A non-bifurcating cervical carotid artery (NBCCA) is a rare anomaly. Hypoplasia of the internal carotid artery (ICA) is also rare. To the best of our knowledge, their simultaneous coexistence has not been previously reported. We report a case of NBCCA associated with ipsilateral ICA hypoplasia diagnosed by magnetic resonance angiography (MRA). A 52-year-old woman was transported to our hospital by ambulance with severe headache. Magnetic resonance imaging revealed a large suprasellar mass. MRA showed impaired delineation of the right ICA and a 2-mm left ICA aneurysm. Extracranial MRA revealed a right NBCCA. Computed tomography showed a narrow right carotid canal. Right NBCCA concomitant with congenital hypoplasia of the ipsilateral ICA was diagnosed. Careful imaging assessment is important to identify these rare anatomical variants and associated aneurysms on the collateral pathway. Awareness of such variations is important in clinical practice, particularly for imaging interpretation and procedural planning.
Soft-tissue filler injection for non-surgical rhinoplasty carries a low but well-documented risk of severe vascular complications, including skin necrosis and irreversible vision loss. This study employed high-resolution Doppler ultrasound in healthy living volunteers alongside macroscopic cadaveric dissection to characterize nasal arterial topography from distinct anatomical perspectives, aiming to identify lower-risk injection planes. Thirty-five healthy Vietnamese adults (20 males, 15 females) underwent color Doppler ultrasound (12 MHz) at the radix, rhinion, and nasal tip to measure soft tissue thickness, arterial depth to skin, clearance to framework, distance to midline, and vessel caliber. Additionally, thirty hemifaces from 15 formalin-fixed Vietnamese cadavers were dissected to document arterial origins and morphological patterns. Data were analyzed using repeated-measures ANOVA and Generalized Estimating Equations. Macroscopic arteries were identified in 80.0
The superficial temporal artery (STA) is the principal donor vessel for extracranial–intracranial bypass, particularly the STA–middle cerebral artery (MCA) bypass. The present study aimed to characterise the topographic and morphometric anatomy of the STA common trunk and terminal branches, to establish surface mapping data for pre-operative planning, and to evaluate the suitability of terminal branches as bypass conduits in Vietnamese adults. Fifty hemi-head specimens from 25 embalmed Vietnamese adult cadavers were dissected. Topographic relationships between the STA, adjacent neurovascular structures (superficial temporal vein [STV] and auriculotemporal nerve [ATN]), and craniofacial landmarks were documented. Terminal branching patterns, outer diameters at defined levels, branch lengths to the 1-mm diameter threshold, branch angulations, and the parietal axis angle were measured. All STAs arose posterior to the mandibular neck. Terminal bifurcation was present in 90
Complete mesocolic excision requires central mesenteric dissection near the middle colic vein (MCV) confluence, where anatomic variability may increase operative risk. However, MCV multiplicity, confluence patterns, and relationships to the middle colic artery (MCA) are not sufficiently defined. We performed a retrospective secondary analysis of 300 consecutive three-dimensional vascular reconstructions from a prospectively maintained database of patients undergoing surgery for right-sided colon cancer (age 65 ± 9 years; 59
The sphenoid sinus is one of the most anatomically variable structures of the skull base. Its volume may be influenced by pneumatization patterns, septation, and the relationship to adjacent neurovascular structures, notably the internal carotid artery (ICA) and optic nerve (ON). The systematic review and meta-analysis assessed the influence of sphenoid sinus volume on pneumatization patterns, neurovascular protrusions, and accessory septa, as well as demographic variables such as sex and age. This systematic review and meta-analysis were conducted per PRISMA guidelines. Eligible studies involving anatomical and radiological studies of sphenoid sinus volume were included. Subgroup analyses were performed based on pneumatization type (conchal, presellar, sellar, postsellar), neurovascular protrusions, accessory septa, sex, and age. Twenty-seven studies involving 1263 observations were included. The pooled mean total sphenoid sinus volume was 9.30 cm3 [95
This study evaluated the performance of artificial intelligence (AI) chatbots in grading handwritten open-ended anatomy examinations and examined whether providing a standardized answer key improved agreement with lecturers’ grading. Examination papers from 81 s-year dental students were included. The examination comprised 10 open-ended questions, each worth 10 points. Two anatomists graded all papers using a standardized answer key, and the mean of their scores was used as lecturers’ grading. Four AI chatbots—ChatGPT, Gemini, Copilot, and DeepSeek—graded each paper under two conditions: without an answer key and with an answer key and detailed grading criteria. Agreement with lecturers’ grading was assessed using the intraclass correlation coefficient (ICC). Differences were observed among the nine grading methods (p < 0.001). No significant differences were found between lecturers’ grading and ChatGPT scores obtained either without or with the answer key. ChatGPT showed the highest agreement with lecturers’ grading after the answer key was provided (ICC = 0.923, 95
