Endoscopic Transcranial Duraplasty for Rhinoliquorrhea: A Cadaveric Study.

Background: Repair of the anterior skull base for cerebrospinal fluid leak requires either endoscopic endonasal approach or open transcranial approach.

Objective: To present a less invasive surgical procedure for sealing of the entire anterior fossa floor for traumatic rhinoliquorrhea.

Methods: Cadaver study in 3 head specimens.

Repair of Large Abdominal Wall Defects Using Total Anterior Aponeurotic Flap: Anatomical Feasibility Study and Comparison with Ramirez's Technique.

In this cadaveric study, we explored the feasibility of a maximal mobilization of the superficial abdominal fascia, in a continuous flap, to achieve a tension-free covering of midline defects. The aponeurosis of the external oblique muscle was incised along the anterior axillary line and then detached up to the anterior rectus sheath. The latter was opened between the external and the internal oblique aponeurosis while keeping the continuity with the external oblique fascia.

Evaluating Preoperative Models: A Methodologic Contribution.

Background: Three-dimensional (3D) printed models of the human skull and parts of it are being increasingly used for surgical education and customized preoperative planning.

Objective: This study, using the calvaria as a model, provides a methodologic analysis with regard to future investigations aimed at evaluating patient-specific skull replicas.

Methods: Postmortem computed tomography was used for 3D reconstruction of a skull.

Adapting anatomy teaching to surgical trends: a combination of classical dissection, medical imaging, and 3D-printing technologies.

Purpose: Many regions worldwide report difficulties in recruiting applicants to surgery. One strategy proposed to reverse this trend consists of early exposure of medical students to the field. Against this backdrop, the present study presents an innovative approach for anatomy teaching, integrating a surgically relevant trend: 3D printing.

A modified posteromedial approach combined with extensile anterior for the treatment of complex tibial pilon fractures (AO/OTA 43-C).

The anterior approaches that have been described for open reduction internal fixation of multifragmentary pilon fractures are designed to reconstruct the comminuted and impacted anterior articular surface onto a stable posterior column. Thus, reduction of the posterior column, particularly proper length, is critical. There are differing opinions of how best to surgically approach the posterior pilon fracture.

Concepts for Liver Segment Classification: Neither Old Ones nor New Ones, but a Comprehensive One.

Concepts dealing with the subdivision of the human liver into independent vascular and biliary territories are applied routinely in radiological, surgical, and gastroenterological practice. Despite Couinaud's widely used eight-segments scheme, opinions on the issue differ considerably between authors. The aim of this article is to illustrate the scientific basis for understanding and harmonizing inconsistencies between seemingly contradictory observations.

Anatomy of the liver: an outline with three levels of complexity--a further step towards tailored territorial liver resections.

The vascular anatomy of the liver can be described at three different levels of complexity according to the use that the description has to serve. The first--conventional--level corresponds to the traditional 8-segments scheme of Couinaud and serves as a common language between clinicians from different specialties to describe the location of focal hepatic lesions. The second--surgical--level, to be applied to anatomical liver resections and transplantations, takes into account the real branching of the major portal pedicles and of the hepatic veins.

Investigation of radialization and rerouting of the extensor digiti minimi (EDM) in the abduction deformity of the little finger: a cadaver study.

Background: One of several operations to correct abduction deformity of the little finger, (Wartenberg's sign) in ulnar nerve palsy, is a combined procedure that radializes the extensor digiti minimi (EDM) at the level of the fifth metacarpophalangeal (MCP) joint and reroutes it from the fifth to fourth extensor compartment. This cadaveric study was designed to investigate the impact of both elements on adduction.

Materials And Methods: Anatomy of the little finger extensor apparatus was studied in 16 freshly frozen cadaver hands sectioned at mid forearm.

Medial coracoclavicular ligament revisited: an anatomic study and review of the literature.

The medial coracoclavicular ligament (MCCL), up to now rarely reported in the literature, was studied in a formol-fixed cadaver by means of dissection, morphometry, and light microscopy. This entity represents a true ligament within the coracoclavicular fascia. Although longer and narrower than its lateral counterpart, the medial coracoclavicular ligament follows the same morphological pattern, including the cartilage at the level of the coracoidal attachment.

The third time is the charm--anastomosis between the celiac trunk and the left colic artery.

An atypical case of abdominal vasculature, found in a 58-year-old woman is presented. The multidetector computed tomography angiogram revealed a large tortuous anastomotic vessel between the stem of the celiac trunk and the left colic artery, supplying branches for the left colon and pancreatic body and tail. We propose a simple embryological explanation for the development of this aberrant artery--the longitudinal ventral anastomosis, which connects the precursors of principal visceral arteries in a loop-like manner, loses its direct communication with the superior mesenteric artery but maintains its continuity above and below this level.

