BACKGROUND: The vidian canal and the Keros classification are well-established computed tomography (CT) landmarks for preoperative skull base assessment. However, their anatomical relationship and their association with the sphenovomer suture–philtrum (SVS–philtrum) distance have not been comprehensively investigated. This study aimed to evaluate the relationship between Keros classification and vidian canal configuration and to determine whether the sphenovomer suture–philtrum distance is associated with either parameter. MATERIALS AND METHODS: This retrospective cross-sectional study included 348 adults who underwent paranasal sinus CT. Vidian canal configuration and Keros classification were assessed separately for the right and left sides, and the SVS–philtrum distance was measured on multiplanar CT images. Associations between ipsilateral Keros classification and vidian canal type were evaluated separately for each side. Age- and sex-adjusted general linear models were used to evaluate the associations of Keros classification and vidian canal type with SVS–philtrum distance. RESULTS: No statistically significant association was identified between ipsilateral Keros classification and vidian canal type on either the right (p = 0.167) or left (p = 0.529) side. In age- and sex-adjusted models, neither right-sided Keros classification (p = 0.612) nor right-sided vidian canal type (p = 0.257) was significantly associated with SVS–philtrum distance. Similarly, no significant associations were observed for left-sided Keros classification (p = 0.199) or left-sided vidian canal type (p = 0.230). SVS–philtrum distance was significantly greater in men than in women (71.80 ± 4.42 mm vs 65.28 ± 3.91 mm, p < 0.001). CONCLUSIONS: No statistically significant associations were detected between ipsilateral Keros classification and vidian canal type or between SVS–philtrum distance and the evaluated anatomical classifications. These findings persisted after adjustment for age and sex and suggest that strong relationships among these parameters were not evident in the present cohort. However, the absence of statistical significance should not be interpreted as evidence of anatomical independence.
BACKGROUND: This study aimed to describe the topographic and morphometric features of a cystic artery arising from the gastroduodenal artery and exhibiting both extra- and intratriangular segments. MATERIALS AND METHODS: The variation was identified during routine dissection of the hepatobiliary region of a formalin-fixed 56-year-old male cadaver. The extra-hepatic bile ducts and adjacent arterial structures were sequentially exposed. The origin, course, topographic relationships, length, and external diameter of the cystic artery were assessed. Photographic documentation was obtained during dissection. RESULTS: The cystic artery arose as a single trunk from the gastroduodenal artery. Its proximal segment coursed along the common bile duct and lay outside the hepatocystic triangle. The middle segment passed anterior to the cystic duct, whereas the distal segment entered the hepatocystic triangle and reached the gallbladder wall. The artery followed a relatively straight course and measured 4.1 cm in length. Its external diameter was 1.1 mm at its origin and 0.8 mm distally. No accessory cystic arteries, choledochal branches, or additional branches to adjacent structures were identified. CONCLUSIONS: The observed configuration combines an uncommon origin of the cystic artery with a transition from an extratriangular to an intratriangular position and an anterior course relative to the bile ducts. Awareness of this anatomical pattern may aid intraoperative vessel identification, interpretation of angiographic findings, and planning of endovascular procedures
BACKGROUND: The celiac trunk supplies the foregut and is a key landmark in upper abdominal, hepatobiliary, and endovascular procedures. Vietnamese population-specific data are scarce, and the branching geometry of the celiac division — along-vessel tapering and cross-sectional area expansion — has rarely been quantified. MATERIALS AND METHODS: Thirty-five formalin-fixed adult Vietnamese cadavers (20 male, 15 female; mean age 67 ± 13 years) were dissected. Length and proximal and terminal external diameters of the celiac trunk and the left gastric, splenic, and common hepatic arteries were measured; the trunk was measurable in 24 specimens. A taper ratio (terminal/proximal diameter) was derived for each vessel, and the ratio of summed branch cross-sectional area to trunk area was calculated for each specimen with complete data. Both indices are within-specimen ratios and are largely insensitive to fixation-related scaling. RESULTS: The left gastric artery was the narrowest branch (all adjusted p < 0.001). The splenic and common hepatic arteries had comparable proximal caliber (p = 0.587), but the splenic artery tapered markedly (taper ratio 0.74 ± 0.11 vs 0.91 ± 0.08 and 0.93 ± 0.18; p < 0.001). Summed branch area was 2.06 ± 0.70 times the trunk area (95% CI 1.77–2.36), exceeding the minimum- work optimum of 1.44 predicted for a symmetric trifurcation (p < 0.001). No association between vessel caliber and age or sex was detected (p ≥ 0.35). CONCLUSIONS: The left gastric artery is consistently the smallest branch, the splenic artery tapers distinctly along its course, and the celiac trifurcation shows a twofold area expansion. These ratio-based indices are robust to fixation and provide reference descriptors relevant to graft and stent sizing and to splenic arterial disease.
