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Tarik Benchaa - One of the best experts on this subject based on the ideXlab platform.
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blood supply to the human sternocleidomastoid muscle and its clinical implications for mandible reconstruction
Laryngoscope, 2012Co-Authors: Franck Marie Leclere, Christian Vacher, Tarik BenchaaAbstract:Objectives/Hypothesis: The use of the sternocleidomastoid (SCM) flap for reconstructive surgery of the mandible seems to be a practicable although underestimated option. Study Design: This study was conducted on 15 cadavers that had been neoprene–latex injected in the middle and inferior pedicles. Methods: Lengths of the SCM were equally divided into upper, middle, and lower thirds. Each third was then subdivided into numbered quadrants. This procedure defined six levels in the SCM, each corresponding to two quadrants: one medial and the other lateral. For each third of the SCM, the origin of the main pedicles was recorded. The quadrants where neoprene–latex was detected were reported in the dissection book. Results: The upper third of the SCM muscle was constantly supplied by branches of the occipital Artery. The middle third of the SCM muscle received its blood supply from a branch of the superior thyroid Artery (right SCM/left SCM: 53%/53%), the external carotid Artery (27%/20%), or branches of both (20%/27%). The lower third of the muscle was supplied by a branch arising from the Suprascapular Artery (73%/73%), the transverse cervical Artery (7%/13%), the thyrocervical trunk (13%/13%), or the superficial cervical Artery (7%/0%). The neoprene–latex injected into the subclavian Artery reached the four lower levels in all SCMs studied (the middle third of the SCM). In 13% of the SCMs, this injection also reached level II (the upper third of the SCM). With a double injection (inferior and middle pedicles), levels I and II were reached in 100% of the cases. Conclusions: This study shows that, used alone, the lower pedicle does not have the ability to ensure the full vascularization of the SCM muscle. A composite flap might be safely raised only if the integrity of both inferior and middle pedicles is respected.
Nabil A. Ebraheim - One of the best experts on this subject based on the ideXlab platform.
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The Suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study
Journal of shoulder and elbow surgery, 2010Co-Authors: Nabil A. Ebraheim, Sreenivasa R. Alla, Richard A. Yeasting, Jennifer L. Whitehead, Muhammad Z. Moral, Sharmaine Castillo, Andre L. Mccollough, Jiayong LiuAbstract:Hypothesis The Suprascapular nerve and its articular branch innervate the acromioclavicular (AC) joint. Documenting the detailed anatomy of this innervation in the AC joint, including the pertinent surgical and anatomic relationships of the Suprascapular nerve and its branches to the AC joint, will aid in the prevention of injury and the reduction of risk of denervation during shoulder surgery. Materials and methods Twelve shoulders from 6 embalmed human cadavers were bilaterally dissected to study the course of the Suprascapular nerve and its motor and sensory branches. Results The sensory branch runs superiorly to the supraspinatus muscle towards the AC joint. The average distance from the supraglenoid tubercle to the nerve at the coracoid base was 15 mm. The average distance from the coracoclavicular ligaments to the nerve at the coracoid base was 6 mm. The average distance from the spinoglenoid notch to the sensory branch at the Suprascapular notch was 22 mm. The average length of the sensory branch was 30 mm. In half of the specimen shoulders, the Suprascapular Artery accompanied the nerve at the Suprascapular notch under the transverse scapular ligament. Discussion The innervation of the AC joint by the Suprascapular nerve has been described, along with pertinent distances to anatomic landmarks. The sensory branch of the Suprascapular nerve, which passed through the scapular notch inferior to the transverse scapular ligament, was found in 100% of the study specimens. Conclusion The sensory branch of the Suprascapular nerve runs superiorly to the supraspinatus muscle towards the AC joint. The detailed information can be used to help decrease the risk of nerve injury during shoulder surgery and to aid in effectively diagnosing and treating AC joint-related disorders.
