Anatomia, Volume 5, Issue 3 (September 2026) – 10 articles

Background: Anthropology relies on the morphological and metric characteristics of bone structures to estimate an individual’s biological traits. The mandible is considered a reliable bone for estimating age and biological sex. Therefore, this scoping review aimed to map and identify the mandibular morphometric parameters used to estimate age and biological sex in modern humans. Methodology: Guided by the methodological framework proposed by literature, this study presents a scoping review of journal articles published between 2004 and 2024. Results: The majority of included publications (43/74; 58.11%) were published after 2020. Most publications were published in India (24/74; 32.43%), then in Türkiye (8/74; 10.8%) and Brazil (7/74; 9.46%). Only 9/74 (12.16%) of the publications originated from the African continent, and notably, 5/74 (6.76%) and 3/74 (4.05%) focused on Egyptian and South African datasets, respectively. Analysis of the keywords revealed that “sex” was the primary keyword in 42 articles (56.8%), followed by “forensic” and “mandible”, each appearing in 30 articles (40.5%). The most common modality used for data collection was panoramic radiographs (33/74; 44.59%), followed by CBCT at 22/74 (29.73%), CT at 9/74 (12.16%) and dry mandibular bones at 9/74 (12.16%). The mandibular ramus was the most frequently studied morphological trait in the publications analysed (39/74; 52.70%). Four themes were identified, with biological sex being the predominant theme (52.70%). Conclusions: The existing literature emphasises mandibular measurements for biological sex estimation. However, the limited focus on age estimation and population-specific variation highlights a need for further investigation to improve accuracy and global applicability. Full article

Background/Objectives: This observational cross-sectional study evaluated sex-related differences in selected implant-relevant measurements of the zygomatic body in patients with atrophic maxillae, stratified by the Zygoma Anatomy Guided Approach (ZAGA) classification. Methods: A total of 230 cone beam computed tomography (CBCT)-derived zygomatic observations (115 per sex; mean age, 67.1 ± 7.1 years) were analyzed. Zygomatic length (mm) and thickness, and software-reported CBCT radiodensity values (nominal HU) were measured in predefined anterior (L1) and posterior (L3) planes using three-dimensional reconstructions in DTX Studio™ Implant. Gamma generalized linear models with an inverse link evaluated sex, ZAGA classification, and their interaction. Sex contrasts within ZAGA were Holm-adjusted, and ZAGA contrasts within sex were Tukey-adjusted. Results: No sex-related difference was identified for length in L1. In L3, males had greater length than females only in ZAGA₃. No sex-related thickness difference remained significant after multiplicity adjustment. A3 radiodensity was higher in males in ZAGA₂ and ZAGA₄, whereas B1 radiodensity was higher in males only in ZAGA₂. Conclusions: Within this atrophic-maxilla sample, adjusted sex-related differences were restricted to L3 length in ZAGA₃, A3 radiodensity in ZAGA₂ and ZAGA₄, and B1 radiodensity in ZAGA₂. These findings concern only the evaluated variables and do not establish that sexual dimorphism is negligible throughout the zygomatic complex. Full article

Background/Objectives: The brachial plexus is a complex network of nerves responsible for the sensory and motor functions of the upper limbs. While extensively studied, the typical configuration taught only sometimes matches what is found in individuals, as numerous variations have been documented. These variations can have significant clinical and surgical implications. This study explored the prevalence and types of brachial plexus variations in donor bodies from the Midwestern United States. Methods: Using bodies donated through the Gift of Body Donation program at A.T. Still University’s Kirksville College of Osteopathic Medicine, the brachial plexuses of 32 donors were analyzed. Results: Among the 64 plexuses examined, 33 (52%) had a typical M-shaped median nerve formation without additional variations, 18 (28%) had a typical M-shaped formation with additional variations, 6 (9%) had an abnormal M without other variations, and 7 (11%) had an abnormal M with other variations. Thus, 31 plexuses (48%) showed atypical branching patterns. The most common variations were extra communicating branches, observed in 17 (55%) of the 31 variant plexuses. These branches were most often found between the medial and lateral cords (13/17, 76%) and between the musculocutaneous and median nerves (4/17, 24%). Other, less common variations included variant nerves, small branches, and rejoining nerves. Conclusions: This study highlights the significant prevalence of variations in the brachial plexus, which may impact clinical and surgical practices. Further research is needed to fully understand the implications of these variations, especially in procedures like nerve blocks and reconstructive surgeries. Full article

