Clinical Anatomy最新文献

{"title":"The effect of increasing motor end-plate innervation on smile activation in acute and early facial palsy","authors":"Lucia Pannuto,&nbsp;Ankur Khajuria,&nbsp;R. Y. Kannan","doi":"10.1002/ca.24216","DOIUrl":"10.1002/ca.24216","url":null,"abstract":"<p>While it has been over half a century since primary cross-facial nerve grafting was first described for facial reanimation, the outcome of this procedure, remains inconsistent and provide lesser smile excursion when compared to the likes of the masseteric nerve. However, the latter itself has limitations in terms of the lack of spontaneity and resting tone. While combinations have been attempted more proximally, we ask the question as to whether more distal nerve transfers with vascularized nerve grafts are a better option. In a retrospective review of clinical practice at our institute, 16 consecutive patients had single, double, and finally triple distal nerve transfers, close to the target facial muscle to reinnervate the motor endplates directly, over a 6-year period (2018–23). All patients had the onset of facial palsy within 18 months. Statistical analysis of the comparison between three sub-cohorts was performed using student's <i>t</i>-test and one-way ANOVA, respectively. Qualitatively, masseteric neurotization of a single facial nerve branch translated into smile improvement in 50% of cases, as opposed to all cases of double- and triple-neurotization of the smile muscles. In terms of upper lip elevation, single neurotization showed improvement in 25% of cases, double-neurotization in 40% of cases and triple-neurotization in 100% of cases. Upper lip elevation was also significantly better in those who had a vascularized cross-facial nerve graft (Student's <i>t</i>-test &lt;0.05). In summary, increasing neural input to the motor endplates of smile muscles can significantly improve smile activation, in acute flaccid facial palsies.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"37 7","pages":"808-814"},"PeriodicalIF":2.3,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996876","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":"Innervation of the human sternoclavicular joint.","authors":"Kenji Emura, Ryo Nitta, Takamitsu Arakawa","doi":"10.1002/ca.24209","DOIUrl":"https://doi.org/10.1002/ca.24209","url":null,"abstract":"<p><p>The sternoclavicular joint (SCJ) functions as the basal joint of the entire upper limb and must move in the proper pattern for normal scapular motion. Afferent sensations from joints, such as proprioception and pain sensation, are important for maintaining the proper motion and condition of joints. Detailed anatomical data are useful for discussing injuries or surgeries that impair the afferent nerve to the SCJ. Nerve branches to SCJs were examined on 12 sides, and the subclavian nerve was investigated on six sides to clarify whether it innervates this joint. On seven of the 12 sides, the SCJ was innervated by two nerves, (1) a branch from the medial supraclavicular nerve that ran medially along the clavicle and (2) a branch from the lateral pectoral nerve that innervated the clavicular head and upper part of the sternocostal head of the pectoralis major. This branch ran medially behind the clavicular head of the pectoralis major and reached the SCJ. In the remaining five sides, the SCJ was innervated solely by the branch from the medial supraclavicular nerve. Subclavian nerves ended within the subclavius muscle or periosteum of the clavicle and were separate from the SCJs. Our data on the route of nerve branches to the SCJ suggest that injury or surgery, such as clavicle fracture or resection of the clavicular head of the pectoralis major for myocutaneous flap transfer, can impair the SCJ's afferent nerve supply.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983815","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":"Lingual nerve revisited-A comprehensive review Part II: Surgery and radiology.","authors":"Kisho Ono, Takashi Nishioka, Kyoichi Obata, Yohei Takeshita, Chista Irani, Yuki Kunisada, Norie Yoshioka, Soichiro Ibaragi, R Shane Tubbs, Joe Iwanaga","doi":"10.1002/ca.24211","DOIUrl":"https://doi.org/10.1002/ca.24211","url":null,"abstract":"<p><p>The lingual nerve (LN) is a branch of the mandibular division of the fifth cranial nerve, the trigeminal nerve, arising in the infratemporal fossa. It provides sensory fibers to the mucous membranes of the floor of the mouth, the lingual gingiva, and the anterior two-thirds of the tongue. Although the LN should rarely be encountered during routine and basic oral surgical procedures in daily dental practice, its anatomical location occasionally poses the risk of iatrogenic injury. The purpose of this section is to consider this potential LN injury risk and to educate readers about the anatomy of this nerve and how to treat it.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141910156","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":"Lingual nerve revisited-A comprehensive review Part I: Anatomy and variations.","authors":"Norio Kitagawa, Keiko Fukino, Chista Irani, Yushi Abe, Yuki Kunisada, Soichiro Ibaragi, R Shane Tubbs, Joe Iwanaga","doi":"10.1002/ca.24210","DOIUrl":"https://doi.org/10.1002/ca.24210","url":null,"abstract":"<p><p>The lingual nerve (LN) is a branch of the mandibular division of the fifth cranial nerve, the trigeminal. It primarily carries sensory fibers from the lingual gingiva, mucous membranes of the floor of the mouth, sublingual gland, and the anterior two-thirds of the tongue. Recent studies have explored and reclassified the five branches of the LN as branches to the isthmus of the fauces, lingual branches, sublingual nerves, posterior branch to the submandibular ganglion, and branches to the sublingual ganglion. The knowledge of the LN anatomy and its variants is clinically relevant to avoid its injury during oral procedures. The objective of this paper is to review the literature on the LN and to describe the anatomy, its course, and its functions.