Bingol, Koray; Celik, Elif

Purpose: The common hepatic artery (CHA) demonstrates considerable anatomical variability with important implications for hepatobiliary, pancreatic, transplant, and endovascular procedures. This study aimed to evaluate the prevalence, morphometric characteristics, and three-dimensional topographic relationships of CHA variations using computed tomography angiography (CTA) in a large cohort. Methods: This retrospective study included 1347 consecutive patients (604 women, 743 men; mean age 55.1 ± 14.4 years) who underwent abdominal CTA. Hepatic arterial anatomy was classified according to the Hiatt and Song classifications. Morphometric parameters of the celiac trunk, CHA, gastroduodenal artery, and proper hepatic artery, and the three-dimensional relationships of the CHA to adjacent structures, were evaluated using multiplanar reformation, maximum-intensity projection, and volume-rendering techniques. Comparisons were performed according to sex, age group, and variation status. Results: Conventional hepatic arterial anatomy (Hiatt type I) was identified in 64.7% of patients, whereas 35.3% had variant anatomy, most commonly an isolated left hepatic artery variation (13.4%). The CHA originated predominantly from the celiac trunk (97.0%), with hepatomesenteric (2.3%) and direct aortic (0.7%) origins being uncommon. Male patients had significantly larger arterial calibres, and most morphometric parameters increased with age. Variant anatomy was associated with longer CHA, greater celiac trunk-to-CHA distance, wider departure angle, and more frequent retropancreatic, intrapancreatic, and portal/superior mesenteric venous confluence-related courses (all p < 0.001). Conclusion: Hepatic arterial variation is associated with distinct morphometric and topographic characteristics. These population-specific reference data may improve preoperative assessment and support safer hepatobiliary, pancreatic, transplant, and endovascular interventions by improving procedural planning and reducing vascular injury.

Akbulut, Yalçın; Karakas, Asli Beril; Yarar, Burhan; Sunar, Mukadder

In this article the author name Asli Beril Karakas was incorrectly written as Aslı Beril Karakaş Tanır. The original article has been corrected.

Akbulut, Yalçın; Karakaş Tanır, Aslı Beril; Yarar, Burhan; Sunar, Mukadder

Purpose: The aim of this study was to construct an osteological map of the morphological projection of the coracoclavicular ligament on the clavicle. Methods: In this study, 93 dry clavicles without age and sex records were used. The attachment sites of the trapezoid and conoid ligaments were examined structurally and formally. Results: The attachment sites of the trapezoid ligament were triangular in 9 clavicles, ellipsoidal in 18 clavicles and trapezoidal in 62 clavicles. The anatomical structures of the attachment sites of the trapezoid ligament were as follows: 57 were tuberosities, 12 were tubercles, 11 were lines, and 9 were fovea. The attachments of the conoid ligament on the clavicle were low in 23 clavicles, moderate in 37 clavicles and high in 29 clavicles. The anatomical structure of the attachment sites of the conoid ligament was as follows: 50 were tubercles, 20 were tuberosities, 8 were adhesions, 6 were crests, 3 were impressions, and 2 were spines. The attachments of the conoid ligament on the clavicle were low in 20 clavicles, moderate in 50 clavicles, and high in 19 clavicles. The prevalence of the coracoclavicular joint was 6% in this study. Conclusion: In conclusion, we believe that this study provides guidance for clinicians by revealing the osteological traces of the components of the coracoclavicular ligament or the coracoclavicular joint on the clavicle.

