Zeliha Kurtoğlu

Formation and location of the sural nerve in the newborn

In this study, the location and formation of the sural nerve were examined in 40 legs of new-born cadavers. The sural nerve was formed by the peroneal communicating branch from the common peroneal nerve joining the medial sural cutaneous nerve in 27 of 40 legs (67.5%). It was formed by the peroneal communicating branch from the lateral sural cutaneous nerve joining the medial sural cutaneous nerve in 4 (10%). It was formed by the peroneal communicating branch from the common peroneal nerve and fibers from the posterior femoral cutaneous nerve joining the medial sural cutaneous nerve in 2 (5%). In 5 of 40 legs (12.5%), the medial sural cutaneous nerve was in the place of the sural nerve without joining any other nerve. In one case (5%), the sural nerve was not formed bilaterally.

An accessory flexor digitorum longus muscle with high division of the tibial nerve

An accessory flexor digitorum longus muscle associated with a high division of the tibial nerve was encountered during routine dissection in the right leg of a newborn cadaver. The tibial nerve divided into its two terminal branches at a higher level than normal with a small branch from the tibial nerve contributing to one of the terminal branches. In addition, an accessory flexor digitorum longus muscle was observed to pass between the terminal branches of the tibial nerve.

Examination of the Accessory Tendons of Extensor Hallucis Longus Muscle in Fetuses

There are various data about the incidence of accessory tendons (AT) of extensor hallucis longus (EHL) muscle; however, their function is unknown. This study aimed to determine the incidence and morphometric features of the AT of EHL muscle in fetuses in order to provide more information to discuss its possible function. Forty‐five fetuses (26 female and 19 male) were used in this study. Fetuses were grouped as Group A (16–21weeks), Group B (22–27 weeks), and Group C (28–34 weeks) according to their age. In 23 (51%) out of 45 fetuses, there were AT. These were bilateral in 15 fetuses (65%) and unilateral in eight fetuses (35%). Fifty‐two percent of the fetuses in group A, 43% in group B, and 67% in group C had AT. AT were observed in 14 female (54%) and 9 male (47%) fetuses. In all cases, the AT were always diverging to the medial side of the main EHL tendons and attached to the metatarsophalangeal joint capsule distal to the joint space. Significant correlations were observed in this study between EHL and AT widths as well as between EHL width and EHL‐AT distance on both sides. The present study is the first to provide morphometric data about the AT of EHL muscle in fetuses which will be of use in understanding their function, particularly in biomechanics of the great toe. Clin. Anat. 21:713–717, 2008.

Morphometric comparison of the human corpus callosum in deaf and hearing subjects: an MRI study.

Auditory cortices are interconnected to each other by fibers passing through the corpus callosum (CC). In totally deaf persons no auditory impulses are conveyed to the auditory cortices, hence the auditory pathways become nonfunctional. It was reported that there has been cross-modal plasticity between auditory, visual, and somatosensory cortices. In this study, our aim was to make a comparison in the CC morphometry in hearing subjects and in a selected group in which the auditory system was deprived before the age of 2. 18 deaf and 18 hearing male, handedness matched volunteers, ages varying between 28 and 56 years old were examined. Audiometrical tests were applied to both groups and then T1-weighted midsagittal MR images were obtained. Certain dimensions and areas were measured on these images. There were no statistically significant difference between deaf and hearing subjects, either when dimensions and areas were analyzed by multivariate analysis of variance or when areas were analyzed by univariate analysis of variance. Absence of any significant morphometric difference in the CC of deaf subjects could be thought as an evidence of reflection of functional cortical plasticity.

Microsurgical anatomy and variations of the anterior clinoid process.

AIM The aim of this study was to better define the microsurgical anatomy of the supra/parasellar region and describe variations of the anterior clinoid process (ACP). MATERIAL AND METHODS Fifteen formalin-fixed cadaver heads and 25 dry skulls were used to define the microsurgical anatomy of the ACP and related structures. The presence of the caroticoclinoid foramen (CaCF) as well as other relevant measurements were all noted. Radiological examination of the CaCF was also demonstrated on dry skulls. RESULTS Interosseous bridges, which form between the anterior and middle clinoid processes or connect all three (anterior, middle and posterior) clinoid processes, were found in 30% of the specimens. The average basal width, length and thickness of the ACP were 7.3 mm, 9.7 mm and 5.4 mm, respectively. Length of the optic nerve (ON) up to the falciform ligament (FL) was 10.9 mm; length of the ON under the FL was 2.7 mm; length of ON after removal of the ACP and unroofing the optic canal was 21.1 mm. CONCLUSION This study contributes to the relationship of important vascular, neural, bone and dural layers of this region and also demonstrates the variations of ACP by means of microsurgical dissections and radiological examinations.

Bilateral congenital anophthalmos and agenesis of the optic pathways.