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908151","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 comparison of 1- versus 3-month regional anatomy exposure on learning outcomes of undergraduate medical students","authors":"Veronica Antipova,&nbsp;Martin Siwetz,&nbsp;Maren Engelhardt,&nbsp;Franz A. Fellner,&nbsp;Simone Manhal,&nbsp;Julian F. Niedermair,&nbsp;Benjamin Ondruschka,&nbsp;Sandra M. Pietras,&nbsp;Amélie J. Poilliot,&nbsp;Michael L. Pretterklieber,&nbsp;Monika Wimmer-Röll,&nbsp;Andreas Wree,&nbsp;Niels Hammer","doi":"10.1002/ca.24206","DOIUrl":"10.1002/ca.24206","url":null,"abstract":"<p>Regional anatomy teaching forms a cornerstone of undergraduate medical education. Owing to an increase in teaching and learning content throughout the medical curriculum in recent years, contact hours and overall course durations in anatomy are under review worldwide. This study aimed to assess whether shortening the course content duration impacts learning gain and the ability to identify anatomical structures correctly. Undergraduate medical students of the Johannes Kepler University Linz (JKU; <i>n</i> = 310) and at the Medical University of Graz (MUG; <i>n</i> = 156) participating in regional anatomy courses were included. Whole body regional anatomy courses, including hands-on dissection and accompanying lectures, were delivered over one or three months. Course content and examination mode were kept consistent, while the duration of knowledge delivery was one or three months, respectively. Objective structured practical examinations (OSPE) were then carried out on prosections for the neck, thorax, and abdomen. 3-month course exposure resulted in significantly higher OSPE scores for the neck (49 vs. 37%), thorax (65 vs. 54%), and abdomen (65 vs. 45%), respectively. Further evaluation of the utility of different embalming types yielded higher 3-month scores in the neck and thorax regions with Thiel-embalmed tissues and thorax and abdomen regions in ethanol-glycerin-embalmed tissues. Course exposure over a more extended period, like three months, appears to be highly beneficial.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 3","pages":"239-248"},"PeriodicalIF":2.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890812","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":"“Anatomy learnt by dissecting is the one rock upon which all sound medicine and surgery rest”","authors":"R. Shane Tubbs","doi":"10.1002/ca.24212","DOIUrl":"10.1002/ca.24212","url":null,"abstract":"<p>In this issue of <i>Clinical Anatomy</i>, we offer the reader anatomical studies that the Cooke School of Anatomy (Figure 1) would have embraced. These include articles on AnatomyGPT, the TA2 Viewer, ultrasound-guided injection of the temporalis tendon via the intraoral route, and variations of the superior intercostal vein.</p><p>Cooke T. 1893. A Plea for Practical Work in Anatomy. London, Longmans &amp; Co.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"37 6","pages":"603-604"},"PeriodicalIF":2.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879806","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":"Number of serotonergic neurons in the subthalamic nucleus and globus pallidus internus could influence the effects of deep brain stimulation in Parkinson's disease.","authors":"Rafika Munawara, Asha Rao, Mayank Sharma, Tulika Gupta","doi":"10.1002/ca.24207","DOIUrl":"https://doi.org/10.1002/ca.24207","url":null,"abstract":"<p><p>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) is a standard treatment for Parkinson's disease (PD), with both regions exhibiting similar treatment effectiveness. However, posttreatment neuropsychiatric side effects, such as severe depression, are common, primarily due to the loss of serotonergic cells. Identifying a region with fewer serotonergic neurons could potentially reduce these side effects. This study aimed to quantify the number of serotonergic neurons in the STN and GPi. Both regions were analyzed using hematoxylin and eosin staining and immunohistochemistry. The GPi exhibited a significantly lower number and H-score of serotonergic neurons than the STN. Within the STN, the number and H-score of serotonergic neurons were higher in the medial aspect than in the lateral aspect. Three different types of neurons, large and small, were observed. In STN, large neurons were concentrated in the center and small neurons in the periphery. This distribution was not observed in GPi. In addition, the concentration of the serotonergic neurons is less in GPi. These findings suggest that the GPi may be a safer target region, potentially reducing the incidence of post-DBS depression.