2026-03-27
Furkan Ozbey, Elif Sadik
Background: The anterior nasal spine (ANS) is a critical anatomical landmark with surgical, orthodontic, and forensic significance. This study aimed to evaluate the morphometric and morphological features of the ANS using cone beam computed tomography (CBCT) and to analyze their relationship with age and gender. Materials and methods: A total of 979 CBCT scans (561 females, 418 males; age range 18–80 years) were retrospectively examined. Linear (length, width) and angular measurements of the ANS were performed in axial and sagittal sections. Morphological assessment was conducted based on four predefined shape categories: triangular, irregular, single rod, and double rod. Statistical analyses included nonparametric tests, correlation analysis, and reliability assessment with intraclass correlation coefficients (ICC) and Weighted Kappa. Results: Mean ANS dimensions were 9.19 ± 2.06 mm (axial length), 5.56 ± 1.86 mm (sagittal length), 108.94° ± 12.51 (axial angle), 70.14° ± 16.26 (sagittal angle), and 5.72 ± 1.92 mm (width). Significant gender differences were observed in all parameters except width (p > 0.05). A weak positive correlation was found between width and age (p = 0.047). The triangular shape was the most prevalent (54.5%), followed by double rod (23.1%), single rod (13.4%), and irregular (9%). Shape distribution also showed significant gender variation. Reliability analysis indicated excellent agreement (ICC: 0.932–0.998). Conclusions: CBCT-based morphometric analysis revealed gender-specific differences in ANS dimensions and morphology. These findings emphasize the clinical importance of the ANS in surgical planning and orthodontics, as well as its potential value in forensic and anthropological identification.
2026-03-19
Yann Lelonge, Florian Camy, Florian Bergandi, Asimakis Asimakopoulos
Background: Conventional embalming relies on arterial cannulation, which may be difficult when vessels are diseased, inaccessible, or damaged. Intraosseous (IO) vascular access, widely used in emergency medicine, provides a rapid and reliable route into the medullary venous system. This technical note describes a simple IO embalming protocol and assesses its feasibility and performance in human cadavers. Materials and methods: IO access was established in cadavers using bone-marrow needles inserted into the proximal tibia, distal femur, sternum and iliac crest. Standard formaldehyde-based embalming solution was infused using a low-pressure pump. Outcomes were assessed qualitatively by evaluating perfusion patterns, fixation quality, tissue handling, and presence of leakage. Results: IO access was quick and dependable, requiring no arterial dissection. The proximal tibia provided the easiest insertion, while the iliac crest allowed the broadest diffusion, particularly toward thoraco-abdominal regions. All specimens demonstrated adequate firmness, coloration, and structural preservation suitable for anatomical education. Conclusions: IO injection is a practical and minimally invasive alternative to arterial cannulation for cadaver embalming. It reduces procedural complexity, limits exposure to biological fluids, and provides adequate fixation for teaching and research.
2026-03-19
Grzegorz Fibiger, Jonasz Tempski, Jakub Wilczek, Katarzyna Majka, Maksymilian Osiowski, Aleksander Osiowski, Szymon Matejuk, Tomasz Kozioł, Aleksandra Malik, Wojciech Fibiger, Jerzy A. Walocha, Przemysław Pękala
Background: The median sacral artery (MSA) is a small but clinically significant artery arising from the aortic bifurcation and travelling along the anterior sacrum. It supplies the lumbar and sacral vertebrae and, in some cases, parts of the rectum. Despite its size, the MSA is crucial in regional circulation and is particularly relevant in spinal, pelvic, and vascular surgeries. This meta-analysis aims to provide a comprehensive synthesis of anatomical evidence regarding the MSA’s origin, variations, and surgical relevance. Materials and methods: A systematic search was conducted in major databases (PubMed, Embase, ScienceDirect, Scopus, Web of Science, and SciELO) up to January 2025. Studies reporting anatomical data on the MSA, including its origin, variations, and clinical significance, were included. A total of 13 studies (n = 1,007 arteries) met our criteria. Results: The MSA originated directly from the aorta in 89.98% (95% CI: 84.05–95.92%) of cases. In 8.27% (95% CI: 3.29–13.25%), it shared a common origin with a lumbar artery, typically the 4th lumbar artery (97.86%). The 5 th lumbar artery variation was very rare (0.66%). Regarding its position relative to the sacral midline, the MSA was found on the left (48.80%), right (31.32%), or directly along the midline (13.35%). The mean distance from the midline was 3.54 mm. Conclusions: Recognizing MSA variations is essential for surgical planning to prevent vascular injury during spinal and gynaecological procedures. Further cadaveric and imaging studies are needed to enhance procedural safety.
