This study investigated the distribution of reticular/type III collagen fibers within the human choroid-ciliary body complex and clarify their relationships with Bruch’s membrane, the sclera, and the trabecular meshwork. Central sagittal sections from 18 globes of 16 East Asian donors (36–94 years; mean age, 73.9 years) were examined using silver impregnation, type III collagen immunostaining, type I collagen immunostaining, and Masson’s trichrome staining. In the choroid, reticular/type III collagen fibers and predominantly type I collagen fibers were abundant in the choriocapillaris and choroidal stroma. In the sclera, reticular/type III collagen fibers were concentrated mainly in the lamina fusca and episclera, whereas predominantly type I collagen fibers were distributed throughout the sclera. No distinct fibrous continuity was identified at the choroid-sclera interface, except for limited posterior apposition to the lamina fusca without fiber interweaving. Bruch’s membrane showed little immunoreactivity for either type III or type I collagen, whereas the choriocapillaris basement membrane constituted its outermost layer. Fibers present between the ciliary body and the trabecular meshwork were positive for type I collagen but not type III collagen. The choroid contains abundant reticular/type III collagen fibers and predominantly type I collagen fibers, whereas Bruch’s membrane is structurally distinct from adjacent choroidal tissues. The choroid-sclera junction represents structural apposition rather than true fibrous fusion, while the ciliary body-trabecular meshwork junction is formed predominantly by type I collagen fibers.
Background Human temporal bone specimens are essential for studying inner ear pathology, age-related hearing loss, and cochlear implantation. However, limited availability and rapid postmortem degeneration of neurosensory structures remain major challenges. Aim To describe a standardised protocol for rapid postmortem human temporal bone retrieval and cochlear chemical fixation and to compare it with previously published methods. Methods PubMed/MEDLINE and Web of Science were searched for protocols published between January 2000 and October 2026, supplemented by Google Scholar and the Cochrane Library. Postmortem interval, retrieval technique, fixation, decalcification, embedding and downstream applications were compared with a standardised workflow of the Inner Ear Laboratory, Medical University of Innsbruck: bilateral en block retrieval, targeted within 12 h postmortem; perfusion through the oval and round windows; fixation with freshly prepared 4% formaldehyde; neutral-pH EDTA decalcification; embedding and serial sectioning. The protocol was validated in 40 donors (aged 61–97 years). Results Of 599 records identified, 19 studies were included, showing considerable variability in preservation methods and reporting standards. In our series, bilateral retrieval took a mean of 35.7 ± 7.2 min (median 32.5; range 25–50 min; n = 32 timed donors), and postmortem interval was below 24 h in 37 of 40 donors. The tissue was well preserved and suitable for histological and immunohistochemical analyses in most specimens evaluated. Conclusion We present an optimised workflow, compare it with the literature, and demonstrate that it yields tissue of sufficient quality for histological and immunohistochemical analyses.
PURPOSE The pyramidal lobe (PL) is a common anatomical variation and embryological remnant, with significant implications for surgical procedures and radioiodine therapy. This systematic review aims to determine the prevalence, structural variations, dimensions, and variations in blood supply, and the clinical significance of the PL. METHODS Following the PRISMA guidelines, a systematic search of PubMed, Embase, Web of Science and Google Scholar was conducted. After screening and risk of bias assessment, forty-six articles were included in this article. Data were extracted using extraction form; the prevalence was analyzed qualitatively, while other findings were summarized descriptively. RESULTS The reported prevalence of the PL varied widely across studies. Morphologically, pyramidal and conical shapes predominated, though rare variants like inverted Y-shapes were observed. The PL typically originated from the left thyroid lobe or the left side of the isthmus; however, midline origins, duplications, and complete separations were also noted. Dimensions such as length, width, and anteroposterior (AP) diameter also varied considerably. In the limited number of studies reporting vascular supply, the PL was most commonly supplied by the superior thyroid artery (STA) or its branches. CONCLUSION The variability across studies in terms of prevalence, shapes, and dimensions emphasizes the need for careful preoperative assessment. Surgeons should be aware of these anatomical nuances, as failure to identify and completely resect the PL can lead to surgical complications and compromise subsequent oncological or endocrinological treatment. Future research should prioritize standardized evaluation methods to resolve current data inconsistencies and optimize surgical outcomes.
PURPOSE The circumflex scapular artery (CSA) is an important vascular pedicle of the posterior shoulder region and is of major relevance in reconstructive and trauma surgery. However, its detailed topography, branching variability, and relationship to the medial axillary space (MAS) remain limited. This study aimed to investigate the branching pattern, morphometry, and topographic relationships of the CSA. METHODS Forty scapular regions from twenty formalin-fixed body donors underwent standardised, systematic bilateral anatomical dissection and morphometric analysis. The CSA's origin, course, branching pattern, vessel calibre, and distances to predefined bony landmarks were assessed. RESULTS The CSA originated from the subscapular artery in 36/40 specimens (90%) and directly from the axillary artery in 4/40 (10%). A cutaneous branch traversing the MAS and an anastomotic connection between the CSA and suprascapular artery were identified in all specimens. Three intrafossal branching patterns were observed: Type 1 in 22/40 specimens (55.0%), Type 2 in 15/40 (37.5%), and Type 3 in 3/40 (7.5%). No significant systematic side-related differences were observed in the morphometric parameters or branching-pattern distribution. Sex-related differences were observed for parameters a, b, c, A, and Tmi, with greater values in male donors after Holm correction. CONCLUSION The CSA demonstrates recurring intrafossal branching patterns with clinically relevant variability in branching architecture. These findings provide a practical framework for flap planning, intraoperative orientation, and reducing the risk of vascular injury in reconstructive and posterior shoulder surgery.
Background Primary cleft lip repair aims to restore both function and aesthetics of the nasolabial complex. Although several surgical techniques provide comparable functional outcomes, their long-term effects on facial symmetry remain unclear. This study compared postoperative facial symmetry following supraperiosteal and subperiosteal primary cleft lip repair using standardized photographic and digital anthropometric analysis. Methods This retrospective monocentric study included 46 patients with non-syndromic unilateral cleft lip and palate. Patients underwent either supraperiosteal repair or subperiosteal reconstruction. Standardized frontal photographs obtained at 0.5, 0.8, 6, and 10 years of age were analyzed. Facial asymmetry was evaluated by visual axis analysis and quantitative landmark-based measurements relative to predefined reference axes. Effect sizes were calculated using Cohen’s d. Results The subperiosteal repair group demonstrated consistently lower facial asymmetry and greater stability of symmetry development throughout follow-up than the supraperiosteal group. At 10 years, asymmetry of the cupid’s bow and lateral nasal wing was reduced by approximately 77% and 84%, respectively, while medial canthus asymmetry was reduced by 59%. The largest between-group differences were observed in the periorbital, nasal, and perioral regions, with large effect sizes for the medial canthus (d = 1.25), lateral nasal wing (d = 1.38), and cupid’s bow (d = 1.29). Conclusions Subperiosteal primary cleft lip repair was associated with improved long-term facial symmetry and greater stability of symmetry development over a 10-year follow-up period. Optimization of primary cleft lip repair techniques may improve long-term aesthetic outcomes and reduce the need for secondary corrective procedures.