Cadaver procurement for anatomy teaching: legislative challenges in a transition-related environment.

Background: Human gross anatomy is one of the cornerstones of a medical curriculum and cannot be performed without adequate cadaver procurement, which is a particular challenge for medical schools with a large student enrolment. The authors present the situation in a country with a low public awareness for willed body donor programmes and the prior absence of adequate legislation.

Aim: Against this background, a comprehensive proposition of a whole-body procurement procedure was elaborated in the health-care law.

Liver segments: an anatomical rationale for explaining inconsistencies with Couinaud's eight-segment concept.

Background And Purpose: An increasing number of surgical and radiological observations call Couinaud's concept of eight liver segments into question and such inconsistencies are commonly explained with anatomical variations. This paper was intended to demonstrate that, beyond variability, another anatomical principle may allow to understand supposedly differing concepts on liver segmentation.

Materials And Methods: The study was performed on 25 portal vein casts scanned by helical CT.

Superior vestibular neurectomy: a novel transmeatal approach for a denervation of the superior and lateral semicircular canals.

Objective: To assess morphologically a transmeatal approach to the lateral and superior ampullary nerves performable under local anesthesia and simultaneously with the existing approach to the singular nerve developed by Gacek during the same operation.

Materials And Methods: Eighty halves of human heads preserved with the Thiel method were operated on by an otologist. Two surgical approaches were tested on each specimen, 1 superior and 1 inferior to the tympanic segment of the facial nerve.

A new anatomical technique to investigate nerves by imagery.

Introduction: We describe a novel post mortem technique that makes it possible to visualise the nerve structure of the brachial plexus using imaging.

Materials And Methods: We dissected in situ the brachial plexus of a cadaver preserved by formaldehyde. A preparation composed of a mixture of baryte powder, water and colorant, was applied to all sides of the brachial plexus and blood vessels of the region under study.

Omental Morgagni-Larrey hernia: an anatomical pictorial essay.

This paper reports on a case of an omental diaphragmatic hernia revealed during routine anatomical dissection of an obese 85-year-old male with plethoric appearance of the upper body. The hernial mass, with a size of 12 cm x 9 cm, was detected in the anterior mediastinum. It had a long peduncle originating from the transverse colon and passing through the right sternocostal diaphragmatic opening of Morgagni-Larrey.

Portal venous territories within the human liver: an anatomical reappraisal.

Subdivision of the human liver into eight portal venous segments (according to Couinaud) is largely established in the anatomical and clinical community. However, this concept is challenged by an increasing number of surgical and radiological reports. We reexamined the intrahepatic portal venous architecture to understand the inconsistencies published.

Transvenous embolization of a dural arteriovenous fistula of the laterocavernous sinus through the pterygoid plexus.

We present a novel access for transvenous embolization of a dural arteriovenous fistula of the laterocavernous sinus through the external jugular vein and the pterygoid plexus. The anatomy of the laterocavernous sinus is reviewed, and its clinical implications discussed in light of the case of a patient whose management was modified after identifying this anatomical variation.

Fascia: a pragmatic overview for surgeons.

The term "fascia" is a very frequently used notion, particularly in an anatomical, surgical, and radiological context. A closer look at the underlying concepts, however, reveals that the denomination is all but a consistent one. It is this use of one and the same term for very different entities that is one of the sources for controversial opinions on fascial structures and their applications in surgical practice.

The petrosquamosal sinus in humans.

This article provides a comprehensive description of the morphology of the human petrosquamosal sinus (PSS) derived from original observations made on 13 corrosion casts of the cranial venous system combined with routine clinical imaging studies in two patients. The PSS is not a rare finding in the adult human. In particular, continuous developments in imaging techniques have made radiologists become increasingly aware of this anatomical entity in recent years.

Transcanal approach to the singular nerve.

Objectives/hypothesis: Intractable benign paroxysmal positional vertigo is rare, and surgery is indicated in only a very small number of cases. Transcanal singular neurectomy is considered a difficult and risky procedure possibly leading to hearing loss and vertigo. The objective of this study was to evaluate the feasibility of the singular neurectomy through the external ear canal in an attempt to explain the contradictory results of previous reports of anatomists and of surgeons who abandoned the technique, considering that the singular neurectomy could not be reached via the external auditory canal without damaging the labyrinth.