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The maxillary artery (MA) passes over the lateral pterygoid muscle in the infratemporal fossa and enters the pterygopalatine fossa through the pterygomaxillary fissure. Refractory epistaxis is managed by ligation of the sphenopalatine artery via a transmaxillary-transantral approach; there is considerable risk of complications associated with such invasive surgical approaches. The aim of this study was to describe the gross anatomy and variations therein of the MA and its branches at the pterygopalatine fossa. One hundred hemifaces of embalmed Korean adult cadavers were dissected to establish the precise course of the MA and its branching patterns. The average thickness of the posterior wall of the maxillary sinus was 0.8 mm, but varied over a wide range from 0.2 to 3.6 mm. We classified the third part of the MA into 3 morphological categories: looped (61%), bifurcated (19%), and straight (18%). Two cases could not be classified into any of these 3 categories. The pattern of the bifurcation between the sphenopalatine and descending palatine arteries was classified into 4 types: Y (19%), intermediate (36%), M (17%), and T (28%). The posterior wall of the maxillary sinus was divided into 9 sections. The branching areas of the sphenopalatine and descending palatine arteries were most frequently (62% of cases) located at the top of the medial partition and at the middle of the medial partition (30% of cases).

The vibrissal follicle-sinus complex (FSC) is a sensory receptor of the mammalian integumentary system that is located around the mouth. The purpose of the present study was to identify the actual 3-dimensional structure of the rat vibrissal FSC. Rat skin tissue was serially sectioned at a thickness of 10 µm and then stained with Masson’s trichrome. The serial sections were reconstructed 3-dimensionally using Reconstruct software. The rat vibrissal follicle is a spindle-shaped structure that is embedded within a blood sinus and enveloped within a thick collagenous capsule. The vibrissal FSC is innervated by the deep vibrissal and superficial vibrissal nerves. The deep vibrissal nerve, travelling in the basal-to-apical direction, penetrates the thick collagenous capsule of the vibrissal FSC. The sinus system can be divided into a superior portion, known as the ring sinus, and an inferior portion, known as the cavernous sinus. The ring sinus contains a C-shaped structure, the ringwulst, which is suspended from the mesenchymal sheath of the follicle. Collagenous trabeculae can be seen in the cavernous sinus but not in the ring sinus. The ring sinus encircles the follicle obliquely and asymmetrically. The ringwulst encircles the follicle incompletely, in a C-shaped fashion. This study has demonstrated the previously underappreciated 3-dimensional structure of the vibrissal FSC, which differs from previously reported descriptions, and provides data that will enhance the understanding of vibrissal function.

The levator labii superioris (LLS) muscle is well known as one of the upper-lip elevators; however, there have been few reports about the anatomic description of the LLS. Especially, the shape of the LLS and its relationship with the nasal ala were not clearly shown in the literature. The aim of this study was to clarify and describe the morphology and topography of the LLS and the anatomic variations to understand the function of the LLS related with the nasal ala. The LLS was examined in 102 specimens of embalmed Korean and French adult cadavers. The LLS was classified into 3 categories according to its shape and attachment: rectangular (83%), fan (10%), or trapezoid (7%) type. The medial fibers of the LLS were attached to the deep surface of the alar facial crease and were mainly intermingled with the alar part of the nasalis. Some of the deeper muscle fibers of the LLS extended to the vestibular skin of the nasal lobule. These new anatomic findings in the current study could be useful information for understanding the function of the LLS and the various surgical procedures of the perinasal region.

It is well known that the head and face are smaller in female subjects than in male subjects. However, almost all previous studies have quantified the size difference between female and male subjects as simple numerical values, which might not clarify the difference. The present study evaluated the female-to-male proportions of the head and face so as to clarify the sex-related differences. A total of 1939 female subjects and 1398 male subjects were divided into 3 age groups: young (20-39 y), middle-aged (40-59 y), and elderly (60-79 y). The dimensions were classified into 3 categories: 5 cephalic, 3 frontal facial, and 6 lateral facial. The female-to-male proportions of individual dimensions were compared in the 3 age groups using the following formula: female measurement value × 100/(mean of male measurement value). The female-to-male proportions of the cephalic dimension increased with age, with the female cephalic dimensions overall being about 96% of the male cephalic dimensions. The female-to-male proportions of the frontal facial dimension were constant across the age groups, with the female frontal facial dimensions overall being 95% of the male frontal facial dimensions. The female lateral facial dimension increased markedly from the young to middle-aged group and was constant or decreased slightly from the middle-aged to the elderly group. Overall, the female lateral facial dimensions were approximately 97% of the male lateral facial dimensions. The present study will suggest a new approach to elucidate those sex-related dimensional differences that are characteristic of female and male subjects.

