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  1. Article ; Online: Preoperative assessment of depressor anguli oris to prevent myectomy failure: An anatomical study using high-resolution ultrasound.

    Vejbrink Kildal, Villiam / Meng, Stefan / Pruidze, Paata / Reissig, Lukas / Weninger, Wolfgang J / Tzou, Chieh-Han John / Rodriguez-Lorenzo, Andrés

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2023  Volume 88, Page(s) 296–302

    Abstract: Background: Myectomies of the lower lip depressor muscles have unexplained high failure rates. This study aimed to examine the depressor anguli oris (DAO) muscle using high-resolution ultrasound to identify potential anatomical explanations for surgical ...

    Abstract Background: Myectomies of the lower lip depressor muscles have unexplained high failure rates. This study aimed to examine the depressor anguli oris (DAO) muscle using high-resolution ultrasound to identify potential anatomical explanations for surgical failures and to determine the accuracy of utilizing preoperative ultrasound assessment to improve myectomies.
    Methods: Anatomical features of DAO and the surrounding anatomy were examined in 38 hemifaces of human body donors using high-resolution ultrasound and dissection.
    Results: The ultrasound and dissection measurements showed the DAO muscle width to be 16.2 ± 2.9 versus 14.5 ± 2.5 mm, respectively, and the location of the lateral muscle border 54.4 ± 5.7 versus 52.3 ± 5.4 mm lateral to the midline. In 60% of the cases, the facial artery was either completely covered by lateral DAO muscle fibers or was found to be in direct contact with the lateral border. Significant muscle fiber continuity was present between the DAO and surrounding muscles in 5% of cases, whereas continuity between the depressor labii inferioris and surrounding muscles was considerably more common and pronounced.
    Conclusions: High-resolution ultrasound can accurately reveal important preoperative anatomical information in myectomies. Two potential explanations for the surgical failures were discovered: an overlap of lateral DAO muscle fibers over the facial artery could lead to inadequate resections and continuity with the surrounding muscles might lead to muscle function takeover despite adequate resections. Both can be uncovered preoperatively by the surgeon through a brief, directed ultrasound examination, which may allow for modification of the surgical plan to reduce surgical failure.
    MeSH term(s) Humans ; Facial Muscles ; Lip ; Dissection
    Language English
    Publishing date 2023-11-10
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2023.11.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uk I Zs.157: Show issues Location:
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  2. Article ; Online: Ultrasound Detection of the Axillary Arch as a Cause of Thoracic Outlet Syndrome: A Prospective Dissection-Controlled Cadaver Study.

    Pruidze, Paata / Rossmann, Tobias / Weninger, Jeremias T / Didava, Giorgi / Seyedian Moghaddam, Atieh / Weninger, Wolfgang J / Meng, Stefan

    Ultrasound in medicine & biology

    2023  Volume 49, Issue 4, Page(s) 946–950

    Abstract: Ultrasound as a diagnostic tool in thoracic outlet syndrome (TOS) is becoming increasingly important. The aim of this study was to investigate the diagnostic value of ultrasound in detecting the axillary arch, an ancillary muscle potentially causing TOS. ...

    Abstract Ultrasound as a diagnostic tool in thoracic outlet syndrome (TOS) is becoming increasingly important. The aim of this study was to investigate the diagnostic value of ultrasound in detecting the axillary arch, an ancillary muscle potentially causing TOS. Two hundred upper limbs of 100 fresh, non-frozen, non-embalmed body donors were screened for axillary arches. Sonographic findings were validated by anatomic dissection. Twelve axillary arches were found in 200 upper extremities, corresponding to a prevalence of 8.0% per individual and 6.0% per upper extremity investigated. Ultrasound had low diagnostic performance in identifying axillary arches, with a sensitivity of 66.7% and specificity of 95.7%. There was a tendency to identify more easily arches consisting of purely muscle tissue. Axillary arch thickness, its cross-sectional area and the predominant tissue type were associated with compression of the neurovascular bundle during shoulder elevation. Ultrasound seems to have limited potential to identify axillary arches. However, arches consisting predominantly of muscle tissue may be identified more easily and were associated with compression of neurovascular structures, thus potentially causing symptoms. Further clinical trials are needed to clarify the true value of ultrasound in patients with symptoms of TOS.
    MeSH term(s) Humans ; Muscle, Skeletal ; Prospective Studies ; Axilla ; Thoracic Outlet Syndrome ; Cadaver
    Language English
    Publishing date 2023-01-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2022.11.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 963: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Axillary arch (of Langer): A large-scale dissection and simulation study based on unembalmed cadavers of body donors.