General growth as well as functional demands that are associated with developmental needs of young individuals are said to contribute to the changes in micro-architecture of maxilla. However, little is known about the nature of these changes on the maxilla, particularly across the different stages of dental development and eruption. Thus, this study aimed to assess variations in micro-architecture of the alveolar region of the human sub-adult and adult maxilla across different stages of dental development and eruption. The study sample included seventy-nine individuals, subdivided into three dentition groups: deciduous dentition (n = 28), mixed dentition (n = 9), and permanent dentition (n = 42). Maxillae were scanned using micro-computed tomography. Seven regions were selected in each dental crypt for evaluation of micro-architecture which included bone volume ratio, bone surface to bone volume ratio, trabecular thickness, trabecular number, and trabecular spacing. The micro-architecture of the maxilla changed from a more porous to a less porous nature, following patterns of remodeling that are due to the general process of bone growth and related functional demands. These changes included an increase in bone volume fraction while bone surface to volume ratio and trabecular number both significantly decreased. The observed changes reflect the normal growth differences, the state of the dentition, as well as the functional adaptation of the oral cavity.
To assess the perception of French medical students regarding the use and place of real (traditional) and virtual dissections in learning Anatomy. A questionnaire was offered to all students in an optional course semester that combined real and virtual dissection. The questionnaire was also offered to near-peer tutor students (tutors). The questionnaire included closed (quantifiable) questions and open-ended questions, attempting to distinguish the advantages and disadvantages of both methods according to anatomical regions. Twenty students and 6 tutors filled the questionnaire. All students agreed that the virtual dissection table is useful for learning anatomy, though most (10/20 strongly) disagreed that it could replace traditional cadaveric dissection. Real dissection was considered significantly superior to virtual dissection for cardiac, thoracic, lung, and abdominal anatomy and myology (p < 0.05). A preference trend toward the virtual dissection table was observed for central neuroanatomy, peripheral neuroanatomy, and angiology, although this did not reach statistical significance (p > 0.05). A positive correlation was found between the ease of tool appropriation and its perceived pedagogical benefit. Real and virtual dissections are complementary rather than competitive. This study advocates for a tailored pedagogical model where the choice of modality is guided by the specific anatomical region and its inherent technical constraints.
To provide an updated, clinically oriented review of the iliotibial band (ITB), emphasizing its surgical anatomy, biomechanical relevance, imaging correlates, and role in knee ligament reconstruction, with a focus on lateral extra-articular tenodesis (LET) and anterior cruciate ligament (ACL) augmentation. A structured narrative review was conducted, summarizing anatomical, biomechanical, radiological, clinical, and surgical literature. Key elements included gross and histological anatomy of the ITB, its relationship with Kaplan fibers and anterolateral capsulo-fascial structures, imaging assessment using MRI and ultrasound, and evidence supporting ITB-based procedures in selected ACL reconstruction settings. The ITB functions as both a passive and dynamic stabilizer of the lateral knee and contributes to control of internal tibial rotation, particularly in ACL-deficient or high-risk knees. Its deep capsulo-osseous component, including the Kaplan fibers, forms part of the broader anterolateral restraint system. MRI and ultrasound may support anatomical correlation and evaluation of associated lesions, but imaging findings should be interpreted as complementary to clinical assessment rather than as independent determinants of LET indication. In selected high-risk populations, including young pivoting-sport athletes, revision ACL patients, and patients with generalized laxity, ITB-based LET has been associated with improved rotatory control and reduced graft failure risk when appropriate tensioning principles are respected. The ITB is a clinically relevant anatomical and biomechanical structure in contemporary ACL reconstruction. Its layered architecture and relationship with Kaplan fibers help explain the rationale for selective LET augmentation. Current evidence supports ITB-based LET as an adjunct in appropriately risk-stratified patients, while imaging should be viewed as supportive for anatomical correlation and associated pathology rather than as a stand-alone basis for surgical decision-making. V (Narrative review).