Kolak, Merve; Kızılgöz, Volkan; Kantarci, Mecit

Purpose: Understanding ethmoid roof morphology is crucial to prevent complications in endoscopic sinus surgery. This study aimed to evaluate the morphological properties of the ethmoidal roof regarding gender and age differences using Keros and Yenigun classifications on high-resolution computed tomography images. Methods: We retrospectively analyzed 891 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in coronal sections and the anterior–posterior length in axial planes. The study retrospectively examined CT images of paranasal sinuses of patients living in the eastern Anatolian region of Turkey. Results: In both Keros and Yenigun Classifications, the most common class was type 2, and the least common class was type 3. According to Keros et al.'s method, no significant difference was observed between men and women (p = 0.698). However, according to Yenigun et al., the average values of women in terms of the anterior–posterior distance of the ethmoid roof were significantly higher than men (p = 0.001). When examined according to age, a very low, negative correlation was revealed regarding Keros and Yenigun classifications (p = 0.047 and p < 0.001 retrospectively). According to Keros and Yenigun's classification, there was no significant difference between the left and right sides (p = 0.488 and p = 0.919, respectively). Conclusion: The morphological properties of the ethmoidal roof have importance to be considered for preoperative planning. Studying larger patient groups and meta-analyses that gather various research results about this subject might help better understand the ethmoidal roof morphology among populations.

Kızılgöz, Volkan; Aydın, Sonay; Aydemir, Hüseyin; Kantarcı, Mecit

Purpose: Awareness of normative values of extra orbital structures would provide useful information to interpret the radiological images better and use them for diagnostic purposes. This study aimed to reveal the average values of major extraocular structures measured on magnetic resonance images. Methods: In this retrospective cross-sectional study, magnetic resonance (MR) images of 256 orbits of 128 patients were re-interpreted regarding the measurements of major orbital structures. Extraocular muscles, superior ophthalmic vein, and optic nerve-sheath complex were measured on orbital MR images of these patients. The data distributions were presented by box-plot analyses for each parameter, and the measurement results were analyzed regarding gender and age groups. Results: Lateral rectus muscle thickness (LR), inferior rectus muscle thickness (IR), globe position (GP), and interzygomatic line (IZL) values were higher in the male group than in the female group (p values were < 0.001, 0.003, 0.020, and < 0.001 respectively). LR, the thickness of the superior group muscles (SUP GR), IR, superior oblique muscle thickness (SOBL), and the thickness of optic nerve-sheath complex (ON) values indicated a significant relationship between age groups. There was a significant, positive, and low-level correlation between age and LR, SUP GR, and IR values (p values were < 0.001, 0.001, and < 0.001, respectively). Conclusion: This study provides quantitative data on normative values of orbital structures with gender and age group comparisons. Clinicians or surgeons can easily use the measured values to gather diagnostic information from the orbital region.

Ay, Mutlu; Ogul, Hayri; Kantarci, Mecit

The temporopolar artery (TPA) originates directly from the sphenoidal segment of the middle cerebral artery (MCA). Its originating from the M1 segment of the MCA as a branch of the anterior temporal artery is not uncommon. However, internal carotid artery origination is a very rare variation of the TPA. Here, we report a very rare case of the variant origin of the TPA and the presence of saccular aneurysm at this origin.

Kayacı, Selim; Ozveren, Mehmet Faik; Bas, Orhan; Ayberk, Giyas; Aslan, Murat Nihat; Sam, Bulent; Arslan, Yusuf Kemal

Purpose: To investigate the effect of the clival bone pattern on the abducens nerve (AN) localization in the petroclival region between the Pediatric and Adult Groups. Methods: This study used 12 pediatric and 17 adult heads obtained from the autopsy. The length and width of the clivus and the length of the petrosphenoidal ligaments (PSLs) were measured. The ratio of the length and width of the clivus was accepted as the clival index (CI). The localization of the AN at the petroclival region below the PSL, classified as lateral and medial, were recorded. Results: The average length of the clivus was 26.92 ± 2.88 mm in the Pediatric Group, and 40.66 ± 4.17 mm in the Adult Group (p < 0.001). The average width of the clivus was 22.35 ± 2.88 mm in the Pediatric Group, and 29.96 ± 3.86 mm in the Adult Group (p < 0.001). The average value of the CI was 1.20 in the Pediatric Group and 1.36 in the Adult Group (p = 0.003). The length of the PSL was 7.0 ± 1.47 mm in the Pediatric Group and 11.05 ± 2.95 mm in the Adult Group (p < 0.001). The nerve was located below the medial side of the PSL in the Pediatric Group and below the lateral side in the Adult Group (p = 0.002). Conclusions: The petrous apex localization of the AN in adults compared with pediatric subjects could be related to the increased growth in the length of the clivus than its width.