Objectives The purpose of this study was to investigate the general structure of the incisive canal (IC) using 3-dimensional reconstruction and to classify into various types according to several criteria. Study design The materials used in the study were 56 anterior maxillae harvested from human cadavers. The specimens were scanned with microscopic computerized tomography (microCT), and the resulting microCT images were reconstructed in 3 dimensions. Results Many ICs had 1 foramen inferiorly and 2 foramina superiorly, and the separating level was just beneath the nasal floor. The middle part of the IC was not always a single hollow canal. Single-channel, 2-channel, 3-channel, and even 4-channel ICs were observed. The ICs were classified into 4 types according to the lateral shape of the canal: vertical-straight, vertical-curved, slanted-straight, and slanted-curved. Conclusions This study disclosed the detailed morphologic features of the IC, which will be helpful in the placement of local anesthesia or implants.

In order to gain insight into the gene expression profiles associated with anterior regeneration of the earthworm, Perionyx excavatus, we analyzed 1,159 expressed sequence tags (ESTs) derived from cDNA library early anterior regenerated tissue. Among the 1,159 ESTs analyzed, 622 (53.7%) ESTs showed significant similarity to known genes and represented 338 genes, of which 233 ESTs were singletons and 105 ESTs manifested as two or more ESTs. While 663 ESTs (57.2%) were sequenced only once, 308 ESTs (26.6%) appeared 2 to 5 times, and 188 ESTs (16.2%) were sequenced more than 5 times. A total of 803 genes were categorized into 15 groups according to their biological functions. Among 1,159 ESTs sequenced, we found several gene encoding signaling molecules, such as Notch and Distal-less. The ESTs used in this study should provide a resource for future research in earthworm regeneration.

The dramatic changes in facial expression are most remarkable in the perioral region. Among the perioral musculatures, the zygomaticus major (ZMj) muscle plays an important role in the facial expression. The aim of this study was to determine the anatomic patterns of the bifid ZMj through a topographic examination at the perioral region. Through 70 dissections of the hemifaces, the insertion area of the ZMj was observed in 70 embalmed cadavers. The bifid ZMj was observed in 28 cases (40%). In most cases of the bifid ZMj, the superior muscle fibers were larger and wider than the inferior fibers. Bilateral bifid ZMj was found in 71.4% of the bifid ZMj specimens. The arrangement and insertion patterns of the ZMj in this study are expected to provide critical information for the surgical planning and procedure for facial reanimation surgery.

Background The purpose of the present study was to determine the locations of the infraorbital foramen and mental foramen based on soft-tissue landmarks to facilitate prediction of the locations of these structures during facial surgery. Methods Fifty embalmed cadavers (100 sides) of Koreans were dissected to expose the infraorbital foramen and mental foramen. The distances between the bilateral infraorbital foramina and between the mental foramina and the distances between the alae of the nose and between the corners of the mouth (cheilions) were measured directly on the cadavers, and the vertical and horizontal distances between the infraorbital foramen and mental foramen and the ala of the nose and cheilions, respectively, were measured indirectly on photographs. Results The distance between the bilateral infraorbital foramina (54.9 +/- 3.4 mm) was greater than that between the bilateral mental foramina (47.2 +/- 5.5 mm). The infraorbital foramen was located 1.6 +/- 2.7 mm lateral and 14.1 +/- 2.8 mm superior to the ala of the nose. The distance between the ala of the nose and the infraorbital foramen was 15.9 +/- 2.8 mm, and the horizontal angle between these structures was 64.1 +/- 9.9 degrees laterosuperiorly. The mental foramen was located 20.4 +/- 3.9 mm inferior and 3.3 +/- 2.9 mm medial to the cheilions. The distance between the cheilions and mental foramen was 20.9 +/- 3.8 mm, and the vertical angle between these structures was 9.2 +/- 8.1 degrees inferomedially. Conclusions This study provides data that will be useful in predicting the locations of the infraorbital foramen and mental foramen when used together with hard-tissue landmarks. These data may be particularly helpful for facial surgery in patients with missing teeth.