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Anatomical basis of the vascular risk related to the circumflex scapular Artery during posterior approach to the scapula
Surgical and Radiologic Anatomy, 2010Co-Authors: Nabil A. Ebraheim, Satheesh K. Ramineni, Sreenivasa R. Alla, Sneh Biyani, Richard A. YeastingAbstract:Purpose The vasculature and anastomosis around the scapula is extremely intricate making surgical treatment complicated. We aimed to determine the “at risk area” for the circumflex scapular Artery and its anastomosis with the Suprascapular Artery during posterior approach to the scapula. Methods Sixteen shoulders from eight embalmed adult cadavers were dissected through posterior approach to the scapula to study the relationship of the circumflex scapular Artery and its anastomosis with the Suprascapular Artery to bony landmarks of the posterior scapula. Three measurements were obtained: from inferior glenoid rim to the point of the bony groove of the circumflex scapular Artery; from the posterior glenoid rim to the spinoglenoid notch; and from the spinoglenoid notch to the circumflex scapular Artery. Results The circumflex scapular was identified at a distance of 2.9 cm from the inferior glenoid rim and at a distance of 4.6 cm from the spinoglenoid notch, as it winds around the lateral border of the scapula to enter the infraspinous fossa. The Suprascapular neurovascular bundle was identified at the spinoglenoid notch 1.8 cm from the posterior glenoid rim. Conclusions We were able to identify the relationship of the circumflex scapular Artery to the anatomic landmarks of the scapula and to define the “at risk area” for the ascending branch of the circumflex scapular Artery and its anastomosis with the Suprascapular Artery. We believe our anatomical study may aid in the avoidance of vascular complications during internal fixation of scapular fractures.
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Anatomical basis of the vascular risk related to the circumflex scapular Artery during posterior approach to the scapula
Surgical and radiologic anatomy : SRA, 2009Co-Authors: Nabil A. Ebraheim, Satheesh K. Ramineni, Sreenivasa R. Alla, Sneh Biyani, Richard A. YeastingAbstract:Purpose The vasculature and anastomosis around the scapula is extremely intricate making surgical treatment complicated. We aimed to determine the “at risk area” for the circumflex scapular Artery and its anastomosis with the Suprascapular Artery during posterior approach to the scapula.
Song Tie-shah - One of the best experts on this subject based on the ideXlab platform.
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Anatomic study of vessels in the subacromial space to prevent vessel injury in arthroscopy procedures
Chinese Journal of Hand Surgery, 2006Co-Authors: Song Tie-shahAbstract:Objective To study vascular distribution in the subacromial space,and avoid vascular injury of the subacromial space in arthroscopy procedures.Methods Ten fresh adult human cadavers underwent whole body arterial perfusion with a mixture of lead oxide-gelatin through the femoral Artery.The shoulders were dissected and radiographed by layer.Angiograms were converted to digital pictures and analyzed by“Scion Image for Windows”. Arteries and anatomic landmarks of the subacromial space were documented.Potential bleeding areas were determined. Results Distribution of major arteries on the walls of the subacromial space were as follows:acromial branch of the thoracoacromial Artery on the anterior wall,posteromedial acromial branch of the supraseapular Artery on the posterior wall,anterior and posterior arteries of the acromioclavicular(AC)joint on the medial wall,posterior AC-joint Artery and posteromedial acromial branch of the suprascaplular Artery on the superior wall,and major vessels such as the Suprascapular Artery and the posterior ascending branch of the circumflex scapular Artery and their anastomosis on the inferior wall.No major arteries were identified on the lateral wall.Conclusion Acromial Artery of the superior zone of the anterior wall,and the posteromedial acromial Artery of the posterior wall,and anterior capsular Artery of the anterior zone of the inferior wall are more likely to he injured during subacromial arthroscopy surgery.
Richard A. Yeasting - One of the best experts on this subject based on the ideXlab platform.
