Horseshoe kidney with surplus renal vessels: A case report in Thai cadaver.

A horseshoe kidney (HK) was discovered in an 84-year-old Thai male cadaver during routine dissection. Inferior poles of the kidneys fused to form a parenchymatous isthmus and constituted a HK. The HK located anterior to the abdominal aorta and the inferior vena cava at a level lower than the normal kidney. Both renal hila directed anteriorly and ureters which drained from each pelvis descended anterior to the isthmus to enter the urinary bladder. Eight renal arteries and five renal veins were observed. In this case the bulky isthmus, anatomical abnormalities, and a variable blood supply were found in association with the HK. It is important to be aware of this anomalous existence in clinical practice, especially during kidney surgeries, kidney transplants, or surgical and endovascular procedures on the aorta.

Dimensional guide to harvesting the radius for orofacial reconstruction.

OBJECTIVE: To provide an accurate harvesting guide to maintain the maximum possible safe dimensions of the radius for orofacial reconstruction using the osteocutaneous radial forearm free flap. MATERIAL AND METHOD: Two hundred radii of 100 adult formalin-embalmed cadavers (52 males, 48 females) were measured. RESULTS: The mean minimum circumference of the radius measured between the pronator teres and brachioradialis insertions was 41.0 +/- 4.3 mm. At this point, the mean medio-lateral diameter was 13.4 +/- 1.6 mm. The mean of the maximum harvested length of the radius between the pronator teres and brachioradialis insertions was 81.3 +/- 10.4 mm. On the average, the maximum harvested length of the radius was 34.9% of its total length. The minimum medio-lateral diameter of the radius was consistently 1-5 mm less than 40% of its minimum circumference. There was no significant dimensional difference between sides but gender difference existed in all measurements (p < 0.001), except the maximum harvested length of the radius. CONCLUSION: The present study may be helpful to guide reconstructive surgeons for safer harvesting of the radius using the osteocutaneous radial forearm free flap to repair orofacial defects.

Anatomical study of the maxillary artery at the pterygomaxillary fissure in a Thai population: its relationship to maxillary osteotomy.

BACKGROUND: The maxillary artery (MA) and its terminal branches are commonly damaged in the maxillary osteotomy, especially during separation of the pterygomaxillary junction (PMJ). OBJECTIVE: To evaluate the positional relationship between the MA at the pterygomaxillary fissure (PMF) and the PMJ in Thais, as well as to measure the diameter of the MA as it enters the pterygopalatine fossa (PPF) and the heights of PMJ, maxillary tuberosity and posterior maxilla. SUBJECTS AND METHOD: Both sides of 100 Thai adult cadavers (50 males and 50 females) were examined The mean age of the subjects was 64.5 +/- 12.8 years. With the lateral infratemporal approach, the branches from the third part of the MA, PMJ and posterolateral maxilla were dissected. Measurements taken included the following: First, the distance from the most inferior point of the PMJ to the most inferior position of the MA as it entered the PPF; second, the external diameter of the MA as it entered the PPF; third, vertical heights of the PMJ, maxillary tuberosity and posterior maxilla. Means, standard deviations and ranges were determined and statistical differences were calculated between sides and genders at p < 0. 05. RESULTS: The MA entered the PPF at a mean distance of 23.5 +/- 2.5 mm above the most inferior point of the PMJ. The mean external diameter of the MA as it entered the PPF was 2.8 +/- 0.6 mm. The mean heights of the PMJ, maxillary tuberosity and posterior maxilla were 19.5 +/- 2.3 mm, 6.1 +/- 2.7 mm, and 25.6 +/- 3.3 mm, respectively. There were no differences with respect to side and gender, except that the distance from the most inferior point of the PMJ to the most inferior position of the MA as it entered the PPF was longer in males than in females (p < 0.05). CONCLUSION: The mean location of the MA was 23.5 mm apart from the most inferior point of the PMJ, therefore, dysjunction of the PMJ using an osteotome with a 15-mm cutting edge may be conducted without damaging to the MA. When properly placed, the margin of safety from the superior cutting edge of the osteotome to the MA is approximately 8 mm in adults.