The lateral femoral cutaneous nerve (LFCN) is a sensory nerve providing cutaneous sensation to the anterolateral thigh. Injury to the LFCN is a known complication of quadriceps tendon (QT) autograft harvest during anterior cruciate ligament (ACL) reconstruction. While the proximal course of the LFCN is well described, its distal anatomy relative to the QT remains poorly defined. This study evaluated the distal course of the LFCN to identify zones of reduced iatrogenic injury during QT harvest. Twenty-nine lower extremity specimens from 17 formalin-embalmed cadavers were dissected to expose the LFCN and define its distal anatomy relative to the QT. Distances from the endpoint to five predefined QT landmarks were measured, and univariate linear regression assessed associations between donor height and LFCN-QT clearance. Group comparisons evaluated differences by height and sex. Twenty-nine lower extremities (16 female, 13 male) were analyzed. Mean LFCN-QT clearance was smallest at the superior QT border (37.4 ± 34.6 mm) and greatest at the inferior QT border (101.9 ± 46.2 mm). Donor height was positively associated with clearance at all landmarks (all p < 0.05). Female donors demonstrated reduced clearance on unadjusted analysis; however, these differences were no longer significant following adjustment for height. The LFCN is at greatest risk of injury near the superior QT border, where LFCN-to-QT clearance is lowest. Shorter individuals demonstrated reduced clearance distances overall, suggesting height may be a more relevant predictor of LFCN-QT clearance than sex. These findings support individualized surgical planning during QT autograft harvest to minimize iatrogenic LFCN injury.
Precise knowledge of the spatial relationships of abdominal aortic branches is essential for safe colorectal surgery and interventional radiologic (IR) procedures. While most studies describe these vessels from an external or imaging perspective, intraluminal morphometric data relevant to catheter-based navigation remain limited. This study aimed to evaluate the positional relationships and morphometry of major abdominal aortic branches from an intravascular perspective. Intravascular dissections were performed in 19 formalin-embalmed cadavers (12 males, 7 females; age range 50–96 years) after exclusion of one specimen with para-aortic pathology. Morphometric parameters of the celiac trunk (CT), superior mesenteric artery (SMA), inferior mesenteric artery (IMA), and left renal artery (LtRA) were measured relative to the aortic bifurcation (BA). Longitudinal, linear, and transverse distances, vessel diameters, and branching angles were obtained using calibrated instruments and analyzed statistically. The longitudinal distance between the CT and SMA was 19.48 ± 4.41 mm. The angle between the transverse aortic axis and the SMA–IMA trajectory was 89.03 ± 3.59°, demonstrating relative angular consistency. A strong positive correlation was identified between LtRA–CT and LtRA–SMA longitudinal distances (r = 0.846, p = 0.001). While the CT–SMA relationship was relatively stable, the SMA–IMA interval exhibited greater variability (p = 0.05). This morphometric study of the lumen provides quantitative spatial data of the major abdominal aortic branches. These findings suggest that the LtRA is a reliable intraluminal landmark and provide further evidence for stable angular relationships between mesenteric vessels. These findings might be helpful for vascular navigation, but their clinical use requires further validation in prospective studies.
