Assessment of the iliolumbar artery: its structural variations and applied aspect

Background: The Iliolumbar artery normally arises from the posterior division of Internal iliac artery. The main artery and its two branches supply the iliacus and lumbar region and other vital structures in that area. However, various studies conducted depict the differences in the pattern of its origin and course. Thus, the goal of this study was to discover the various origins of the iliolumbar artery, as well as its relationships with other surgically significant anatomical structures; the importance of which can prevent any intraoperative hemorrhages during surgery.Methods: The study was conducted in Department of Anatomy Lady Hardinge Medical College between 2019-2021. Pelvis of 12 formalin fixed adult cadavers (8 females, 4 males) were dissected to observe the iliolumbar artery. Its origin, caliber and course were measured using a digital vernier caliper. The relationship of iliolumbar artery was established with obturator nerve, lumbosacral trunk and sympathetic chain.Results: Iliolumbar artery was originating from trunk of internal iliac artery in 70.83% cases in which the mean distance of origin and mean caliber was more on right side. In the remaining 29.17% cases where the Iliolumbar artery was arising from posterior division of internal iliac artery, the mean distance of origin and mean caliber was higher on left side. The truncal origin of iliolumbar artery was predominant in females.Conclusions: The variant origin of the iliolumbar artery and its clinic-anatomical relationships have been highlighted to reduce iatrogenic artery trauma during surgery.

Maxillary Artery runs medial to the mandibular nerve unilaterally: Case report and Literature Review

Background: The maxillary artery supplies the deep structures of the face and cranium. The maxillary artery and the mandibular nerve form a clinically important relation in the infratemporal fossa. Variations of the maxillary artery may complicate dental, oral, and maxillofacial surgeries in this region. Methods: During routine academic dissection of a 91-year-old Caucasian female cadaver, the pterygoid segment of the left maxillary artery was found medial to the posterior division of the mandibular nerve in the infratemporal fossa. Results: The maxillary artery coursed superior to the point of division of the mandibular nerve and remained undivided. Conclusion: This rare unilateral variation will be of interest to anatomists and clinicians, as an understanding of anatomical variations of the maxillary artery can help decrease the risk of hemorrhage and other surgical complications. KEY WORDS: Maxillary artery, Mandibular nerve, Lateral pterygoid muscle, Infratemporal Fossa.

Topographical Landmarks for Identification of Inferior Alveolar Nerve and its Surgical Implications - a Cadaveric Study

Background: Inferior alveolar nerve, which arises from the posterior division of the mandibular nerve, contains both sensory and motor fibres. The intraosseous course of the nerve is variable. Mandibular foramen is situated on the medial surface of the mandibular ramus. It is an important anatomical landmark for procedures like sagittal split osteotomies and inferior alveolar nerve block.Methods: The precise location of mandibular foramen was studied by the dissection of formalin fixed cadavers available for undergraduate dissection for a period of two years fron 2014-2016. Results: The mandibular foramen was 21±3.33 mm superior to the gonion at an angle of 980±50 with the base of the mandible. The mandibular foramen was 20.13±3.1 mm inferior to the lowest point of the mandibular notch. Accessory mandibular foramen was observed in 9.37% of the samples dissected.Conclusion: The present study explains the position of mandibular foramen in relation to prominent bony landmarks and the knowledge about the mandibular foramen, helps dental surgeons during inferior alveolar nerve blocks and split osteotomies.Practical implications: Failure rate of the inferior alveolar nerve block has been reported to be approximately 20-25%. A thorough anatomical knowledge of the mandibular ramus is essential for inferior alveolar nerve blocks and sagittal split osteotomies, since they are technically difficult procedures and as they are also associated with a higher incidence of complications.

The distribution pattern of periprostatic neurovascular bundles examined with successive celloidin slices

Background Although several distribution patterns of periprostatic neurovascular bundles have been proposed, variant dissection technique based on these patterns still confused surgeons. The aim of this study was to describe the periprostatic neurovascular bundles and their relationship with the fascicles around prostate and provide the accurate morphologic knowledge of periprostatic tissue for prostate operation. Methods The pelvic viscera were obtained from 26 adult male cadavers. They were embedded in celloidin and cut into successive slices. The slices were explored with anatomic microscopy. 3-Dimensional reconstruction was achieved with celloidin sections and series software. Results The prostatic capsule which surrounded the dorsal, bilateral aspect of the prostate was attached ventrally to anterior fibrous muscular stroma (AFMS). The lower part of the striated sphincter completely embraced the urethral; the upper part of this muscle covered the lower ventral surface of prostate. The upper ventral surface of prostate is covered by the circular muscle of detrusor. The levator fascia and the capsule adhered on the most convex region of the lateral prostate, but separated on the other region. The pelvic neurovascular bundles (PNVB) divided into the anterior and posterior divisions. The anterior division continued as dorsal vascular complex (DVC). The distal part of DVC entered into penile hilum. The posterior division continued as neurovascular bundles, and then as the cavernous supply (CS). The distal part of CS joined into pudendal neurovascular bundles. Conclusions The capsule and AFMS formed a pocket like complex. There were anterior and posterior neurovascular approaches from PNVB to penile hilum.

