Ipek Ergur

Stature and gender estimation using foot measurements.

In forensic investigation difficulties are being experienced in the stature and gender estimation of bodies dismembered in mass destruction. So as to eliminate these difficulties, new methods are being developed. The aim of this study is to develop formulae for estimation of the stature and gender through foot measurements when necessary. For this purpose, the length, width, malleol height, navicular height measurements of the right and left foot as well as stature have been taken from the 249 subjects who are attending Medical Faculty of Dokuz Eylul University and School of Physical Therapy and Rehabilitation in Turkey. In males, stature and foot measurements were higher than in females, and the difference between the average measures was significant. The highest correlation was observed in the right and left foot length for female, male and study (mix-gender group) groups when stature and foot measurement relations were evaluated. The lowest correlation was observed in foot width for the right foot in all groups but, differed in left foot measurements for each group. Formulae were obtained by using multiple regression analysis for stature estimation and logistic regression analysis for gender estimation. As a consequence, whilst stature estimation formulae, depending on the gender, allow 9-10 cm errors, those that are independent on the gender help make estimation with less than 4 cm errors. Gender estimation formula can help determine the gender with 95.6% accuracy via right foot measurements, and 96.4% accuracy via left foot measurements. In population similar to our subjects, stature and gender estimation can be made by using foot measurements.

Thoracic duct variations may complicate the anterior spine procedures

The aim of this study is to localize and document the anatomic features of the thoracic duct and its tributaries with special emphasis on the spinal surgery point of view. The thoracic ducts were dissected from nine formaldehyde-preserved male cadavers. The drainage patterns, diameter of the thoracic duct in upper, middle and lower thoracic segments, localization of main tributaries and morphologic features of cisterna chyli were determined. The thoracic duct was detected in all cadavers. The main tributaries were concentrated at upper thoracic (between third and fifth thoracic vertebrae) and lower thoracic segments (below the level of ninth thoracic vertebra) at the right side. However, the main lymphatic tributaries were drained into the thoracic duct only in the lower thoracic area (below the level of the tenth thoracic vertebra) at the left side. Two major anatomic variations were detected in the thoracic duct. In the first case, there were two different lymphatic drainage systems. In the second case, the thoracic duct was found as bifid at two different levels. In formaldehyde preservation, the dimensions of the soft tissues may change. For that reason, the dimensions were not discussed and they may not be a guide in surgery. Additionally, our study group is quite small. Larger series may be needed to define the anatomic variations. As a conclusion, anatomic variations of the thoracic duct are numerous and must be considered to avoid complications when doing surgery.

Cadaveric study of the arterial anatomy of the upper lip.

Arterial distribution of the upper lip was investigated in this study. The location, course, length, and diameter of the superior labial artery and its alar and septal branches were determined on 14 preserved cadaver heads. Another cadaver head was used to show the arterial tree by the colored silicone injection technique. The superior labial artery was the main artery of the upper lip and always originated from the facial artery. The superior labial artery was 45.4 mm in length, with a range from 29 to 85 mm. The mean distance of the origin of the superior labial artery from the labial commissura was 12.1 mm. The superior labial artery was 1.3 mm in external diameter at its origin. The mean distance of origin of the superior labial artery from the lower border of the mandible was 46.4 mm. The alar division of the superior labial artery was mostly found as a single branch (82 percent). Its mean length was 14.8 mm and the mean diameter at the origin was 0.5 mm. The distance between the origins of the superior labial artery and the septal branch was 33.3 mm. The septal branch was single in most of the cases (90 percent). The mean length of the septal branch was 18.0 mm and the diameter at its origin was 0.9 mm. After all dissections, it was concluded that the arterial distribution of the upper lip was not constant. The superior labial artery can occur in different locations unilaterally and bilaterally, with the branches showing variability.