This report presents a rare example of a bilateral congenital anophthalmos and an agenesis of the optic pathways. The MR imaging studies revealed that the eyeballs, optic nerves, optic chiasm, optic tracts and optic radiation were absent. The chromosomal examination was normal. Mild mental retardation was also observed. Apart from the rarity of the anophthalmos and the total absence of the optic pathways, no etiologic reason for this pathology could be detected, which makes this case more significant.

Internal supravesical hernia accompanied with anomalous fold formations: a cadaveric case report

During the abdominal dissection of a 67-year-old male cadaver, an unusual peritoneal fold was encountered on the inner surface of the anterior abdominal wall. The peritoneal fold had two parts: the anterior part was located at the midsagittal plane including dispersed urachus remnants, the other part was located at the coronal plane with a triangular shape at the posterior edge of the sagittal part. Remnants of the umbilical arteries were ascending in the lateral margins of the coronal part. Accordingly, two peritoneal sacs were formed on both sides of this abnormal fold. Part of the small bowel herniated into the left peritoneal sac situated on the left side of the bladder. Although the aperture of the hernia sac was at the lateral side of the remnant of the umbilical artery which is concordant with the normal position of the medial inguinal fossa, the bottom of the sac was found to be located at the supravesical region. Therefore, this case was interpreted as an internal supravesical hernia with an unusual course. Although these rarely seen internal supravesical hernias in the literature were reported to be observed either preoperatively or postoperatively, to our knowledge our case is the first to be revealed in a cadaver which in detail enabled us to examine the features of this unique peritoneal variation and accompanying anatomic structures that caused hernia formation.

Morphometric properties of the levator scapulae, rhomboid major, and rhomboid minor in human fetuses

PurposeThe main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants.MethodsTwenty-five formalin-fixed fetuses (11 male–14 female) with a mean gestational age of 21.80 ± 2.61 (range 18–27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers.ResultsNeither sex nor side significant differences were observed in relation with the numerical data of levator scapulae, rhomboid major, and rhomboid minor (p > 0.05). Algebraic parameters such as surface area, width and length were detected to exhibit a linear growth from 18th to 27th week. Linear functions for levator scapulae, rhomboid major and rhomboid minor surface areas were obtained as y = − 136.871 + 10.598 × age (weeks), y = − 480.567 + 33.147 × age (weeks) and y = − 128.090 + 8.843 × age (weeks), respectively.ConclusionThe results and data of this study can potentially be beneficial in planning of surgeries for many infancy diseases such as trapezius paralysis, obstetrical brachial plexus palsy, Sprengel’s disease, or winged scapula. Linear functions calculated in this study are expected to provide a better understanding of the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor in fetal term and more precise estimation of muscle sizes.

Evaluation of the origin and branching patterns of the iliolumbar artery and its implications on pelvic and vertebral surgery

Objectives: To evaluate the origin, distribution pattern, branches, and neighboring structures of the iliolumbar artery (ILA) concerning the anterolateral surgical approaches to the spine. Methods: This study was performed in the Anatomy Department of Medical School, Mersin University, Mersin, Turkey between 2014 and 2015. Pelvises of 11 male formalin-fixed human cadavers were dissected by anterior and posterior approaches under surgical microscope. The origins, distribution patterns, calibers, and distances to certain structures were measured. Results: The ILA was found as a single trunk on 17 sides arising either from the IIA (12 sides, 70.6%) or the PT (5 sides, 29.4%). The average caliber of those originated from the posterior trunk was significantly larger (p=0.010). The ILA started as a single trunk in 17 sides, while its lumbar and iliac branches separately originating from different arteries in 4 sides. The close relation of the posterior rami of both the lumbar and iliac branches with transverse process and spinal nerve were noted. Conclusion: Findings suggest that the ILA and its branches may have different and significant patterns, which may be crucial to consider during certain surgical procedures, such as far lateral disc herniation and posterior pelvic fixations.

Morphometric properties of the tensor fascia lata muscle in human fetuses

BACKGROUND In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used. However, there are not enough data about structural properties of TFL in foetuses, which can be considered as the closest to neonates in terms of sampling. This studys main objective is to gather data about morphological structures of TFL in human foetuses to be used in newborn surgery. MATERIALS AND METHODS Fifty formalin-fixed foetuses (24 male, 26 female) with gestational age ranging from 18 to 30 weeks (mean 22.94 ± 3.23 weeks) were included in the study. TFL samples were obtained by bilateral dissection and then surface area, width and length parameters were recorded. Digital callipers were used for length and width measurements whereas surface area was calculated using digital image analysis software. RESULTS No statistically significant differences were found in terms of numerical value of parameters between sides and sexes (p > 0.05). Linear functions for TFL surface area, width, anterior and posterior margin lengths were calculated as y = -225.652 + 14.417 × age (weeks), y = -5.571 + 0.595 × age (weeks), y = -4.276 + 0.909 × age (weeks), and y = -4.468 + 0.779 × age (weeks), respectively. CONCLUSIONS Linear functions for TFL surface area, width and lengths can be used in designing TFL flap dimensions in newborn surgery. In addition, using those described linear functions can also be beneficial in prediction of TFL flap dimensions in autopsy studies.