Morphological Variations Of The Coraco-acromial Ligament: A Cadaveric Study

Introduction: The coraco-acromial ligament forms coraco-acromial arch along with acromion and coracoidprocess of scapula which prevent the superior humeral head displacement. It plays a key role in the pathoetiology of sub-acromial impingement syndrome when there are no significant bony abnormalities.Material and Methods: In the present study we have studied 120 formalin preserved upper limbs (right: 60; left:60) of unknown age and sex. Each shoulder was dissected carefully to see coraco-acromial ligament. The CALwas identified with careful blunt dissection to prevent overlooking any thinner bands. We observed the numberof bands present and shape of the ligament. Photographs were taken.Results: Different morphological subtypes of coraco-acromial ligament were observed and classified accordingto Kesmezacar et al. Type II (28.33 %) was the most common then type I (25 %), type IV (17.5 %), type V (15 %), typeIII (11.66%). Anterolateral band of ligament extended antero-laterally to form coracoacromial falx in 51%.Discussion: Coraco-acromial ligament shows different morphological variations in Indian population. Knowledgeof morphological variations of coraco-acromial ligament will be helpful for orthopedic surgeon for clinical andintraoperative decision while dealing with sub-acromial impingement syndrome.

Morphometric study of styloid process of temporal bone in Indian adult dry skull.

Background: Styloid Process (SP) of temporal bone is a spike like process which is usually straight but it can show curvature and concavity. Many important neurovascular structures are adjacent to it. These structures may be compressed due to morphological variations of styloid process when SP abnormally elongated it may pose threat to anesthetist while performing intubation. Methods: Study was carried out on 70 (50 males, 20 females) adult dry skulls. All measurements such as length, direction, thickness at base of styloid process, distance between of two processes, and distance between it and stylomastoid foramen were taken with the help of vernier caliper in millimeters. Results: We found mean length of styloid process in males on right side 17.8 mm and on left 15.4 mm. In females, it was 13 mm on right and 16.8 mm on left side. Average distance between of two styloid processes at base was 68.13 mm in males and 67.42 mm in females. Thickness at the base of styloid process, in males on right 4.53 mm and on left side it was 4.83 mm while in females on right 4.33 mm and on left side it was 5 mm. Conclusions: Neurovascular structures which lie within the territory of styloid process may be compressed due to its anatomical variation. This data may be useful for clinicians, surgeons, radiologists, anesthetists and anatomists as an academic interest.

Anatomical Study Of Arrangement Of Renal Hilar Structures In Indian Adult Human Cadavers.

Abstracts: Background: Knowledge of arrangement of renal hilar structure is essential in the era of minimally invasive surgery. Nephron sparing surgeries like partial nephrectomy by laparoscope is treatment of choice and in this surgery hilar dissection is one of the important steps. However, in literature very few reports are available regarding the different patterns of dispositions of renal hilar structures. Aim of present study was to evaluate the arrangement of renal hilar structures. Methodology: Present work was carried out on fifty seven pairs of morphological normal kidneys of embalmed cadavers. Renal hilum of each kidney was dissected carefully to see the arrangement of renal artery, vein and pelvis. Results: Arrangement of renal hilar structures showed great variation. We classified arrangement of renal hilar structures into ten different patterns. In 22.80 % kidney we observed the arrangement of hilar structures according to textbooks. We observed anterior and posterior tributaries of renal vein in 32.45% and in 41.22% kidneys pelvis was the posterior most relation. Conclusion: Present study will help to understand the better knowledge of the disposition of hilar structures for the urological surgeons, radiologist and anatomists.

The foramen meningo-orbital in Indian dry skulls.

Background & objective: Foramen meningo-orbital is present in greater wing of sphenoid bone close to superior orbital fissure. It provide route for an anastomosis between the orbital branch of the middle meningeal artery and recurrent meningeal branch of ophthalmic artery. Basic textbooks of anatomy stated that it was a rare occurrence but some recent studies indicate a more frequent incidence of this which shows side and gender variation. These discrepancies were verified in our research work. Methods: We studied 150 dried human skulls (100 male and 50 female) of known sex. Only patent foramina were included in the observation. Results: Incidence of foramen as whole was 44.33% (male- 37.5% and female- 58%). In 4%, it was present bilaterally. Average distance between lateral end of superior orbital fissure and foramen was 6.22 mm. Conclusion: Our study indicates that a foramen meningo-orbital is present as often as, mostly unilaterally and multiple foramina may exist and also it shows side and genders variation. Knowledge of it may be of surgical significance to ophthalmologist and neurosurgeons and for radiologist because it masquerading as an intraocular foreign body. Further detail study on this topic in other populations from different areas is required.