No abstract available.
Hemangioma* ; Manubrium*

Although the sternalis muscle has been well known to anatomists, it is quite unfamiliar to clinicians. During routine educational dissection, we came across a well-defined bilateral double sternalis muscle innervated by the intercostal nerve, respectively. The right sternalis muscle 1) became tendinous to insert into the sternum and 2) crossed midline and then intermingled with the left pectoralis major muscle, which could be classified into a double with single cross based on Snosek et al.'s criteria. The left sternalis muscle was composed of two bellies, which were combined at the midway, and became tendinous to insert into the contralateral manubrium, which could be classified into a bicipital diverging with double cross based on Snosek et al.'s criteria. The detailed knowledge on the sternalisis is important for clinicians as well as for anatomists, since the clinical importance of the sternalis muscle has been highlighted in recent years.
Anatomists ; Cadaver* ; Humans ; Intercostal Nerves ; Manubrium ; Sternum

OBJECTIVES: In tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not. METHODS: The 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens. RESULTS: Squamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens. CONCLUSION: In tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma.
Cholesteatoma ; Epithelium ; Humans ; Malleus ; Manubrium ; Tympanic Membrane Perforation ; Tympanoplasty

OBJECTIVES: In tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not. METHODS: The 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens. RESULTS: Squamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens. CONCLUSION: In tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma.
Cholesteatoma ; Epithelium ; Humans ; Malleus ; Manubrium ; Tympanic Membrane Perforation ; Tympanoplasty

Recently we performed a modified sternum-splitting approach in surgery for anterior space-taking lesion in the upper thoracic region. In contrast to the original trans-sternal approach introduced by Cauchoix, we cut only the manubrium and split it using vertebral spreader. After reaching the anterior surface of the cervico-Thoracic vertebrae, the central portion of the vertebral body was removed with air-drill under an operating microscope. The longitudinal bone defect of the vertebral bodies was filled with a bone graft obtained from the iliac bone. Removal of the space-taking lesions in the cervico-thoracic junction and upper thoracic region can be performed safely by utilizing the modified sternum-splitting approach. This approach can be applied also to endarterectomies at the origins of the vertebral arteries and the subclavian artery.
Endarterectomy ; Manubrium ; Microsurgery ; Spine ; Subclavian Artery ; Transplants ; Vertebral Artery

Sternocostoclavicular hyperostosis is a benign ossifying diathetic disorder characterized by hyperostosis and soft tissue ossification of the clavicles, anterior portion of the first ribs, and manubrium, with variable hyperostosis or ankylosis in the spine and sacroiliac joints. A review of the literature and our own case describes the clinical findings and its characteristic features in RI, CT, and plain film.
Ankylosis ; Clavicle ; Hyperostosis ; Hyperostosis, Sternocostoclavicular* ; Manubrium ; Ribs ; Sacroiliac Joint ; Spine

The upper thoracic vertebrae through anterior approach depends upon several variables; The diameter of the thoracic inlet, the height of the clavicles and manubrium anteriorly, and the extent of the cervicothoracic kyphosis. Preoperatively, the upper margin of the manubrium should be compaired with the vertebral body level on a standard lateral roentegenogam or mid-sagittal MRI of the upper thoracic spine. We measured the distance and the level of the corresponding vertebra of line A(horizontal line from the suprasternal notch to the corresponding vertebra) and line B(perpendicular line from the suprasternal notch to the corresponding vertebra ; thoracic inlet) on mid-sagittal MRI of normal subjects. The results were as follows: 1) In 95 cases(94 cumulative %), the line A fell to the T2 lower one third through T4 lower one third and the mean distance was 49.8+/-4.2mm(means standard deviation). 2) In 92 cases(91 cumulative %), the line B fell to the T1 lower one third to T3 middle one third and the mean distance was 45.5+/-4.9mm(means standard deviation). 3) The relation of the height and the distance with age, sex, weight, height, and body mass index were not statistically significant. We concluded that anatomical analysis of the mid-sagittal MRI of the cervicothoracic vertebrae will be helpful in selecting the access route to the cervicothoracic lesion.
Adult* ; Bays ; Body Mass Index ; Clavicle ; Humans ; Kyphosis ; Magnetic Resonance Imaging ; Manubrium ; Spine* ; Thoracic Vertebrae

BACKGROUND: A correct estimate of the tracheal tube insertion depth can prevent complications, including endobronchial intubation and vocal cord trauma. We evaluated a new topographical method for endotracheal tube positioning relative to the carina, using a well-known prior topographical method for comparison. METHODS: One hundred adult (male 50, female 50) patients were studied. The comparison topographic length (in cm) was measured by adding the distance between the right mouth corner and the right mandibular angle to the distance between the right mandibular angle and the center of the sternal manubrium. The new endotracheal tube insertion depth (in cm) was determined by adding the distance between the right mouth corner and the vocal cords, measured with the endotracheal tube itself, to the distance between the thyroid prominence and the manubriosternal joint, and then subtracting 4 cm. After intubation, the endotracheal tube was positioned properly at the right mouth corner and the endotracheal tube tip was evaluated using a fiberoptic bronchoscope at the carina. RESULTS: The distances from the tip of the endotracheal tube to the carina were not significantly different between the methods in the same gender. However, our method allowed endotracheal tube tip placement between 3 cm and 5 cm, above the carina more frequently than the prior method in males. CONCLUSIONS: The new topographical method can be used as a guide to positioning the endotracheal tubes.
Adult ; Bronchoscopes ; Female ; Humans ; Intubation ; Joints ; Manubrium ; Mouth ; Thyroid Gland ; Vocal Cords

A 65-year-old male was admitted to our hospital complaining of painful swelling of right sternocostoclavicular area. In the past history, he had no specific disease including trauma. After admission, chest CT and neck CT showed right empyema and right cervical abscess. Empyemectomy was performed through open thoracotomy and fistulous tract was detected on right parietal pleura and right sternocostoclavicular area. Ostomyelitis was also detected on right sternocostoclavicular area and removal of right cervical abscess, partial resection of proximal clavicle, resection of chondral portion of 1st rib, and partial resection of manubrium were performed. Empyema that extends from sternocostoclavicular osteomyelits, as in this case, is rare. Herein we report a case of loculated empyema with sternocostoclavicular osteomyelitis and neck abscess.
Abscess* ; Aged ; Clavicle ; Empyema* ; Humans ; Male ; Manubrium ; Neck* ; Osteomyelitis* ; Pleura ; Ribs ; Thoracotomy ; Tomography, X-Ray Computed

Thyroglossal duct cysts develop in the persistent remnants of the thyroglossal tract between the origin of the thyroid at the foramen cecum and the final position of the thyroid gland. Thyroglossal duct cyst can present anywhere from the base of the tongue to the manubrium, but its occurrence within the thyroid gland is very rare. We report here on a 41-year-old woman who presented with a cystic thyroid nodule that was due to an intrathyroid thyroglossal duct cyst. The sonogram, showed a hypoechoic nodule that measured 0.7 x 0.6 cm in the left thyroid lobe. Left lobectomy of the thyroid gland was performed and microscopic examination revealed a cyst lined by non-keratinized squamous epithelium, which was consistent with a thyroglossal duct cyst in the thyroid gland. Intrathyroid thyroglossal duct cyst should be considered in the differential diagnosis of a cystic thyroid nodule. This is the first reported case of a intrathyroid thyroglossal duct cyst in a Korean adult.
Adult ; Cecum ; Diagnosis, Differential ; Epithelium ; Female ; Humans ; Manubrium ; Thyroglossal Cyst* ; Thyroid Gland ; Thyroid Nodule ; Tongue