The purpose of this study was to estimate the distance from the mandibular marginal branch of the facial nerve to the inferior margin of the mandible in order to determine the best and safest location to approach the posterior mandibular region. Forty-five hemi-faces of 27 Brazilian adult cadavers were dissected and the distance between the mandibular marginal branch and the inferior margin of the mandible was measured. The number of marginal branches and anastomoses with other branches of the facial nerve was also recorded. The evaluation of the anatomic pieces showed 1 to 3 branches of the marginal mandibular branch, anastomoses with the buccal and cervical branches of the facial nerve and distances between -1.3 cm to +1.2 cm from the inferior margin of the mandible. In 57.7% of the cases, the nerve passed superiorly and along the length of the inferior margin of the mandible. Based on the findings of the present anatomosurgical study, it may be recommended an incision 3 cm below the inferior margin of the mandible associated to a careful dissection in planes and flap retraction. This is expected to reduce the risk of neuropraxia of the marginal mandibular nerve making the submandibular incision a safe approach.
SUMMARY:The aim of this study was to verify the prevalence of the ossified superior transverse scapular ligament (STSL) on dry bones of scapulae. 221 dry bones were analyzed, (111 rights and 110 lefts), proceeding from Rio de Janeiro and of Santa Catarina, Brazil. As exclusion criterion, were not analyzed bones of children or damaged. For the quantitative analysis of the data, the software Graphad Instat was used. Fisher exact test was used considering the p≤ 0,05 as significant. After analysis of the scapulae, 30,76% (68/ 221) presented the ossified STSL (p≤ 0,0001) of which, 52,94% (36/68) were ossified on the right side and 47,05% (32/68) on the left one. The 153 scapulae that did not present the ossified STSL, it was observed in 19,6 % (30/153) of these bones, the superior edge varying in the transverse plan, increasing superior angulation and, modified the width and depth of the scapular incisure. This anatomical curiosity should be kept in mind by clinicians that approaches painful syndrome of the shoulder, as well as, this anatomical curiosity should be kept in mind by students that may manipulate this anatomical area.
SUMMARY:The aim of our study was to verify the prevalence of the sternal foramen in adult cadavers and dry bones, as well as to determine its exact localization and relation to acupuncture points. One hundred eighty sternums fixed and contained in 10% formaldehyde solution were examined, of which 100 were dry bones and 80 belonged to adult cadavers. The morphometric measures were expressed in millimeters when measuring the length: 1) from jugular incision to the foramen (JI-F); 2) from sternal angle to the foramen (EA-F); 3) from xiphoid process to the foramen (XP-F). Statistical analysis was performed to compare expected vs obtained foramina frequency, using Fisher's test (p≤0.05 was considered significant). The results showed 16.6% sternal foramina, significant higher than expected (p≤0.0248). Of the 30 foramina, 53.3% were found in cadavers, of which one was a woman, and 46.7% sternums were found in dry bones. Of the cadavers with sternal foramen, 10 foramina were at the 5th sternochondral articulation level and 6 foramina at the 4th sternochondral level. Of the 14 analyzed dry bones, 9 foramina were at the space between the 4th and the 5th costal pit level and 5 foramina were at the 5th costal pit level. The mean±SD (mm) total length of the sternums was 151.8±34 and the measures JI-F, EA-F, and XP-F were, respectively, 103.8±22.1mm, 65.6±15mm and 46.9 ±15mm. Knowledge of this occurrence is important to avoid serious heart injury by needle insertion, especially as this area holds a commonly used acupuncture point and sternal puncture.
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