Arterial anatomy of the lower lip: A cadaveric study

The aim of the study was to investigate the arterial anatomy of the lower lip. The location, course, length, and diameter of the inferior labial artery and the sublabial artery were revealed by bilateral meticulous anatomic dissections in 14 adult male preserved cadaver heads. Another cadaver head was used for silicone rubber injection to fill the regional arterial tree. The inferior labial artery was the main artery of the lower lip and in all cases branched off the facial artery. The mean length of the inferior labial artery was found to be 52.3 mm (range, 16 to 98 mm). The mean distance of the origin of the inferior labial artery from the labial commissura was 23.9 mm. The mean external diameter of the inferior labial artery at the origin was 1.2 mm. The sublabial artery was present in 10 (71 percent) of the cadavers. Mean measurements of this artery were 1 mm for diameter, 23.4 mm for length, and 27.6 mm for distance from the labial commissura. The sublabial artery may originate from the facial artery or the inferior labial artery. This study found that this region does not have a constant arterial distribution, the inferior labial artery and the sublabial artery (if it exists) can be in different locations unilaterally or bilaterally, and the diameter and the length may vary.

Anatomy of the Dorsal Nerve of the Penis, Clinical Implications

OBJECTIVE To show the branching patterns and the anatomic variations of the dorsal nerve of the penis (DNP) along the penile shaft, particularly the relation with the tunica albuginea. METHODS The penises of 22 adult cadavers were dissected. The number and the diameters of the branches, the presence of anastomoses between the main trunks, the positioning of the nerves before entering the glans penis, and the presence of branches emerging from the body of the DNP and perforating the tunica albuginea were noted and photographed. The compartments where the anatomic findings were located were noted. RESULTS The DNP was composed of 2, 3, 4, 5, and 6 main branches in 6 (27.3%), 6 (27.3%), 6 (27.3%), 1 (4.5%), and 3 (13.6%) of 22 dissections, respectively. We could trace 2, 3, 4, and 5 terminal branches of the DNP going into the glans penis in 4 (18.2%), 8 (36.4%), 7 (31.8%), and 3 (13.6%) dissections, respectively. In 2 dissections (9.1%), fine branches were present between the main trunks crossing the midline. Anastomosing branches between ipsilateral main trunks of the DNP were identified in 5 dissections (22.7%). In 16 (72.7%) dissections, branches emerging from the inferior aspect of the body of the DNP, which perforated the tunica albuginea, could be identified. CONCLUSION The exact anatomic knowledge of the DNP is mandatory during penile reconstructive surgeries. The presence of branches perforating the tunica albuginea is the most important finding of this cadaveric study, together with the other documented variations, which must be taken into consideration during penile reconstructive surgeries.

Anatomical variations of iliolumbar artery and its relation with surgical landmarks

OBJECTIVES The aim of this study was to reveal the variations of origin of iliolumbar artery, and its relations with the surrounding surgically important anatomical structures. METHODS The origin, diameter, and tract of iliolumbar artery were determined bilaterally in 21 formalin-fixed adult male cadavers (21 right and 21 left arteries) in the Laboratory of Department of Anatomy. RESULTS Iliolumbar artery was originating from common iliac artery in 4.8% (2 arteries), internal iliac artery in 71.4% (30 arteries), posterior trunk of internal iliac artery in 19% (8 arteries), and as two different arteries from internal iliac artery in 4.8% (2 arteries) of the cases. The mean diameter of the iliolumbar artery was 3.7 mm. CONCLUSION The anatomical properties of iliolumbar artery and its relation with anatomical landmarks, which were presented here, would be helpful in decreasing iatrogenic trauma to iliolumbar artery during surgery.

A new method of identifying the posterior inferior nasal nerve: implications for posterior nasal neurectomy.