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794032","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":"Simple modified silicone rubber injection technique in fresh cadaveric pelvis and extremities","authors":"Wuttipong Siriwittayakorn,&nbsp;Thanawat Buranaphatthana,&nbsp;Jongkolnee Settakorn,&nbsp;Theerachai Apivatthakakul,&nbsp;Varat Apivatthakakul,&nbsp;Bodin Theppariyapol","doi":"10.1002/ca.24197","DOIUrl":"10.1002/ca.24197","url":null,"abstract":"<p>The silicone rubber injection technique was first described in 1999 and has been used in the vascular study of neurology and head and neck dissection. Silicone rubber is durable, flexible, and inexpensive. However, the original silicone rubber injection formula perfuses poorly into the pelvis and extremities. We present a simple modification to the silicone rubber injection technique, showcasing its effectiveness in studying the vascular structures in the pelvis and extremities. We used an ordinary mold-making silicone rubber. The new formula involves mixing the silicone rubber with silicone thinner, acetone, catalyst, and resin color. The mixture is then injected into the artery until the color becomes visible under the skin. The specimen is left at room temperature for 0.5–1 h for the silicone rubber to harden. With our technique, the silicone rubber substance perfuses adequately into small arterial perforators and can penetrate into the subdermal plexus. The smallest subdermal arteries identified under a light microscope measured 6 μm. The modified silicone rubber injection technique has proven to be a valuable tool in anatomical education and surgical training.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 2","pages":"127-133"},"PeriodicalIF":2.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794033","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":"New anatomical findings in the mandibular body region: Two parts that make up bucco-mandibular space.","authors":"Eiko Inoue, Joe Iwanaga, Aya Han, Yoko Tabira, Yuto Haikata, Keishiro Kikuchi, Tsuyoshi Saga, Koichi Watanabe","doi":"10.1002/ca.24204","DOIUrl":"https://doi.org/10.1002/ca.24204","url":null,"abstract":"<p><p>Soft tissue spaces not only enable gliding by contraction of the facial muscles, but they also cause drooping of the superficial fat due to gravity in the upright position. This study was performed to clarify the structures around the bucco-mandibular space (BMS) and to apply this anatomical knowledge to clinical practice. Four sides of the face were dissected using a conventional gross anatomical dissection technique, and 10 sides (5 horizontal and 5 frontal sections) of the removed semi-facial soft tissue were dissected using the stretched tissue dissection (STD) method. Histological examination of the mandible was performed on two sides to confirm the findings of conventional gross anatomical dissection and STD. In all cases, both gross dissection and STD revealed that the BMS was composed of two parts. The superficial part was filled with adipose tissue containing nerves and vessels, including the marginal mandibular branch of the facial nerve, facial artery, facial vein, and mental nerve. We named this part the adipo-neuromandibular part. By contrast, the deep part was separated from the adipo-neurovascular part by facial deep fascia and composed of loose connective tissue. We named this deep part the loose connective tissue part. The STD method enabled us to obtain detailed anatomical findings of the mandibular region and elucidate two parts of the BMS in which the neurovasculature is distributed. We believe that these findings provide new insights into facial anatomy by resolving existing anatomical uncertainties and will contribute to safer surgical treatment in the facial region.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789725","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":"Prevalence and characteristics of osseous bridging between vertebral bodies in the cervical spine: A skeletal study","authors":"David Ezra,&nbsp;Reuven Mader,&nbsp;Arthur Yosef,&nbsp;Leonid Kalichman,&nbsp;Khalil Salame,&nbsp;Aliza Amiel,&nbsp;Deborah Alperovitch-Najenson","doi":"10.1002/ca.24205","DOIUrl":"10.1002/ca.24205","url":null,"abstract":"<p>Osseous bridging (OB) in three or more segments of motions (SOMs) of the mobile spine was initially defined as diffuse idiopathic skeletal hyperostosis (DISH), located particularly in the thoracic spine (T-spine). This pathological phenomenon is often characterized by calcification and ossification, which take place simultaneously or separately. The soft tissues, mainly ligaments and entheses, are calcified, with bone formation not originating from the anterior longitudinal ligament (ALL). DISH formation can involve osteophytes, which are created by the ossification process and can involve soft tissue such as the ALL. The ALL can also be calcified. Until recently, the prevalence of DISH in the general population was considered low (0%–5%) and rare in the cervical spine (C-spine). In a cross-sectional observational skeletal study, we investigated the prevalence and location of C-spine OB between vertebral bodies with fewer than three SOMs. We tested a large sample (<i>n</i> = 2779) of C-spines housed in the Cleveland Museum of Natural History (Ohio, USA). The human sources of the samples had died between the years 1912 and 1938 and represented both sexes and two different ethnic groups: Black Americans and White Americans. The process development can be seen on the ALLs as calcification, osteophytosis, and candle-shaped. Among all of the specimens, 139 (5%) were affected by OB, mostly in one SOM. Prevalence tended to be higher in women, White Americans, and the older age group. The levels most affected were C3–C4, followed by C2–C3 and subsequently, C5–C6. OB involving two consecutive SOMs was found only at C5–C7. We believe it is important to respond to the presence of a single SOM with a presumptive diagnosis of OB and to follow up, identify whether the diagnosis is correct, and take preventive action if possible. There is a need for updated diagnostic criteria and research approaches that reflect contemporary lifestyle factors and their impact on spine health.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"75-82"},"PeriodicalIF":2.3,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753249","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}