such as might occur during prolonged submergence.

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