Morphological Study of Accessory Foramina in Dry Mandible and Its Clinical Significance

Background: To provide anatomical information on theposition and incidence of accessory foramina in mandible asthey are important for dental surgeons and anesthetists inachieving complete nerve blocks and for avoiding injury toneurovascular structures passing through them.Objective: To study the incidence of accessory foramina in drymandible in population of Bihar & compare it with incidenceamong various races of the world.Materials & Methods: Present study is a cross sectional studywhich has been carried out on 56 dried fully ossified adulthuman mandibles, which were examined in the Department ofAnatomy and Forensic Medicine of Indira Gandhi Institute ofMedical Sciences, Patna, Bihar. The age of the bones used inthe study was not predetermined. Only fully ossified dried,macerated and thoroughly cleaned mandibles which werecomplete in all respects, in order to give the correctobservations, were included in the study while the mandibleshaving any deformity or pathology were excluded. Theaccessory foramina and their positions were observed.Results: Accessory mandibular foramina were found in 55.36%, accessory mental in 23.22 %, and retromolar in 17.85% ofthe cases. The accessory foramen observed most commonly inright side (39.28%) followed by bilateral (37.5%) then left side(19.65%).Conclusion: The anatomical variability of incidence andposition of accessory foramina should be considered as theymay be used to give additional locoregional anesthesia in caseof failed mandibular blocks. Knowledge of the commonestpositions will be beneficial for oncologists and oromaxillofacialsurgeons in planning graft implants.

Mullerian Duct Anomaly- A Spectrum of Varied Clinical Manifestations

Introduction: Multiple integrated steps are required fornormal development of the female genital tract. A wide varietyof malformations can occur when this system is disruptedeither in form of non- development or defective fusion orfailure of resorption. The purpose of this study was to reviewthe spectrum of symptoms with which mullerian anomaliespresent so that timely intervention could be done to savesexual and reproductive life.Material and methods: The study was done in the departmentof Obstetrics and Gynaecology of a tertiary care teachinghospital in Bihar. Only the admitted cases i.e,those whorequired surgical correction were taken into study.Results: Majority of patients presented with severeabdominal pain(71.4%) followed by menstrual problems(46.4%), and urinary symptoms (35.7%) including vvf. 25%patients reported subfertility, 14.2% abdominal lump and14.2% dyspareunia, 10.7%PID and 10.7% rectal pressuresymptoms.Majority had transverse vaginal septum (28.5%),followed byMRKHS and OHVIRA syndrome (14.2% each),Conclusion: The variety of ways with which mullerian ductanomalies present hints that clinical suspicion should be thereif early diagnosis is not to be missed.