Morphometric analysis of the mandibular ramus and its clinical and medicolegal significance

Background: During natural calamities entire skeleton of single person could not be found. In such case, determination of sex with fragments of the bone available required range of data with proven accuracy. Hence this study is aimed at to provide range of data for minimum number of parameters of the ramus of the mandible.Methods: Three hundred dry mandibles of known sexes and bearing all teeth or intact alveolar margin were included in the study. Vertical height; maximum and minimum breadths of the ramus of the mandible were measured. All the data were analyzed for significance of the occurrence in relation to sex and laterality by means of paired t-test.Results: On the basis of all the three parameters together, we got 95% accuracy in determination of sex. Statistically significant differences were found in all parameters between male and female mandibles. The laterality distributions for all the parameters were found to be insignificant.Conclusions: Accurate determination of sex from the available bone fragments such as the ramus of the mandible required wide number of data from the least parameters that could be utilized medicolegally.

Study Of Pattern Of Distribution Of Mylohyoid Bridging And Their Clinical Implications

Background: The occurrence of mylohyoid bridges in mandible resulting compression of inferior alveolar andmylohyoid nerves, and vessels, is important cause of neuropathy in this region.Aim and objective: The present study was aimed at analyzing influence of sex and laterality in the occurrence ofmylohyoid bridging in Indian population, and establishing a clue to the underlying causes of paraesthesia ofidiopathic origin, in the territory of inferior alveolar and mylohyoid nerves.Methods: We studied 300 human mandibles (141 female and 159 male) for location and degree of mylohyoidbridging.Results: We found mylohyoid bridges in 15.66% mandibles. The proximal bridging was found more frequentlythan the distal bridging. The mylohyoid bridges were found in 7.8% female and 13.2% in male mandibles studied.We found mylohyoid bridges on 5% on right side and 5.66% on the left side, bilateral bridging was found in 5.33%mandibles.Conclusion: The frequency of occurrence of mylohyoid bridging was higher in male; however, laterality was not tobe significant amongst the mandibles studied. The location and degree of mylohyoid bridging are one of theimportant etiological factors of paraesthesia in the region of inferior alveolar and mylohyoid nerves distribution.

Clinical relevance of variations in the origin of inferior phrenic arteries.

Introduction: The inferior phrenic arteries are major source of collateral arterial supply to hepatocellular carcinoma second only to the hepatic artery. The right inferior phrenic artery is one of the chief postoperative bleeding sources in liver transplant recipients. The aim of the present study was to identify the variations in origin of inferior phrenic arteries. Methods: We dissected inferior phrenic arteries in 100 human adult cadavers (75 males and 25 females) for the origin of both inferior phrenic arteries. Results: We found variant origin of left inferior phrenic artery in 22 male cadavers and in 7 female cadavers. The variant origin of right inferior phrenic artery was found in 27 male cadavers and in 8 female cadavers. Conclusion: The higher incidences of variant origin of inferior phrenic arteries have major clinical implications in the transcatheter arterial chemoembolization in hepatocellular carcinoma patients.

Clinical significance of occurrence of osteophytes and its effect on sagittal diameter of the cervical spinal canal in indian population: morphometric and radiological analysis of cervical spinal canal.

Backgroud: Osteophyte occurrence in cervical vertebral column is leading cause of cervical spondylosis. The aim of the present study was to estimate the average anatomical changes in cervical vertebral column due to occurrence of osteophytes and changes in the sagittal diameters of the cervical vertebral canal in Indian population to establish a clue to the underlying causes of the neck pain of unknown etiology. Methods: We dissected the cervical part of the vertebral column of 50 human adult cadavers (25 males and 25 females) and obtained 200 plain X-rays of lateral view of cervical spine of living patients (100 males and 100 females) for both morphometric and radiological analyses. Results: We found posterior osteophytes more frequently than anterior. The highest frequency of posterior osteophytes was found in the fifth cervical vertebra and of anterior osteophytes in the sixth cervical vertebra. The mean sagittal diameter of the cervical vertebral canal of cadavers ranged from 29.6 mm at C1 to 15.2 mm at C7 in males and 26.6 mm at C1 to 14.5 mm at C7 in females. The mean sagittal diameters of the cervical spinal canal in lateral radiograph of the cervical spine were ranged from 20.7 mm at C1 to 14.4 mm at C7 in males and from 19.9 mm at C1 to 13.4 mm at C7 in females. In general the sagittal diameters in female were less than that of male at all vertebral levels. The canal-body ratio at all vertebral levels was found to be less than 0.8 and was significant to develop cervical spondylotic myelopathy.Conclusion: This study has shown the effects of occurrence of osteophytes in cervical vertebra column and its impact on cervical spondylotic myelopathy.

How can we prevent birth of fetus with holoprosencephaly? anatomical and embryological aspects of holoprosencephaly.

Objectives: Holoprosencephaly is a rare condition characterized by different degrees of fused ventricles of the brain resulting from impaired midline cleavage of the embryonic forebrain. The present study aimed to identify cases of holoprosencephaly over a period of three years, to assess the incidence of this malformation, and if possible, prevention of birth of such malformed fetus or infant through genetic counseling. Methods: Diverse features of holoprosencephalic fetus or infant and incidence of holoprosencephaly were studied at GSL Medical College, Rajahmundry; Andhra Pradesh. Results: Incidence found for holoprosencephaly is 2.58 per 10,000 births. Out of total four cases of holoprosencephaly two cases were of alobar and there was each case of semilobar and lobar holoprosencephaly. In two cases there was association between holoprosencephaly and gestational diabetes and in another two cases; there was a familial distribution of holoprosencephaly. Conclusion: Prenatal diagnosis of this rare disorder and genetic counseling has immense importance to prevent holoprosencephaly.

Anatomical variations in formation and branching pattern of the femoral nerve in iliac fossa: A study in 64 human lumbar plexuses.

Femoral nerve is used for nerve block in several surgeries and is vulnerable to compression in tight ilio-psoas compartment. The knowledge of origin and variations of femoral nerve in iliac fossa is important for anatomists, anesthetists and surgeons to prevent iatrogenic femoral nerve palsy. We dissected 32 human cadavers to study the anatomy of the femoral nerve. We dissected the lumbar plexus bilaterally; dissected the psoas major muscle to see formation of the femoral nerve. We measured the length of the femoral nerve from its formation to inguinal ligament; and recorded variations of the femoral nerve with digital photography. The average length of the femoral nerve was 144 mm. Anatomical variations of the femoral nerve were found in 25% lumbar plexuses. These variations included abnormally long L2 root, early division of the femoral nerve, origin of lateral cutaneous nerve of thigh from the femoral nerve, origin of nerve to pectineus from the femoral nerve in iliac fossa, splitting of the femoral nerve into two slips by psoas major or accessory slips of iliacus muscle. The aim of this study was to highlight variations in branching pattern of the femoral nerve in iliac fossa for appropriate exposure of the femoral nerve.