ABSTRACT
Compression of the femoral nerve (FN) to the iliac fossa has been reported as a consequence of several pathologies as well as due to the aberrant muscles. The purpose of this research was to investigate the patterns of the accessory muscles of iliopsoas muscles and the relationship of the FN in fifty semi pelvis. Accessory muscular slips from iliacus and psoas, piercing or covering the FN, were found in 19 specimens (7.9%). Based on the macroscopic structure, the muscle was categorized into two types. Pattern 1 as the more frequent variation, was sheet muscular type covering the FN (17 specimens, 89.5%). Pattern 2, the less frequent variation was found on a muscular slip covering the FN (2 specimens, 10.5%). Iliac and psoas muscles and their variants on both types were defined. Appraising the relation between the muscle and the nerves, each disposition of the patterns may be a potential risk for nerve entrapment. The knowledge about the possible variations of the iliopsoas muscle complex and the FN may also give surgeons confidence during pelvic surgery. Recognition of these variations in normal anatomy may be useful to the clinicians when treating patients with refractory leg pain.
ABSTRACT
BACKGROUND: Reconstruction of the upper eyelids following traumatic, congenital and tumor surgeries is often difficult owing to a variety of reasons including the influence of the lacrimal system, visual system and aesthetic appearance. In most cases of the reconstruction in the upper eyelid tarsal plate is the main anatomical area that should be protected against the damage. The aim of this study is to investigate the types and the measurements of the tarsal plate of the upper eyelids in Anatolian population. METHODS: Fifty cadaver upper eyelids, tarsal plates were exposed to investigate the location, shape, position and their relationships to the upper eyelid. Their morphometric details such as linear analyses (vertical and horizontal) and ratio analyses were studied. As for the shape of the upper tarsal plate, it was categorized into three distinct types: sickle, trapezoid, and triangular type. RESULTS: The vertical height of the upper tarsal plate was the greatest at the central point 10.6 ± 1.1 mm, followed by the lateral point (7.81 ± 1.0 mm), and medial point (6.2 ± 0.8 mm) medially. The mean medial width of the upper tarsal plate was measured as 37.6 ± 4.1 mm and the lower width as 38.5 ± 4.6 mm. The base-central height ratio of the upper tarsal plate was approximately 0.28. For the upper eyelids, the shapes of tarsal plates were observed as sickle (48%), trapezoid (28%) and triangular (24%). Sickle type was the most frequent upper eyelid type. CONCLUSIONS: Considering the shielding function of the upper eyelid, tarsal plate, serves as fibrocartilaginous skeleton of the upper tarsal plate. In successful lid oculoplastic reconstructive surgery, tarsal plate may be restored by evaluating each patient individually to have symmetrical and youthful eyes. Although sickle tarsal plate is the most frequent type, personalized treatment requires measurement and classification. The findings manifest the necessity of oculoplastic surgical treatment peculiar to each individual. LEVEL OF EVIDENCE: I, Randomized controlled trial.