Why It Is Necessary to Use the Entire Root rather than Partial Root When Doing Contralateral C7 Nerve Transfer: Cortical Plasticity Also Matters besides the Amount of Nerve Fibers

Previous studies suggested that the mode of donor transection is a critical factor affecting the efficacy of the contralateral C7 (CC7) nerve transfer. Nevertheless, the mechanism underlying this phenomenon remains elusive. The aim of this study was to investigate the relationship between the division modes of the CC7 nerve and cortical functional reorganization of Sprague-Dawley rats. We hypothesized that different methods of CC7 nerve transection might induce differences in cortical functional reorganization, thus resulting in differences in surgery efficacy. BDNF, TNF-α/IL-6, and miR-132/134 were selected as indicators of cortical functional reorganization. No significant differences in all these indicators were noted between the entire group and the entire root+posterior division group ( P > 0.05 ). BDNF and miR-132/134 levels in the entire group and the entire root+posterior division group were significantly increased compared with their levels in the posterior group and the blank control group ( P < 0.001 ). In all groups, BDNF, TNF-α/IL-6, and miR-132/134 levels in both hemispheres initially increased and subsequently decreased until week 40. In conclusion, this study provided the evidence of dynamic changes in BDNF, TNF-α/IL-6, and miR-132/134 in the cortex of rats after CC7 nerve transfer using different transecting modes, demonstrating that different CC7 nerve divisions might result in different surgical effects through modulation of cortical reorganization.

Study of Renal Posterior Segmental Artery by Corrosion Cast Method

BACKGROUND Variations in origin, course and distribution of renal blood vessels are frequent observations. The aim of this study was to observe the pattern of posterior segmental renal artery by corrosion cast method. METHODS Thirty pairs of kidneys were collected from cadavers in anatomy department of Subharti Medical College, Meerut. Corrosion casts of renal arteries were prepared by infusing cellulose acetate butyrate solution through abdominal aorta. They were macerated in conc. hydrochloric acid. Origin, course and distribution of the posterior segmental artery were studied. RESULTS Renal posterior segmental artery most frequently originated as a continuation of the posterior division (93 %). It has no anastomosis with nearby segmental arteries. CONCLUSIONS Posterior segmental artery supplies posterior segment of kidney and may also frequently give origin to apical segmental artery. This study of origin, course, distribution and variations of renal posterior segmental artery will be useful for surgical and radiological practice. KEYWORDS Kidneys, Renal Artery, Anterior Division, Posterior Division, Posterior Segmental Artery, Abdominal Aorta, Corrosion Casts

The Distribution Pattern of Periprostatic Neurovascular Bundles Examined with Successive Celloidin Slices

Background: Although several distribution patterns of periprostatic neurovascular bundles have been proposed, variant dissection technique based on these patterns still confused surgeons.The aim of this study was to describe the periprostatic neurovascular bundles and their relationship with the fascicles around prostate and provide the accurate morphologic knowledge of periprostatic tissue for prostate operation.Methods: The pelvic viscera were obtained from 26 adult male cadavers. They were embedded in celloidin and cut into successive slices. The slices were explored with anatomic microscopy. 3-Dimensional reconstruction was achieved with celloidin sections and series software.Results: The prostatic capsule which surrounded the dorsal, bilateral aspect of the prostate was attached ventrally to anterior fibrous muscular stroma (AFMS). The lower part of the striated sphincter completely embraced the urethral; the upper part of this muscle covered the lower ventral surface of prostate. The upper ventral surface of prostate is covered by the circular muscle of detrusor. The levator fascia and the capsule adhered on the most convex region of the lateral prostate, but separated on the other region. The pelvic neurovascular bundles (PNVB) divided into the anterior and posterior divisions. The anterior division continued as dorsal vascular complex (DVC). The distal part of DVC entered into penile hilum. The posterior division continued as neurovascular bundles NVB, and then as the cavernous supply (CS). The distal part of CS joined into pudendal neurovascular bundles. Conclusions: The capsule and AFMS formed a pocket like complex. There were anterior and posterior neurovascular approaches from PNVB to penile hilum.