This study aimed to quantify the biomechanical strain of the human cervical spinal dura mater in fresh-frozen versus embalmed (formalin-fixed) states, elucidate the impact of formaldehyde fixation on its mechanical response, and provide evidence-based guidance for specimen selection in spinal biomechanical research. A paired repeated-measures design was employed using 20 fresh cadaveric specimens (10 male, 10 female; 35–40 years). After initial testing in the fresh-frozen state (− 20 °C storage, slow thawing), specimens were fixed in 20
This report describes an exceptionally rare case of an incidental angiographic fenestration of a dominant right transverse sinus (TS) associated with a Kobayashi type 4B torcular variant in a 54-year-old patient who presented with a coexisting intracranial arterial aneurysm. While TS fenestrations are known from cadaveric studies and non-invasive imaging, high-resolution dynamic digital subtraction angiography (DSA) documentation of an isolated TS fenestration in vivo remains exceptionally scarce in the literature. The patient initially underwent computed tomography angiography (CTA), which identified the arterial aneurysm and a suspicious image in the right TS. Subsequently, a DSA was performed for definitive neurovascular evaluation. While the arterial phase characterized the aneurysm, the late venous phase incidentally revealed a TS fenestration, coexisting with a Kobayashi type 4B torcular configuration. This case underscores the importance of a meticulous evaluation of the cerebral venous phase during DSA. Precise knowledge of this dual-lumen dural variant is critical for neurosurgeons and neurointerventionalists, as its presence on the hemodynamically dominant side significantly influences surgical corridors and endovascular navigation strategies required to manage concurrent neurovascular pathologies safely.
The tibialis anterior tendon (TAT) typically divides into two slips inserting onto the medial cuneiform and first metatarsal. This report describes an unusual undivided TAT inserting simultaneously onto both bones. During dissection of a 74-year-old Korean female cadaver, an undivided TAT was observed crossing the first tarsometatarsal joint and attaching to both the medial cuneiform and first metatarsal. The total attachment width was 18.9 mm, with 8.68 mm (45.9
Accessing the anterolateral maxillary sinus is challenging. The endoscopic pre-lacrimal recess approach (PLRA) involves removing the medial wall of the pre-lacrimal recess (PLR) between the piriform aperture (PA) and the nasolacrimal duct (NLD) while preserving the inferior turbinate and NLD. We studied the radiologic dimensions of the medial wall of the PLR to assess the feasibility of this approach across different maxillary sinus pathologies. A retrospective analysis of 104 triplanar CT scans (208 sides) was conducted in patients with maxillary sinus pathologies. Anteroposterior distances from the piriform aperture (PA) to the NLD were measured at three axial levels (inferior, middle, superior). Vertical height from the nasal floor to the orbital floor was recorded. Data were compared between sides using paired t-tests, and between sexes using patient-level averaged values to account for within-patient clustering; level differences were assessed with repeated-measures ANOVA and post-hoc Bonferroni-corrected paired testing. Mean anteroposterior distances were: inferior, 6.8/6.9 mm (right/left); middle, 5.7/5.8 mm; superior, 4.7/4.7 mm. Mean vertical height was 25.1/25.0 mm. All level-to-level differences were significant (p < 0.0001). Males showed a trend toward greater dimensions at all levels, though this did not reach statistical significance after accounting for within-patient clustering (p = 0.08–0.09); vertical height remained significantly greater in males (p < 0.0001). Bilateral symmetry was observed for most measurements. The PLR medial wall shows significant interindividual variation, with the widest anteroposterior corridor consistently located inferiorly and a vertical height reliably exceeding 20 mm. Individualized preoperative CT assessment is essential when planning the PLRA.
Complex aortic arch branching variants with multiple direct branches and variant vertebral artery origins are rare and typically incidental. We report a postmortem-confirmed case of a rare five-vessel aortic arch configuration identified in a 65-year-old man who underwent elective mitral and tricuspid valve repair for severe mitral regurgitation. The postoperative course was complicated by delayed neurological deterioration and fatal tonsillar herniation. Examination of the thoracic aorta revealed a five-branch aortic arch consisting of the right common carotid artery, left common carotid artery, left vertebral artery arising directly from the arch, left subclavian artery, and an aberrant right subclavian artery with a retroesophageal course. The right vertebral artery originated anomalously from the proximal right common carotid artery. This rare vascular configuration highlights the embryological complexity of multi-branch aortic arch variants and suggests potential implications for vertebrobasilar perfusion during cardiothoracic procedures. Recognition of such variants through careful preoperative imaging of the supra-aortic vessels may help reduce unforeseen perioperative risks.
