No abstract available.
Anatomy, Regional*

OBJECTIVE: To provide transsphenoidal endoscopic surgery with the anatomic reference through anatomic study on the lateral wall of sphenoid sinus under transnasal endoscope. METHOD: The dissection of the lateral wall of sphenoid sinus were performed on 10(20 sides) damp cadaveric heads of Chinese adults via transsphenoidal approach. The anatomic relationship of the lateral wall of sphenoid sinus and its adjacent structures were observed. The distance and angle from the bony prominence of optic canal and internal carotid artery to the columella nasi and midline of sellar floor were measured by ruler and protractor respectively. RESULT: From the study of endoscopic anatomy, the specific structure of optic canal and internal carotid artery were found, and the lateral wall of the cavernous sinus could be exposed by tracing the internal carotid artery. The mean distance from the midpoint of the medial wall of optic canal orbital aperture and the anterior bony prominence of internal carotid artery to the columella nasi were (75. 33 +/- 5. 59)mm and (81. 02 +/- 5. 29) mm respectively, to the midline of sellar floor were (5. 81+/- 1. 52)mm and (5. 53 +/- l. 47)mm respectively. The angle from the midpoint of the medial wall of optic canal orbital aperture to columella nasi was (53.4 +/- 4. 1) degrees. CONCLUSION Taken the columella nasi and midline of sellar floor as the reference points, the anatomic observation and measurement under endoscope via transsphenoidal approach can provide a guide for surgeons.
Adult ; Anatomy, Regional ; Endoscopy ; Humans ; Sphenoid Sinus ; anatomy & histology ; surgery

Major technologic advances in fiberoptic light transmission, video cameras, and instrumentation have allowed great advances in small-joint arthroscopy. Arthroscopy in particular is now well established procedure for accurate diagnosis and operative management of certain ankle disorders. The small size of the ankle and significant periarticular soft tissue structures make placement and advancement of the arthroscope and instrumentation more difficult than in larger joints. Successful arthroscopy of the ankle requires knowledge of the regional anatomy and a familiarity with the available arthroscopic portals. This review article is going to describe the gross and arthroscopic anatomy of the ankle as it relates to current arthroscopic techniques. Particular emphasis is placed on the anatomic relations of the important osseous and soft tissue structures for a safe, reproducible approach to arthroscopic treatment of ankle pathology. Also, current arthroscopic equipment and instruments are included.
Anatomy, Regional ; Animals ; Ankle ; Arthroscopes ; Arthroscopy ; Joints ; Light ; Recognition (Psychology)

The detailed knowledge of the microvascular anatomy and the recognition of the anatomical variations of the middle cerebral artery (MCA) are very important for neurosurgeons to construct a better and safer microdissection plan and to prevent postoperative neurological deficits. This paper mainly reviewed segments, perforators, cortical arteries, branching patterns, anomalies, and regional anatomy relating various neurovascular surgery such as vascular anastomosis and the management of aneurysms and arteriovenous malformations of the MCA.
Anatomy, Regional ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Microdissection ; Middle Cerebral Artery*

The detailed knowledge of the microvascular anatomy and the recognition of the anatomical variations of the middle cerebral artery (MCA) are very important for neurosurgeons to construct a better and safer microdissection plan and to prevent postoperative neurological deficits. This paper mainly reviewed segments, perforators, cortical arteries, branching patterns, anomalies, and regional anatomy relating various neurovascular surgery such as vascular anastomosis and the management of aneurysms and arteriovenous malformations of the MCA.
Anatomy, Regional ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Microdissection ; Middle Cerebral Artery*

Spinal surgery of the anterior aspect of the cervicothoracic junction is difficult and has technological challenges because of the kyphotic alignment of the upper thoracic spine. This approach requires knowledge of the cervicothoracic regional anatomy. Surgery in this region is rare because of its indications; despite this rarity, surgeons must be prepared to expose this region. In addition, surgery in this region demands extensive opening of the surgical field and results in severe postoperative pain. Therefore, a less invasive procedure must be considered. Six cases of cervicothoracic lesion operation have been reported. The patients were successfully treated using an anterior modified approach (J-type manubriotomy). Anterior reconstruction and instrumentation of the cervicothoracic junction offers a distinct advantage of a stable anterior implant bone construction while preserving the posterior osseo-ligamentous tension band. Moreover, the modified anterior approach (J-type manubriotomy) provides the same exposure of the cervicothoracic junction without a full median sternotomy and avoids injury to subclavian vessels during resection of the clavicle or sternoclavicular junction. Therefore, the anterior cervical approach combined with J-type manubriotomy allows extensive exposure of the cervicothoracic junction and causes less complications. We performed preoperative radiological evaluation to identify the cases in which J-type manubriotomy was necessary.
Anatomy, Regional ; Clavicle ; Humans ; Pain, Postoperative ; Spine ; Sternotomy ; Surgeons

