An 89-year-old Caucasian male cadaver with prostate cancer demonstrated bilateral persistence of the median artery and bifid median nerve (BMN) during upper limb dissection. The persistent median artery (PMA) originated from the common interosseous artery and coursed alongside the median nerve. Proximal to the carpal tunnel, the median nerve bifurcated into medial and lateral branches. To our knowledge, this is the first documented case of a bilateral PMA and BMN. While the majority of existing literature focuses on a unilateral PMA or unilateral BMN, bilateral occurrences of either variation are rare. This report presents a novel finding by documenting the simultaneous presence of a bilateral PMA and BMN.

BACKGROUND: To conduct a morphological and morphometric analysis of the sacral hiatus (SH) using lumbosacral spine CT scans and to evaluate its clinical relevance in caudal epidural analgesia (CEA).
METHODS: This retrospective study analyzed 77 lumbosacral spine CT scans from a diverse patient population. The shape of the SH was classified into common types: inverted U, inverted V, irregular, and bilobed. Morphometric measurements included the length, width, and depth at the apex of the SH. The apex level of the SH was also determined in relation to the sacral vertebrae, and statistical analysis was performed to identify any correlation between the apex level and the morphometric dimensions.
RESULTS: The most frequent SH shape was inverted U (68.83%), followed by inverted V (20.77%), irregular (9%), and a single instance of a bilobed shape (1.29%). The apex of the SH was most commonly located at the level of the S4 vertebra (75.32%), followed by the S3 vertebra (20.77%), S5 in two (2.59) and S2 in one (1.29%). No significant correlation was found between the level of the apex and the length, width, or depth of the SH. These findings indicate a high degree of anatomical variability in the SH, independent of the apex level.
CONCLUSIONS: The anatomical variability of the SH, as observed in this study, underscores the need for individualized assessment during CEA. The lack of correlation between the apex level and the morphometric dimensions of the SH highlights the importance of imaging modalities such as ultrasound or fluoroscopy to ensure precise localization and effective analgesia administration. These insights can improve clinical outcomes by enhancing the accuracy and safety of caudal epidural procedures.

UNASSIGNED: Knowledge of the venous systems of the neck is important in microvascular anastomosis as well as to avoid unintended bleeding during neck dissection.
UNASSIGNED: We present three rare variations of the jugular system of the neck which could have complicated neck dissection.
UNASSIGNED: The first case is of a posterior tributary from an internal jugular vein (IJV). The second case is an IJV with increased diameter of 3 cm and the third case is an aneurysm of the external jugular vein.
UNASSIGNED: Careful dissection was carried out to avoid complications and to preserve the vessels for microvascular anastomosis.
UNASSIGNED: No complications were encountered intraoperatively and post-operatively.
UNASSIGNED: Variations from normal anatomy should be dealt with caution to avoid complications and to perform surgery precisely and efficiently.

Purpose: Like other muscular compartments of the human body, the intrinsic muscles of the foot present considerable morphological variability. The aim of this review was to present variations that can potentially cause problems during surgery but might be detected during an ultrasound examination. Materials and methods: PubMed was searched for relevant articles. The identified papers were listed, and citation tracking was performed. Results: Even though lower limb structure is well studied, the variations associated with the intrinsic muscles of the foot and their related ultrasound examination are not. Conclusions: The muscles and tendons of the foot demonstrate similar degrees of variance as other regions of the human body; however, this subject is not as widely covered in the literature. Further ultrasound studies are needed to build awareness of morphological variability in this region, as the findings could prevent misdiagnosis.

