Anatomical variations of the celiac trunk in adult Filipino cadavers: A retrospective study

Objectives@#The celiac trunk (CT) is the first major branch of the abdominal aorta and typically gives rise to the left gastric artery (LGA), common hepatic artery (CHA), and splenic artery (SA), which supply blood to the abdominal viscera. Variations in the branching pattern of the CT exist and knowledge of such is crucial when performing surgical, laparoscopic, and angiographic procedures. The aim of this study is to determine the anatomic variations of the CT in adult Filipino cadavers and to compare the proportions of these with those reported in the foreign literature.@*Methods@#Adult Filipino cadavers from the University of the Philippines College of Medicine Anatomy Laboratory were dissected by first year medical students from 2014-2019. The CT and its branches were identified, drawn on a separate piece of paper, and confirmed to be correct and accurate by an anatomist. The data collected from that period was reviewed. Percentages were calculated for the branching patterns identified. A Z-test of Two Populations was used to compare the results of the current study to that of Pinal-Garcia (2018), Pillay (2020) and Venieratos (2013).@*Results@#A total of 107 drawings based on 107 dissected preserved cadavers were reviewed. Ninety-two specimens (85.98%) showed typical branching into the LGA, CHA, and SA. The CT presented as a true tripod (tripus Halleri) in 75 specimens (70.09%) and as a bifurcation with one of the three arteries arising first along the trunk (false tripod) in 17 specimens (15.89%). Nine cadavers (8.41%) showed additional branches arising from the CT and four (3.74%) showed bifurcation of the CT with the third branch arising from a different artery.@*Conclusion@#The most common configuration of the CT among Filipino adult cadavers is a true tripod, followed by a false tripod, additional branching, and bifurcation of the CT with the third branch arising elsewhere. The present study most closely resembles the results of the study of Venieratos.

Implementation of Universal Newborn Hearing Screening in the Philippines: A survey of registered newborn hearing centers

Background@#Universal newborn hearing screening is mandated in the Philippines through the Universal Newborn Hearing Screening and Intervention Act of 2009 (RA 9709). Newborn hearing screening (NBHS) centers are required to perform screening tests, compile and submit data on screened newborns, and advise parents on the subsequent steps after NBHS.@*Objective@#The study aimed to conduct a survey of the implementation of the Universal Newborn Hearing Screening and Intervention Program (UNHSIP) in the different regions of the country; and assess the information technology (IT) capabilities of hearing centers.@*Methods@#Fifty-one NBHS centers across twelve regions were surveyed through on-site inspections in 2016. Data was gathered on the centers’ testing capability, staffing, access to specialists, use of local protocols, connectivity, and IT capabilities. @*Results@#All surveyed centers followed the recommended protocols of the Manual of Operations of the Universal Newborn Hearing Screening and Intervention Act of 2009 (RA 9709). Among the 12 regions visited, only five (41.67%) had Category C centers with confirmatory testing and early amplification services as recommended. Majority of facilities (96.1%) were staffed by trained and certified personnel. A small percentage had access to subspecialists such as clinical audiologists (39.2%) and speech-language pathologists (23.5%). All facilities had computer access, but only 58.8% had internet access. Majority (94.1%) of the centers visited were not using the recommended data submission methods, specifically the use of registry cards and the online registry. Only 27.5% of centers had data on newborns who underwent confirmatory testing or early intervention. @*Conclusion@#Facilities were found to be compliant to NBHS screening protocols and majority complied with certification requirements for staff; but were found to be non-compliant with use of registry cards or the online registry. Majority of centers were able to contact the parents of neonates who did not pass newborn screening, but had no system to track outcomes. Lack of confirmatory and early intervention services in identified areas emphasize the need for development of regional centers. It is recommended that measures to improve the utilization of the online registry are taken.

Anatomical variations of the Celiac trunk in adult Filipino cadavers: A retrospective study

Objectives@#The celiac trunk (CT) is the first major branch of the abdominal aorta and typically gives rise to the left gastric artery (LGA), common hepatic artery (CHA), and splenic artery (SA), which supply blood to the abdominal viscera. Variations in the branching pattern of the CT exist and knowledge of such is crucial when performing surgical, laparoscopic, and angiographic procedures. The aim of this study is to determine the anatomic variations of the CT in adult Filipino cadavers and to compare the proportions of these with those reported in the foreign literature. @*Methods@#Adult Filipino cadavers from the University of the Philippines College of Medicine Anatomy Laboratory were dissected by first year medical students from 2014-2019. The CT and its branches were identified, drawn on a separate piece of paper, and confirmed to be correct and accurate by an anatomist. The data collected from that period was reviewed. Percentages were calculated for the branching patterns identified. A Z-test of Two Populations was used to compare the results of the current study to that of Pinal-Garcia (2018), Pillay (2020) and Venieratos (2013). @*Results@#A total of 107 drawings based on 107 dissected preserved cadavers were reviewed. Ninety-two specimens (85.98%) showed typical branching into the LGA, CHA, and SA. The CT presented as a true tripod (tripus Halleri) in 75 specimens (70.09%) and as a bifurcation with one of the three arteries arising first along the trunk (false tripod) in 17 specimens (15.89%). Nine cadavers (8.41%) showed additional branches arising from the CT and four (3.74%) showed bifurcation of the CT with the third branch arising from a different artery. @*Conclusion@#The most common configuration of the CT among Filipino adult cadavers is a true tripod, followed by a false tripod, additional branching, and bifurcation of the CT with the third branch arising elsewhere. The present study most closely resembles the results of the study of Venieratos.

Neck bypass modification for inferior trapezius flaps: A discussion of surgical technique and experience

@#<p style="text-align: justify;">The inferior trapezius flap (ITF) is useful as a primary means of head and neck reconstruction or as a salvage flap when a previous flap has failed. This report illustrates a neck bypass modification technique which places the pedicle external and lateral to the neck, thereby 1) increasing the flap's reach and 2) decreasing compression from subcutaneous tunneling. It also describes the authors' experience with this technique.</p>