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A rare case of aberrant facial nerve course in the mastoid segment

100%

Rana A. K., Khan M. M., Parab S. R.

Polski Przegląd Otorynolaryngologiczny

2021

vol. 10(2)

30-33

Facial nerve is the main motor supply to the part of facial skeleton system responsible for expressions. The reported rate of iatrogenic injury to the facial nerve in primary mastoid surgeries was 0.6% to 3.7%. Temporal bone is one of the most complex anatomical parts of human body. A variety of facial nerve courses has been described in literature. Normally, horizontal segment of the facial nerve traverses from geniculate ganglion to second genu which is usually situated medial and inferior to lateral semicircular canal. From here it passes posteriorly and laterally along the medial wall of the middle ear. Mastoid or vertical segment extends from the second genu to stylomastoid foramen deep to tympano-mastoid suture line from where the nerve exits out of the temporal bone. During our endoscopic dissection we encountered a grossly anomalous course of facial nerve in which after turning at second genu, the nerve curves posteriorly and lies in the floor of mastoid cavity and traverse’s its whole length of mastoid and instead of moving out of foramen it travels towards sinus plate and then takes another (3rd) turn to travel anteriorly towards the tip of mastoid from where it finally exits.

Free gas in the peritoneal cavity after colonoscopy. Indication for immediate action or incidental finding in imaging tests after uncomplicated colonoscopy? Literature review

86%

Znamirowski P., Głuszek S.

Polish Journal of Surgery

2020

vol. 92(3)

44-50

Colonoscopy is a routine diagnostic and therapeutic procedure. Along with the increase in the complexity of the procedures performed, the risk of complications increases. In 2017, WSES (World Society of Emergency Surgery) published the principles of safe colonoscopy. Intestinal perforation is one of the most common complications. The risk of perforation in treatment procedures such as mucosectomy or endoscopic dissection is significantly greater than the risk of diagnostic colonoscopy. The basic rule of the procedure in case of suspected perforation is close supervision over the patient’s condition and the soonest possible repair of damage. The role of the endoscopist is not only early recognition, but also early treatment of damage. Immediate endoscopic treatment of lesions is an effective, final and acceptable management strategy. In patients who have undergone imaging diagnostics for another reason, free gas in the peritoneal cavity can be recognized. It does not have to mean the need for urgent surgical intervention. Patients with asymptomatic pneumoperitoneum after colonoscopy should, however, be treated as patients with suspected perforation of the large intestine and undergo careful clinical observation in accordance with WSES recommendations. Colonoscopy is a procedure with a risk of complications, which should be reported to patients qualified for endoscopy, but appropriate management reduces the risk of morbidity and mortality associated with this procedure.

The anatomical description of the pericruciate fat pad (PCFP) – a brief report of cadaveric dissection

58%

Kanak M., Mostowy M., Domżalski M., Lesman J.

Chirurgia Narządów Ruchu i Ortopedia Polska

2023

vol. 88

issue 4

187-192

Wstęp. Ciała tłuszczowe stawu kolanowego są już relatywnie dobrze poznanymi strukturami z jednym wyjątkiem – ciałem tłuszczowym okołokrzyżowym (PCFP). Cel. Do celów badania należały: (1) dysekcja, opis i pomiar cech anatomicznych PCFP oraz (2) ocena obecności, morfologii i relacji tętnicy środkowej kolana (MGA) względem PCFP. Materiał i metody. Dysekcji zostały poddane cztery kończyny dolne z męskich zwłok. PCFP zostało wycięte, a następnie zmierzono jego długość horyzontalną i wertykalną oraz objętość. Oceniono obecność, morfologię i relację MGA względem PCFP oraz zmierzono jej średnicę wewnętrzną. Wyniki. PCFP było zlokalizowane w dole międzykłykciowym. Granice PCFP stanowiły od strony górnej, dolnej, przyśrodkowej i bocznej oraz tylnej kolejno dach dołu międzykłykciowego, plateau piszczeli, kłykcie udowe i tylna torba stawowa. Przednia część PCFP otaczała więzadło krzyżowe tylne (PCL), do którego przyłączone było włóknistą wypustką. PCFP miało konsystencję homogennej tkanki tłuszczowej z małymi płacikami. Średni wymiar horyzontalny, wertykalny i objętość wyniosły kolejno 56,85±3,4 mm (zakres wartości 52,1-60,2 mm), 42,8±5,8 mm (zakres wartości 34,2-46,1 mm) i 43,75±4,79 ml (zakres wartości 40-50 ml). MGA przeszywała wszystkie 4 ciała tłuszczowe w górno-tylnym brzegu a jej średnica wewnętrzna wyniosła 1,18±0,33 mm (zakres wartości 0,8-1,55 mm). Wnioski. PCFP jest stosunkowo dużą strukturą z MGA obecną w każdym z 4 badanych przypadków. Należy zachować dodatkową ostrożność podczas operacji tylnego przedziału kolana, ponieważ PCFP może wykazywać niedoceniany potencjał do obrzęku i krwawienia.

Introduction. Fat pads of the human knee joint are relatively well-known structures except for the pericruciate fat pad (PCFP). Aim. The study aimed to describe (1) the anatomy of the pericruciate fat pad (PCFP) and (2) its relation to the middle genicular artery (MGA). Materials and methods. Four male cadaveric lower limbs were dissected. PCFP was excised, and its horizontal and vertical lengths and volume were measured. The presence of MGA was assessed, and its internal diameter was registered. Results. PCFP was located in the intercondylar fossa. Its superior, inferior, medial&lateral and posterior borders were the intercondylar roof, tibial plateau, femoral condyles, and posterior knee capsule, respectively. The anterior part of the PCFP enveloped the posterior cruciate ligament (PCL). PCFP had a homogenous appearance of adipose tissue with small lobules. It was connected to the PCL with a fibrous process. The mean horizontal&vertical length and volume were 56.85±3.4 mm (range 52.1-60.2 mm), 42.8±5.8 mm (range 34.2-46.1 mm) and 43.75±4.79 ml (range 40-50 ml), respectively. The MGA penetrated the PCFP in all four examined limbs; its mean diameter was 1.18±0.33 mm (range 0.8-1.55 mm). Conclusions. PCFP is a relatively large structure, with MGA present within all examined cases. Care must be taken when performing surgeries involving the posterior intra-articular part of the knee because the PCFP may present an underestimated potential for oedema and bleeding.

Refine search results

1 Chirurgia Narządów Ruchu i Ortopedia Polska

1 Polish Journal of Surgery

1 Polski Przegląd Otorynolaryngologiczny

1 2023

1 2021

1 2020

1 Domżalski M.

1 Głuszek S.

1 Kanak M.

1 Khan M. M.

1 Lesman J.

1 Mostowy M.

1 Parab S. R.

1 Rana A. K.

1 Znamirowski P.

Search results

A rare case of aberrant facial nerve course in the mastoid segment

Free gas in the peritoneal cavity after colonoscopy. Indication for immediate action or incidental finding in imaging tests after uncomplicated colonoscopy? Literature review

The anatomical description of the pericruciate fat pad (PCFP) – a brief report of cadaveric dissection