Objective: To propose a safe and reproducible injection point for botulinum toxin-A (BTX-A) as a supplementary method for the treatment of gummy smile, as determined by assessment of the morphologic characteristics of three lip elevator muscles. Materials and Methods: A total of 50 hemi-faces from 25 adult cadavers (male 13, female 12; ages, 47 to 88 years) were used in this study. Topographic relations and the directions of the lip elevator muscles (ie, levator labii superioris [LLS], levator labii superioris alaeque nasi [LLSAN], and zygomaticus minor [ZMi]), were investigated. Possible injection points were examined through the study of predetermined surface landmarks. Results: The insertion of the LLS was covered partially or entirely by the LLSAN and the ZMi, and the three muscles converged on the area lateral to the ala. The mean angle between the facial midline and each muscle vector was 25.8 ± 4.8 degrees for the LLS, 55.7 ± 6.4 degrees for the ZMi, and −20.2 ± 3.2 degrees for the LLSAN; no significant differences were noted between male and female subjects or between left and right sides. The three vectors passed near a triangular region formed by three surface landmarks. The center of this triangle, named the “Yonsei point”, was suggested as an appropriate injection point for BTX-A. The clinical effectiveness of the injection point was demonstrated in selected cases with or without orthodontic treatment. Conclusions: Under careful case selection, BTX-A may be an effective treatment alternative for patients with excessive gingival display caused by hyperactive lip elevator muscles.

The mandible is the largest and hardest facial bone and retains its shape better than other bones in the forensic and physical anthropologic field. The mandible can be used to distinguish among ethnic groups and between sexes. We examined the morphological characteristics of the mandibles of 102 Koreans of either sex. Of 13 nonmetric items of the mandible, the characteristic that best allowed the sexes to be distinguished was the contour of the lower border of the mandible: rocker-shaped mandibles predominated in males (68.1%), whereas most females (84.6%) exhibited a straight mandible. In addition, the mental region was shaped differently between the sexes: the shape of the chin in most males was generally bilobate or square (91.7%), whereas the chin in females was either square (45.5%) or pointed (54.5%). In this study, the positive predict values of male and female were 92.5% and 73.7%, respectively. Therefore, the nonmetric method used to analyze the mandible in this study can be used for sex discrimination.

The purposes of this study were therefore to characterize the degeneration and regeneration of nerves to the calf muscles after selective neurectomy, both macroscopically and microscopically, and to determine the incidence of such regeneration in a rabbit model. Seventy four New Zealand white rabbits were used. Selective neurectomy to the triceps surae muscles was performed, and the muscles were subsequently harvested and weighed 1-4 months postneurectomy. The gastrocnemius muscles were stained with Sihler's solution to enable the macroscopic observation of any nerve regeneration that may have occurred subsequent to neurectomy. The change in triceps surae muscle weight was measured along the time course of the experiment. After neurectomy, nerve degeneration was followed by regeneration in all cases. The weight of the triceps surae muscle decreased dramatically between completion of the neurectomy and 1 month postneurectomy, but increased thereafter. The nerve branches were weakly stained with Sihler's solution until 2 months postneurectomy, and then strongly stained after 3 months. The number of myelinated axons was decreased at 2 month after neurectomy compared to nonneurectomized controls, but then gradually increased thereafter. Although there are currently no reports on the incidence of recovery after calf reduction, it may be a very common occurrence in the clinical field based on our findings. The findings of this study provide fundamental anatomical and surgical information to aid planning and practice in calf-reduction surgery.

