To provide anatomical and morphological data regarding the coccyx using three-dimensional images, with a view to aiding the diagnosis of idiopathic coccydynia, one hundred and thirty-six normal adult pelvises were investigated. Three-dimensional models of the pelvis were reconstructed using software from computed tomography images of whole specimens. The following six coccyx parameters were measured: (1) width, (2) straight length, (3) thickness, (4) sacrococcygeal angle, (5) intercoccygeal angle, and (6) angle of lateral deviation of the coccyx. The presence of fusion between the sacral and coccygeal cornua, and between the sacrum and the transverse process of the coccyx was also investigated, and lateral deviations of the coccyx were classified and analyzed. Most of the measured coccyx parameters were larger in males than in females, with the exception of the sacrococcygeal and intercoccygeal angles. Unilateral or bilateral fusion of the sacral cornu and the coccygeal cornu was not a rare finding. With respect to the sacrum and the transverse process of coccyx, the separated type was more common than the fused type. The incidence and angle of lateral deviation of the coccyx varied widely between individuals. The present detailed description of the gross anatomy of the coccyx obtained using three-dimensional modeling will help toward understanding the mechanism underlying the development of idiopathic coccydynia. Fusion of the sacrum and coccyx or lateral deviation of the coccyx may cause coccydynia by compressing the coccygeal nerves. Anat Rec, 299:307-312, 2016. V C 2015 Wiley Periodicals, Inc.
Posterior projections of the ophthalmic division of the trigeminal nerve (the ophthalmic nerve) are distributed in the tentorium cerebelli as recurrent meningeal branches. We investigated the morphological tentorial distribution of the ophthalmic nerve. Fifty-two sides of the tentorium cerebelli and adjacent dura mater obtained from 29 human specimens were stained using Sihler's method to examine the nerve fibres in the dural sheets. The innervation patterns of the tentorium cerebelli were classified into the following four types according to their distributions: Type 1, where nerve fibres projected to both the straight and transverse sinuses; Type 2, where nerve fibres projected only to the transverse sinus and lateral convexity; Type 3, where nerve fibres projected medially only to the straight sinus and the posterior part of the falx cerebri; and Type 4, where the nerve fibres terminated within the tentorium cerebelli. Images of the tentorium cerebelli were superimposed to identify areas of dense innervation. The incidence rates of Types 1-4 were 71.2% (n = 37), 21.2% (n = 11), 3.8% (n = 2) and 3.8% (n = 2), respectively. More branches of nerve fibres traversed towards the transverse sinus posterolaterally than towards the straight sinus medially. The space between the anterior half of the straight sinus and the medial tentorial notch can be considered a safe surgical area where innervation is scarce. The posterior part of the falx cerebri was innervated by the ophthalmic nerve that traversed to the straight sinus. The parietal branches of the middle meningeal artery in the lateral convexity that were projected orthogonally by the ophthalmic nerve traversed the transverse sinus, implicating their vulnerability and possible sensitivity under physiological or neurosurgical conditions. This study has revealed the macroscopic tentorial innervation of the dura mater in humans, which could be useful information for both neurosurgeons and neurologists.
Sihler's staining is a useful technique for visualizing the entire nerve network of the LR. Improving the knowledge of the nerve distribution patterns is important not only for researchers but also clinicians to understand the functions of the LR and the diverse pathophysiology of strabismus.
To investigate the topographical relationship between the frontal branch of the superficial temporal artery (FSTA) and the temporal branch of the facial nerve (TFN) with the aim of preventing nerve injury during FSTA biopsy. Fifty-seven hemifaces of 33 cadavers were dissected. Vertical lines drawn to the lateral orbital margin (LOM) and the superior root of the helix were used as the anterior and posterior reference positions, respectively. Horizontal lines drawn through the supraorbital margin and lateral canthus were used as the superior and inferior reference points, respectively. The depth and course relationships of the FSTA and TFN were examined. Midpoints between the FSTA and TFN are situated approximately 6.0 and 4.5 cm posterior to the lateral orbital margin at the levels of the lateral canthus and supraorbital margin, respectively. The TFN is generally situated 1-2 cm anteriorly and inferiorly to the FSTA in the temporal region. However, in two cases (3.6%), the TFN ran just underneath the FSTA with only a very small safe distance, making it highly vulnerable to iatrogenic injury. In conclusion, when performing an FSTA biopsy, the surgeon should not dissect below the superficial temporal fascia because there is an overlap between the course of the FSTA and the TFN in a minority of cases. Also, surgical incisions should be made outside the area delineated by an oblique line passing through the points 6.0 and 4.5 cm posterior to the lateral orbital margin at the levels of the lateral canthus and the supraorbital margin, respectively. Clin. Anat. 31:608-613, 2018. © 2017 Wiley Periodicals, Inc.
One-third of the medial branch of the superficial SON without corrugator muscle protection is vulnerable to iatrogenic injury during direct browplasty. Therefore, the oculofacial surgeon must bring the dissection plane of the forehead tissue more superficially around the vertical line through the upmost point of the lacrimal caruncle in order to avoid nerve injury.
We determined the variability of the location of the LFCN at the boundary between the pelvic and femoral portions. The reported results will be helpful for diagnosis and treatment of MP. Muscle Nerve 55: 646-650, 2017.
Background: Vision loss and skin necrosis caused by an accidental intraarterial embolism or vascular compression are rare but devastating complications when injecting filler materials into the face. Methods: The external and internal diameters and wall thicknesses of the facial artery and its branches were measured from 41 formalin-embalmed cadavers after removing connective tissues attached to the arterial wall. Results: The diameter and thickness of the facial artery exhibited significant interregional differences. The external and internal diameters of the facial artery were 1.9 ± 0.4 and 1.2 ± 0.3 mm (mean ± SD), respectively, at the inferior border of the mandible; 1.7 ± 0.3 and 1.2 ± 0.3 mm in the vicinity of the inferior labial artery; 1.5 ± 0.3 and 1.0 ± 0.3 mm at the mouth corner; 1.4 ± 0.3 and 0.9 ± 0.2 mm in the vicinity of the superior labial artery; and 1.1 ± 0.2 and 0.7 ± 0.2 mm in the vicinity of the lateral nasal artery. The external and internal diameters at the proximal parts of the inferior labial artery, superior labial artery, and lateral nasal artery were 1.0 ± 0.3 and 0.6 ± 0.2 mm, 0.9 ± 0.3 and 0.6 ± 0.2 mm, and 0.8 ± 0.2 and 0.5 ± 0.2 mm, respectively. Conclusion: Morphometric examinations of the facial artery under stereomicroscope observation as performed in the present study are expected to be more accurate than direct measurements obtained during cadaveric dissection or conventional histologic evaluations.
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