Introduction: The superficial palmar branch of the radial artery (SPBRA) typically arises from the radial artery 10 to 20 mm proximal to the distal wrist crease, before the radial artery curves dorsally around the carpal bones toward the dorsum of the hand. From its origin, the SPBRA courses toward the palmar aspect of the hand, traverses the fibers of the thenar muscles, and typically anastomoses with the ulnar artery to contribute to the superficial palmar arch. Anatomical variations involving this branch have been described in the literature. Given its potential use as a vascular pedicle for thenar flaps in the reconstruction of distal finger and hand injuries, knowledge of its morphology is essential for surgical safety. Objective: To report a high origin of the SPBRA and discuss its possible clinical and surgical implications. Case Report: During routine dissection, an anatomical variation in the origin of the SPBRA was identified in an isolated right upper limb disarticulated at the elbow. The radial artery followed its usual course along the anterior aspect of the forearm and gave rise to the SPBRA in the distal third, 61.05 mm proximal to the most distal transverse wrist crease. The SPBRA coursed obliquely in a distal and medial direction, entered the fibers of the abductor pollicis brevis muscle, and, after traversing this intramuscular segment, anastomosed with the ulnar artery to form the superficial palmar arch. The straight-line distance between the origin of the SPBRA and its distal anastomosis was 92.68 mm. Conclusions: A high origin of the SPBRA is a rare anatomical variation with potential clinical relevance. Awareness of this variation may assist in planning surgical and reconstructive procedures of the hand, particularly thenar flaps. In addition to corroborating previous reports, the present study provides a quantitative morphometric description of the distance between the high origin of the SPBRA and the most distal transverse wrist crease, contributing to the anatomical characterization of this variation. Full article

Background/Objectives: Damage to the contents of the mandibular canal is of great concern during endodontological procedures, particularly in the region of the mandibular molar teeth due to their proximity to the mandibular canal. The objectives of this study were to assess variations in the morphology and dimensions of the mandibular canal between the sexes in a Black South African population. Materials and Methods: CBCT scans of 30 mandibles were analysed bilaterally to determine the presence of an anterior loop and/or bifid canals in the sagittal view. The distance between the root apices of the first and second mandibular molars and the mandibular canal were determined using the coronal CBCT view. The distance between the mandibular canal and the buccal and lingual cortical plates were also measured. Results: Anterior loops were identified in 11.67% of cases, while bifid mandibular canals were present in 5% of cases. The mean distance between the mandibular canal ranged between 5.45 and 6.71 mm for the first molar mesial and distal roots and between 2.37 and 3.62 mm for the second molar roots. The mean distance between the mandibular canal and the lingual cortical plate ranged between 1.75 and 2.84 mm for first molars and 1.40–1.91 mm for second molars. The buccal cortical plate distances ranged from 3.14 to 4.97 mm and 5.21–5.75 mm for the first and second molars, respectively. No statistically significant sex differences were demonstrated for the morphometric measurements. Conclusions: The observed mandibular canal variations between populations and sexes highlight the need for patient-specific planning prior to oral dental procedures. Imaging modalities, such as CBCT scans, are essential for accurate measurements between landmarks and the identification of anatomical variations. These findings provide preliminary insights into mandibular canal anatomy in a Black South African sample that should be considered in dental procedures. No significant sex differences were observed; however, these findings should be interpreted with caution given the study’s limited statistical power. These findings cannot yet be generalised or extrapolated to the Black South African population. Full article

Backgrond/Objectives: Human anatomy education has traditionally relied on cadaveric dissection as the reference standard for acquiring anatomical knowledge. However, decreasing availability of donated bodies, curricular changes, and rapid technological advances have encouraged the progressive integration of complementary educational resources, including historical anatomical collections, physical models, plastinated specimens, and digital technologies. At the same time, anatomical museums have evolved from repositories of scientific heritage into dynamic educational environments that promote public engagement, accessibility, and lifelong learning. Methods: This article presents the educational experience of the Human Anatomy and Histology Institute of the University of Palermo, where historical anatomical collections, cadaveric dissection, plastination, three-dimensional (3D) digitization, virtual anatomy, and interactive educational technologies have been integrated within a single multimodal teaching framework. Results: The strengths and limitations of each educational resource are discussed in relation to contemporary anatomy education and museum communication. Our experience suggests that digital technologies achieve their greatest educational value when they complement rather than replace traditional anatomy teaching. Conclusions: Integrating historical collections with cadaveric study, physical models, and immersive digital tools offers a comprehensive educational approach capable of enhancing anatomical understanding, improving accessibility, and promoting more engaging learning experiences for students and the wider public. Full article

Background/Objectives: Ansa-cervicalis-to-recurrent laryngeal nerve (ARA) anastomosis is an established reinnervation procedure for unilateral vocal fold paralysis (UVFP). Successful surgery requires reliable identification of the ansa cervicalis motor entry point and the recurrent laryngeal nerve (RLN) laryngeal entry point to facilitate tension-free anastomosis while avoiding neurovascular injury. Their positions relative to a single palpable external landmark have not been quantified. Methods: Thirty-two ansa cervicales and corresponding RLNs were dissected from 23 formalin-embalmed cadavers. Mediolateral and superoinferior distances from each nerve entry point to the inferior border of the thyroid cartilage at the midline laryngeal prominence were measured and combined into a Euclidean landmark-referenced straight-line distance. Ansa cervicalis root lengths and branching patterns were also documented. Results: The mean straight-line distance was 43.3 mm (SD 9.7) for the ansa cervicalis and 55.5 mm (SD 11.7) for the RLN laryngeal entry point. The paired analysis mean difference in landmark-referenced straight-line distance was 12.2 mm (95% CI 8.3–16.0; p < 0.001), driven primarily by a mediolateral difference of 13.6 mm (p < 0.001). Mean lengths were 34.7 mm for the superior root, 38.6 mm for the inferior root, and 42.6 mm for main branch. No statistically significant differences were detected by sex or laterality. A three-root variant was observed in 6.25% of cases. Conclusions: The RLN laryngeal entry point is about 12 mm farther from the shared landmark than the ansa cervicalis motor entry point, with the difference primarily attributable to mediolateral position. This relationship may warrant intraoperative evaluation as a supplemental spatial reference during ARA dissection. Full article

