Vasudha Saralaya

Pterygospinous bar and foramina in Indian skulls: incidence and phylogenetic significance

Incomplete or complete ossification of the pterygospinous ligament is uncommon. Entrapment of mandibular nerve and its branches was reported due to this anatomical variation, when found. The aim of the present study is to investigate the incidence of the pterygospinous bony bridges in Indian dry skulls. A total of 416 adult dry skulls of Indian origin were studied. In 9.61% of the samples the pterygospinous bony bars were found, out of which 5.76% was complete and 3.84% was incomplete. Such variations are of clinical significance while dealing with mandibular nerve and its branches and various clinical symptoms related to it.

Abnormal Branching of the Axillary Artery: Subscapular Common Trunk. A Case Report

Una inusual variacion unilateral en el patron de ramificacion de la arteria axilar se observo en un cadaver embalsamado de 60 anos de edad. La arteria axilar tuvo solo dos ramas derivadas de su parte proximal (primera) y no otorgo ramas de su parte distal (segunda y tercera). Las ramas son superiores toracica (habitual) y otra gran rama colateral (inusual). Esta rama colateral es el origen de varias arterias importantes como la circunflej a escapular, toracodorsal, circunflej a humeral posterior, taraco-acromial y toracica lateral. Proponemos el nombre variacion arterial como tronco comun subescapular. El curso de este tronco comun subescapular y sus ramas y tambien el significado clinico de esta variacion son discutidas en este trabajo.

Mastoid emissary foramina: an anatomical morphological study with discussion on their evolutionary and clinical implications

The identification of mastoidal emissary veins is of importance in the neurosurgical practice to diagnose abnormal and normal structures. In the present study, the objectives were to estimate the prevalence rate of mastoidal emissary foramina in the temporal bones of the adult skull and to study their number and morphology. The present study included 48 adult human skulls which were obtained from the gross anatomy laboratory of our institution. The mastoid parts of 96 temporal bones were macroscopically observed for the prevalence, number and morphology of the emissary foramina. It is observed that, the mastoidal emissary foramen was present in 88 temporal bones (91.7%) of our specimens. The foramen was observed single in 60 temporal bones (62.5%), double in 22 bones (22.9%), and triple in 6 temporal bones (6.2%). The mastoidal emissary foramen was absent in 8 (8.3%) temporal bones. The foramen was bilaterally absent in 3 (3.1%) skulls. It was unilaterally absent in 2 (2.1%) skulls and both were on the left side. The mastoidal emissary vein is prevalent in a large number (91.7%) of cases. It was observed that the accessory mastoidal emissary foramina were present in 29.1% of cases. Recognition of the mastoid emissary veins and accessory mastoid emissary veins during the otologic surgery is critical to avoid the significant bleeding. In the neurosurgical practice, the knowledge is important due to variability in the number of mastoidal emissary veins and their connection to the venous sinuses.

Morphological study of lingula of the mandibles in South Indian population

PURPOSE OF THE STUDY The objectives were to study the morphology of the lingulae in adult human dried mandibles of South Indian population. MATERIALS AND METHODS The study was carried out on 67 (37 males and 30 females) dry mandibles and the morphological variants of the shapes of the lingulae were macroscopically noted and classified. Totally, 134 lingula were studied from both sides of mandibles. RESULTS From our observations, 29.9% (40) of the lingula had triangular shape, 27.6% (37) were truncated, 29.9% (40) were found nodular and 12.6% (17) were assimilated. In 61.2% (41) of the mandibles, the shape of the lingula was symmetrical on both the sides. The triangular lingulae were found bilaterally in 14, truncated in 11, nodular in 10 and assimilated in six mandibles. CONCLUSION In our specimens, the majority of the mandibles were having triangular shaped lingula and the shape of the lingula was symmetrical on both sides. There was sexual dimorphism observed, as in males the triangular shape was more common and in females it was nodular. The incidence of different forms of lingulæ can be used as an anthropological marker to assess the different group of population and races, with other non-metric variants of the skull. The morphology of this subject is important to the maxillofacial and orodental surgeons as the inferior alveolar nerve is close to the lingula and may assist in the inferior alveolar block.

Variant Origins of Arteries in the Carotid Triangle -A Case Report

The left superior laryngeal artery was observed arising from the external carotid artery instead of the superior thyroid artery in the cadaver of an approximately 70 year-old Asian man. In addition, on the same side, the superior thyroid artery arose from the common carotid artery 2 cm before the bifurcation instead of its usual origin from the external carotid artery. From the external carotid artery, the lingual and facial arteries arose from the common linguofacial trunk. The nerves in the carotid triangle were normal in course. No variations were observed on the right side carotid system. The multiple variations in this case have not been previously described. The embryogenesis of this combination of variations is not clear, but the anatomic consequences may have important clinical implications. As angiography has gained popularity in diagnostic approaches in recent years, it is essential to be aware of these variations so that they are not overlooked in differential diagnoses.

