Surgical and Radiologic Anatomy最新文献

{"title":"The relationship between structures affecting maxillary sinus ventilation and maxillary sinus volume: a CT study.","authors":"Mervenur Güven, Duygu Akin Saygin, Ismihan Ilknur Uysal, Ganime Dilek Emlik","doi":"10.1007/s00276-025-03607-x","DOIUrl":"https://doi.org/10.1007/s00276-025-03607-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to identify anatomical variations inside and outside the maxillary sinus (MS), determine their prevalence and coexistence, and investigate their relationship with MS volume in individuals without MS pathology, using ImFusion Suite software.</p><p><strong>Methods: </strong>Analysis of 330 paranasal CT scans obtained from the radiology archive (2018-2021) was performed using the ImFusion Suite program. Anatomical variations, including accessory ostium, Haller cells, ethmomaxillary sinus, concha anomalies, septa, and impacted teeth, were identified and their frequency of coexistence was determined. MS volume and nasal septum deviation (NSD) angle were measured. The relationship between MS volume and gender, as well as the impact of anatomical variations on MS volume, was analyzed. Statistical analyses were conducted using SPSS software.</p><p><strong>Results: </strong>The most common anatomical variation was NSD (98%), while the least common was ethmomaxillary sinus (9.4%). Middle and inferior concha hypertrophy were more frequent in males, whereas concha bullosa and impacted teeth were more prevalent in females (p < 0.05). A normal anatomical appearance on CT scans was observed in only 2.1% of cases (3.5% in males; 1.1% in females), with a notable coexistence of multiple variations. MS volume was significantly higher in males (right: 16.79 ± 5.23 cm³; left: 16.39 ± 5.61 cm³) than in females (right: 14.44 ± 4.54 cm³; left: 14.59 ± 4.62 cm³) (p < 0.05). MS volume was significantly smaller when the NSD angle was ≥9° and larger in the presence of septa.</p><p><strong>Conclusion: </strong>This study provides a comprehensive analysis of anatomical variations in the MS and their relationship with MS volume. The findings indicate that septa increase MS volume, while a higher NSD angle (≥9°) is associated with reduced MS volume. Other variations, including accessory ostium, Haller cells, and concha anomalies, showed no significant impact on MS volume. These results highlight the importance of detailed radiological evaluation in clinical and surgical planning.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"98"},"PeriodicalIF":1.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding horizons: the feasibility and challenges of tubular retraction in endoscopic transorbital skull base approaches.","authors":"Gardashkhan Karımzada, Demet Evleksiz Karımzada, Gökberk Erol, Emrah Celtikci, Nail Çağlar Temiz, Ahmet Murat Kutlay, Yusuf İzci, Walter C Jean, Abuzer Güngör","doi":"10.1007/s00276-025-03592-1","DOIUrl":"https://doi.org/10.1007/s00276-025-03592-1","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic transorbital skull base approaches are always challenging and require good anatomical knowledge.The aim of this study was to describe the anatomical pathways of endoscopic transorbital approaches and to determine the limitations of these procedures. To evaluate the feasibility of the tubular retractor and the difference with manual retractor.</p><p><strong>Methods: </strong>The targets of endoscopic transorbital approach were the anterior and middle cranial fossa, mesial temporal region, meckel's cave, petroclival area, opticocarotid region, anterior and lateral walls of the cavernous sinus, etc. Step-by-step anatomical dissections were performed in cadaveric heads using manual and tubular retractors.</p><p><strong>Results: </strong>Anterior and middle cranial fossa was reached. The branches of the trigeminal nerve, the lateral wall of the cavernous sinus, meckel's cave and gasserian ganglion were exposed by manual and tubular retraction using an endoscopic transorbital approach. Access to the temporal horn of the lateral ventricle and the mesial temporal region was more accessible with a tubular retractor. Also, following the anterior clinoidectomy, the cavernous segment of the internal carotid artery, as well as, the arteries of the anterior circulation were exposed to gain access the vascular skull base lesions.</p><p><strong>Conclusion: </strong>The endoscopic transorbital approach is suitable for the surgical treatment of many pathologies located in the anterior and middle skull base. It provides direct access to vascular and tumoral lesions. We observed that mesial temporal region interventions are possible with this approach. The transtubular technique may have some limitations, but in selected cases it can provide clear vision without brain retraction.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"96"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of a large venous ring around the mandibular condyle.","authors":"Keitaro Nishi, Tatsuo Okui, Yohei Takeshita, Jingo Kusukawa, R Shane Tubbs, Joe Iwanaga","doi":"10.1007/s00276-025-03602-2","DOIUrl":"10.1007/s00276-025-03602-2","url":null,"abstract":"<p><p>Anatomical details regarding venous drainage of the head and neck are an important matter for surgeons to avoid unnecessary complications such as hemorrhage. This report describes a case of the large venous ring around the mandibular condyle found in the cadaver. The left maxillofacial region of a latex-injected embalmed male cadaver (82 years of age at death) was dissected. The large two maxillary veins ran lateral to the capsule and superior to the mandibular notch and coursed posteroinferiorly to merge, and one trunk was formed at the posterior border of the ramus. It then received the superficial temporal vein superiorly to form the retromandibular vein (RMV). In addition, three maxillary veins were drained from the pterygoid venous plexus (PVP), medial to the ramus, one maxillary vein drained from the PVP into the RMV trunk, while two maxillary veins drained from the PVP into the anterior division of the RMV. All five large veins lateral and medial to the condyle drained from the PVP into the RMV. The knowledge of such an anatomical variation might prevent intraoperative bleeding in the temporomandibular joint region.