Unusual anatomical variants of infrahyoid muscles - case report.

Anatomical anomalies of neck muscles are rarely observed and usually comprise variations of digastric and omohyoid muscles. Neck muscles' abnormalities might be correlated with embryological development and are observed in individuals with aneuploidies such as Edward's syndrome (18-trisomy) or Down syndrome (21-trisomy). Some infrahyoid muscles are important landmarks during surgery, therefore their anatomical variations of these muscles are related to higher risk of surgical complications. Herein, we present a rare case of infrahyoid muscles anomalies found during routine dissection of male cadaver. Redundant muscle bellies of sternohyoid muscle (sternohyoid azygos muscle), presence of levator glandulae thyroideae and also one hypoplastic superior belly of the omohyoid muscle were observed. Presence of muscle fibers within found structures was confirmed using Masson's trichrome staining method.

Polyorchidism: An Up-to-Date Systematic Review.

Polyorchidism is a rare male urogenital tract anomaly characterized by at least one supernumerary testis in the scrotum or ectopically. According to data based on our systematic review, 76% of the supernumerary testes (SNTs) were located in the scrotum, and 24% were extra-scrotal (p < 0.001). Among testes located outside the scrotum, 87% were found in the inguinal canal and 13% in the abdominal cavity. In 80% of cases, the diagnosis of SNT was made based on imaging tests, and the remaining 20% of cases were detected incidentally during surgery. The imaging tests performed (US or MRI) resulted in a significantly higher rate of patients who qualified for observation vs. surgical treatment (45% vs. 35%, p < 0.001). The most common conditions associated with SNT were ipsilateral inguinal hernia (15% of cases) and cryptorchidism (15% of cases). Surgery (orchidopexy/orchidectomy) was performed on 54% of patients with SNT, and the decision to observe the SNT was made in a total of 46% of patients (p = 0.001). The therapeutic approach depends on the location of the SNT and the presence of factors that raise suspicion of neoplastic proliferation.

Anatomy of the deep brachial artery - general overview (cadaveric study) - discussion on terminology.

There are only very few studies on the anatomy of the deep brachial artery - DBA (arteria profunda brachii), both regarding its course, branching pattern and contribution to the cubital rete. Most of the textbooks are based on data which remain unchanged for years. The aim of this article was to summarize the current knowledge on this vessel, based on the anatomical and clinical studies and other sources available including also own cadaveric study. We tried to present also some controversies regarded to the nomenclature of the branches of the DBA.

The course of the main septum in the sphenoid sinuses - evaluation before the FESS.

The purpose of this study was to determine the course of the main septum (MS) in the sphenoid sinuses in the adult population. Materials and Methods: 296 patients (147 females, 149 males), who did not present any pathology in the paranasal sinuses, were included in this retrospective analysis of the computed tomography (CT) scans. Spiral CT scanner (Siemens Somatom Sensation 16) was used in order to glean the images of the paranasal sinuses, using standard procedure, in the option Siemens CARE Dose 4D, without using any contrast medium. Secondary reconstructions of the sagittal and frontal planes were obtained using multi- plans reconstruction (MPR) tool after obtaining transverse planes in the first instance. R e s u l t s: The course of the MS changed the most often from the anterior to the posterior part of the sphenoid sinuses. Such situation took place in 83.78% of the patients, in 32.43% of whom a clear shift to the lateral side was noticed only in the posterior part of the MS: in 18.24% of the patients to the right side, and in 14.19% of the patients to the left side. In 17.57% of the patients the lateral shift was visible in both anterior and posterior parts of the septum, where in 9.46% of the patients it was from the left side to the right, whereas in 8.11% of the patients the shift took place from the right side to the left. The MS had the shape of the letter 'C' in 22.29% of the cases, and 11.82% had the typical shape of the letter 'C,' and in 10.47% of the patients it paralleled the inverted letter 'C' (upside down). Amongst the types of the MS shifting directions the rarest was the MS that resembled the letter 'S' - 11.48% of the patients. In 5.74% of the cases it looked like the typical letter 'S,' and in 5.74% of the cases it was similar to the inverted letter 'S.' Only 16.22% of the cases had the MS that did not change its course nor its shape and ran medially in the sagittal plane from the anterior to the posterior part of the sinuses. Conclusions: In furtherance of reducing the risk of problems occurring during a surgery in the paranasal sinuses, it is prudent to have a CT scan done in all the patients beforehand, due to the high prevalence of the anatomical variations in the sinuses.