2026-03-04
Stancho Stanchev, Lyubomir Gaydarski, Iva N. Dimitrova, Georgi Kotov, Boycho Landzhov, Vidin Kirkov, Alexandar Iliev
Background: Arterial hypertension is a primary risk factor for kidney disease. Recent advances have implied a potential link between the apelin system and renal homeostasis. Materials and methods: The authors used 6- and 12-month-old spontaneously hypertensive rats and age-matched normotensive controls to assess changes in the renal expression of the apelin receptor by the immunohistochemical method. The study also evaluated correlations between the renal apelin receptor’s expression and renal injury indicators. Results: Histological analysis showed elevated glomerular sclerosis and tubulointerstitial damage indices in both groups of hypertensive rats compared to age-matched controls. Older rats within each group exhibited higher scores than younger ones. Immunohistochemical analysis revealed varying apelin receptor expression patterns, with tubular expression intensifying with both hypertension severity and age. Glomerular expression was notably higher in older hypertensive rats compared to normotensive controls. The authors found significant positive correlations between glomerular apelin receptor expression and glomerular sclerosis index in older hypertensive animals. Similarly, a positive correlation between tubular apelin receptor expression and tubulointerstitial damage index was discovered in hypertensive rats, suggesting hypertension-related changes in apelin receptor expression and renal damage. Conclusions: This study found kidney changes and varying apelin receptor correlations in hypertensive rat kidneys, suggesting complex roles requiring further research.
2026-03-02
Seul Ki Kim, Jin Seo Park, Mi-Sun Hur
Background: This study integrated high-resolution sectioned images withultrasound imaging to investigate the sequential anatomical transitions of the dorsa l wrist, with a particular focus on bony morphology and the positioning of extensor tendons. Materials and methods: High-resolution real-colour sectioned images of the dorsal wrist were obtained from a 70-year-old male cadaver, and ultrasonographic images were acquired from a healthy 31-year-old female volunteer. Serial axial sectioned images at 1-mm intervals and corresponding transverse ultrasonographic images were analysed along the same proximodistal axis to assess changes in carpal bone morphology and associated shifts in extensor tendon trajectories. Notable patterns included the radial migration of the extensor pollicis longus tendon and the convergence of the extensor carpi ulnaris and extensor digiti minimi tendons. Results: These dynamic spatial relationships provide valuable clinical insights for differentiating normal anatomical variation from tendon displacement or injury. Sequential imaging demonstrated level-dependent changes in carpal bone morphology associated with characteristic shifts in extensor tendon trajectories, including radial migration of the extensor pollicis longus tendon and convergence of the extensor carpi ulnaris and extensor digiti minimi tendons. Conclusions: The integration of detailed anatomical visualization with ultrasound assessment enhances diagnostic accuracy, facilitates safer minimally invasive procedures, and informs surgical planning for dorsal wrist pathologies.
2026-03-02
Bartosz Kołodziejczyk, Izabela Zamojska, Joanna Jaworek-Troć, Julia Łukasik, Ilona Klejbor, Janusz Moryś, Jerzy A. Walocha
While anatomical variations in both aortic arch branching and rib cage development are considered relatively common, compared to various other anomalies, their coexistence seems to be underreported. We present a case report of a 70-year-old Polish woman with bilateral complete cervical ribs forming a pseudoarthrosis with the superior surface of the first ribs, and an aberrant right subclavian artery (arteria lusoria) with a retroesophageal course. We believe that the frequency of their co-occurrence may be higher than would be expected based on statistical probability derived from their prevalence in the general population, possibly due to a common genetic mechanism leading to disruption in the segmental development of both vascular and skeletal systems. We also believe that the combination of both anomalies may render synergistic consequences on the right subclavian artery patency and may complicate intravascular procedures.
