The facial artery (FA) is the main artery supplying the anterior face, making this artery a very important structure to consider while performing plastic and reconstructive procedures. The literature shows discrepancies in anatomical classifications and the frequency of occurrence of individual variations. Therefore, the goal of this meta‐analysis is to provide surgeons with helpful knowledge about the variety of the termination of FA. Articles with data about the termination of the FA were found in major online medical databases such as PubMed, Scopus, Embase, Web Of Science, and Cochrane Library. A total of 1346 articles were initially evaluated by two independent reviewers. Out of those, 24 articles matched the required criteria, and were used in this meta‐analysis. A total of 2119 studied FAs were included in this study. The FA termination patterns were divided into five previously classified types. The data show that the FA terminates most frequently as the lateral nasal or angular artery with the prevalence for this group being 69.81% (95% confidence interval [CI]: 59.83%–78.94%). Authors believe that this is the most accurate and up to date study regarding termination patterns and the prevalence of the FA. The results of this meta‐analysis could provide a helpful tool for surgeons preforming plastic and cosmetic procedures, especially when injecting dermal fillers or choosing and preforming facial flaps. Detailed anatomical knowledge about the FA may prevent potential surgical complications.
Background Over the past 4 decades, gluteal augmentation has increased tremendously in popularity. Therefore, numerous techniques have been developed to provide patients with the best possible outcomes. The submuscular technique has been proven to be a reliable option for a broad cohort of patients. Objectives The main objective of the present retrospective study is to describe the characteristics and clinical outcomes of a group of patients that underwent gluteal augmentation using the submuscular technique. Methods A retrospective analysis was conducted on 80 female patients that underwent submuscular gluteal augmentation with silicone implants from August 2019 to May 2022. All of the patients were operated on by the authors of the present study. Results Information about the patient demographic, implants, complications, and treatments was analyzed. Moreover, the satisfaction of the patients was assessed with a short survey. The most frequent complication was wound dehiscence. Only 7 patients necessitated surgical revisions, while two required isolated antibiotic therapy. All complications were effectively addressed, and no implants had to be removed. Furthermore, the retrospective analysis revealed a noteworthy association between the size of the implant and the occurrence of complications. Conclusions In the authors’ opinion, the submuscular method provides the best aesthetic results and adequate safety for the patients. It significantly minimizes the possibility of complications, such as fluid collection due to muscle fiber dissection or implant exposure/extrusion.
Background: The aim of this study was to assess the innervation of the dorsal articular capsule of the wrist using modified Sihler's staining. Materials and methods: Thirty dorsal wrist capsules were collected from 15 donors (both sides) within 12 hours of death. All the capsules were collected in the same mannerusing the dorsal incision. The specimens were stained according to the protocol of the modified Sihler's staining technique. The preserved capsules were analyzed under 8-16× magnification of an optical microscope for the presence of major nerve trunks, their major and minor branches, and nerve connections. Results: The range of innervation visualized was that the posterior interosseous nerve innervated approximately 60% of the central part; the remaining area was innervated by the dorsal sensory branch of the radial nerve and medial antebrachial cutaneous nerve. The constant findings were the branches departing from the ulnar side of the posterior interosseous nerve and from the radial side, with an exception seen in two cases. A communicans branch between the posterior interosseous nerve and medial antebrachial cutaneous nerve was seen in all the specimens. The posterior interosseous nerve innervation extended beyond the level of the carpometacarpal joints II-V. Conclusions: The modified Sihler's staining technique allows for transparent visibility of the nerves that innervate the dorsal wrist capsule. However, it does not allow as accurate assessment as does histological examination, especially regarding the evaluation of nerve endings. Nevertheless, this method provides a significantly larger area of nerve observation than is provided by histological examination.
Background: The aim of this study was to evaluate the terminal branch of the posterior interosseous nerve (PIN) by anatomically and histologically assessing the number, dimension, and area of its individual fascicles, by determining the dimension and area of the whole nerve itself, and by calculating the nerve density ratio (ratio of the sum of the areas of individual fascicles to the area of the whole nerve) of the terminal branch of the PIN. Methods: Twenty-eight terminal branches of the PIN nerve samples were collected from patients undergoing partial denervation of the wrist. The nerve samples were fixed in 10% buffered formalin and stained with hematoxylin and eosin to visualize their nerve bundles. Quantitative analysis of individual fascicles and the whole nerve itself were carried out. Results: Ten nerve samples (35,7%) had one single fascicle (group 1) while the remaining 18 nerve samples (64,3%) contained 2-9 fascicles (group 2). The difference in the sum of the areas of individual fascicles between the two groups did not constitute a statistical difference. Statistically significant differences (p <0.05) were seen between area of whole nerve, percentage of fascicles to the nerve surface and the cross-section maximum nerve length and width. Conclusions: The number of nerve fascicles in the terminal branch of the PIN does not affect the overall size of the nerve. The majority of the volume of multi-fascicle nerves, therefore, primarily consists of the internal perineurium. However, due to the low number of nerves, this 2 question cannot be clearly answered. This sets a further direction for further research on a larger group.
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