1.An elongated dorsally curved xiphoid process
Stefan LACHKAR ; Joe IWANAGA ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(1):102-104
The xiphoid process of the sternum lies in the epigastric region and functions to serve as an attachment point for vital muscles that aid in respiration. With the xiphoid process extending as the most inferior portion of the sternum, variable morphology is widely observed. During a routine dissection of a 44-year-old Caucasian male cadaver, we discovered a hook-shaped, elongated xiphoid process that protruded dorsally. Potential clinical significance can arise leading to misdiagnosis of the hook-shaped xiphoid process as an epigastric mass during imaging. Though various variations of xiphoid process have been well documented, knowledge of a hook-shaped xiphoid process orientated dorsally remains scarce. Herein, this case study provides clinicians, surgeons, and radiologists a rare anomaly of the xiphoid process in order to further the knowledge of morphological variations of the xiphoid to prevent misdiagnosis and surgical complications.
Adult
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Anatomic Variation
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Cadaver
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Diagnostic Errors
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Humans
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Male
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Muscles
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Respiration
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Sternum
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Surgeons
2.Direct drainage of the basal vein of Rosenthal into the superior petrosal sinus: a literature review
Santiago GUTIERREZ ; Joe IWANAGA ; Aaron S. DUMONT ; R. Shane TUBBS
Anatomy & Cell Biology 2020;53(4):379-384
An adult male was found to have a variation of the left basal vein of Rosenthal after presenting with complaints of headache and balance issues. In this case, the vein drained directly into the left superior petrosal sinus (SPS) instead of the great vein of Galen. Anatomical variation of the basal vein is likely due to embryonic development of the deep cerebral venous system as primitive structures either differentiate regress or further with age. These changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case that shows the basal vein drains into the SPS. The normal and variant anatomy of this vessel are discussed.
3.Ossification of the roof of the porus trigeminus with duplicated abducens nerve
Graham DUPONT ; Juan ALTAFULLA ; Joe IWANAGA ; Koichi WATANABE ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(2):211-213
Ossification of parts of the intracranial dura mater is common and is generally accepted as an age-related finding. Additionally, duplication of the abducens nerve along its course to the lateral rectus muscle is a known, although uncommon anatomical variant. During routine cadaveric dissection, an ossified portion of dura mater traveling over the trigeminal nerve's entrance (porus trigeminus) into the middle cranial fossa was observed unilaterally. Ipsilaterally, a duplicated abducens nerve was also observed, with a unique foramen superolateral to the entrance of Dorello's canal. To our knowledge, there has been no existing report of a simultaneous ossified roof of the porus trigeminus with an ipsilateral duplicated abducens nerve. Herein, we discuss this case and the potential clinical and surgical applications. We believe this case report will be informative for the skull base surgeon in the diagnosis of neuralgic pain in the frontomaxillary, andibular, orbital, and external and middle ear regions.
Abducens Nerve
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Cadaver
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Cranial Fossa, Middle
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Diagnosis
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Dura Mater
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Ear, Middle
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Orbit
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Skull Base
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Trigeminal Neuralgia
4.An anatomical study of the lingual nerve in the lower third molar area
Shogo KIKUTA ; Joe IWANAGA ; Jingo KUSUKAWA ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(2):140-142
The lingual nerve (LN) is a branch of the mandibular division of the trigeminal nerve, and its injury is one of the major complications during oral surgery. This study aims to investigate the anatomy of the LN in the lower third molar area. Twenty sides from ten fresh-frozen adult cadaveric Caucasian heads were examined to measure the diameter of the LN. The mean diameter of the LN was 2.20±0.37 mm (range, 1.61–2.95 mm). There were no statistically significant differences in the measurements between sexes, sides, or tooth status (dentulous or edentulous). Understanding the anatomical features of the LN is essential for performing any surgical procedure in the oral region.