The most important factor for breast augmentation is to dissect the accurate size of implantation pockets. This study was performed to investigate the anatomical association of the pectoralis major muscle(PMM) with the female breast shape for improving the success rate of mammoplasty. This study included 60 women(120 breasts) in their twenties to thirties who were imaged by CT between September 2006 and December 2007. On reconstructed 3D CT images, 6 points in the area of the PMM were selected as fiducial points, and the PMM contour and the correlation of the PMM with the nipple were analyzed using the imaginary lines connecting individual points. As the volume increased, the lateral and inferior borders of the PMM moved to the superomedial side from the nipple. As the ptosis degree increased, the density became lower, and the lateral and inferior borders of the PMM moved to the superomedial side of the nipple. However, there was no significant correlation between age and PMM contour. The results of this study suggest that the PMM contour may change according to the volume, ptosis and density of the breast. This study can provide objective information for breast surgery, thereby increasing the success rate of mammoplasty.
Anatomy, Regional ; Breast ; Female ; Humans ; Mammaplasty ; Nipples ; Pectoralis Muscles

OBJECTIVETo study the anatomy of internal mammary artery perforator (IMAP) flap.

METHODSFive fresh cadavers were used, the morphology and blood supply of IMAP flap were examined by the method of microsurgical anatomy. During dissections, following parameters were recorded: number, type and diameter of perforators vessels, course (infra fascia and supra fascia) and location of perforators vessels.

RESULTSAll 1st-4th IMAPs were found in 10 specimen. Average diameter of 1st-4th IMAP artery/vein was as follows (x +/- s): (1.29 +/- 0.28) mm, (1.46 +/- 0.22) mm; (1.1 +/- 0.27) mm, (1.41 +/- 0.39) mm; (0.87 +/- 0.23) mm, (1.17 +/- 0.15) mm; (0.92 +/- 0.22) mm, (1.12 +/- 0.14) mm. The largest perforator was mostly first or second IMAP. The angiosomal territory of IMAPs extended from the clavicle superiorly to the xiphisternum inferiorly, from the midline medially to anterior axillary fold laterally.

CONCLUSIONIMAP flap offers an option in reconstruction of head neck defects and should be considered as an alternative to the deltopectoral flap and pectoralis major flap in some patients.

Adult ; Anatomy, Regional ; Female ; Humans ; Male ; Mammary Arteries ; anatomy & histology ; Surgical Flaps ; blood supply ; Thorax ; anatomy & histology ; blood supply

OBJECTIVETo provide anatomic data for clinical use of reversed submental island flap in reconstruction of buccal and facial defects.

METHODSTwenty cadavers with 40 sides of head and neck which were fixed by formalin and perfused by red emulsion, 6 fresh cadavers which were perfused by coloring agent were dissected, observed and measured.

RESULTSThe diameter of the submental artery, the superior lip artery and the inferior lip artery at their origins were respectively (1.42 +/- 0.30) mm (x +/- s, same at below), (1.34 +/- 0.35) mm and (1.34 +/- 0.27) mm respectively. The realistic distance from the origin of inferior and superior lip arteries to the origin of submental artery were (50.13 +/- 13.79) mm and (92.09 8.73) mm, respectively. However, the straight distances from the origin of inferior and superior lip arteries to the origin of submental artery were (35.19 +/- 9.18) mm, (64.99 +/- 5.24) mm, respectively. There were rich anastomoses between both facial arteries, and the facial arteries also anastomosed richly with the ophthalmic artery and the superficial temporal artery. On the marginal mandibular plane, the facial vein ran closely with the artery, the marginal mandibular branch of the facial nerve crossed superficially to the facial blood vessels; superior to this plane, the vein ran 1 cm behind the artery. The buccal branches of the facial nerve crossed superficially to the facial vein and ran into the muscles behind or across the facial artery. The facial vein anastomosed richly with the ophthalmic vein and the maxillary vein.

CONCLUSIONThere is anatomic feasibility for the reconstruction of buccal and facial defects by using pedicled submental reversed island flap. The reversing point of the flap ought to be at the cheilion plane or inferiorly. Anatomy, regional

Adult ; Anatomy, Regional ; Carotid Artery, Common ; anatomy & histology ; Chin ; anatomy & histology ; Female ; Humans ; Male ; Surgical Flaps ; blood supply

OBJECTIVETo provide endoscopic anatomic bony structures of pterygopalatine fossa for skull base surgery.

METHODSThe bony structures of the pterygopalatine fossa were observed in ten dry skulls under endoscope.

RESULTSThe pterygopalatine fossa showed a long and narrow cleft composed of the body and pterygoid process of sphenoid bone, the lamina perpendicular of palatine bone, and the posterior wall of maxillary sinus. The pterygopalatine fossa is (21.4 +/- 0.8) mm x (5.2 +/- 0.3) mm x (3.2 +/- 0.3) mm, with seven paths communicating with nasal cavity, mouth cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. Under endoscope,the whole pterygopalatine fossa could be observed.

CONCLUSIONSEndoscopic anatomic study of the pterygopalatine fossa is important to endoscopic endonasal skull base surgery. Under endoscope,the whole pterygopalatine fossa can be observed.

Adult ; Anatomy, Regional ; Asian Continental Ancestry Group ; Cranial Fossa, Middle ; anatomy & histology ; surgery ; Endoscopy ; Humans ; Otorhinolaryngologic Surgical Procedures ; Pterygopalatine Fossa ; anatomy & histology ; surgery ; Skull Base ; anatomy & histology ; surgery