Vrinda Hari Ankolekar

Morphology of Papillary Muscles in Human Adults: A Cadaveric Study

Introduction: The papillary muscles (PM) play an important role in ventricular overextension. The variability in the number, shape and location of papillary muscle of the right and the left ventricle is important for the surgeon in reparative procedures, papillary muscle dysfunction, mitral valve replacement and use of mitral valve homograft for mitral/tricuspid replacement. Materials and Methods: The study was conducted using 15 formalin fixed adult human hearts. The presence, number, shapes, length, number of additional heads of the papillary muscles were observed. The presence of moderator band (MB) was noted and its level of attachment to the anterior PM was observed. Results: Double anterior and posterior PM were found in few cases. The length of PM was longer in the left ventricle when compared to the right ventricle which was statistically significant. In the right ventricle cone-shaped PM was observed in the majority of the cases whereas flat topped PM was observed in 2 cases. In the left ventricle all the PM were cone shaped. In majority of the cases (N=13) the MB was attached to the lower third of the PM whereas in one case each it was attached to the upper third and to the middle third respectively. Conclusions: The morphology and morphometry of the papillary muscles of both ventricles and moderator band were defined. These may help cardiac surgeons during surgical procedures conducted for correction of their defects.

Morphometric Study of Anterior Clinoid Process and Optic Strut and the Ossification of Carotico-Clinoid Ligament with their Clinical Importance

INTRODUCTION Knowledge about the ossification of the Carotico-Clinoid Foramen (CCF), as it forms a potential site for compression of the internal carotid artery may be beneficial for neurosurgeons and radiologists. AIM To obtain a detailed knowledge of morphometry of Anterior Clinoid Process (ACP) and Optic Strot (OS) and the type of ossification of CCF which would be necessary to increase the success of surgeries related to the cavernous sinus and internal carotid artery. MATERIALS AND METHODS Parameters such as the length of ACP from its base to the tip, the width at its base and the distance between the tip of ACP to optic strut were measured in mm using digital calipers. SPSS version 17 was used for the statistical analysis. Paired t-test was applied to compare between right and left sides. Presence of carotico-clinoid foramen was observed and was classified as incomplete, contact form or complete. RESULTS The average length of ACP ranged from 12 to 15mm on right side and 11 to 16mm on the left side. Paired t-test was applied to compare the means between the right and left sides. The width of ACP varied between right and left sides and this difference was statistically significant (p<0.05). Out of 12 CCF observed, the commonest type was incomplete (N=7) followed by complete (N=3) and contact form (N=2). CONCLUSION Considering the immense anatomical surgical and radiological importance of morphology of ACP, OS and CCF, this study highlighted the detailed morphometry of these structures. The study also has explained the sexual dimorphism in their morphology.

Anatomy of maxillary sinus and its ostium: A radiological study using computed tomography

Background: Interventions involving the middle meatus are commonly performed because the majority of the paranasal sinuses open into the osteomeatal complex. Therefore, the aim of the present study was to locate the level of maxillary sinus ostium (MSO), to measure the distances between MSO and different anatomical landmarks, to measure the different dimensions of maxillary sinus and to compare the morphology of maxillary sinus between the right and the left sides. Materials and Methods: The study involved 50 computed tomography (CT) images of normal paranasal sinus anatomy in coronal and sagittal planes from the Department of Radiodiagnosis. The location of the sinus ostium (upper, middle, or lower third) was observed. Perpendicular distance from the sinus ostium to the lower border of inferior turbinate and hard palate were measured. The maximum vertical, transverse, and antero-posterior diameters of the maxillary sinus were measured. Results: Of 50 CT images, the MSO was located in the upper third in 40 cases while in 10 it was located in the middle third. The most common location of MSO was in the upper third. The dimensions of the maxillary sinus indicated bilateral symmetry. Conclusion: The dimensions of the maxillary sinus indicated bilateral symmetry, and there were no significant gender differences when compared. However, the distances of the MSO from the major anatomical landmarks were significantly different between males and females which are seldom reported earlier. This knowledge about the variations in the lateral wall of the nasal cavity is crucial during the endoscopic interventions and for functional endoscopic sinus surgeries.

Determination of inter-bronchial and subcarinal angles in fetuses of different gestational age and their clinical implication

Introduction:The tracheo-bronchial angles in the human fetus are of increasing relevance in perinatal medicine to determine both normal and pathological criteria. The present study was undertaken to calculate the inter-bronchial angle using a novel method by an image analyzer at different gestational ages. Materials and Methods:The present study was carried out using 24 human fetuses in the department of Anatomy, Kasturba Medical College, Manipal. The right and left bronchial, inter-bronchial and subcarinal angles were calculated by using an image analyzer named Image J. Results:The right bronchial angle ranged from 21.99° to 43.96°. The left bronchial angle ranged from 29.48° to 56.21°. The inter-bronchial angle ranged from 60.53° to 100.86°. Student t test was applied to compare the means of bronchial angles between the second and third trimesters which did not show any statistical significance. The subcarinal angle ranged from 41.69° to 74.88° with an average of 61.15 ± 9.73°. Conclusion:The present study analyses the inter-bronchial and subcarinal angles in different GA, the knowledge of which would be essential to understand the developmental changes of the respiratory passages.

Surgical relevance of sphenoid sinus and its ostium: An anatomical study -

Back ground: Sphenoid sinuses and their ostia are highly variable structures. Normal opening of sphenoid sinus lies in the spheno ethmoidal recess medial to superior turbinate. The sphenoid sinus is surrounded by several important structures like optic nerve, carotid arteries and the trigeminal nerves. Objective: The present study was performed to determine the anatomical correlations of the sphenoid sinus ostium with surrounding structures. Materials and Methods: The study was carried out in the Department of Anatomy, Kasturba Medical College, Manipal on 40 sagittal head and neck sections of adult formalin fixed cadavers. The shape of the sphenoid sinus ostia was noted. The distance of the ostium from the major landmarks were measured using vernier calipers. The landmarks used were the choana, nasion, anterior end of superior concha and basi sphenoid. The extent of pneumatization towards the sella was also noted. Results: In our study, majority of cases showed sellar variety on both right and left side. The shape of the sphenoid sinus ostia was slit type in majority of cases followed by oval and round shape. Conclusion: The sphenoid ostium provides a natural portal for entering the sphenoid sinus and beyond up to the base of the skull. It is not always easy to locate the ostium during endoscopic approach. The present study was therefore designed to establish readily identifiable anatomical landmarks for locating the sphenoid ostium.