Adult
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Cadaver
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Head
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Humans
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Lingual Nerve
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Mandibular Nerve
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Molar, Third
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Surgery, Oral
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Tooth
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Trigeminal Nerve
5.Triangles of the neck: a review with clinical/surgical applications
Shogo KIKUTA ; Joe IWANAGA ; Jingo KUSUKAWA ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(2):120-127
The neck is a geometric region that can be studied and operated using anatomical triangles. There are many triangles of the neck, which can be useful landmarks for the surgeon. A better understanding of these triangles make surgery more efficient and avoid intraoperative complications. Herein, we provide a comprehensive review of the triangles of the neck and their clinical and surgical applications.
Intraoperative Complications
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Neck
6.Ossification of the mamillo-accessory ligament: a review of the literature and clinical considerations
Graham DUPONT ; Emre YILMAZ ; Joe IWANAGA ; Rod J OSKOUIAN ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(2):115-119
Ossification of the mamillo-accessory ligament (MAL) is a misunderstood phenomenon; however, many have posited that it can result in nerve entrapment of the medial branch of the dorsal ramus causing zygapophyseal joint related low back pain. The MAL has been studied anatomically by few, yet the data indicate possible associations between ossification of this ligament and spondylosis. It has been proposed that mechanical stress upon the lumbar spine may also lead to progressive ossification of the MAL into a bony foramen.
Ligaments
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Low Back Pain
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Nerve Compression Syndromes
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Spine
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Spondylosis
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Stress, Mechanical
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Zygapophyseal Joint
7.Stafne bone cavity: a rare cadaveric case report
Joe IWANAGA ; T L WONG ; Shogo KIKUTA ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(3):354-356
The Stafne bone cavity (SBC), also called the static bone cavity, salivary inclusion cyst, latent cyst, and lingual bone defect is an asymptomatic bony defect that is commonly located inferior to the mandibular canal and slightly above the inferior border of the mandible. It is rare to see the actual bony defect in the cadaver because of its relatively low incidence of 0.1% to 6.06%. We report a unilateral SBC found in a 76-year-old at death male Caucasian cadaver and involving the right mandible. The SBC was oval in shape with a smooth surface and measured 10.8×6.0 mm. The SBC was continuous with the right mylohyoid groove. Since actual photographs of the SBC are lacking in the literature, this report might provide additional insight for better understanding the SBC.
Aged
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Cadaver
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Humans
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Hyoid Bone
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Incidence
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Male
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Mandible
8.Report of an inferior rectal nerve variant arising from the S3 ventral ramus
Graham DUPONT ; Joe IWANAGA ; Rod J OSKOUIAN ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(1):100-101
In surgical approaches to the perineum in general and anal region specifically, considering the possible variations of the inferior rectal nerve is important for the surgeon. Normally, the inferior rectal nerve originates as a branch of the pudendal nerve. However, during routine dissection, a variant of the inferior rectal nerve was found where it arose directly from the third sacral nerve ventral ramus (S3). Many cases have described the inferior rectal nerve arising independently from the sacral plexus, most commonly from the fourth sacral nerve root (S4); however, few cases have reported the inferior rectal nerve arising from S3. Herein, we describe a variant of the inferior rectal nerve in which the nerve arises independently from the sacral plexus.
Anal Canal
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Lumbosacral Plexus
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Perineum
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Pudendal Nerve
9.Variant anatomy of the buccal nerve
Mayank PATEL ; Joe IWANAGA ; Shogo KIKUTA ; Rod J OSKOUIAN ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(1):82-83
Knowledge of the anatomy and variations of the nerves of the oral cavity is important to surgeons who operate this region. Herein, we report a rare case of a buccal nerve with two distinct roots. The anatomy of this case and its clinical applications is discussed.
Mouth
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Surgeons
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Trigeminal Nerve
10.A multiply split femoral nerve and psoas quartus muscle
T. l. WONG ; Shogo KIKUTA ; Joe IWANAGA ; R Shane TUBBS
Anatomy & Cell Biology 2019;52(2):208-210
Cadaver
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Embryology
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Femoral Nerve
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Femur
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Intervertebral Disc
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Ligaments
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Lumbosacral Plexus
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Pelvis
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Psoas Muscles
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Spinal Nerves
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Spine
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Surgeons