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"95"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the relationship of the sigmoid sinus with the facial nerve and semicircular canals in terms of mastoid surgery.","authors":"Berin Tuğtağ Demir, Hilal Melis Altıntaş, Burak Bilecenoğlu, Kaan Orhan","doi":"10.1007/s00276-025-03609-9","DOIUrl":"https://doi.org/10.1007/s00276-025-03609-9","url":null,"abstract":"<p><strong>Purpose: </strong>The location of the sigmoid sinus may change according to the ventilation status of the mastoid bone, in which case the relationship of the sigmoid sinus to the facial nerve and semicircular canals is predicted to change. The purpose of this study was to evaluate the importance of sigmoid sinus distances to the facial nerve and semicircular canals concerning mastoid surgery.</p><p><strong>Methods: </strong>The relationship of the sigmoid sinus and the facial nerve with the semicircular canals was analyzed from the cone beam computed tomography images of 75 male and 95 female subjects, aged 18-65 years. First, a line drawn from the posterior semicircular canal to the sigmoid sinus on axial CT images was used to assess whether the sigmoid sinus was lateral or medial. Second, sigmoid sinus typing was performed quantitatively on 3D reconstructed images. The distance between the sigmoid sinus-facial canal, sigmoid sinus-semicircular canals and sigmoid sinus-basal part of the cochlea was measured.</p><p><strong>Results: </strong>The sigmoid sinus was found to be lateral to the posterior semicircular canal in 80.8% of cases and medial in 19.2% of cases. The posterior semicircular canal-sigmoid sinus distance was determined to be 11.76 ± 0.99 mm and 9.99 ± 0.93 mm on the right side and 11.99 ± 0.43 mm and 9.87 ± 0.02 mm on the left side, respectively, according to the sigmoid sinus patterns.</p><p><strong>Conclusion: </strong>According to our results, it was found that the relationship between the semicircular canals and the facial canal varied according to the location of the sigmoid sinus, and in the medially located sigmoid sinus, the facial canal was very close to all three semicircular canals.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"94"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiral twisting of distal (V4) vertebral arteries in an asymptomatic female and its embryological basis.","authors":"Krishnan Nagarajan, Vendoti Nitheesha Reddy, Vendoti Midhusha Reddy","doi":"10.1007/s00276-025-03593-0","DOIUrl":"https://doi.org/10.1007/s00276-025-03593-0","url":null,"abstract":"<p><p>Intracranial vessels develop early in embryonic life through mutual interaction and integration of aortic arches giving the carotid arteries and intrinsic longitudinal neural system forming the posterior circulation. Due to the relatively short time and faster pace of completion of development, minor absent/persistent segments may give rise to either asymptomatic anatomical variants or hemodynamically significant changes. Intracranial vessels - both anterior carotid and posterior vertebrobasilar systems - are known to have many common anatomical variations like hypoplastic segments (A1 or P1 segments of anterior or posterior cerebral arteries) and persistent carotid-vertebrobasilar anastomotic channels. These variants may be displayed using MRI and MRA which represent useful non-invasive investigative modality of the neck and Willis's circle. We report an interesting hitherto rarely reported anatomical variation in the form of spiral twisting of distal vertebral (V4 segments) and vertebrobasilar junction in a 36-year-old female and discuss the underlying embryological possibilities based on the embryological development of the vertebrobasilar system.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"97"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual innervation of the sartorius muscle by the ilioinguinal and femoral nerves with unique arrangement of the lumbar plexus: a case report and clinical implications.","authors":"Anhelina Khadanovich, Michal Benes, Radek Kaiser, David Kachlik","doi":"10.1007/s00276-025-03604-0","DOIUrl":"https://doi.org/10.1007/s00276-025-03604-0","url":null,"abstract":"<p><p>The sartorius muscle is typically innervated by two branches of the femoral nerve arising from the lumbar plexus. We present an unreported variant where the sartorius muscle was innervated by an accessory branch arising from the ilioinguinal nerve in addition to the proper two branches from the femoral nerve. The iliohypogastric nerve was fused with the ilioinguinal nerve. More proximally, the lumbar plexus also showed unusual arrangement. The anterior branch of the lateral femoral cutaneous nerve arose from the femoral branch of the genitofemoral nerve while the posterior branch arose directly from the second lumbar nerve. The genital branch of the genitofemoral nerve pierced the psoas major muscle more distally than usual, and featured a close proximity with the femoral nerve. Possible variable appearance of these nerves should be kept in mind during several surgical and diagnostic procedures since their iatrogenic or traumatic damage, or their susceptibility to entrapment, pose unpredictable clinical consequences.