2026-02-27
Lyubomir Gaydarski, Georgi Mirazchiyski, Atanas Panev, Boycho Landzhov, Maria Piagkou, George Triantafyllou, Łukasz Olewnik, Georgi P. Georgiev
Variations in the development of carpal bones are uncommon, with the scaphoid bone typically forming from the fusion of the os centrale carpi and the radial chondrification centre during embryogenesis. A bipartite scaphoid is a rare congenital disorder that occurs when these ossification centres fail to fuse, with a prevalence ranging from 0.1% to 0.6% in adult dissection. Differentiating between a bipartite scaphoid and pseudoarthrosis is challenging, and complicates accurate diagnosis and evaluation. A 37-year-old male presented with right wrist pain following a minor fall. Physical examination revealed no visible deformity or swelling but a restricted range of motion due to pain. Radiographic imaging identified a bipartite scaphoid with two distinct, similar-sized ossification centres, regular oval shape, smooth margins, and consistent cortical-to-medullary ratio, with no acute fractures or dislocations. The patient was treated conservatively with non-steroidal anti-inflammatory drugs and immobilisation. Upon follow-up, the patient reported complete pain resolution and a full range of motion in the wrist. This case demonstrates the unusual occurrence of a bipartite scaphoid bone in a patient experiencing wrist pain after a minor injury. It highlights the challenge of differentiating between a congenital bipartite scaphoid and post-traumatic pseudoarthrosis, underlining the importance of taking into consideration this uncommon developmental variant when diagnosing and treating wrist pain.
2026-02-26
Rabia Mihriban Kılınç, Nizamettin Emre Ozen
Background: This study aimed to investigate the prevalence, morphology, and anatomical characteristics of corona mortis (CMOR) using routine portal-phase contrast-enhanced abdominopelvic computed tomography (CT). Corona mortis is defined as the anastomoses between the external iliac and inferior epigastric vessels and the obturator vascular structures. Accidental injury of these vascular connections during surgical operations, or damage from pelvic trauma, can lead to difficult-to-control pelvic haemorrhages. Materials and methods: We conducted a retrospective review on 1,593 abdominopelvic CT scans performed between January and April 2023. Patients’ demographics, CMOR prevalence, morphology, and measurements — including vessel diameter and distance from the pubic symphysis — were analysed. CMOR was classified using the Rusu classification system, and arterial and venous anastomoses were documented. Results: CMOR was identified in 49.3% of patients. Venous CMOR was observed in 34% of cases, and arterial CMOR was detected in 7.1%, with 5.8% of patients exhibiting combined arterial and venous anastomoses. Venous vessel diameters averaged 3.1 mm on the right and 3.2 mm on the left, with significant sex-based differences (p = 0.001). The distance from the pubic symphysis to venous CMOR averaged 63 mm. Most arterial anastomoses were Type 1-2 (89.4%), and venous anastomoses were predominantly Type 2-1 (72%). Conclusions: Routine portal-phase CT effectively identifies and classifies CMOR, providing valuable preoperative information. Bilateral and contralateral anastomoses are frequent, highlighting the need for detailed anatomical evaluation to lessen surgical complications. Future studies could enhance detection via the use of advanced imaging techniques such as 3D reconstructions.
2026-02-18
Nurşat Türker, Duygu Göller Bulut
Background: The aim of the present study was to determine the presence, frequency, and characteristics of the accessory maxillary ostium (AMO) in a specific Turkish population using cone-beam computed tomography (CBCT), and to evaluate the frequency of pathologies and anatomical variations in the nasal cavity and maxillary sinus and to assess their relationship with the AMO. Materials and methods: This study retrospectively evaluated the presence of AMO in CBCT images of 543 patients, the patients’ age, gender, and dentition status, the presence of nasal cavity variations and maxillary sinus pathologies, and their relationship to the presence of AMO. Descriptive values of the data and comparative results were included. Results: A total of 249 males and 294 females participated in the study. The majority of right and left sinus pathologies were irregular type mucosal thickenings (right/left; 14%, 14.9%). The majority of nasal variations were concha bullosa (right/left; 37.9%, 39.2%). There were 148 (27.3%) and 138 (25.4%) AMOs on the right and left sides, respectively, with the majority in the middle position (right/left; 21.2%/17.5%). The frequency of right and left AMOs was significantly higher in men (p = 0.019 and p = 0.020, respectively). The left AMO frequency was significantly higher in patients with left-sided sinus pathology (p = 0.003). AMO diameters were larger in men (right/left p = 0.010 and p = 0.021, respectively), and the left AMO diameter was significantly larger in patients with left sinus pathology (p = 0.006). Conclusions: Before any surgical intervention in the maxillary sinus and osteomeatal region, the presence and location of the AMO, existing pathologies, and variations in the region should be carefully checked to avoid complications.