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In vivo Morphometry of Menisci of the Knee in South Indians:A Preliminary Study

Background: Since the in vivo morphometric data on the menisci of the knee joint of Indian subjects are scarce, we hereby studied the width and thickness of the menisci using Magnetic Resonance Imaging (MRI) to establish standard dimensions of the normal medial and lateral meniscus as an aid to orthopaedic surgery. Methods: Eighty menisci from 40 knee joints were analysed in each of three regions, the anterior horn, the mid body and the posterior horn. The thickness and width of the menisci were measured in sagittal and coronal T1-weighted and T2-weighted MRI images and analysed statistically. Results: The mean thickness of medial meniscus at the anterior horn, mid body, and posterior horn were 6.3 ± 1.1 mm, 5.2 ± 1.3 mm, and 6.9 ± 1.1 mm, respectively. The respective values for the lateral meniscus were 4.8 ± 0.7 mm, 6.4 ± 1.1 mm, and 7.0 ± 0.9 mm. The mean width of medial meniscus at the anterior horn, mid body, and posterior horn were 10.5 ± 1.2 mm, 7.8 ± 1 mm and 13.9 ± 0.9 mm, respectively. The widths of lateral meniscus at the same regions were 11.8 ± 1.4 mm, 8.6 ± 1.2 mm, and 12.0 ± 0.9 mm, respectively. The lateral meniscus was significantly wider than medial at the anterior horn and mid body (p = 0.00). In contrast, the posterior horn of medial meniscus was significantly wider than lateral meniscus. Both menisci were significantly wider at their posterior horn, followed by the anterior horn and were significantly narrower at their mid body. Conclusion: The present study provides new information on the meniscal thickness and width in South Indians that can be used in planning of orthopaedic and arthroscopic surgeries of the knee joint. However, the study needs to be analyzed with a large sample size for the better interpretation.

Anatomical morphometry of the tibial plateau in South Indian population

The objectives were to study the morphometry of lateral and medial tibial plateau in South Indian population. The study was performed using 73 dry cadaveric tibiae which were obtained from the gross anatomy laboratory of our institution. The antero-posterior length and medio-lateral breadth of the lateral and medial tibial condyles were measured. The data of the medial and lateral compartments, right and left sided tibiae were statistically analyzed and compared. The mean length and breadth of medial tibial plateau (± standard deviation) were 39.8 ± 3.8 mm and 26.7 ± 2.8 mm respectively. The same parameters for the lateral tibial plateau were 33.6 ± 3.7 mm and 26.1 ± 2.9 mm. For both length and breadth the dimensions were statistically lower for the lateral tibial condyle than the medial (p<0.05). Differences were not statistically significant between right and left sides except for the length of lateral tibial plateau, which was longer on the right side (p<0.05). The present study observed differences in the morphometric parameters between the lateral and medial tibial condyles and has provided additional information on the morphometric data of the tibial plateau which is important to the orthopedic surgeons.

Morphology and topography of the parietal emissary foramina in South Indians: an anatomical study

The objectives of the present study were to study the prevalence of the parietal emissary vein in adult South Indian population and to study the distance of foramen from the sagittal suture. There were 58 adult human skulls in the present study which were available at the anatomy department of our institution. The study included 116 parietal bones which have been observed macroscopically for the number, prevalence and topography of the emissary foramen. The emissary foramen was present in 83 parietal bones (71.5%) of the present study. It was present at the junction between the middle 1/3 and posterior 1/3 region of the parietal bone. The foramen was observed solitary in 73 parietal bones (62.9%), double in 8 bones (6.9%), and triple in 2 parietal bones (1.7%). The foramen was not observed in 33 parietal bones (28.4%). The bilateral absence of parietal emissary foramen was seen in 7 skulls (12.1%). It was absent unilaterally in 19 skulls (32.7%). The accessory foramina were seen in only 8 skulls (13.8%). The mean distance of the foramen from the sagittal suture was 6.7±2.9 mm and 6.8±2.8 mm on the right and left sides respectively. The prevalence of parietal emissary vein in the present study was 71.5%. The present study has observed important data about the morphology and morphometry of the parietal emissary vein in South Indian population. The identification of parietal emissary veins and accessory veins is important in the operation room to prevent the blood loss.

Predicting Lumbar Central Canal Stenosis – A Magnetic Resonance Imaging Study

BACKGROUND Low back pain is a common complaint among adults, worldwide. Lumbar canal stenosis is frequently diagnosed as a cause for low back pain. In this study we evaluate morphometric measures using MRI sections to predict the occurrence of lumbar central canal stenosis. SETTINGS AND DESIGN One hundred and fifty four lumbar spinal MRI sagital and axial section images, 77 males and females each were evaluated from the Department of Radiology, Kasturba Medical College, Mangalore, Manipal University. The study design was a prospective study. MATERIALS AND METHODS Various measurements were taken and two constant ratios were calculated. The Canal Body Ratio and the Ratio between the area of the dural sac and the vertebral body was evaluated. STATISTICAL ANALYSIS Unpaired t-test analysis was conducted using SPSS software. RESULTS A canal body ratio less than 0.6 from L1 to L3 levels and less than 0.5 at L4 and L5 levels were found. The ratio between area of dural sac and vertebral body was found to be a constant at 0.2 at all levels. It was found that maximum central canal stenosis occurred at the L5 lumbar vertebral level in 15.6% males and 13% females. This was followed by stenosis at the L4 and L3 lumbar vertebral levels with 5.1% males having stenosis at both levels and 3.9% and 5.1% females in L4 and L3 lumbar levels respectively. CONCLUSION These morphometrical findings of the lumbar vertebrae could be of use in evaluating the possible cases of lumbar canal stenosis.