ABSTRACT
Introduction Due to the variable degree of pneumatization, the shape and size of the sphenoid sinus are irregular. An endoscopic intranasal transsphenoidal approach is made in sphenoid sinus pathologies, sphenoid sinusitis, and sellar and parasellar diseases. A diagnostic approach to the sphenoid sinus is also done to get a better MRI scan of the pituitary. The present study aims to describe the variant types of sphenoid sinus, morphometry, anatomy, and relations of sphenoid sinus, which will be helpful to surgeons during an endoscopic approach to the sphenoid sinus. Materials and methods We studied 76 cadaveric sphenoid sinuses that were exposed by taking a sagittal section of 38 formalin-fixed cadaveric heads. After examining the inter-sphenoidal septum, it was removed to observe the inside aspect of the sphenoid sinus. Different dimensions of the sinus were noted down. The bulges inside the sinus due to neurovascular structures in relation to the sinus were observed. Results The most prominent type found was the sellar in 68.4% of cases preceded by the postsellar in 23.7% of cases. Presellar type of pneumatization was seen only in 7.9% of cases and the conchal type was absent. Intersphenoid septum was seen in 92,1% of cases, out of which 11.4% of septums were deficient on the posterior aspect. An internal carotid artery bulge in the sphenoid sinus was seen in 46% of cases. In 27.6% and 19.7% of sphenoid sinuses, bulging of the optic and vidian nerves, respectively, were seen. Some of these structures were dehiscent in the sphenoid sinus. Conclusions To get more space in the sphenoid sinus, the septa in the sinus are removed by surgeons, which may damage the walls of the sphenoid sinus. Knowledge of the relations of neurovascular structures with the sphenoid sinus will be helpful to surgeons during the transsphenoidal endoscopic approach to avoid any injury to these structures.
ABSTRACT
BACKGROUND: The medial patellofemoral ligament (MPFL) is one of the major soft tissue stabilizers on the medial side of the knee joint, extending from the medial condyle of the femur to the medial aspect of the patella. Different kinds of literature described different sizes and different origins and insertions of MPFL. Injury of MPFL causes patellar instability and dislocation. We reported the anatomy and morphology of MPFL and its implications in the repair of MPFL. The aim of the study was also to look at the variant forms of the MPFL. Methodology: A total of 40 lower limbs fixed in formalin were dissected to study the MPFL of the knee. After reflecting the deep fascia and retinaculum on the medial side of the knee joint the MPFL was exposed. For better learning the lower medial part of vastus medialis was reflected, so that the part of MPFL undercover was exposed. RESULTS: Different forms of MPFL were seen like two straps 12.5%, broad rectangle 20%, and triangular shaped 67.5% MPFL. The origin of MPFL was found between the adductor tubercle and medial epicondyle of the femur and insertion was seen extending from the proximal medial half of the patella to the tendinous aponeurosis of vastus medialis obliquus (VMO) and vastus intermedius muscle (VIM). CONCLUSIONS: This is the first study that described three variant patterns of MPFL in accordance with their morphological appearance. This knowledge will be helpful to the surgeons for easy identification and repair of the MPFL.