2026-02-18
Qingyi Cai, Baohua Cheng, Wenming Gao
Background: This study reports a rare case of a nonbifurcating carotid artery with bilateral internal carotid artery anastomoses. Special anatomical features related to nonbifurcating carotid arteries are comprehensively summarized. The embryological causes and potential clinical significance of this variation are discussed. Materials and methods: An anatomical variant of the left common carotid artery was discovered in a middle-aged elderly Chinese female cadaver during standard dissection in an anatomy course. Results: The left common carotid artery was unbranched; instead, it continued intracranially as the internal carotid artery and gave rise to branches of the external carotid artery. In the sella turcica region, bilateral internal carotid arteries developed aberrant anastomoses, which is even rarer. Furthermore, both posterior communicating arteries arose from the left posterior cerebral artery and were accompanied by multiple large intracranial aneurysms. According to a thorough literature review, this is the first documented instance of this complex combination of variants. Conclusions: This study demonstrates that abnormal vascular embryogenesis can lead to complex vascular variants. Clinicians should remain vigilant for potential hemodynamic irregularities and take prompt action to prevent larger aneurysms from forming and enlarging. Precise identification and thorough preoperative evaluation are crucial for reducing surgical risks and avoiding serious complications, such as infarction. Detailed knowledge of these variations is critical for imaging, interventional procedures, and surgery involving the cervical and cerebral vessels.
2026-02-18
Michał Ebisz, Marcin Mostowy, Przemysław Pękala, Jerzy A. Walocha, Janusz Moryś, Ilona Klejbor, Konrad Malinowski
Background: Ultrasound identification of genicular nerves to perform their blockade can be challenging due to high anatomical variability. Initial identification of the easier to visualize genicular artery could allow for further identification of the genicular nerve, permitting precise ultrasound-guided nerve blockades. Materials and methods: Three subsequent patients with the end-stage medial knee osteoarthritis (OA) with history of non-successful intraarticular treatment were included. The procedure assumed an ultrasound-guided blockade of the superior and inferior medial genicular nerves using 7 mL solution of lidocaine 8.33 mg/mL and betamethasone 1.17 mg/mL. Firstly, the superomedial genicular artery was visualized near the femoral medial metaphysis. Then, 3.5 mL of solution was injected in the plane between the deep fascia of the vastus medialis and the femur using 21G 50 mm needle. The same procedure was repeated at the distal part of the knee using the medial condyle of the tibia and inferomedial genicular artery as landmarks. Results: In all cases, initial visualization of the genicular artery allowed for further identification of the genicular nerve adjacent to it. The procedure led to significant reduction of pain and improvement of the quality of life, with 50–80% of pain reduction at 6 weeks follow-up. Conclusions: Despite the high variability of the course of genicular nerves, the ultrasound guidance of perineural blockades facilitates a highly reliable and consistent measure to provide symptomatic relief in patients with knee OA. Genicular arteries are easier to visualize than adjacent genicular nerves, helping in effective identification of anatomical variations.
2026-02-13
Wojciech Bocheński, Marcin Mostowy, Przemysław Pękala, Jerzy A. Walocha, Janusz Moryś, Ilona Klejbor, Konrad Malinowski
Background: Femoroacetabular impingement (FAI) morphology is defined by anatomical variants that may predispose to mechanical conflict between the bony structures of the acetabulum and proximal femur with underlying bony incongruence leading to damage of adjacent tissues. Repetitive abnormal contact in this region can contribute to the formation of herniation pits (HPs) in the anterosuperior femoral head–neck junction, which may exacerbate symptoms and complicate surgical management of FAI. Case report: This case report describes a 55-year-old male who underwent arthroscopic osteochondroplasty for mixed-type FAI morphology, combined with resection of a large HP and subsequent cavity filling using allogenic bone graft. Importantly, even though he did not have classic acetabular overcoverage, focal acetabular retroversion resulted in mechanical impingement when combined with anatomical variation of the femoral head–neck junction and patient’s activity patterns. The postoperative course was uneventful, and graft incorporation was confirmed during the three-year follow-up. Conclusions: This case highlights the anatomical and surgical interplay between osseous morphology, soft-tissue integrity, and joint biomechanics in the setting of FAI. Importantly, the various FAI morphologies should be considered anatomical variants that, when combined with specific movement patterns or loading conditions, may predispose to impingement and subsequent clinical symptoms. Additionally, this case demonstrates that allogenic bone grafts used to fill the herniation pit cavity can successfully incorporate into the surrounding bone, even in the anterosuperior femoral neck — a region known for relatively limited vascular supply.