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"90"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are the terms \"mesometrium\", \"mesosalpinx\" and \"mesovarium\" appropriate?","authors":"Grégoire Prum, Frédéric Crampon, Fabrice Duparc, Olivier Trost","doi":"10.1007/s00276-025-03600-4","DOIUrl":"https://doi.org/10.1007/s00276-025-03600-4","url":null,"abstract":"","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"92"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal fusion between the long P1 segment of the posterior cerebral artery and the long posterior communicating artery diagnosed by magnetic resonance angiography.","authors":"Akira Uchino, Ryushi Kondo","doi":"10.1007/s00276-025-03603-1","DOIUrl":"https://doi.org/10.1007/s00276-025-03603-1","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of abnormal fusion between the long P1 segment of the posterior cerebral artery (PCA) and the long posterior communicating artery (PCoA) diagnosed by magnetic resonance angiography (MRA).</p><p><strong>Methods: </strong>An 83-year-old woman with left pulsatile tinnitus underwent cranial MRA using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.</p><p><strong>Results: </strong>MRA showed no dural arteriovenous fistula; however, there was a stenotic lesion in the precavernous segment of the left internal carotid artery (ICA). This lesion was not considered to be the cause of her symptoms. In addition, the left PCA arose from the basilar artery and the left ICA. There was a small connecting artery between these two PCAs at their proximal segments. These two PCAs fused distally and formed a single PCA. Thus, there was a large arterial ring. Partial maximum intensity projection (MIP) images showed that the left anterior choroidal artery (AChA) appeared normal. Thus, we concluded that there was no hyperplastic AChA, and there was abnormal fusion between the long P1 segment of the PCA and the long PCoA.</p><p><strong>Conclusion: </strong>We diagnosed the first case of abnormal fusion between the long P1 segment of the PCA and the long PCoA. Careful observation using MRA is important for the detection of rare arterial variations. Partial MIP MRA images are useful for identifying tiny arteries, such as the AChA.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"93"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid-anterior cerebral artery anastomosis with an anteromedial course variant diagnosed by magnetic resonance angiography.","authors":"Akira Uchino, Kazuo Tokushige","doi":"10.1007/s00276-025-03606-y","DOIUrl":"https://doi.org/10.1007/s00276-025-03606-y","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of right carotid-anterior cerebral artery (ACA) anastomosis with a unique course in the proximal segment.</p><p><strong>Methods: </strong>A 78-year-old woman with a history of right carotid endarterectomy 2 years prior underwent cranial magnetic resonance (MR) imaging (MRI) and magnetic resonance angiography (MRA) of the head and neck regions separately using a 3.0-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.</p><p><strong>Results: </strong>MRA of the intracranial region revealed no pathological lesions. However, a large artery arose from the ophthalmic segment of the right ICA, took an anteromedial course and after making a hairpin turn, continued to the bilateral A2 segments of the ACA. Bilateral A1 segments of the ACA were absent. MRA source images and oblique sagittal reformatted images showed that the anomalous artery was running inferior to the right optic nerve, indicative of carotid-ACA anastomosis or an infraoptic course of the ACA. As some patients have an ipsilateral normal A1 segment, the latter name seems to be inadequate.</p><p><strong>Conclusion: </strong>We encountered a case of right carotid-ACA anastomosis in which the proximal segment had a unique course, ran anteromedially, and made a hairpin turn. This type has not been reported in the relevant English-language literature. Usually, this variation takes a medial course and ascends between the bilateral optic nerves. Careful observation of MRA images, including their source images, is required for the correct diagnosis of this rare variation.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"91"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An accessory sphenoidal foramen of the middle cranial fossa detected on computed tomography.","authors":"George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Łukasz Olewnik, Fabrice Duparc, George Tsakotos, Nicol Zielinska, Maria Piagkou","doi":"10.1007/s00276-025-03601-3","DOIUrl":"10.1007/s00276-025-03601-3","url":null,"abstract":"<p><strong>Background: </strong>The skull base depicts significant morphological variability, which is frequently described due to its neurosurgical significance. The middle cranial fossa's accessory foramen has rarely been described.</p><p><strong>Materials: </strong>A 53-year-old female patient's computed tomography (CT) scan was further investigated for its unusual morphology.</p><p><strong>Results: </strong>On the left-sided middle cranial fossa, an accessory sphenoidal foramen (ASF) was observed, located 3.3 mm posterior to the foramen rotundum (FR) and 5.5 mm anterior to the foramen ovale (FO). Extracranially, the ASF opened into the infratemporal fossa and coexisted with another sphenoidal emissary foramen (SEF), anteromedially to the FO. On the right side, two SEF were located anteromedially to the FO.</p><p><strong>Conclusions: </strong>Similar to the current case, ASF of the middle cranial fossa were reported in a previous study with a prevalence of 0.20%. The unconstraint well described accessory foramina are the emissary foramina that transmit emissary veins, and are of interest for anatomists, radiologists and neurosurgeons.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"89"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}