variant anatomy
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Author(s):  
Paul M. Manning ◽  
Michael R. Shroads ◽  
Julie Bykowski ◽  
Mahmood F. Mafee

Abstract Purpose of Review To review the role of imaging in otosclerosis with an emphasis on pre- and post-operative imaging evaluation. Recent Findings Pre-operative CT imaging can help define the extent of bone involvement in otosclerosis and may help avoid surgical complications due to variant anatomy or unsuspected alternative causes of conductive hearing loss. In patients with recurrent hearing loss after surgery, CT imaging can clarify prosthesis position and re-assess anatomy. Summary CT imaging complements otologic exam and audiometry findings in patients with suspected otosclerosis, for pre-operative planning, and post-operative assessment for patients with recurrent symptoms.


2021 ◽  
Vol 8 (4) ◽  
pp. 314-319
Author(s):  
Anjalee G Ovhal ◽  
K Ravikumar ◽  
Devender Sachdev

The knowledge of variable branching pattern of Axillary artery is needed for vascular surgeons, onco surgeons, anaesthesiologists, orthopedic surgeons and radiologists due to increased use of invasive diagnostic, interventional procedures. The aim was to study the variable branching pattern of Axillary artey in cadavers. 15 cadavers (30 upper limbs) - 12 male and 3 female embalmed with 10% formalin were dissected for this study. Variable branching pattern was observed in 6.6% of the cases on right side and 6.6% of the cases on left side in first part of axillary artery, 40% of the cases on right side and 53.3% of the cases on left side in second part and 53.3% of the cases on right side and 26.6% of the cases on left side in third part. The anatomical knowledge of the normal and variant anatomy of the Axillary artery is of importance for anatomists, surgeons, radiologists and clinicians during various interventional, diagnostic, therapeutic and surgical procedures on pectoral and axillary regions.


2021 ◽  
Vol 9 (4) ◽  
pp. 8156-8159
Author(s):  
Patel Dinesh K ◽  
◽  
Shinde Amol A ◽  

Background: Sciatic nerve is a branch of sacral plexus. It passes below the pyriformis and divides in the popliteal fossa. Higher division and relation of sciatic nerve to pyriformis have been documented. Beaton and Anson have classified relation of sciatic nerve to pyriformis. The aim of this study is to find incidence of variant anatomy of sciatic nerve as per Beaton and Anson classification. Materials and methods: 48 formalin embalmed lower limbs used for regular anatomy teaching were used. Branching and course of sciatic nerve was observed in gluteal region,thigh and popliteal fossa. Observations: As per Beaton and Anson classification, we found 81.2% showed type A or normal arrangement. Type B variation was seen in 14.6% while 4.2% showed type D variation. Conclusion: Variations in branching of sciatic nerve and it’s relation to pyriformis muscle are important from point of view of Surgeons and Anaesthetists. Knowledge of these variations will help reducing block failures in cases of sciatica, pyriformis syndrome and hip replacement surgeries. KEY WORDS: Sciatic nerve, Sacral plexus, Pyriformis Syndrome, Hip replacement.


2021 ◽  
Vol 27 (3) ◽  
pp. 55-68
Author(s):  
Svetla Dineva ◽  
Milko Stoyanov ◽  
Aneliya Partenova ◽  
Boyan Kunev ◽  
Victoria Stoyanova ◽  
...  

Anatomical variants of pulmonary venous drainage in the left atrium are often found. Divergent results have been reported on the impact of variant anatomy on atrial fi brillation (AF) recurrence after catheter ablation. We aimed to study the frequency of different anatomical variants of pulmonary venous drainage and their relationship with documented recurrences of AF after ablation. Material and methods: A retrospective study of patients with AF in whom radiofrequency pulmonary vein isolation was done after previously performed cardiac contrast-enhanced multidetector computed tomography. Clinical and procedural characteristics, type and frequency of anatomical variants of the veno-atrial junction and their association with AF recurrences were studied. Results: One hundred seventy-seven patients (112 men, 63.3%) with AF were studied, of which 148 (83.6%) with paroxysmal AF. Variant anatomy was found in 91 patients (51.4%). In 20.9% there was a common left trunk, in 23.2% – more or less than two right-sided veins, and in 7.3% – variations for both right and left veins. No differences in clinical and procedural characteristics were found between the groups with normal and variant anatomy. Recurrences of AF and their association with pulmonary venous anatomy were studied in 104 patients with follow-up ≥ 3 months. No signifi cant relation was found between the presence of variant anatomy and AF recurrences within the blinding period after ablation, OR = 0.864, 95% CI = 0.397 – 1.88, p = 0.843, nor afterwards, OR = 1.12, 95% CI = 0.5 – 2.5, p = 0.839. Cox regression analysis showed no differences in AF recurrence-free survival regardless of the anatomical variant of pulmonary venous drainage, HR = 1.09, 95% CI = 0.58 – 2.05, p = 0.779. Conclusion: In this local population of patients with AF, the incidence of variant pulmonary venous drainage is just over 50%. No association was found between variant anatomy and the rate of AF recurrences after fi rst pulmonary vein isolation.