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The Suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study
Journal of shoulder and elbow surgery, 2010Co-Authors: Nabil A. Ebraheim, Sreenivasa R. Alla, Richard A. Yeasting, Jennifer L. Whitehead, Muhammad Z. Moral, Sharmaine Castillo, Andre L. Mccollough, Jiayong LiuAbstract:Hypothesis The Suprascapular nerve and its articular branch innervate the acromioclavicular (AC) joint. Documenting the detailed anatomy of this innervation in the AC joint, including the pertinent surgical and anatomic relationships of the Suprascapular nerve and its branches to the AC joint, will aid in the prevention of injury and the reduction of risk of denervation during shoulder surgery. Materials and methods Twelve shoulders from 6 embalmed human cadavers were bilaterally dissected to study the course of the Suprascapular nerve and its motor and sensory branches. Results The sensory branch runs superiorly to the supraspinatus muscle towards the AC joint. The average distance from the supraglenoid tubercle to the nerve at the coracoid base was 15 mm. The average distance from the coracoclavicular ligaments to the nerve at the coracoid base was 6 mm. The average distance from the spinoglenoid notch to the sensory branch at the Suprascapular notch was 22 mm. The average length of the sensory branch was 30 mm. In half of the specimen shoulders, the Suprascapular Artery accompanied the nerve at the Suprascapular notch under the transverse scapular ligament. Discussion The innervation of the AC joint by the Suprascapular nerve has been described, along with pertinent distances to anatomic landmarks. The sensory branch of the Suprascapular nerve, which passed through the scapular notch inferior to the transverse scapular ligament, was found in 100% of the study specimens. Conclusion The sensory branch of the Suprascapular nerve runs superiorly to the supraspinatus muscle towards the AC joint. The detailed information can be used to help decrease the risk of nerve injury during shoulder surgery and to aid in effectively diagnosing and treating AC joint-related disorders.
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Anatomical basis of the vascular risk related to the circumflex scapular Artery during posterior approach to the scapula
Surgical and Radiologic Anatomy, 2010Co-Authors: Nabil A. Ebraheim, Satheesh K. Ramineni, Sreenivasa R. Alla, Sneh Biyani, Richard A. YeastingAbstract:Purpose The vasculature and anastomosis around the scapula is extremely intricate making surgical treatment complicated. We aimed to determine the “at risk area” for the circumflex scapular Artery and its anastomosis with the Suprascapular Artery during posterior approach to the scapula. Methods Sixteen shoulders from eight embalmed adult cadavers were dissected through posterior approach to the scapula to study the relationship of the circumflex scapular Artery and its anastomosis with the Suprascapular Artery to bony landmarks of the posterior scapula. Three measurements were obtained: from inferior glenoid rim to the point of the bony groove of the circumflex scapular Artery; from the posterior glenoid rim to the spinoglenoid notch; and from the spinoglenoid notch to the circumflex scapular Artery. Results The circumflex scapular was identified at a distance of 2.9 cm from the inferior glenoid rim and at a distance of 4.6 cm from the spinoglenoid notch, as it winds around the lateral border of the scapula to enter the infraspinous fossa. The Suprascapular neurovascular bundle was identified at the spinoglenoid notch 1.8 cm from the posterior glenoid rim. Conclusions We were able to identify the relationship of the circumflex scapular Artery to the anatomic landmarks of the scapula and to define the “at risk area” for the ascending branch of the circumflex scapular Artery and its anastomosis with the Suprascapular Artery. We believe our anatomical study may aid in the avoidance of vascular complications during internal fixation of scapular fractures.
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Anatomical basis of the vascular risk related to the circumflex scapular Artery during posterior approach to the scapula
Surgical and radiologic anatomy : SRA, 2009Co-Authors: Nabil A. Ebraheim, Satheesh K. Ramineni, Sreenivasa R. Alla, Sneh Biyani, Richard A. YeastingAbstract:Purpose The vasculature and anastomosis around the scapula is extremely intricate making surgical treatment complicated. We aimed to determine the “at risk area” for the circumflex scapular Artery and its anastomosis with the Suprascapular Artery during posterior approach to the scapula.
Eray Tüccar - One of the best experts on this subject based on the ideXlab platform.
