ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 12 of 67
Up
JMBS 2020, 5(4): 100–109
https://doi.org/10.26693/jmbs05.04.100
Experimental Medicine and Morphology

Methods of Preparing and Manufacturing the Topographic-Anatomic Sections for Determining the Fetal Anatomic Variability of Organs and Structures of the Anterior and Lateral Cervical Regions

Khmara T. V., Lopushniak L. Ya., Marchuk O. F., Halahdyna A. A., Boichuk O. M.
Abstract

To obtain data on the formation of fetal macroscopic structure and topography of the organs, muscles, fascial-cellular and vascular-nerve formations of the anterior and lateral portions of the neck, which can be used for age-related mapping, it is necessary to compile and try a standard sequence of steps when preparing these structures. The purpose of the study was to determine the method of the most rational sequence of actions during the preparation of fascia, muscles, vascular-nerve structures, organs and cellular spaces of the anterior and lateral cervical sections of human fetuses in order to obtain standard results, suitable for age-related comparison. Material and methods. The study was performed on 75 fetuses of 4-10 months by thin preparation under the control of binocular magnifier, as well as the method of making topographic-anatomical sections of the neck at different levels. Results and discussion. In the study of fetal anatomical variability of organs and structures of the cervical region, the algorithm of anatomical preparation becomes a priority in the age aspect. Consistency of the following sequence during the preparation of the anterior and lateral portions of the neck: dissection of the skin in the longitudinal and transverse directions; reparation of skin flaps with superficial veins and weakly expressed subcutaneous muscle fibers of 4-7 months fetus and skin removal with preservation and subsequent dissection of subcutaneous muscle of 8-10 months fetus; preparation of superficial vessels and nerves; dissection of the surface plate of the cervical fascia; gradual dissection of the fascial vagina and preparation of the sternocleidomastoid muscle and the sternal clavicle-mastoid area; preparation of the pre-tracheal plate of the cervical fascia and sublingual muscles of the neck; preparation of structures of carotid triangles, with subsequent dissection of the vagina of the neurovascular beams and study of the topography of their components; preparation of the muscles of the supra-lingual group and structures of the mandibular triangle; preparation of the cervical part of the trachea, esophagus and cellular spaces of the neck provides not only the scientific value of the obtained results, but also the rational use of biological material. Conclusion. The obtained results allowed establishing age and individual anatomical variability of shape, size, topography of muscles; skin branches of the cervical plexus; components of the vascular-nerve bundles of the neck; the anterior branches of the external carotid artery and the inflow of the jugular veins, the cervical parts of the trachea and the esophagus in human fetuses of all ages. The proposed and tested technique of preparation of the anterior and lateral sections of the neck ensures the standard of obtaining data on the individual and age-related anatomical variability of the muscles, fascial-cellular formations, organs and vascular-nervous structures of the neck. The sequence of actions used during the preparation of the cervical area of the human fetus preserves the natural appearance and correlation between the structures of the objects of the study.

Keywords: cervical region, preparation, topographic-anatomical section, anatomical variability, fetus, human