Situs ambiguous with polypsleny or heterotaxy syndrome is a rare occurrence in vascular surgery. We report, for the first time in the literature, the association of situs ambiguous with polyspleny with an infrarenal aortic aneurysm. CT-scan performed to evaluate the aortic aneurysm incidentally revealed the situs ambiguous. CT-scan was analysed to report all anomalies of situs ambiguous in this patient. This article provides an update on the various abdominal anomalies encountered in situs ambiguous. This syndrome is poorly known in vascular surgery, particularly with regard to its surgical implications.
The optic canal represents a critical surgical landmark during endoscopic endonasal and transcranial skull base procedures. Variations in canal orientation and its relationship with the internal carotid artery (ICA) may directly influence surgical safety. Cranial computed tomography angiography (CTA) datasets of 100 adults (50 males and 50 females) were retrospectively evaluated. Bilateral optic canal transverse diameters, canal length, distance from the midline, angular orientation, and optic canal–ICA distance were measured using multiplanar reconstructed images. Significant side-related differences were observed in optic canal position relative to the midline (right: 11.25 ± 2.62 mm, left: 10.08 ± 2.92 mm; p < 0.001) and angular orientation (right: 53.88 ± 9.50°, left: 62.26 ± 11.58°; p < 0.001). No significant side differences were identified for canal diameter, length, or optic canal–ICA distance. The mean optic canal–ICA distance was approximately 2.2 mm, indicating a narrow surgical safety margin. Sex-related differences were limited to selected morphometric parameters. Optic canal morphology is characterized by substantial variability in spatial orientation and side-related asymmetry. In addition to linear dimensions, canal trajectory and its relationship to the ICA represent critical determinants of the surgical corridor. Preoperative CTA evaluation may contribute to safer and more individualized planning of skull base procedures.
The thoracic splanchnic nerves—greater (GSN), lesser (LSN), and least (lSN)—are important targets in thoracic surgery and image-guided interventions, yet detailed quantitative characterization of their anatomy remains limited. This study aimed to define the morphometry, segmental origins, and anatomical variability of these nerves to improve understanding of clinically relevant anatomy. Eighty sets of thoracic splanchnic nerves from 42 formalin-embalmed donors were dissected. Segmental contributions were recorded and classified, and morphometric measurements were obtained relative to the sympathetic trunk, transverse processes, midline, and aorta. Statistical analyses were performed to evaluate differences in morphometric parameters by configuration, laterality, and sex. The GSN was present in 100
To evaluate the effect of forearm rotation on the spatial relationship between the median nerve and the ulnar artery at the carpal tunnel inlet using ultrasonography, and to characterize position-dependent anatomical variations in the transverse interval relevant to the ultrasound-defined safe zone. This prospective observational study included 120 healthy adult volunteers (60 females, 60 males; age range 18–45 years). Ultrasonographic measurements were obtained at the carpal tunnel inlet in three standardized forearm positions: supination, neutral, and pronation. The cross-sectional area of the median nerve and its distances to adjacent anatomical landmarks, including the ulnar artery, pisiform, and scaphoid tubercle, were measured. Participants were stratified by sex and palmaris longus tendon presence. Statistical comparisons were performed to assess position-dependent changes and subgroup differences. Forearm pronation resulted in a significant increase in the distance between the median nerve and the ulnar artery compared with neutral and supinated positions (p < 0.05), indicating widening of the ultrasonographically defined transverse interval. The cross-sectional area of the median nerve also increased in pronation. No significant differences were observed based on palmaris longus tendon presence. Sex-based differences were identified, with larger absolute measurements in males. Effect size analysis demonstrated large position-dependent effects for median nerve displacement parameters. Forearm pronation is associated with widening of the median nerve–ulnar artery interval at the carpal tunnel inlet in healthy adults. These findings describe a position-dependent anatomical variation that may be relevant to future studies of pronation-based injection planning; however, procedural application requires clinical validation.