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Ultrasonographic evaluation and morphometric measurements of the Suprascapular notch
Surgical and Radiologic Anatomy, 2009Co-Authors: Cüneyt Yücesoy, Eray Tüccar, Taylan Akkaya, Özgür Özel, Ayhan Cömert, Nurdan Bedirli, Ece Ünlü, Baki Hekimoğlu, Haluk GümüşAbstract:Background: The aim of this study was to define the sonographic evaluation and morphometric measurements of the Suprascapular notch. Methods The Suprascapular notch was evaluated by ultrasound on both sides in 50 volunteers (25 males, 25 females). By means of ultrasound, the notch width, the notch depth and the distance between the skin and the notch base (skin–notch base interval) were measured and imaging of the superior transverse scapular ligament was attempted. Furthermore, imaging of the Suprascapular Artery and vein was performed by Doppler ultrasound. Results On the measurements performed, the notch was found to be deeper in men than in women on both the right ( P = 0.022) and the left ( P = 0.011) sides. Taking all volunteers into account without grouping sex, no differences were detected between the two sides with respect to the measurements of the notch width, notch depth and distance between the skin and the notch base. The superior transverse scapular ligament was demonstrated in 48 (96%) of 50 volunteers. On color Doppler ultrasound, the Artery–vein complex was visualized in a total of 43 (86%) volunteers. Conclusions Suprascapular notch measurements and the visualization of the anatomical neighborhood, which may be beneficial for the Suprascapular nerve blockade procedure, can be successfully performed by the use of high-frequency ultrasound imaging.
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The significance of the neurovascular structures passing through the spinoglenoid notch.
Saudi medical journal, 2003Co-Authors: Mustafa Aktekin, Deniz Demiryürek, Alp Bayramoglu, Eray TüccarAbstract:OBJECTIVES To define the detailed anatomy of the neurovascular bundle at the spinoglenoid notch and to report the dimensions of these structures in cadavers. METHODS In the present study, the external diameters of Suprascapular Artery, vein and nerve were measured at the spinoglenoid notch region in 18 formalin fixed cadavers (36 shoulders) by using a caliper. The study was carried out in the dissection laboratory of Anatomy Departments of Hacettepe University, Ankara University, Ankara and Mersin University, Mersin, Turkey, between 2002 and 2003. RESULTS The average external diameter for the Suprascapular vein was 2.6 mm, Artery was 2.2 mm and nerve was 2.2 mm. The spinoglenoid notch was roofed by the spinoglenoid ligament and appeared as a fibroosseous foramen in all cadavers. We found that the vascular structures (Suprascapular Artery and vein) occupied 68.5% and the Suprascapular nerve occupied 31.5% of this foramen. CONCLUSIONS Although the diameters of the vascular structures at the spinoglenoid notch measured by magnetic resonance imaging have been reported, to our knowledge, external diameters of these structures at the spinoglenoid notch have not been described in cadavers. We believe that detailed anatomy of Suprascapular neurovascular bundle at the spinoglenoid notch should be appreciated for better understanding of risk factors possibly causing the Suprascapular nerve entrapment syndrome, specially for those who are involved in violent overhead sports activities such as volleyball and baseball.
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The significance of the neurovascular structures passing through the spinoglenoid notch.
Neurosciences (Riyadh Saudi Arabia), 2003Co-Authors: Mustafa Aktekin, Deniz Demiryürek, Alp Bayramoglu, Eray TüccarAbstract:To define the detailed anatomy of the neurovascular bundle at the spinoglenoid notch and to report the dimensions of these structures in cadavers. In the present study, the external diameters of Suprascapular Artery, vein and nerve were measured at the spinoglenoid notch region in 18 formalin fixed cadavers (36 shoulders) by using a caliper. The study was carried out in the dissection laboratory of Anatomy Departments of Hacettepe University, Ankara University, Ankara and Mersin University, Mersin, Turkey, between 2002 and 2003. The average external diameter for the Suprascapular vein was 2.6 mm, Artery was 2.2 mm and nerve was 2.2 mm. The spinoglenoid notch was roofed by the spinoglenoid ligament and appeared as a fibroosseous foramen in all cadavers. We found that the vascular structures (Suprascapular Artery and vein) occupied 68.5% and the Suprascapular nerve occupied 31.5% of this foramen. Although the diameters of the vascular structures at the spinoglenoid notch measured by magnetic resonance imaging have been reported, to our knowledge, external diameters of these structures at the spinoglenoid notch have not been described in cadavers. We believe that detailed anatomy of Suprascapular neurovascular bundle at the spinoglenoid notch should be appreciated for better understanding of risk factors possibly causing the Suprascapular nerve entrapment syndrome, specially for those who are involved in violent overhead sports activities such as volleyball and baseball.