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The clinical anatomy of the accessory submandibular gland: a comprehensive review
Andrea Yazbeck(Andrea Yazbeck ),Joe Iwanaga(Joe Iwanaga ),Jerzy A. Walocha(Jerzy A. Walocha ),Łukasz Olewnik(Łukasz Olewnik ),R. Shane Tubbs(R. Shane Tubbs ) 대한해부학회 2023 Anatomy & Cell Biology Vol.56 No.1
An accessory submandibular gland is a rare variation. As such, there is limited literature regarding the embryology, anatomy, variations, clinical imaging, and pathology of the accessory submandibular gland. In this article, we review the existing literature on the accessory submandibular gland from clinical and anatomical perspectives. The goal of this review is to provide comprehensive knowledge of this variation which can be useful for oral and maxillofacial/head and neck surgeons, radiologists, and anatomists. Within this review, the embryologic origin as well as the anatomy of the accessory submandibular gland is detailed. Several imaging modalities which can be used to visualize the accessory submandibular gland are outlined as well as its variations. Lastly, this review investigates several reported clinical considerations regarding the accessory submandibular gland including sialoliths, Wharton’s duct obstruction, and pleomorphic adenoma.
Jenilkumar Patel(Jenilkumar Patel ),Graham Dupont(Graham Dupont ),Joho Katsuta(Joho Katsuta ),Joe Iwanaga(Joe Iwanaga ),Łukasz Olewnik(Łukasz Olewnik ),R. Shane Tubbs(R. Shane Tubbs ) 대한해부학회 2023 Anatomy & Cell Biology Vol.56 No.1
Tibialis anterior (TA) muscle originates from the lateral surface of tibia and its tendon attaches to the medial cuneiform and base of the first metatarsal. The TA muscle is responsible for both dorsiflexion and inversion of the foot. We present a case of bilateral TA muscle variations that diverge slightly from the current classification systems of this muscle. Recognizing variations such as these may be important for anatomists, surgeons, podiatrists, and physicians. Following routine dissection, an accessory tendon of the TA muscle was found on both sides. Accessory tendons of the extensor hallucis longus and extensor hallucis brevis joined to form a common tendon on both sides. We believe that this unique case will help further the classification systems for the tendons of the TA and also be informative for clinical anatomists as well as physicians treating patients with pathology in this region.
Radiological Study of Atlas Arch Defects with Meta-Analysis and a Proposed New Classification
Suphamungmee Worawit,Yurasakpong Laphatrada,Poonudom Kanchanaphan,Tubbs R. Shane,Iwanaga Joe,Kruepunga Nutmethee,Chaiyamoon Arada,Suwannakhan Athikhun 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5
This study consists of a retrospective cohort study, a systematic review, and a meta-analysis which were separately conducted. This study aimed to investigate the prevalence of atlas arch defects, generate an evidence-based synthesis, and propose a common classification system for the anterior and combined atlas arch defects. Atlas arch defects are well-corticated gaps in the anterior or posterior arch of the atlas. When both arches are involved, it is known as a combined arch defect. Awareness of these defects is essential for avoiding complications during surgical procedures on the upper spine. The prevalence of arch defects was investigated in an open-access OPC-Radiomics (Radiomic Biomarkers in Oropharyngeal Carcinoma) dataset comprising 606 head and neck computed tomography scans from oropharyngeal cancer patients. A systematic review and meta-analysis were performed to generate prevalence estimates of atlas arch defects and propose a classification system for the anterior and combined atlas arch defects. The posterior arch defect was found in 20 patients (3.3%) out of the 606 patients investigated. The anterior arch defect was not observed in any patient, while a combined arch defect was observed in one patient (0.2%). A meta-analysis of 13,539 participants from 14 studies, including the present study, yielded a pooled-posterior arch defect prevalence of 2.07% (95% confidence interval [CI], 1.22%–2.92%). The prevalences of anterior and combined arch defects were 0.00% (95% CI, 0.00%–0.10%) and 0.14% (95% CI, 0.04%–0.25%), respectively. The anterior and combined arch defects were classified into five subtypes based on their morphology and frequency. The present study showed that atlas arch defects were present in approximately 2% of the general population. For future studies, larger sample sizes should be used for studying arch defects to avoid the small-study effect and to predict the prevalence accurately.
A large sublingual glandular branch of the lingual nerve: a rare case report
Aaron Albuck,Yuto Haikata,Koichi Watanabe,R. Shane Tubbs,Joe Iwanaga 대한해부학회 2022 Anatomy & Cell Biology Vol.55 No.3
While the route, location, and pathology of the lingual nerve has been detailed extensively in reports in the literature, its terminal branch to the sublingual gland is often overlooked. It is known, via both gross and histological observation, that the sublingual glandular branch terminates at the posterior aspect of the sublingual gland. Upon routine cadaveric dissection of a male cadaver, one of the lingual nerve branches was found to terminate at the anteroinferior portion of a herniated sublingual gland. This specific course has not previously been discussed or reported via gross or histological observation. Therefore, a timely review of the lingual nerve’s terminal sublingual glandular branch’s anatomy and clinical significance pertaining to this case is warranted. Surgeons who treat patients with submental masses should be aware of the anatomy of this nerve and the potential variance described here in order to avoid postprocedural complications.
