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Structural variations of the sella turcica occur more often than might be supposed. Some of these may assume technical significance in surgery for intracranial aneurysm.
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In a young woman with an anomaly of the ocular motility evoking Brown's syndrome, an insertion anomaly of the superior oblique muscle, situated in the superior nasal quadrant 10 mm of the limbus, was found during operation. A stair-like tenotomy restored an almost normal motility.
Examinations were done on 1150 scapular bone specimens from museum collections. A localized hypoplasia of the posteroinferior glenoid was found in significant numbers (20%-35%) depending on the population group studied. Criteria were established for the identification of this variant in computed tomography and magnetic resonance studies. Localized hypoplasia of the posteroinferior glenoid was detected as an incidental finding in 54 (18%) of 300 such studies. Using these same imaging criteria in a prospective manner, 9 of 12 patients seen for voluntary multidirectional instability of the shoulder displayed a localized posteroinferior glenoid hypoplasia. This phenomenon also may add to the picture of extreme posterior glenoid wear that sometimes is seen in association with osteoarthritis of the shoulder.
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We report a case of radial sensory nerve entrapment caused by a variation of the brachioradialis tendon. The nerve passed through the split tendon and gliding was hindered at this level. After resection of the supernumerary dorsal part of the tendon, relief of pain could be achieved in the 40-year-old patient.
Anomalies of the anterior belly of the digastric muscle are not very rare. An anomaly in this region may have clinical significances. In this study, bilateral anomalies of the anterior bellies of both digastric muscles are presented. When an asymmetry in the floor of the mouth is detected during diagnostic procedures like radiologic studies, anomalies of the anterior belly of the digastric muscle should also be considered besides other reasons of asymmetry. Additionally, possible occurrence of this kind of anomalies should be remembered during surgical procedure involving this region.
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Sixty-five Nigerian and 34 Indian adult human skulls with full eruption of the 3rd molar teeth were examined to ascertain the location of the greater palatine foramen. The location of the foramen from the posterior border of the hard palate was quite consistent, being 0.35 cm in Nigerian and 0.37 cm in Indian skulls. The usually accepted description as opposite the upper 2nd molar was observed for only 13.1% of foramina in Nigerian skulls. The most common position of the foramen was found to be medial or opposite the 3rd maxillary molar, the next most common being between the 2nd and 3rd maxillary molars. The direction of opening of the foramen into the oral cavity was inferiorly in an anteromedial direction in 58.5% Nigerian and 91.1% Indian skulls. In 38.5% Nigerian skulls the opening was in an anterolateral direction. A bilaterally symmetric bony projection extending from the posterior margin of the foramen was observed in 24.6% of the Nigerian and 35.3% of Indian skulls. The palatal vault of was U-shaped in all instances, its height varying from flat to 0.3-0.8 cm.
A bilateral anomaly of deltoid muscles was found in cadaver dissection of a middle aged male. Posterior part of the muscle was enclosed with a separate fascial sheath. There was no concomitant muscular anomaly in any part of the body.
The frequency of an abnormally anterior insertion of scalenus anterior to the scalene tubercle on the superior aspect of the 1st rib was examined as a possible contributory factor to venous compression syndromes and to difficulties in cannulation of the subclavian vein. The insertion of scalenus anterior was exposed bilaterally in 21 adult cadavers and its position determined. The position of the scalene tubercle was also determined in a sample of 50 dried 1st ribs. The results were normalised for height. Three of the cadavers had position values that were above or at the upper point of the 95% confidence limits for the sample, indicating an abnormally anterior insertion. Two dried 1st ribs had values just below the lower 95% confidence limits, implying an abnormally posterior position. In the 3 cadavers with an abnormally anterior position, the subclavian artery and vein followed an abnormally anterior and inferior course with respect to the clavicle, and in 1 the subclavian vein was stenosed bilaterally at the costoclavicular angle. An abnormally anterior insertion of scalenus anterior may be a cause of venous compression syndromes in the root of the neck and give rise to difficulties when undertaking cannulation of the subclavian vein.
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Variations in the size and shape of the human vestibular aqueduct were evaluated in 118 plastic casts of unselected specimens of human temporal bones. They were examined by conventional radiography and by high resolution CT. The degree of the mastoid and perilabyrinthine pneumatization was defined and classified into 3 types. The dimensions of the peripheral portion of the aqueduct were found to be related to the extent of the perilabyrinthine pneumatization.
The human vestibular aqueducts are classified into 3 types and into the types hyper-, normo- and hypoplastic. The types correspond with each other up to over 85%. For a better understanding of the radioanatomy and for the proper interpretation of radiograms, we describe the presence of a flat recess-like widening of the peripheral portion of the aqueduct, as well as other findings.
PURPOSE: To obtain information on the morphology of the tympanic and mastoid portions of the facial nerve canal, and on the appearance of unusual vascular channels and anomalies such as dehiscences. MATERIAL AND METHODS: One hundred and two temporal bone preparations were examined by conventional radiography to evaluate mastoid pneumatization. Of these, 73 were examined by high resolution CT in order to test the ability of the method to detect dehiscences in the bony wall of the tympanic portion of the canal and the accompanying channels along its mastoid portion. Subsequently produced plastic preparations were used to measure the length and width of these 2 portions of the facial canal. RESULTS: Our study reports observations on the three-dimensional morphology of the canal in the plastic casts. The study shows variations in the course and dehiscences of the tympanic portion. Additional bony channels along the mastoid portion are described. These results supplement those in previous investigations. CONCLUSION: The measurement results agree with those of previous investigations. The course of the tympanic portion is S-shaped and has an impression on its upper surface. High resolution CT reproduces dehiscences of the bony canal in a percentage similar to that of microscopical methods and in relevant sites. Pneumatization does not influence the dimensions of the 2 portions.