Modified Skin Incision and Location of Burr-Hole Surgery via a Retrosigmoid Approach: An Anatomical Study

Objective This study aims to reduce the tissue damage during craniotomy with retrosigmoid approach. A modified sickle-shaped skin incision was developed, and a new burr-hole positioning method was proposed. Methods Five adult cadaveric heads (10 sides) were used in this study. The sickle-shaped skin incision was performed during craniotomy. The nerves, blood vessels, and muscles were observed and measured under a microscope. Additionally, 62 dry adult skull specimens (left sided, n = 35; right sided, n = 27) were used to measure the distance between the most commonly used locating point (asterion [Ast] point) and the posteroinferior point of the transverse sigmoid sinus junction (PSTS) (Ast-PSTS), as well as the distance between the new locating O point and the PSTS (O-PSTS). Then, the reliability of the new locating O point was validated on the same five adult cadaveric heads (10 sides) used for the sickle-shaped skin incision. Results The sickle-shaped skin incision reduced the damage to the occipital nerves, blood vessels, and muscles during the surgery via a retrosigmoid approach. The dispersion and variability of O-PSTS were smaller than those of Ast-PSTS. Conclusion The sickle-shaped skin incision of the retrosigmoid approach can reduce the tissue damage and can completely expose the structures in the cerebellopontine angle. The modified O point is a more reliable locating point for a burr-hole surgery than the Ast point.

Computed Microtomography (Micro-CT) in the Anatomical Study and Identification of Solenogastres (Mollusca)

Solenogastres are vermiform marine molluscs characterised by an aculiferous mantle, a longitudinal ventral pedal groove and a terminal or subterminal pallial cavity. Their classification is based in part on the type of mantle sclerites, but identification to even the family level generally requires the study of internal anatomical characters. Taxonomically important internal characters include those related to radular structure, the type of ventrolateral glandular organs of the pharynx and the reproductive system, among others. In order to study their internal anatomical organisation, according to the classical reconstruction method, serial histological sections of specimens are made, from which the 2D internal anatomy of the specimen can be reconstructed manually. However, this is a time-consuming technique that results in destruction of the specimen. Computed microtomography or micro-CT is a non-destructive technique based on the measurement of the attenuation of X-rays as they pass through a specimen. Micro-CT is faster than histology for studying internal anatomy and it is non-destructive, meaning that specimens may be used for e.g., DNA extraction or retained as intact vouchers. In this paper, the utility of micro-CT for studying taxonomically important internal anatomical structures was assessed. Results of the 3D anatomical study of the soft parts of four specimens of three species using micro-CT are presented: Proneomenia sluiteriHubrecht, 1880, Dorymenia menchuescribanaeGarcía-Álvarez et al., 2000 and Anamenia gorgonophilaKowalevsky, 1880. Micro-CT enabled detailed study of most taxonomically important anatomical characters, precise measurements of structures, and observation of the relative position of organs from a variety of angles. However, it was not possible to observe the radula and some details of the ventral foregut organs could not be discerned. Despite these limitations, results of this study highlight micro-CT as a valuable tool to compliment histology in the study of solenogaster anatomy and in non-destructively identifying animals to the family and even genus-level.

The Superficial Anastomosing Veins of the Human Brain Cortex: A Microneurosurgical Anatomical Study

Introduction: In this microneurosurgical and anatomical study, we characterized the superficial anastomosing veins of the human brain cortex in human specimens.Material and Methods: We used 21 brain preparations fixed in formalin (5%) that showed no pathological changes and came from the autopsy sections. The superficial veins were dissected out of the arachnoid with the aid of a surgical microscope.Results: We dissected nine female and 12 male brain specimens, with an average age of 71 ± 11 years (range 51–88 years). We classified the superficial veins in five types: (I) the vein of Trolard as the dominat vein; (II) the vein of Labbé as the dominant vein; (III) a dominant sylvian vein group, and the veins of Trolard and Labbé nonexistent or only rudimentary present without contact to the Sylvian vein group; (IV) very weak sylvian veins with the veins of Trolard and Labbé codominant; and V) direct connection of Trolard and Labbé bypassing the Sylvian vein group. The vein of Trolard was dominant (Type I) in 21.4% and the vein of Labbé (Type II) in 16.7%. A dominant sylvian vein group (Type III) was found in 42.9%. Type IV and Type V were found in 14.3 and 4.7% respectively.Conclusion: No systematic description or numerical distribution of the superior anastomotic vein (V. Trolard) and inferior anastomotic vein (V. Labbé) has been found in the existing literature. This study aimed to fill this gap in current literature and provide data to neurosurgeons for the practical planning of surgical approaches.

Microsurgical Anatomy of the Hypoglossal Nerve in the Lateral Approaches to the Craniovertebral Junction: A Study on Fresh Non-Formalin-Fixed Human Specimens

The aim of this anatomical study is to describe the anatomy of the hypoglossal nerve (HN) from its origin to the extracranial portion as it appears by performing a combined posterolateral and anterolateral approach to the craniovertebral junction (CVJ). Twelve fresh, non-formalin-fixed adult cadaveric heads (24 sides) were analyzed for the simulation of the combined lateral approach to the CVJ. The HN is divided into three main parts: cisternal, intracanalicular, and extracranial The anatomical relationships between the HN and other nerves, muscles, arteries and veins were carefully recorded, and some measurements were made between the HN and related structures. Thus, various landmarks were determined for the easy identification of the HN. Understanding the detailed anatomy of the HN and its relationships with the surrounding structures is crucial to prevent some complications during CVJ surgery.