Summary The position, distribution pattern, and perforating branch of the superior gluteal artery (SGA) and the inferior gluteal artery (IGA) in the gluteus maximus muscle (GMM) were investigated through fine dissection and the radiological method. The SGA was located at about the upper one-third of the posterior superior iliac spine (PSIS)–greater trochanter of the femur (GT) line and medially at about 1 cm from the line. The IGA was located at around the middle point of the PSIS–ischial tuberosity (IT) line. The perforating branches passed through the muscle to the subcutaneous tissue and were distributed to the GMM that divided the upper and lower parts; the SGA supplied to the upper two-fifths of the GMM; and the IGA supplied to the rest of the muscle. The course of the SGA and the IGA in the GMM were classified into four types according to their distribution patterns, and the most common type was the typical type whereby the IGA supplied an area larger than the SGA. These results were somewhat different from previous studies, but these differences must be considered for a safe and effective flap procedure.

When making a sternocleidomastoid (SCM) osteomuscular flap to include the clavicle and determining the rotation arc of the osteomuscular flap, it is very important to know the location and the origin of the superior thyroid artery and the distribution pattern of the SCM branch. Accordingly, in this study, the 50 SCM muscles and their arteries were dissected in 26 Korean cadavers, and the results were analyzed. The average distances from the origin of the superior thyroid artery to the clavicular and sternal heads of the SCM muscle were 87.6 mm (57.7-123.8 mm) and 131.2 mm (99.7-166.8 mm), respectively. The average distance from the origin of the superior thyroid artery to the SCM branch entering the SCM muscle was 30.1 mm (16.0-37.7 mm). After entering the SCM muscle, the SCM branches of the superior thyroid artery bifurcated into the clavicular and sternal branches at a point located an average of 58.8 mm (28.4-130.4 mm) above the clavicle. The distribution patterns of the superior thyroid artery were classified into six types based on the branching order and the dual supplies to the SCM muscle. Among them, type I in which the laryngeal branch first divided from the superior thyroid artery was the most common case (36%).

Knowledge of the relationship between the root apex and the inferior wall of the maxillary sinus are crucial for diagnosing and treating a sinus pathosis as well as in assisting in dental implantation. Therefore, identifying the proximity between the root apex and the inferior wall of the sinus and clarifying the cortical thickness of the inferior wall of the sinus is essential for determining the topography of a spreading dental infection into the maxillary sinus. Accordingly, knowledge of the topography between the root apex and the inferior wall of maxillary sinus is important for diagnosing and planning dental implantation, endodontic procedures, and orthodontic treatment. This study was undertaken to clarify the morphological and clinical characteristics of the maxillary sinus, particularly the inferior wall of the sinus in Koreans, and to identify the relationship between the inferior wall of the maxillary sinus and the roots of the maxillary teeth. Twenty-four sides of the maxillae of hemi-sectioned Korean heads were used in this study. All specimens were decalcificated and sectioned coronally. On the sectioned specimens, 21 items were measured using an image analyzing system. The distances between the each root apex and the inferior wall of the maxillary sinus were measured. The distance from the root apex to the inferior wall of the sinus was the shortest in the second molar area and the longest in the first premolar area. The thickness of the cortical plate of the inferior wall of the maxillary sinus was thinnest in the first premolar area but it was thickest in the second premolar area. The vertical relationship between the inferior wall and the roots of the maxillary molars was classified into five types. Type I (the inferior wall of the sinus located above the level connecting the buccal and lingual root apices) dominated (54.5% in the first molar area, 52.4% in the second molar area). The horizontal relationship between the inferior wall of the sinus and the root apex was classified into three types. Type 2 (the alveolar recess of the inferior wall of the sinus was located between the buccal and lingual roots) was most common (80% in the first and second molar area). Overall, this study demonstrated the many anatomical characteristics and determined the relationships between the maxillary sinus and their surrounding structures. These findings may have an impact on the clinical management of patients.

The purpose of this study was to evaluate the topography of the nerve distribution on the two heads of the lateral pterygoid and to clarify their morphological-functional correlations. The nerve distribution on the lateral pterygoid was studied in 24 hemi-sectioned heads. Both heads of the lateral pterygoid were innervated from the mandibular nerve branches, but with various nerve distribution patterns. The nerves innervating the superior head of the lateral pterygoid originated from the buccal nerve only in 45.8% of cases. In contrast, the nerves innervating the inferior head of the lateral pterygoid originated from both the buccal and mandibular nerve trunk in 58.3% of cases. In the seven distribution categories of the mandibular nerve branches, both the superior and inferior heads of the lateral pterygoid had a common source of nerve innervation in only 20.8% of cases, the buccal nerve. In contrast, in 45.9% of cases, additional nerve twigs from the mandibular nerve trunk were distributed on the inferior head of the lateral pterygoid. In summary, besides the buccal nerve described in anatomy textbooks, the nerve branches that originated directly from the mandibular nerve trunk innervated the lateral pterygoid.

