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Morphometric study of the ciliary ganglion and its pertinent intraorbital procedure

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Tesapirat L. , Jariyakosol S. , Chentanez V.

Folia Morphologica

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2020

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tom 79

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nr 3

EN

Background: Ciliary ganglion (CG) can be easily injured without notice in many intraorbital procedures. Surgical procedures approaching the lateral side of the orbit are at risk of CG injury which results in transient mydriasis and tonic pupil. This study aims to focus on the morphometric study of the CG which is pertinent to intraoperative procedure. Materials and methods: Forty embalmed cadaveric globes were dissected to observe the location, shape and size of CG, characteristics and number of roots reaching CG, number of short ciliary nerve in the orbit. Distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were measured. Results: Ciliary ganglion was located between optic nerve and lateral rectus in every case. Its shape could be oval, round and irregular. Mean width of CG was 2.24 mm and mean length was 3.50 mm. Concerning the roots, all 3 roots were present in 29 (72.5%) cases. Absence of motor root was found in 7 (17.5%) cases. Absence of sympathetic root was found in 4 (5%) cases. The number of motor root could be 1, 2 and also 3 roots. Three motor roots were found in 1 case which originated from nerve to inferior oblique muscle. Only one sensory root was found in every specimen. One sympathetic root could be observed in most of the specimens and 6–14 short ciliary nerves were found. Mean distances from CG to posterior end of globe, optic nerve, lateral rectus muscle and its scleral insertion were 16.04 mm, 1.47 mm, 2.88 mm, and 31.53 mm, respectively. Conclusions: This study described the characteristic of CG, number of its nerve root and some measurements relevant to intraorbital procedures in Asian population. Moreover, a new parameter was the distance between CG and scleral insertion of the lateral rectus muscle. This parameter should be considered when performing operation involved the lateral rectus muscle and BTX-A injection to lateral rectus muscle to reduce CG injury. (Folia Morphol 2020; 79, 3: 438–444)

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Co-existence of the double inferior vena cava with complex interiliac venous communication and aberrant common hepatic artery arising from superior mesenteric artery: a case report

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Chentanez V. , Nateniyom N. , Huanmanop T. , Agthong S.

Folia Morphologica

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2018

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tom 77

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nr 1

EN

Variations of the arterial and venous system of the abdomen and pelvis have important clinical significance in hepatobiliary surgery, abdominal laparoscopy, and radiological intervention. A case of double inferior vena cava (IVC) with complex interiliac communication and variation of the common hepatic artery (CHA) arising from superior mesenteric artery (SMA) in a 79-year-old male cadaver is presented. Both IVCs ascended on either side of the abdominal aorta. The left-sided IVC crossed anterior to the aorta at the level of the left renal vein. The union of both IVCs was at the level just above the right renal vein. The diameter of right-sided IVC, left-sided IVC and the common IVC were 16.73 mm, 21.57 mm and 28.75 mm, respectively. In the pelvic cavity, the right common iliac vein was formed by a union of right external and internal iliac veins while the formation of left common iliac vein was from the external iliac vein and two internal iliac veins. An interiliac vein ran from right internal iliac vein to left common iliac vein with an additional communicating vein running from the middle of this interiliac vein to the right common iliac vein. Another co-existence variation in this case was the origin of the CHA arising from the SMA with a suprapancreatic retroportal course. Clinical importance of double IVC are observed in retroperitoneal surgery, whole organ transplantation or radical nephrectomy, surgical ligation of the IVC or the placement of an IVC filter for thromboembolic disease. The variation of CHA has an important clinical significance in liver transplantation, abdominal laparoscopy and radiological abdominal intervention. (Folia Morphol 2018; 77, 1: 151–155)

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Morphometric study of the extraocular muscles in Thai population

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Surawatsatien N. , Papassornsiri Y. , Chentanez V.

Folia Morphologica

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2017

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tom 76

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nr 4

EN

Morphology of the extraocular muscles plays an important role in many ophthalmological surgeries and diagnostic imaging studies. Detailed understanding of length, width, point of insertion and the relationships between these muscles could be of significance for successful surgical outcomes. Forty-six orbital contents were extracted from formaldehyde-embalmed cadavers. Dissection was performed to reveal the extraocular muscles from their origins to insertions on the sclera. Muscle length, muscle width, distance from point of insertion to the sclerocorneal limbus, relationship between the superior oblique and superior rectus and between the inferior oblique and lateral rectus were measured. The lateral rectus and superior rectus were the longest muscles. The insertion of the medial rectus muscle was closest to the sclerocorneal limbus while the inferior rectus, lateral rectus and superior rectus insertions were progressively further apart. Only the length of the inferior rectus and medial rectus were significantly different between males and females. The distances between the superior oblique and superior rectus and between the inferior oblique and lateral rectus were slightly greater than in previous study. A direct comparison of these parameters between ethnic groups is still needed for an improvement of the procedural outcomes. (Folia Morphol 2017; 76, 4: 635–641)

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Morphometric study of the left atrial appendage related to closure device deployment: a cadaveric study in Thai population

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Panyawongkhanti M. , Fuktongphan P. , Chentanez V.