UNASSIGNED: Several anatomical variations of the ilioinguinal nerve branches have been recorded in older studies. Knowledge of these variations is useful for the improvement of peripheral nerve blocks and avoidance of iatrogenic nerve injuries during abdominal surgeries. The purpose of this study is to perform a systematic review of the literature about the anatomical topography and variations of the ilioinguinal nerve.
UNASSIGNED: An extensive search in PubMed, Scopus, and Web of Science electronic databases was conducted by the first author in November 2021, with the use of the PRISMA guidelines. Anatomical or cadaveric studies about the origin, the course, and the distribution of the ilioinguinal nerve were included in this review. Thirty-one cadaveric studies were included for qualitative analysis.
UNASSIGNED: Several anatomical variations of the ilioinguinal nerve were depicted including its general properties, its origin, its branching patterns, its course, its relation to anatomical landmarks, and its termination. Among them, the absence of ilioinguinal nerve ranged from 0% to 35%, its origin from L1 ranged from 65% to 100%, and its isolated emergence from psoas major ranged from 47% to 94.5%. Numerous anatomical variations of the ilioinguinal nerve exist, not commonly cited in classic anatomical textbooks. The branches of the ilioinguinal nerve may be damaged during spinal anesthesia and surgical procedures in the lower abdominal region.
UNASSIGNED: Therefore, a better understanding of the regional anatomy and its variations is of vital importance for the prevention of ilioinguinal nerve injuries.

OBJECTIVE: TMD is a multifaceted condition with various contributing factors, but the actual impact of the lateral pterygoid plate on the development of TMD remains uncertain. This research aims to investigate the relationship between anatomical variations of the lateral pterygoid plate (LPP), including its angle and proximity to the condyle, and the prevalence of temporomandibular disorders (TMD), to improve diagnostic accuracy and therapeutic approaches for TMD.
METHODS: A retrospective analysis was conducted on 189 Cone Beam Computed Tomography (CBCT) images of individuals aged 18 to 45. Inclusion criteria were based on definitive diagnoses of degenerative joint disease, excluding individuals with orthodontic treatments, injuries, or craniofacial disorders.Participants were divided into TMD and control groups using standardized DC/TMD protocols for assessment. A radiologist, blinded to the patient\'s clinical status, then analyzed the CBCT images. LPP dimensions, angles, and condyle distances were measured using OnDemand 3D Imaging Software.
RESULTS: The study found a statistically significant higher average LPP length in females compared to males (right LPP p < 0,001, left LPP p = 0,004), with no significant differences in LPP-condyle distances and angles between genders. Comparing the TMD and control groups revealed a positive correlation between lateral plate angles and TMJ disorders (p = 0,044), suggesting a potential biomechanical linkage.
CONCLUSIONS: Conclusively, the study challenges the assumption that LPP anatomical variations significantly impact TMD while underscoring a potential link between LPP angle and TMD. The novel insight into the potential role of the LPP angle in TMD provides a new direction for research and clinical practice, emphasizing the importance of considering subtle anatomical differences in the management of TMD.

BACKGROUND: Comprehension of the intrucate anatomy and variations in the termination of the popliteal artery (PA) is increasingly essential for endovascular interventionists, plastic surgeons, vascular surgeons, and orthopedic surgeons, due to the rise in procedures like embolectomy, vascular grafting, free fibular flap surgery, and high-tibial osteotomy. Few studies from India have reported on the variant anatomy of PA termination, and none have used 128-slice tomography. This study aimed to observe the terminal branching pattern of the PA and the morphology of its terminal branches using 128-slice computed tomography angiography (CTA) and to analyze its relation to gender and laterality.
METHODS: A retrospective review of CTA images of 181 lower extremities from 100 patients (137 males and 44 females), aged five to 75 years, was conducted.
RESULTS: The usual type I-A pattern was found in 75.69% of cases, while 24.31% exhibited variant patterns. Type III was the most common variation observed (19.34%), with type III-A being the most prevalent (11.05%). Types II-B and II-C were not observed. Among 84 bilaterally examined cases, 19.05% had unilateral variations and 15.48% had bilateral variations, with 8.33% showing bilaterally similar variations and 7.14% dissimilar variations. No significant difference in branching patterns was found between genders or sides. The mean length of the tibial-peroneal trunk (TPT) in the type I-A pattern was 3.00 ± 0.99 cm (right side: 3.21 ± 1.02 cm; left side: 2.82 ± 0.93 cm; males: 2.9 ± 1.00 cm; females: 3.37 ± 0.85 cm), with statistically significant differences between sides and genders. In the type II-A pattern, the mean TPT length was 7.16 ± 3.75 cm. An exceptionally long TPT (12.97 cm) was noted in one case of the III-B pattern.
CONCLUSIONS: There is a high prevalence of variation in the termination pattern of the PA. Knowledge of these variations is crucial for any interventions in this region to avoid postoperative vascular complications and reduce patient suffering.