The Hox genes of the oligochaete, Perionyx excavatus, were surveyed using PCR and phylogenetic analysis. We were able to identify 11 different Hox gene fragments. Comparative and phylogenetic analyses revealed that this oligochaete would have at least five Hox genes of the anterior group, including three copies of labial-type, five of the central group and one of the posterior group. This is the first report regarding sequence information and phylogenetic analysis of Hox genes in the earthworm.

Numerous reports exist upon clinical viewpoints of the four cervical cutaneous nerves. Unfortunately, a detailed description of the cervical cutaneous nerves has not yet been published. For this reason, administering effective anaesthesia to a particular nerve branch is difficult. The aim of this study was to clarify the anatomical knowledge about the emerging patterns of the cervical cutaneous nerves in the superficial neck using 35 Korean cadavers (22 male, 13 female). Four cervical cutaneous nerve branches penetrating the fascia of the posterior border of the sternocleidomastoid muscle (SCM) were classified into seven types based on the locations of their nerve emergence. Among these, the separated type (L-G-T-S) was the most frequent (50%). followed by the L-G x T-S type (20.3%), in which the great auricular nerve (G) and the transverse cervical nerve (T) emerged at the same level on the posterior SCM border.

Abstract. Vascularized fibula flaps have many advantages in the restoration of the contour and function of the mandible. Potential disadvantages include, unreliable skin paddle and the limited volume of the fibula. This study was designed, to clarify the anatomy of the peroneal artery to the fibula and lateral leg skin, and to measure the dimensions of the fibula available for dental implant placement in Korean. Through the dissection of 63 legs of Korean cadavers, we demonstrated that in most cases the musculoperiosteal (mp) and septocutaneous (sc) branches of the peroneal artery were distributed at the middle and lower thirds of the fibula. There were double the number of mp perforators to the skin compared to sc branches. This indicates the inclusion of a generous >1 cm cuff of Peroneous longus and flexor hallucis longus (FHL) in the distal and middle third of the fibula. The location of the nutrient foramen was just proximal to the midpoint. Thus, a 15–20 cm length of the fibula is available in Koreans and an 8–12 mm length of implant can be placed to the fibula, which provides sufficient bone to reconstruct a large mandibular defect.

Illustrations in almost all textbooks and atlases of anatomy normally show that the zygomatic arch (ZA) and coronoid process (CP) of the mandible overlap vertically. Their topographic relationship is important for plastic surgeons in various situations, such as restorations of ZA fractures. The present study investigated the topographic relationship between the ZA and CP of the mandible in three-dimensional models of Korean human cadavers. The topographic relationship was classified into three types: overlapped, tangential, and separate. The overlapped type was the most common, but the three types showed similar incidences in three-dimensional models. There were no lateral or sex differences according to the three types. The incidence of both sides showing the same type was 70.1%. In conclusion, the predominance of illustrations in almost all textbooks and atlases showing the overlapped type is misleading, since the other two types - where the CP of the mandible does not overlap the ZA - are almost as common.

Identification of an individual is the mainstay of forensic investigation. In the present study, criteria for sex determination were established using 111 adult Korean sternums (63 males and 48 females). They were analyzed using identification points (IPs) and limit points (LPs), as reported previously. Only three of the ten parameters measured-sternal body length, sternal length (i.e., manubrium+body), and sternal area-were useful for sex determination, with sternal length being the most useful. The IP of sternal length was 147 and 130 mm for males and females, respectively. Using this parameter, 53.9% of males and 37.5% of females could be sexed with 100% accuracy. The LP was 141 mm for both males and females; sex could be discriminated accurately using this parameter in 85.7% of males and 85.4% of females.

