Here we describe a case of double suprascapular foramen formed by the ossification of bifid superior transverse scapular ligament (STSL). During an osteological study of scapula done in the Department of Anatomy, All India Institute of Medical Sciences, Raipur in 2014, we found a left sided scapula with double suprascapular foramen. The measurements of the ossified ligaments and the foramen were done using a digital vernier caliper (Mitutoyo Company, Tokyo, Japan). The length of the suprascapular notch was 11.68mm and the breadth was 7.92mm. There were two bony bars bridging the suprascapular notch [Table/ Fig-1,2]. The superior bony bar was 11.06 mm long. The width of the superior bar was 3.47mm in the medial end, 2.11mm in the middle and 2.49mm in the lateral end. The inferior bony bar was 6.02mm in length. The width of the inferior bar was 3.81mm in the medial end, 3.59mm in the middle, 3.89mm in the lateral end. The superior foramen was triangular in shape with a length of 3.27mm and breadth of 5.78mm. The inferior foramen was oval shaped with a length of 2.99mm and a breadth of 1.34mm. The two bony bars had a common attachment on the lateral border and were attached one below the other on the medial border of the suprascapular notch. Ossified bifid superior transverse scapular ligament causing a double suprascapular foramen is a very rare finding. This ossified ligament reduces the suprascapular space by half of its original size. It is one of the precipitating factors of suprascapular nerve entrapment. Here we describe a double suprascapular foramen in a dry left scapula of Indian origin. There were two bony bars bridging the suprascapular notch thereby making two foramina. The bony bars were 'V' shaped with its apex attached to the lateral side of the suprascapular notch. The upper foramen was large and triangular whereas the lower foramen was small and oval. Considering the shape of the foramen and the 'V' shaped attachment of the bony bars, we conclude it to be due to the ossification of bifid superior transverse scapular ligament. A double suprascapular foramen should always be kept in mind while diagnosing and treating suprascapular nerve entrapment. Knowledge about the double suprascapular foramen would be useful to orthopaedic surgeons who perform decompression for suprascapular nerve entrapment through arthroscopy and open procedures. DisCussionThe suprascapular notch is bridged by the STSL on the superior border of the scapula. The suprascapular nerve goes below the ligament in the notch and the suprascapular vessels pass above the ligament

Purpose: The foramen tympanicum (FT) represents a developmental anomaly that forms due to incomplete fusion of processes of the tympanic ring. Its presence in the population is controversial and it has been associated with a number of otologic complications. The aim of this study was to systematically analyze the prevalence, anatomical characteristics, and ethnic variations of the FT and compare these parameters in cadaveric and radiologic studies. Methods: An extensive search was conducted through the major electronic databases, and identified articles were separated into 2 groups based on their methodology: cadaveric and radiologic studies. Data extracted included study modality, prevalence data, ethnicity, gender, side, laterality, and diameter. Results: A total of 8 studies (n = 2671 patients) were included into our meta-analysis. The main findings revealed that the prevalence of the FT in the population is 14.9%, it is more often unilateral (62.5%) than bilateral (37.5%), it is most often reported in Asia (21.4%), and it is more prevalent in cadavers (21.2%) than in radiologic studies (8.8%) (not statistically significant). Conclusion: As the FT is present in more than one-tenth of the population, it is important to consider the possibilities of its presence when undertaking surgical procedures in the temporomandibular joint and ear region and plan accordingly to avoid injuries. Clinicians should keep it as one of the possible diagnoses while confronted with patients presenting with otologic complications. The use of newer imaging techniques was recommended, such as cone-beam computer tomography to detect the FT prior to surgery.

The Baker's or Popliteal cyst is a bursa seen between medial head Gastrocnemius and Semimembranosus. This bursa when present usually communicates with the cavity of Knee joint, most of the times being asymptomatic. They can occur due to any intra-articular pathology including bony inflammation, cartilaginous lesions, meniscal or ligament tear, etc. The symptomatic cases are mainly leading to pressure effects due to anatomical vulnerability of surrounding structures. Symptoms related to Popliteal vein compression and Tibial nerve entrapment are the most common clinical presentations. Although, Baker's cyst is a chronic disorder and after treatment also requires follow up to prevent relapses, it causes difficulty in differential diagnosis while presenting in acute state. Ultrasonographic examination and Magnetic Resonance Imaging is important tool to avoid misdiagnosis and inappropriate treatment. Surgical resection of the cyst is rarely indicated when intra-articular pathology cannot be diagnosed or its treatment is not responding.

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Introduction: The basilar artery (BA) is formed by the fusion of right and left vertebral arteries and divides to form right and left posterior cerebral arteries. This study was done to provide a baseline database regarding length, mid-length diameter, level of origin, and level of termination of BA.Materials and Methods: Thirty-eight formalin-fixed brains were obtained from cadavers dissected for undergraduate studies. The external length and the average external diameter of BA were measured by a digital Vernier caliper. Variation in origin and termination of BA was noted using magnifying glass. Results: The length and diameter of the BA were 25.58 ± 3.57 mm and 3.05 ± 0.41 mm, respectively. The origin and termination of BA was normal in most cases. In two cases, the origin was above the pontomedullary junction, and in one case, it was below. In two cases, the termination was above the pontomesencephalic junction, and in one case, it was below. Conclusion: There was no gender predisposition in length and diameter of the basilar artery. The baseline data established in this study regarding length, diameter, level of origin and level of termination of basilar artery will help neurosurgeons and interventional radiologists to diagnose as well as plan and execute various vascular procedures such as shunting for the treatment of aneurysms and stenosis in the blood vessels of the posterior cranial fossa.

Background and aims :The petrous apex and the middle cranial fossa is a commonly explored area in neurosurgeries and hence require a holistic approach which should include the possibility of anatomical variants and morphometric dissimilarities. Material and Methods:This morphometric study was undertaken on 91 dry adult skulls [182 petrosal apices] to analyze a number of parameters relevant to Anterior Petrosectomy [AP] via the Kawase’s Triangle [KT]. The anatomical landmarks most pertinent to Anterior Petrosectomy [Kawase's approach] were defined, recorded and validated. The findings of the study were compared with earlier workers who have employed other means of investigation viz. dry bones/CT scans or cadaveric studies . Results : The parameters undertaken for the study presented with variable values and moresoever for the surface area of the KT. This can be very logically attributed to the variant anatomy amongst races and also to the physiological status of the individual Conclusions : AP has evolved as a preferred method for approaching petroclival region and thus requires an in depth understanding. The present analysis throws significant light on certain parameters that would be helpful in making anterior petrosectomy safer. Surgeries of the skull base demand for high end precision and proficiency and thus our findings provide enhanced alertness for a better and safe procedure. A methodical approach to the area with the background knowledge of these parameters shall culminate in desired neurosurgical outcomes.

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