OBJECTIVE: To assess the prevalence and configuration of bifid (BMC) and trifid (TMC) mandibular canals using computed tomography (CT), describing the anatomical characteristics of the accessory canals, especially of the retromolar type.
METHODS: CT scans of 123 patients were analysed. BMCs were identified and the patterns of bifurcation were classified, including trifid canals. The width of accessory canals was measured. Retromolar canals were further classified according to their course and morphology, while their position and width were evaluated using linear measurements on CT images.
RESULTS: The majority of patients (53.6%) presented at least one BMC or TMC. 36.2% of mandibular canals were bifid, while 4.5% were trifid. The forward canals (12.6%) and retromolar canals (10.2%) were the most common among BMCs. In relation to the retromolar canals, 60% were vertical and 40% curved, with a mean width of 1.03 ± 0.28mm.
CONCLUSIONS: BMCs and TMCs are common 3D radiographic findings, so that they should be considered as anatomical variations, not anomalies. Preoperative CT or CBCT evaluation should aid in identifying these variations and analysing their position and course in surgical planning.

Polydactyly is typically observed as isolated and sporadic occurrences, although familial cases do exist, albeit with lower frequency, manifesting in various inheritance patterns. In around 30% of polydactyly cases, there exists a familial history, suggesting the probable involvement of a single gene. Given its potential for hereditary transmission, thorough investigation of the patients\' parents, first-degree relatives, grandparents, and even great-grandparents for similar disorders becomes imperative. In our clinic, we conducted an analysis focusing on patients presenting with foot polydactyly, along with occurrences of polydactyly among their first- and second-degree relatives spanning two to three generations of family history. The study encompassed three patients and their respective families, including a pair of siblings. We speculate that the inheritance type in our cases was autosomal dominant. Among our patients, one presented with central polydactyly, while the remaining patients and all familial cases displayed postaxial polydactyly. In terms of morphologic classification, one patient had a Y-shaped metatarsal, another had a T-shaped metatarsal, and the third patient exhibited a duplicated ray-shaped anomaly. In our review of the literature, we haven\'t come across a case spanning three generations like the ones we encountered. Additionally, the presence of a transverse accessory extensor tendon between both extensor tendons in cases with T- and Y-shaped metatarsals intrigued us from an anatomical perspective. Our goal is to present these rare cases of congenital familial polydactyly spanning three generations, highlighting the anatomical variations observed and aiming to contribute to the existing body of literature on the subject.

UNASSIGNED: Surgical procedures in the anterior mandibular region require a profound understanding of the complex anatomical structures to ensure patient safety. The lingual foramen (LF) and its intra-osseous canal are pivotal structures, supplying vascular and neural support to the mental region. The prevalence of LF is widely recognized, with variations among populations.
UNASSIGNED: The study involved 650 adult participants. Data were collected using high-resolution cone-beam computed tomography (CBCT), and statistical analysis was conducted, establishing inter-rater agreement.
UNASSIGNED: The population had a varied age distribution, with males comprising 53.23% and females comprising 46.77%. The median lingual canal was found in the Supra and Infra spinosum (65.38%). Most participants had lateral lingual canals (60.92%). The most prevalent lingual foramina was 4 (30.62%). The study found no significant associations between gender and LF diameter, distribution in different travel directions, or LF locations. However, males had a slightly larger diameter.
UNASSIGNED: The findings provide valuable insights into LF variations based on anatomical locations, and there were no statistically significant differences in measurements across different age groups. This knowledge contributes to the evolving field of oral and maxillofacial surgery, ensuring better patient outcomes.