    Weninger, Jeremias T / Pruidze, Paata / Didava, Giorgi / Rossmann, Tobias / Geyer, Stefan H / Meng, Stefan / Weninger, Wolfgang J

    Journal of anatomy

    2023  Volume 244, Issue 3, Page(s) 448–457

    Abstract: Connective or muscular tissue crossing the axilla is named axillary arch (of Langer). It is known to complicate axillary surgery and to compress nerves and vessels transiting from the axilla to the arm. Our study aims at systematically researching the ... ...

    Abstract Connective or muscular tissue crossing the axilla is named axillary arch (of Langer). It is known to complicate axillary surgery and to compress nerves and vessels transiting from the axilla to the arm. Our study aims at systematically researching the frequency, insertions, tissue composition and dimension of axillary arches in a large cohort of individuals with regard to gender and bilaterality. In addition, it aims at evaluating the ability of axillary arches to cause compression of the axillary neurovascular bundle. Four hundred axillae from 200 unembalmed and previously unharmed cadavers were investigated by careful anatomical dissection. Identified axillary arches were examined for tissue composition and insertion. Length, width and thickness were measured. The relation of the axillary arch and the neurovascular axillary bundle was recorded after passive arm movements. Twenty-seven axillae of 18 cadavers featured axillary arches. Macroscopically, 15 solely comprised muscular tissue, six connective tissue and six both. Their average length was 79.56 mm, width 7.44 mm and thickness 2.30 mm. One to three distinct insertions were observed. After passive abduction and external rotation of the arm, 17 arches (63%) touched the neurovascular axillary bundle. According to our results, 9% of the Central European population feature an axillary arch. Approximately 50% of it bilaterally. A total of 40.74% of the arches have a thickness of 3 mm or more and 63% bear the potential of touching or compressing the neuromuscular axillary bundle upon arm movement.
    MeSH term(s) Humans ; Axilla ; Muscle, Skeletal/innervation ; Pectoralis Muscles ; Dissection ; Cadaver
    Language English
    Publishing date 2023-11-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2955-5
    ISSN 1469-7580 ; 0021-8782
    ISSN (online) 1469-7580
    ISSN 0021-8782
    DOI 10.1111/joa.13976
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ub I Zs.38: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Ultrasound-Guided Injections for Treatment of Facial Paralysis Sequelae: A Randomized Study on Body Donors.

    Vejbrink Kildal, Villiam / Rodriguez-Lorenzo, Andrés / Pruidze, Paata / Reissig, Lukas / Weninger, Wolfgang J / Tzou, Chieh-Han John / Jonsson, Lars / Meng, Stefan

    Plastic and reconstructive surgery

    2023  Volume 153, Issue 3, Page(s) 617e–625e

    Abstract: Background: Botulinum toxin injection is the accepted standard treatment for synkinesis and gustatory hyperlacrimation in patients with facial paralysis. However, poor injection accuracy can result in inconsistent treatment outcomes, variable treatment ... ...

