Background The arcade of Frohse (AF) is a potential site of compression of the deep branch of the radial nerve (DBRN). However, its direct anatomical relationship with the nerve has not been systematically characterized using standardized macroscopic criteria. This study aimed to develop a classification of the AF–DBRN relationship, assess interobserver agreement, and investigate selected morphometric associations. Methods Forty-two formalin-fixed upper limbs from 29 donors were examined. The AF–DBRN relationship was classified as type 0 (no direct contact), type 1 (direct contact without visible nerve deformation), or type 2 (direct contact with macroscopic nerve deformation). Two investigators independently classified all specimens. DBRN cross-sectional area (CSA) was estimated from anteroposterior and mediolateral dimensions at three anatomical levels. The central-to-proximal CSA ratio was calculated in 36 limbs from 23 donors. Exploratory comparisons were supplemented by donor-clustered regression and exhaustive one-limb-per-donor sensitivity analyses. Results Types 0, 1, and 2 were identified in 12 (28.6%), 14 (33.3%), and 16 (38.1%) limbs, respectively. Initial interobserver agreement was 92.9% (unweighted Cohen's κ = 0.892; linearly weighted κ = 0.918). Median central-to-proximal CSA ratios were 1.01, 0.88, and 1.65 for types 0, 1, and 2, respectively. The ratio differed among relationship types in the original limb-level analysis (Kruskal–Wallis H(2) = 9.88; nominal p = 0.0071). Pairwise comparisons demonstrated differences between type 2 and types 0 and 1 after Holm adjustment (p = 0.032 and p = 0.018, respectively). An exploratory donor-clustered regression also indicated an association between relationship type and the log-transformed CSA ratio (F(2,22) = 4.69; p = 0.0201). Across all 8192 one-limb-per-donor configurations, the median ratio for type 2 exceeded that for types 0 and 1 combined, although nominal statistical significance varied between configurations. Conclusions The proposed classification demonstrated high interobserver agreement under standardized cadaveric conditions. Type 2 was associated with a higher estimated central-to-proximal CSA ratio, although this finding remains exploratory and does not establish pathological nerve compression. The classification provides a standardized anatomical framework that may facilitate future anatomical, imaging, biomechanical, and clinical investigations. Independent validation using direct nerve-area measurements, blinded morphometry, and dynamic assessment is warranted.
Background The superior epigastric artery (SEA) supplies the upper rectus abdominis and is relevant to perforator and rectus-based flaps and epigastric port placement. Data from Vietnam are lacking, and the effect of specimen preparation on SEA branch counts is unknown. Objective To describe SEA morphology in Vietnamese cadavers and to compare its branching between two preparation protocols. Material and methods The right SEA was dissected in 35 adult cadavers: 15 formalin-embalmed, uninjected and 20 fresh-frozen, methylene blue-injected. Origin, course, calibre, branching and linear distances were compared between groups and sides. Results The SEA originated between the superior border of the sixth and the inferior border of the seventh costal cartilage in all specimens and ran superficial to the transversus thoracis in every right-sided specimen. Mean external diameter was 1.96 ± 0.71 mm, and the largest perforating branch measured 1.56 ± 0.50 mm. Fresh-frozen, dye-injected specimens showed more primary branches than embalmed ones (6.90 ± 2.10 vs. 4.00 ± 1.20), a higher prevalence of division into two terminal branches (15/20 vs. 1/15) and of paired venae comitantes (20/20 vs. 7/15); this difference was reproduced on the left. The origin lay at the sixth rather than the seventh costal cartilage more often in fresh-frozen specimens (14/20 vs. 3/15), whereas the origin-to-midline distance, age and sex did not differ between groups. Conclusion SEA origin, course and calibre in this Vietnamese series agree with other populations and suit its use as a flap pedicle. Branch counts depended strongly on the preparation protocol; because preservation and dye injection varied together, their separate contributions cannot be resolved; both should be reported in cadaveric vascular studies.
Background The persistent foramen of Huschke (foramen tympanicum) is a developmental osseous opening of the tympanic plate that may provide a communication between the external auditory canal and the temporomandibular joint (TMJ) region. Focal tympanic-plate thinning and acquired dehiscence can resemble a persistent foramen radiologically but represent distinct morphologic categories. Objective To map developmental persistence, morphology, morphometry, demographic patterns, imaging features, and clinical associations of the persistent foramen of Huschke. Methods: PubMed/MEDLINE was searched from database inception (without a lower publication-year limit) to 16 September 2026; OpenAlex/Crossref metadata, journal and publisher websites, and bidirectional citation tracking provided supplementary discovery. Eligible human osteological and cross-sectional imaging studies were charted descriptively by sampling frame and analytic unit; pooling was not undertaken because study populations and ascertainment methods differed. Results Forty-four primary studies were included (13 osteological/developmental and 31 imaging studies). Reported frequencies ranged from 0.7% in an early anatomical series to approximately 38% in selected skull collections; estimates from TMD and necrotizing external otitis cohorts were analyzed separately from routine imaging cohorts. Most imaged patent defects were oval and approximately 1–4 mm. Sex and laterality findings varied. Cross-sectional age associations do not demonstrate closure, enlargement, or progression within individuals. Conclusion A patent developmental foramen, intact focal tympanic-plate thinning, and acquired osseous dehiscence require separate characterization. Standardized morphology, acquisition reporting, and explicit individual- and side-level denominators will improve future anatomical and imaging comparisons.
Background Penile anomalies encompass conditions affecting the size, curvature, number, or appearance of the male external genitalia. Some are congenital, resulting from embryological defects, whereas others are acquired because of trauma or other factors. These conditions are of significant concern because of their potential impact on sexual function and fertility. Methods A systematic PubMed search was conducted from inception through June 2026 using terms related to penile torsion, chordee, inconspicuous penis, buried penis, webbed penis, trapped penis, micropenis, aphallia, and diphallia. Backward citation was also performed. Studies addressing pathophysiology, epidemiology, clinical presentation, diagnostic evaluation, or management were included. Non-English articles, animal studies, letters, editorials, expert opinions, and other descriptive reports were excluded. Study selection followed PRISMA guidelines. Results Of 496 identified articles, 63 met eligibility criteria. Ten studies evaluated penile torsion in 525 patients, and ten evaluated chordee in 706 patients, with surgical correction predominant for both conditions. Three studies evaluated inconspicuous penis in 187 patients. Fourteen evaluated buried penis, three webbed penis and one trapped penis. Seven studies evaluated micropenis in 153 patients, with testosterone therapy and surgical management associated with increased penile length. Ten studies evaluated aphallia in 44 patients, and five evaluated diphallia in six patients; both were frequently associated with genitourinary and other congenital abnormalities. Conclusion Penile anomalies demonstrate differences in presentation, severity, and management of penile anomalies. Treatment ranges from conservative medical therapies to complex reconstructive surgery. Understanding their etiology, pathophysiology, diagnostic evaluation, and appropriate management is crucial for optimizing patient outcomes.