Full text: PDF (Ukr) 482K

References
  1. Pedreira DA. Advances in fetal surgery. Einstein (Sao Paolo). 2016; 14(1): 110-2. https://doi.org/10.1590/S1679-45082016MD3449. https://www.ncbi.nlm.nih.gov/pubmed/27074241. https://www.ncbi.nlm.nih.gov/pmc/articles/4872928
  2. Okrim II. Anatomichna minlyvistʹ mizhrebrovoho sudynno-nervovoho puchka u plodiv lyudyny [Anatomic variability of the intercostal neurovascular bundle in human fetuses]. Morphologia. 2019; 13(3):86-92. [Ukrainian] https://doi.org/10.26641/1997-9665.2019.3.86-92
  3. Hasselt AV, Wong EW, Eds. Head and Neck: Dissection and Reconstruction Manual. Hong Kong: The Chinese University of Hong Kong; 2015. 175 р.
  4. Carini F, Salerno M, Mazzola M, Piccolo CL, Cavallo G, Musso S, et al. A brief anatomo-surgical dissection guide to human neck: results of the collaboration between the university of Palermo and the university of Malta. EuroMediterranean Biomedical Journal. 2018; 13(14): 069-072. https://doi.org/10.3269/1970-5492.2018.13.14
  5. Kulish AS, Sheyan DN, Nedorezova VA, Lyutenko MA, Sukhonosov RA. Sposib dostupu do hrudnyno-klyuchychno-soskopodiboyi dilyanky zi zberezhennyam tsilisnosti hrudnyno-klyuchychno-soskopodibnoho m'yaza [Method to access the sternocleidomastoid area, with preservation of the integrity of the sternocleidomastoid muscle]. Tavricheskiy Mediko-Biologicheskiy vestnik. 2013; 16(1.2(61): 99-100. [Ukrainian]
  6. Périé S, Lesnik M, Samaha S, Lacau St Guily J. How to release neck dissections: Role of the triangle between the spinal accessory nerve and the internal jugular vein. European Annals of Otorhinolaryngology, Head and Neck diseases. 2017; 134: 201-3. https://doi.org/10.1016/j.anorl.2016.10.002. https://www.ncbi.nlm.nih.gov/pubmed/27840043
  7. Kikuta S, Iwanaga J, Kusukawa J, Tubbs RS. Triangles of the neck: a review with clinical/surgical applications. Anat Cell Biol. 2019; 52: 120-27. https://doi.org/10.5115/acb.2019.52.2.120. https://www.ncbi.nlm.nih.gov/pubmed/31338227. https://www.ncbi.nlm.nih.gov/pmc/articles/6624334
  8. Tsyhykalo OV, Popova IS. Osoblyvosti budovy ta topohrafiyi pidpid'yazykovykh trykutnykiv perednʹoyi shyynoyi dilyanky v plodovomu periodi ontohenezu lyudyny [Peculiarities of structure and topography of infrahyoid triangles in anterior region of neck during fetal period of human ontogenesys]. Сlinical and experimental pathology. 2019; 18(4(70): 92-96. [Ukrainian] https://doi.org/10.24061/1727-4338.XVIII.4.70.2019.15
  9. Ferreli F, Mercante G, Spriano G. Levator Claviculae Muscle: Anatomic Variation Found During Neck Dissection. Laryngoscope. 2019 Mar; 129: 634-6. https://doi.org/10.1002/lary.27280. https://www.ncbi.nlm.nih.gov/pubmed/30565677
  10. Bandarupalli NK, Bolla SR. Bilateral cleidohyoideus accessorius muscle-a case report. Journal of Evolution of Medical and Dental Sciences. 2013 Jan; 2(4): 356-8. https://doi.org/10.14260/jemds/268
  11. Heude E, Tesarova M, Sefton EM, Jullian E, Adachi N, Grimaldi A, et al. Unique morphogenetic signatures define mammalian neck muscles and associated connective tissues. eLife. 2018; 7: e40179. https://doi.org/10.7554/eLife.40179. https://www.ncbi.nlm.nih.gov/pubmed/30451684. https://www.ncbi.nlm.nih.gov/pmc/articles/6310459
  12. Ericsson R, Knight R, Johanson Z. Evolution and development of the vertebrate neck. Journal of Anatomy. 2012; 222: 67-78. https://doi.org/10.1111/j.1469-7580.2012.01530.x. https://www.ncbi.nlm.nih.gov/pubmed/22697305. https://www.ncbi.nlm.nih.gov/pmc/articles/3552416
  13. Vasylʹchyshyna AV, Khmara TV, Vasylʹchyshyn YaM. Perynatalʹna anatomiya sidnychnoyi dilyanky [Perinatal anatomy of the gluteal region] Chernivtsi: Meduniversytet; 2017. 220 p. [Ukrainian]
  14. Bilash SM, Pronina OM, Koptev MM. Comprehensive morphological studies as an intergal part of modern medical science. Literature review. Visnyk problem biolohiyi i medytsyny. 2019; 2.2(151): 20-3. [Ukrainian]