Folia Morphologica

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2020

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tom 79

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nr 1

EN

Background: This study aims to investigate the left atrial appendage (LAA) regarding external morphology, positional relation of the ostium of LAA to the left superior pulmonary vein (LSPV), ostium shape, ostium diameter and functional depth. Materials and methods: Left atrial appendages of 65 cadaveric hearts were examined. Results: The prevalence of Cauliflower, Windsock, Cactus and Chicken wing type of LAA were 27.7%, 27.7%, 26.1%, and 18.5%, respectively. LAA with two lobes was the most common. All specimens showed no accessory LAA. The relation of the ostium to the LSPV was found in two types which were mid-type (LAA ostium was at the same level as LSPV) in 29 (44.6%) cases and inferior type (LAA ostium was below the level of LSPV) in 36 (55.4%) cases. The shapes of LAA ostium were oval and round with a prevalence of 55.4% and 44.6%, respectively. The diameter of round type ranged from 9.53 to 21.51 mm with a mean of 14.56 ± 2.6 mm. While in oval type, the long and short diameters ranged from 11.61 to 31.71 mm with a mean of 14.23 ± 4.2 mm and from 6.70 to 23.90 mm with a mean of 11.66 ± 3.5 mm, respectively. The surface area of the ostium was calculated from the ostium diameter, range from 71.29 to 594.92 mm2 with a mean of 169.56 ± 84.73 mm2 . There was no statistically significant difference of the surface area between LAA types. The mean functional depth of LAA was 11.57 ± 4.43 mm. The functional depth of the Windsock-type appeared to be statistically significant from the others. However, there was no correlation between the functional depth and the ostium surface area. Conclusions: This morphometric data might be beneficial for deployment of LAA closure device in the Thai population. (Folia Morphol 2020; 79, 1: 79–85)

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Evaluation of the sciatic nerve location regarding its relationship to the piriformis muscle

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Wan-ae-loh P. , Huanmanop T. , Agthong S. , Chentanez V.

Folia Morphologica

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2020

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tom 79

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nr 4

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Morphometric study of inferior peroneal retinaculum and contents of inferior peroneal tunnel

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Dangintawat P. , Apinun J. , Huanmanop T. , Agthong S. , Chentanez V.

Folia Morphologica

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2019

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tom 78

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nr 3

EN

Background: The aims of this study are to investigate the inferior peroneal retinaculum (IPR) regarding morphometric parameters, and contents in the inferior peroneal tunnel (IPT). Materials and methods: One hundred and nine embalmed cadaveric legs were dissected in prone position. Results: The extension band of the IPR was found in 31.19% of cases. The mean of length, width at the origin, width at the middle part, width at the insertion, and thickness of the IPR [mm] were 23.42 ± 3.54 (17.05–33.68), 13.29 ± 2.56 (5.83–20.92), 14.50 ± 2.37 (6.68–21.34), 10.10 ± 2.63 (4.59–19.17) and 0.48 ± 0.16 (0.20–0.87), respectively. The angle of the IPR to the horizontal axis was 38.51 ± 7.07 (11.67–54.00) degrees. The IPT was divided into the upper and lower tunnels. The normal contents were the tendons of peroneus brevis and peroneus longus in the upper and lower tunnels, respectively. However, additional contents were found in the upper tunnel in 2 cases. One was the tendon of peroneus digiti quinti, and peroneus quartus in the other one. Moreover, an unusual accessory peroneal muscle coursed into the lower tunnel and inserted on the peroneal tubercle. Tears of the peroneus brevis tendon were observed in 2 cases. Conclusions: These morphometric data might be beneficial in surgical repair for IPR injury. (Folia Morphol 2019; 78, 3: 582–587)

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Multiple variations in the course and motor branching pattern of the musculocutaneous nerve with unusual communication with the median nerve

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Chentanez V. , Jaruprat P. , Udomchaisaku P. , Agthong S. , Huanmanop T.

Folia Morphologica

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2016

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tom 75

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nr 4

EN

Anatomic variations in course and motor branching pattern of the musculocutaneous nerve (MCN) with unusual communication with the median nerve were determined on the left arm of a 62-year-old formalin fixed male cadaver. The MCN did not pierce the coracobrachialis muscle. It provided 4 primary motor branches. The first branch emerged 1.5 cm inferior to the coracoid process to innervate the coracobrachialis muscle. The second branch emerged 8 cm inferior to the coracoid process to innervate the biceps brachii muscle. The third branch to brachialis muscle emerged 13.9 cm inferior to the coracoid process. The last branch to the common belly of biceps brachii muscle emerged 19.6 cm inferior to the coracoid process. Two communications with the median nerve were observed. The proximal thick communicating branch had the direction from the MCN to the median nerve while the distal one was a small nerve bundle with a direction from the median nerve to the MCN. The present report provided evidence of multiple variations in one MCN which had not been reported previously. Anatomic variation in this case has clinical implications, considering that injury of the MCN in the upper part of arm would cause unexpected paralysis of flexor muscles of forearm and thenar muscle due to communications between this and median nerve. (Folia Morphol 2016; 75, 4: 555–559)

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New aspect of morphometric study of the superior peroneal retinaculum: pertinent data for surgical repair and reconstruction

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Dangintawat P. , Apinun J. , Huanmanop T. , Agthong S. , Chentanez V.

Folia Morphologica

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2020

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tom 79

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nr 3