Browsing by Author "Fowers, Rylan"
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Item Deep Profunda Femoris variant found within the Sciatic Sheath supplying the posterior compartment of the leg(2023) Driskill, Austin; Fowers, Rylan; Craig, Taylor; Lovely, Rehana S.Abstract The lower extremity has well documented arterial variations; however, finding an artery within the sciatic sheathing and providing muscular branches to the proximal leg is abnormal. During the dissection of a 64-year-old male cadaver, a branch of the deep femoral artery was found within the sciatic sheath of the lower right extremity in the posterior compartment. Knowledge of the branches of the femoral and deep femoral arteries is clinically relevant in radiology nerve blocking treatment and surgically relevant in knee and femoral surgeries. The deep femoral artery branches off the femoral artery on the proximal portion of the anteriomedial side of the thigh. Deep to the rectus femoris muscle and between the vastus medialis muscle and adductor magnus muscle, the deep femoral artery provides perforating branches that give off cutaneous, anastomotic, and muscular branches to the flexor aspect of the thigh. The variant artery in this cadaver was found as an enlarged perforating branch of the profunda femoris artery, piercing through the adductor magnus muscle and supplying the posterior compartment of the thigh. Perforating branches commonly terminate in the posterior thigh, but this variant continues through the posterior leg and popliteal fossa within the sciatic sheath. The variant blood vessel terminates distal to the knee as muscular branches for both heads of the gastrocnemius and soleus muscles.Item Prevalence of Bilateral Frontal Sinus Absence in Cadaveric Specimens: A Cross-Sectional Study(2024-03-21) Fowers, Rylan; Driskill, Austin; Stucki, Brenton; Van Alfen, Braden; Heidenreich, Taylor; Lovely, RehanaPurpose: The frontal sinus is one of four pairs of paranasal sinuses, developed early in gestation and continuing pneumatization into teenage years. Due to the differences in pneumatization, large variability exists in the size and dimensions of the frontal sinus, with the majority of radiologic studies showing prevalence of bilateral frontal sinus agenesis to be between 3-5%. While frontal sinus agenesis has not been identified as a frequent cause of patient complaints, it has contributed to worsening symptoms in certain diseases, and this anatomical variation may pose complicated risks to patient treatments, such as surgery. This study aims to demonstrate the prevalence of bilateral frontal sinus agenesis in a population of fixed cadavers from the United States. Methods: The sagittally hemisected skulls of forty-eight cadavers donors of the HSC Willed Body Program were used for this study, and were not separated based on sex, race, or age. All donors were above the age of 35, allowing for complete pneumatization of the frontal sinuses at the time of hemisection. Initial gross observation of the frontal sinus was performed by the researchers at the midline site of hemisection. If the hollow frontal sinus was not identifiable, sagittal cuts with a bone shear were performed in the bilateral supraorbital regions laterally up to two centimeters from the site of midline hemisection in order to determine if the frontal sinus was present. This method was performed on each of the forty-eight cadaveric skulls. During gross observation and further dissection of the supraorbital regions of the skulls, bilateral presence or absence of the frontal sinuses was noted. Results: Three of the forty-eight donors exhibited bilateral agenesis of the frontal sinus leaving forty-five to exhibit unilateral or bilateral presence of frontal sinuses. This correlates to a prevalence of bilateral frontal sinus absence in 6.25% of the population. Conclusion: This study contributes valuable insights to variations and developmental sequences of the frontal sinus. Literature is consistent regarding prevalence of frontal sinus agenesis in various populations, ranging from 2% to 8% depending on the country of origin; the prevalence of bilateral frontal sinus absence in the sample population of this study was 6.25%. Our findings contribute to current data highlighting prevalence rates, which highlights the importance of noting radiologically determined frontal sinus abnormalities in patient histories, ensuring appropriate care during surgeries and future treatments of conditions such as chronic sinusitis and primary ciliary dyskinesia (PCD).Item Variant Blood Supply of the Superficial Face: A Case Report(2024-03-21) Stucki, Brenton; Fowers, Rylan; Judd, Dallin; Van Alfen, Braden; Rosales, Armando; Lovely, RehanaIntroduction: The facial and transverse facial arteries provide the major arterial supply for the superficial face. The facial artery arises from the external carotid artery, in the carotid triangle of the neck, and crosses the angle of the mandible as it ascends the anterolateral face. Following a distinctive course, it continues by running along the oral commissure where it gives off the superior and inferior labial branches. Continuing its trajectory, the artery ascends along the nasolabial sulcus, providing the lateral nasal branch, and concludes its course by terminating as the angular branch near the medial aspect of the eye. The transverse facial artery, which arises from the superficial temporal artery, has a significant role in lateral face vascularization by supplying blood to the parotid gland, masseter, and integument and terminating near the buccal area. Case Presentation: During a unilateral dissection of a previously hemisected head of a 78-year-old donor from the UNTHSC Willed Body program, variations of the facial and transverse facial arteries were observed. The superficial and deep structures of the face were subsequently dissected and cleaned to expose arterial origins and terminations. The variant anatomical structures were then noted and photographed. The facial artery arose from the external carotid between the lingual and occipital arteries. After crossing the angle of the mandible, the variant facial artery terminated below the oral fissure, supplying blood to the lower face only. The transverse facial artery arose from the superficial temporal, running deep to the parotid gland extending across the lateral face. It then continued in the typical path of the facial artery, following the nasolabial sulcus supplying the muscles and tissues above the oral fissure. It was observed that this variant transverse artery supplied blood to the superficial face instead of the facial artery. Conclusion: The face, like the rest of the human body, has a variety of documented anatomical variations. The observed anatomical variations of the facial and transverse facial arteries highlight the complexity and diversity regarding the vascular supply of the face. The documentation of such variations serves as vital information in clinical and surgical practice to yield the best patient outcomes during treatment.