A variation of the brachial plexus, characterized by the absence of the musculocutaneous nerve on the left arm, was found during the dissection of a 28-year old male cadaver. The whole lateral cord was joined to the median nerve, which it met in two points. One was a typical junction of both roots of the median nerve at the level of the coracoid process. The other was a junction of the remaining lateral cord and the median nerve, which was 92 mm away from the typical junction. This case provided some evidence about the absence of the musculocutaneous nerve, rather than a complete fusion of the median and musculocutaneous nerves. As the nerves are named due to their course or innervation, and not from their origin, it is reasonable to assume that the combined nerve was actually the median nerve, and that the musculocutaneous nerve did not exist.

This study demonstrates the anatomical relationships and variability of the facial nerve trunk and branches with emphasis on intraparotid connections between divisions. Microsurgical dissections were performed on 30 Korean halfheads. The facial nerve trunk was exposed, depth from the skin surface to the stylomastoid foramen (21.03.1 mm) and distance between the stylomastoid foramen and the bifurcation point of temporofacial (upper) and cervicofacial (lower) divisions (13.02.8 mm) were measured. In 26 out of 30 dissections, the facial nerve terminated in a bifurcation into two main divisions, and in four cases, the nerve ended in a trifurcation pattern. According to the origin of the buccal division, branching patterns of the facial nerve were classified into 6 categories. A buccal division was originated from the upper and lower divisions (type I, 13.8%), from the two main and zygomatic divisions (type II, 44.8%), from the two main and marginal mandibular divisions (type III, 17.3%), from the two main, zygomatic and mandibular divisions (type IV, 17.3%), from the lower, zygomatic and mandibular divisions (type V, 3.7%), and from the upper, zygomatic and mandibular divisions (type VI, 3.7%). These details of facial nerve anatomy suggest surgical procedures such as tumor resection, facial nerve reconstruction, and facelift.

Objectives: The blood supply to the nasal tip and columella was examined to determine whether it could be damaged as a result of transcolumellar incision during an external rhinoplasty approach in Asians. Methods: The blood vessels that supply the nasal tip were examined by dissecting 51 cadavers, and their corresponding 102 nasal sections were injected with red latex before dissection. The size and distribution of the vessels were measured with the unaided eye and the primary supply vessels were determined. The subdermal layer in which the vessels lie and the course of the vessels were also investigated. Results: The main blood supply source of the nasal tip proved to be the lateral nasal artery in 78% (80/102) of the cases examined, while the remaining cases (22%) received their blood supply via the dorsal nasal artery. Columellar branches were narrow in diameter and varied in size and appearance, and were therefore appeared insufficient as a main blood supply. These arteries passed through the musculoaponeurotic layer, but they were also in close proximity to the main surgical plane in the dome of the lower lateral cartilage. Conclusions: The authors speculate that the nasal tip blood supply in Asians is primarily derived from the lateral nasal or dorsal nasal arteries, with a variable contribution from the columella arteries. Therefore, it is important to correctly determine the surgical plane below the musculoaponeurotic layer in order to prevent skin flap necrosis or nasal tip deformity that may occur from damage to the main vessel during an external rhinoplasty approach.

Objectives: Although a complete anatomic knowledge of the fontanelle is a prerequisite to perform a surgical antrostomy opening, little is known about the boundary, shape, and size of the fontanelle. The purpose of this paper is to determine the best site for maintaining the patency of a surgical antrostomy opening by defining the anatomic boundaries, shape, and size of the fontanelle as well as its histological structure. Materials and Methods: One hundred sagittally divided heads were utilized. Mucosa overlying the lateral nasal wall was carefully removed with an operating microscope under 6× magnification. In some cases, a double mucous membrane, including the posteroinferior portion of the uncinate process, was cut as a whole and embedded in paraffin. The sections were stained with H&E. Results: The boundary of the fontanelle and the location of the natural ostium were described in detail. Eight patterns of the posteroinferior portion of the uncinate process were observed. There were three major fontanelle shapes when observed from the medial aspect to the lateral: triangular, pencil-like, and oval. The triangular type was the most common. The anterior portion of the fontanelle was shorter than the posterior when observed medially and was wider than the posterior portion when observed inferiorly. Conclusions: The anterior portion of the fontanelle is more prone to stenosis than the posterior portion. An antrostomy in the posterior fontanelle may be more ideal for a middle meatal antrostomy of the maxillary sinus.