BACKGROUND: Variations in the azygos venous system (AVS) are not uncommon and underscore the need for proper classification and awareness to ensure accurate radiological interpretation and increased caution during surgical procedures. This study evaluated anatomical variations in the AVS in a South African donor population using the modified Anson and McVay classification. MATERIALS AND METHODS: This descriptive study included 60 adult South African donor bodies of both sexes. Fine anatomical dissections were performed to expose the AVS along with adjacent vertebrae. Photographic documentation and schematic illustrations were created to record observations. The AVS was classified into Types 1, 2, or 3 based on the number and anatomical relationship of retroaortic communications between the azygos and hemiazygos systems, following the classification described by Anson and McVay. The vertebral levels of these communications were also documented. RESULTS: Of the 60 donor bodies examined, Type 2 was the most frequently observed pattern, accounting for 90% (n = 54). Within this group, Group B was identified in 37.0% of cases (n = 20), while Group E was observed in 11.1% of cases (n = 6). Types 1 and 3 were each identified in 5% (n = 3) cases. In 60% of cases (36 out of 60), the left-to-right crossings of the azygos system occurred at the T7 and T8 thoracic vertebral levels. CONCLUSIONS: This study demonstrates notable anatomical variations in the AVS. Awareness of these variations is essential during mediastinal imaging to avoid misinterpretation as pathological conditions such as tumors, lymphadenopathy, or aneurysms.
BACKGROUND: The inferior hypogastric plexus, also known as the pelvic plexus, represents an important autonomic structure of the lesser pelvis, providing sympathetic and parasympathetic innervation to the pelvic viscera. This study aimed to investigate the detailed morphology, topography, and neural composition of its branches and secondary plexuses, including the vesical, prostatic, middle rectal, and uterovaginal plexuses, with particular emphasis on their terminal visceral branches and their anatomical variability. MATERIALS AND METHODS: A total of 50 formalin-fixed human cadavers were examined using macroscopic dissection and analysis performed under an operating microscope. Special attention was paid to surgically relevant structures, including the Walsh bundle. Immunohistochemical techniques were employed to characterize adrenergic and cholinergic fiber components within the examined structures. RESULTS: Adrenergic fibers were predominantly associated with periarterial pathways, whereas cholinergic fibers typically coursed independently of vascular structures. Contrary to some prior reports, the vesical plexus did not contribute fibers to the prostatic plexus; both plexuses were most often identifiable as distinct and independent nerve bundles. The vesical plexus showed a predominance of cholinergic fibers, while the prostatic plexus was mainly adrenergic. Rectal nerves within the mesorectum were largely cholinergic, with increased adrenergic contribution distally and convergence with somatic pudendal motor fibers. In females, the uterovaginal plexus followed the uterine artery, with predominantly adrenergic fibers in the vaginal part and mixed innervation in the uterine part. CONCLUSIONS: These findings may provide clinically relevant insights for nerve-sparing pelvic surgery and the prevention of iatrogenic damage, while offering an updated perspective on the functional organization of the autonomic innervation of the pelvis.