    Abstract Background: Botulinum toxin injection is the accepted standard treatment for synkinesis and gustatory hyperlacrimation in patients with facial paralysis. However, poor injection accuracy can result in inconsistent treatment outcomes, variable treatment durations, and complications. Ultrasound guidance should increase injection accuracy in the facial region; however, this has not been proven.
    Methods: Twenty-six hemifaces of nonembalmed cadavers were studied in a randomized split-face manner. Ink was injected with ultrasound or landmark guidance into the lacrimal gland and three common synkinetic muscles: the orbicularis oculi, depressor anguli oris, and mentalis. Injection accuracy was evaluated using several measures.
    Results: Using ultrasound guidance, most ink (>50%) was found inside the correct target in 88% of cases, compared with 50% using landmark guidance ( P < 0.001). This was most pronounced in the lacrimal gland (62% versus 8%), depressor anguli oris (100% versus 46%), and mentalis (100% versus 54%) ( P < 0.05). All ink was found inside the correct target (no ink outside) in 65% using ultrasound guidance versus 29% without ( P < 0.001). Injection accuracy (any ink in target) was 100% when using ultrasound guidance versus 83% without ( P < 0.01). Twenty-three percent of the landmark-guided depressor anguli oris injections stained the facial artery ( P = 0.22).
    Conclusions: Ultrasound guidance significantly increased injection accuracy and reduced the amount of ink lost in the surrounding tissue compared with landmark guidance. Clinical trials are needed to explore the effects of ultrasound guidance on treatment outcome, duration, and complications in patients with facial paralysis.
    MeSH term(s) Humans ; Facial Paralysis/diagnostic imaging ; Facial Paralysis/drug therapy ; Injections ; Facial Muscles ; Treatment Outcome ; Ultrasonography, Interventional ; Botulinum Toxins, Type A
    Chemical Substances Botulinum Toxins, Type A (EC 3.4.24.69)
    Language English
    Publishing date 2023-06-06
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000010802
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.142: Show issues Location:
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    Zs.MO 293: Show issues

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  5. Article ; Online: Performing nasopharyngeal swabs-Guidelines based on an anatomical study.

    Pruidze, Paata / Mincheva, Plamena / Weninger, Jeremias T / Reissig, Lukas F / Hainfellner, Andreas / Weninger, Wolfgang J

    Clinical anatomy (New York, N.Y.)

    2021  Volume 34, Issue 6, Page(s) 969–975

    Abstract: Nasopharyngeal swabs are performed to collect material for diagnosing diseases affecting the respiratory system, such as Covid-19. Yet, no systematic anatomical study defines concrete prerequisites for successfully targeting the nasopharyngeal mucosa. We ...

    Abstract Nasopharyngeal swabs are performed to collect material for diagnosing diseases affecting the respiratory system, such as Covid-19. Yet, no systematic anatomical study defines concrete prerequisites for successfully targeting the nasopharyngeal mucosa. We therefore aim at simulating nasopharyngeal swabs in human body donors to characterize parameters allowing and supporting to enter the nasopharynx with a swab, while avoiding endangering the cribriform plate. With the aid of metal probes and commercial swabs a total of 314 nasopharyngeal swabs in anatomical head/neck specimens stemming from 157 body donors were simulated. Important anatomical parameters were photo-documented and measured. We provide information on angles and distances between prominent anatomical landmarks and particularly important positions the probe occupies during its advancement through the nares to the upper and lower parts of the nasopharynx and cribriform plate. Based on these data we suggest a simple and safe three-step procedure for conducting nasopharyngeal swabs. In addition, we define easily recognizable signals for its correct performance. Evaluations prove that this procedure in all specimens without deformations of the nasal cavity allows the swab to enter the nasopharynx, whereas a widespread used alternative only succeeds in less than 50%. Our data will be the key for the successful collection of nasopharyngeal material for detecting and characterizing pathogens, such as SARS-CoV-2, which have a high affinity to pharyngeal mucosa. They demonstrate that the danger for damaging the cribriform plate or olfactory mucosa with swabs is unlikely, but potentially higher when performing nasal swabs.
    MeSH term(s) Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19 Testing ; Cadaver ; Female ; Humans ; Male ; Middle Aged ; Nasopharynx/pathology ; Nasopharynx/virology ; Practice Guidelines as Topic ; SARS-CoV-2/isolation & purification ; Specimen Handling/methods
    Language English
    Publishing date 2021-07-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1025505-9
    ISSN 1098-2353 ; 0897-3806
    ISSN (online) 1098-2353
    ISSN 0897-3806
    DOI 10.1002/ca.23762
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2592: Show issues Location:
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