An unusual anatomical variation of the inferior alveolar nerve
Shogo Maekawa,Mizuki Nagata,Yuki Matsushita,R. Shane Tubbs,Joe Iwanaga 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.4
A number of studies have previously shown variations of inferior alveolar, however, only a few reports focused on nearby the foramen ovale. In a formalin fixed cadaver, we identified three minor branches (anterior, middle, and posterior branches) arising from the main trunk of the mandibular nerve adjacent to the foramen ovale, passing lateral to the maxillary artery (MA), and joining the inferior alveolar nerve. The diameter of the branches was 0.68 mm, 1.43 mm, and 0.40 mm, respectively. The branches traveled inside the lateral pterygoid muscle (LPM) or between the LPM and tensor/levator veli palatini. Moreover, all of the branches were superficial to MA. Knowledge of such a variation might be helpful to dentists during, for example, anesthetic blockade and various oral surgeries.
Variant muscle fibers connecting the orbicularis oculi to the orbicularis oris: case report
Norio Kitagawa,Joe Iwanaga,R. Shane Tubbs,Hongtae Kim,Yong-Suk Moon,Mi-Sun Hur 대한해부학회 2022 Anatomy & Cell Biology Vol.55 No.4
The orbicularis oculi (OOc) is a sphincteric muscle of the eyelids, whereas contraction of the orbicularis oris (OOr), another sphincteric muscle, causes narrowing of the lips. Facial muscle fibers normally blend with adjacent muscles. However, muscle fibers connecting the various facial muscles that have different actions and that are located at distant sites, such as the OOc and the OOr have been rarely reported. Herein, we report a rare case of connecting fibers between the inferior margin of the OOc and the OOr. These connecting fibers were blended with the OOr between the inserting fibers of the levator labii superioris and levator anguli oris. Contraction of such variant muscles might affect typical facial expressions.
The pterygomandibular raphe: a comprehensive review
Rithvik Vutukuri,Norio Kitagawa,Keiko Fukino,R. Shane Tubbs,Joe Iwanaga,Norio Kitagawa 대한해부학회 2024 Anatomy & Cell Biology Vol.57 No.1
The pterygomandibular raphe (PMR) is a tendinous structure connecting the bucinator and the superior pharyngeal constrictor muscles. With its implications in the spread of oral cancer, the proper treatment of obstructive sleep apnea, and dental procedures, it is important to obtain a thorough understanding of the PMR. We reviewed the existing literature to compile the published information regarding its anatomy, embryology, imaging, variations, functions, pathologies, and clinical relevance of the pterygomandibular raphe.
Triangles of the neck: a review with clinical/surgical applications
Shogo Kikuta,Joe Iwanaga,Jingo Kusukawa,R,Shane Tubbs 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.2
The neck is a geometric region that can be studied and operated using anatomical triangles. There are many triangles of the neck, which can be useful landmarks for the surgeon. A better understanding of these triangles make surgery more efficient and avoid intraoperative complications. Herein, we provide a comprehensive review of the triangles of the neck and their clinical and surgical applications.
An anatomical study of the lingual nerve in the lower third molar area
Shogo Kikuta,Joe Iwanaga,Jingo Kusukawa,R,Shane Tubbs 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.2
The lingual nerve (LN) is a branch of the mandibular division of the trigeminal nerve, and its injury is one of the major complications during oral surgery. This study aims to investigate the anatomy of the LN in the lower third molar area. Twenty sides from ten fresh-frozen adult cadaveric Caucasian heads were examined to measure the diameter of the LN. The mean diameter of the LN was 2.20±0.37 mm (range, 1.61–2.95 mm). There were no statistically significant differences in the measurements between sexes, sides, or tooth status (dentulous or edentulous). Understanding the anatomical features of the LN is essential for performing any surgical procedure in the oral region.
An elongated dorsally curved xiphoid process
Stefan Lachkar,Joe Iwanaga,R. Shane Tubbs 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.1
The xiphoid process of the sternum lies in the epigastric region and functions to serve as an attachment point for vital muscles that aid in respiration. With the xiphoid process extending as the most inferior portion of the sternum, variable morphology is widely observed. During a routine dissection of a 44-year-old Caucasian male cadaver, we discovered a hookshaped, elongated xiphoid process that protruded dorsally. Potential clinical significance can arise leading to misdiagnosis of the hook-shaped xiphoid process as an epigastric mass during imaging. Though various variations of xiphoid process have been well documented, knowledge of a hook-shaped xiphoid process orientated dorsally remains scarce. Herein, this case study provides clinicians, surgeons, and radiologists a rare anomaly of the xiphoid process in order to further the knowledge of morphological variations of the xiphoid to prevent misdiagnosis and surgical complications.