Electrodiagnostic Studies in the Surgical Treatment of Carpal Tunnel Syndrome-A Systematic Review.

The aim of our paper was to provide comprehensive data on the role of electrodiagnostic (EDX) studies in the surgical treatment of carpal tunnel syndrome (CTS). An extensive search was conducted through the major electronic database to identify eligible articles. Data extracted included grade of CTS based on neurophysiological testing, preoperative data of EDX studies, time of complete or partial resolution after surgery, postoperative Boston carpal tunnel questionnaire (CTQ) scores, age, sex, intraoperative and postoperative data of EDX studies, time to complete or partial resolution of symptoms, and number of patients without postsurgical improvement. Our main findings revealed that that electrodiagnostic testing is still a powerful tool for diagnosis of CTS. Moreover, it can also detect other pathologies. EDX testing provides a quantitative measure of the physiological function of the median nerve, which may be used to guide surgical treatment. Thirdly, when the outcome of surgery is unsatisfactory, NCS can assist in determining the reason for failure.

Revisiting the Morphology and Classification of the Paracingulate Gyrus with Commentaries on Ambiguous Cases.

The anterior cingulate cortex is considered to play a crucial role in cognitive and affective regulation. However, this area shows a high degree of morphological interindividual variability and asymmetry. It is especially true regarding the paracingulate sulcus and paracingulate gyrus (PCG). Since the reports described in the literature are mainly based on imaging techniques, the goal of this study was to verify the classification of the PCG based on anatomical material. Special attention was given to ambiguous cases. The PCG was absent in 26.4% of specimens. The gyrus was classified as present in 28.3% of cases. The prominent type of the PCG was observed in 37.7% of the total. Occasionally, the gyrus was well-developed and roughly only a few millimeters were missing for classifying the gyrus as prominent, as it ended slightly anterior the level of the VAC. The remaining four cases involved two inconclusive types. We observed that the callosomarginal artery ran within the cingulate sulcus and provided branches that crossed the PCG. Based on Klingler's dissection technique, we observed a close relationship of the PCG with the superior longitudinal fascicle. The awareness of the anatomical variability observed within the brain cortex is an essential starting point for in-depth research.

Incorporation of the sphenoid sinuses' septum / septa in the carotid canal - evaluation before the FESS.

The purpose of the research was to define the frequency prevalence of the incorporation of sphenoid sinuses' septum / septa in the carotid canal of the adult population. MATERIALS AND METHODS: 296 computed tomography (CT) scans of the patients (147 females, 149 males), who did not present any pathology in the sphenoid sinuses, were evaluated in this retrospective analysis. Spiral CT scanner - Siemens Somatom Sensation 16 - was used to glean the medical images. Standard procedure applied in the option Siemens CARE Dose 4D. No contrast medium was administered. Multiplans reconstruction (MPR) tool was used in order to obtain frontal and sagittal planes from the transverse planes previously received. RESULTS: Bilateral incorporation of the main septum (MS) in the carotid canal was not present in any of the patients, whereas unilateral incorporation was noticed in 21.96% of the patients (17.68% females, 26.17% males). On the right side it occurred in 11.82% of cases (10.88% females, 12.75% males), and on the left side in 10.14% of cases (6.8% females, 13.42% males). Bilateral incorporation of the additional septum (AS) was found in 8.45% of the patients (4.08% females, 12.75% males), whereas unilateral incorporation was noted in 28.37% of the patients. It was seen on the right side in 11.82% of cases (12.93% females, 10.74% males), and on the left side in 16.55% cases (15.65% females, 17.45% males). The most common variant was the incorporation of only one of the septa (either the MS or the AS) in the wall of the carotid canal unilaterally. Such situation took place in 30.07% of the patients (29.25% females, 30.87% males). Incorporation of two septa on the same side was noticed in 4.39% of cases (4.08% females, 4.7% males), and incorporation of three septa in 0.34% of cases (0.7% males). CONCLUSIONS: The anatomy of the paranasal sinuses is varied to a great extent, hence performing a CT scan is crucial before the scheduled surgery, as it may lessen the unforeseeable surgical complications, that may result from the high prevalence of variants in the sinuses.