2021 ◽  
Vol 4 (2) ◽  
pp. 36-40
Author(s):  
Beryl Shitandi Ominde ◽  
◽  
Joyce Ikubor ◽  
Wilson Iju ◽  
Okolugbo Nekwu ◽  
...  
Keyword(s):  

2021 ◽  
Vol 10 (2) ◽  
pp. 23-29
Author(s):  
I. V. Gaivoronskii ◽  
G. V. Kovalev ◽  
D. D. Shkarupa ◽  
G. I. Nichiporuk

The aimof  this research was to study the variant anatomy of the obturator complex in terms of surgical treatment of stress urinary incontinence, as well as to determine the most atraumatic technique for conducting a surgical trocar for a transobturator suburethral sling.Material and methods.A suburethral sling was implanted on 40 sagittally dissected samples of the female pelvis with preserved soft tissues using two techniques: the conventional one based on the use of external landmarks and the technique of the trocar rotation around the lower branch of the pubic bone developed at the University  Clinic  of  St.  Petersburg.  After  implantation  of  a  transobturator  suburethral  sling,  the  probability  of injury  to  the  branches  of  the  obturator  nerve  was  assessed  by  precision  preparation  for  each  of  the  presented techniques using 40 samples. It was also suggested to develop a protocol for atraumatic placement ofa sling for stress urinary incontinence.Results. Based  on  the  results  obtained  and  study  of  the  topographic  relationships  of  the  trocar  and branches of the obturator nerve, it is concluded that the obturator complex has significant anatomical variability. This relates to both the muscular component  –the internal and external obturator muscles, and neurovascular structures. The obturator nerve has two types of branching: joint and separate. The latter is a risk factor for intraoperative nerve injury. The technique of suburethral sling implantation by rotating the surgical trocar around the inferior branch of the pubic bone is atraumatic and safe.Conclusions.Variant anatomy of the obturator complex influences the probability of trauma in a transobturator suburethral sling implantation. In particular, the separate branching of the obturator nerve is a risk factor for its intraoperative injury. Further clinical studies are required to assess the outcomes of surgical t reatment of stress urinary incontinence taking into account the variant anatomy of the true pelvis.


2021 ◽  
Vol 11 (3) ◽  
pp. 54-60
Author(s):  
Taisiya Kochkonyan ◽  
Ghamdan Al-Harazi ◽  
Dmitry Domenyuk ◽  
Sergei Dmitrienko ◽  
Stanislav Domenyuk

Cone-beam computed tomograms of 68 people (age — 21–35) with physiological occlusion and various gnathic dental arches were analyzed by a method developed for identifying the palatal arch index, taken as a height (depth)-to-width dimension ratio. The results of the study revealed that palatal parameters are determined by main variants (types) of the palatal vault. In case of the mesopalatal type of the arch (index value — 35–45%), the width parameters exceeded the depth values by an average of 2.4 times, while the divergence angle of alveolar processes was 116.7 ± 5.6°. The dolichopalatal type of the arch (index value – above 45%) featured domination of the width parameters over the depth-related ones, by an average of 1.8 times, while the alveolar processes divergence angle made up 127.6 ± 6.1°. As far as the brachypalatal type of the arch is concerned (index value — below 35%), the width parameters exceeded the depth parameters by 4.0 times on average, the divergence angle of the alveolar processes being 113.5 ± 5.3°. The obtained data can be used in clinical orthodontics when diagnosing pathologies of the palatal vault, as well as to interpret data from additional methods of examination and to choose the right treatment for issues related to the dental arch shape and size.


2021 ◽  
pp. 20210012
Author(s):  
Natasha Naidoo ◽  
Nausheen Khan

Accessory articulation of the transverse processes of the cervical vertebrae is an extremely rare congenital anomaly. We present two cases of accessory articulation of the transverse processes of the left C5/C6 and C6/C7 cervical vertebrae. The articulation at C5/C6 was found in a 34-year-old male following a mob assault, the C6/C7 accessory articulation occurred in a 28-year-old female involved in a high velocity motor-vehicle accident. Cervical spine fractures were suspected in both cases. Recognition of this variant anatomy and differentiation from a fracture is important especially in an acute trauma setting to prevent unnecessary immobilization and inappropriate specialist referral of these patients. Our search revealed only five previously reported cases in the literature mostly occurring at the C5/C6 level. This is only the second case ever described at the C6/C7 level.


2021 ◽  
Vol 5 (1) ◽  
pp. 71-78
Author(s):  
E. V. Mahiliavets ◽  
◽  
P. V. Harelik ◽  

Background. Making treatment / prevention decisions in bleeding from gastroesophageal varices in patients with subhepatic portal hypertension remains challenging and thus requires further research. Objective. To perform a preliminary analysis of the outcomes of selective devascularization of the gastric fundus in patients with chronic pancreatitis and subhepatic portal hypertension. Material and methods. Selective devascularization of the gastric fundus was performed in five patients (3 men and 2 women) aged 23 to 54 with chronic recurrent pancreatitis and subhepatic portal hypertension. In 2 patients, Roux-en-Y cystojejunostomy for pancreatic pseudocyst was performed as the main treatment, and in 3 patients - Frey's surgery. Selective devascularization of the gastric fundus was adjuvant to a draining surgery or a resection-draining one. Results. All patients underwent surgery successfully. The duration of the operation (Me [min; max]) was 205 [190; 255] min. The time spent in the Department of anesthesiology, resuscitation and intensive care comprised 1 [1; 2] days. Postoperative follow-up of these patients over the period of 17 - 58 months detected no recurrence of bleeding from gastric varices. Endoscopy performed a year after revealed a decrease in the size of esophageal varices in all patients. Conclusions. The proposed technique of selective devascularization of the gastric fundus is substantiated by numerous studies of the variant anatomy of venous outflow from the spleen in extrahepatic portal hypertension. This technique is regarded as adjuvant to a draining surgery or a resection-draining one in patients with chronic pancreatitis and subhepatic portal hypertension performed to prevent bleeding from gastric fundus varices. There should be noted the reproducibility of this surgical intervention, its effectiveness and safety. Further research on the efficiency of the technique using randomized controlled trials is required.


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