Introduction:Posterior nasal neurectomy is an effective way of treating recalcitrant rhinitis. The aim of this study is to describe the anatomic relationship between the posterior inferior nasal nerve (PINN) and the structures that might be important for posterior nasal neurectomy. Materials and Methods:An anatomic study was conducted in a university hospital dissection laboratory with 15 formalin-fixed, sagittally cut adult cadaver heads. The distance between PINN and (1) nasal sill, (2) maxillary sinus ostium, (3) posterior fontanel, (4) torus tubarius, and (5) crista ethmoidalis was measured and the location of PINN with respect to the sphenopalatine artery was assessed to define the exact location of PINN. Results:The mean distance between PINN and nasal sill (56.4 mm), maxillary sinus ostium (27 mm), posterior fontanel (12.5 mm), torus tubarius (13 mm), and crista ethmoidalis (8 mm) was determined. PINN was found consistently posterior to the sphenopalatine artery where the inferior turbinate attaches to the lateral nasal wall. Conclusion:Instead of finding PINN around the sphenopalatine foramen, PINN can be located more easily posterior to the sphenopalatine artery where the inferior turbinate attaches to the lateral nasal wall without cauterizing the sphenopalatine artery.

Sphenovomerine suture: a useful landmark for locating sphenoid sinus ostium.

AimThe aim of this study was to determine whether the sphenovomerine suture (SVS) can be used as a landmark to localize the sphenoidal sinus ostium. MethodsEndoscopic imaging was done on 152 skulls to identify ostium of the sphenoidal sinus, the SVS, and the articulation of sphenoidal process of palatine bone between the body of the sphenoid and the sphenopalatine foramen. The variables were as follows: (1) the distance between the medial border of the ostium and SVS (DSO-SVS); (2) the angle between them (ASO-SVS); (3) the distance between the inferior border of the ostium and the horizontal line (DSO-HL); (4) the distance between intersection point of the SVS-sphenoidal process of the palatine bone and the medial border of sphenopalatine foramen (DSPF-SVS); and (5) the number of sphenopalatine foramen. ResultsOf the 152 skulls, 289 sides were included in the study. The mean value for DSO-SVS was 3.15 (1.35) mm, DSO-HL was 5.99 (2.38) mm, DSPF-SVS was 7.07 (1.96) mm, and ASO-SVS was 5.99 (9.73) mm. As DSPF-SVS decreases, DSO-SVS and DSO-HL decrease with statistical significance (Ps = 0.02 and 0.001, respectively). The distribution of the numbers of sphenopalatine foramen was as follows: one 90%, two 9.7%, and four 0.3%. ConclusionsThe horizontal distance between the SVS and the sphenopalatine foramen plays a significant role in identifying the location of sphenoid sinus ostium. As with the other landmarks, the SVS provides an additional benefit in locating the sphenoid sinus ostium for endoscopic sinus surgeons. The incidence of 4 sphenopalatine foramen is 0.3%.

An anatomic study of the lateral patellofemoral ligament

Objective The lateral patellofemoral ligament (LPFL) is part of the lateral retinaculum cut during arthroscopic or open release. We investigated its anatomic and morphometric characteristics. Materials and methods We identified the LPFL insertion point on the condyle in vertical and sagittal planes in 32 adult cadaveric knees. We measured its length and width at the insertion point. We located the midpoint of this point and measured from it to the distal and posterior condylar ends. We measured anterior-posterior and proximal-distal lateral condylar lengths. We evaluated the insertion point shape on the lateral femoral condyle. Degree of relationship between variables was assessed using Pearsons correlation coefficient. p < 0.05 was considered statistically significant. Results The LPFL mean length was 23.2 mm, and mean width at the insertion point was 15.6 mm. Regarding its insertion into the lateral condyle, central insertions were more frequent (vertical plane: 53.1% central and sagittal plane: 75% central). A significant positive correlation was evident between the LPFL length and width at the insertion point (p = 0.05). Thus, the LPFL length was proportional to its width at the insertion point. A significant positive correlation was found between the anterior-posterior condylar length and width of the LPFL at the insertion point (p = 0.017). Therefore, greater anterior-posterior condylar length equates to a larger area of insertion on the condyle. Conclusion Greater width of the LPFL at the insertion point corresponds to greater LPFL and anterior-posterior lateral condylar lengths.