Background/Objectives: Anatomical variations in the long head of the biceps brachii tendon (LHBT) and coracobrachialis (CB) have been independently reported, but concurrent bilateral variants involving both structures are rare. Because the LHBT and CB share functional relationships around the shoulder and proximal arm and lie near the musculocutaneous nerve (MCN), combined variants may have implications for shoulder biomechanics and surgical procedures, including biceps tenodesis and the Latarjet procedure. This study describes a rare bilateral LHBT and CB variant and discusses clinical relevance. Methods: During routine cadaveric dissection of an adult female whole-body donor, bilateral variations in the LHBT and CB were identified. Morphometric measurements were obtained, including tendon length, width, circumference, origin-to-landmark distances, muscle architecture, and MCN course. The LHBT was measured from its proximal origin to the distal bicipital groove, proximal border of the pectoralis major, and musculotendinous junction bilaterally. CB morphology, number of heads, and MCN penetration pattern were documented. Results: The LHBT demonstrated bilateral elongation with atypical proximal origins and distal displacement of the musculotendinous junction. The left CB exhibited a rare three-headed configuration with superficial and bifurcated deep heads, whereas the right CB was single-headed. The MCN pierced the CB more distally on the left than typically described and demonstrated altered penetration angles. These findings increased the distance between common surgical fixation sites and adjacent neurovascular structures. Conclusions: This case represents an unusual combination of bilateral LHBT elongation and asymmetric CB morphology. Recognition of compound variants may improve surgical planning, intraoperative decision-making, and individualized rehabilitation strategies. Full article

Background/Introduction: At the foramen magnum of the American alligator (Alligator mississippiensis), the central nervous system is surrounded by three concentric and continuous layers: the cerebrospinal fluid (CSF), the dura, and venous blood in sinuses. The present study examined how this spatial arrangement influenced the dura. Methods: Pressure recordings from CSF and venous blood were taken simultaneously with laser vibrometric analysis of dural and spinal venous sinus displacement. Results: In the cranial compartment, the cardiac-related pulsations in the CSF induce similar pulsations in the dura, while during ventilation, the dura withdraws from the skull even as the pressure increases in the cranial CSF. Below the foramen magnum, the pulsatile displacement of the spinal venous sinus matches the pattern of the CSF pressure and the dura, but is not aligned with the venous blood pressure. There is an intrinsic pattern of dural movement that greatly influences the dynamics of the CSF and spinal venous blood. Conclusions: By measuring both the displacement of the dura and the underlying CSF pressure, the study confirmed early findings of low compliance within the CSF system of the alligator. The findings of the present study may offer insight into the best practices for duraplasty and the treatment of dural leaks. Full article

Background/Objectives: Ischemic injury resulting from the blockage of the left coronary artery or its terminal left anterior descending and circumflex branches is associated with relatively high rates of morbidity and mortality. Variations in left coronary artery size and the number of terminal branches may in part influence the development of such blockages due to altered intraluminal fluid dynamics, while also potentially complicating medical imaging interpretation or preoperative planning for interventions of coronary circulation. While left coronary artery morphology has been extensively reported on, the results reveal substantial geographical variability, with the Eastern United States being largely underrepresented. Methods: We aimed to establish baseline measurements of left coronary artery length and width and the prevalence of variable branching patterns by examining 101 cadaveric hearts from adult, whole-body donors (59 F, 42 M) that were ethically willed to the State of Virginia. Results: The most common terminal branching pattern was left coronary artery bifurcation (n = 54), followed by trifurcation (n = 45), tetrafurcation (n = 1), and aberrant circumflex artery origin, with the left coronary artery traveling in the anterior interventricular sulcus without branching (n = 1). Compared to females, the left coronary artery of males was significantly longer ($\overline{\mathrm{x}}$ = 14.87 mm ± 5.73 mm vs. $\overline{\mathrm{x}}$ = 12.64 mm ± 4.79; p = 0.04) and wider ($\overline{\mathrm{x}}$ = 6.31 mm ± 1.10 mm vs. $\overline{\mathrm{x}}$ = 5.54 mm ± 0.90 mm; p < 0.01), regardless of terminal branching pattern. Conclusions: These results can support the interpretation of coronary angiograms and the preoperative planning of surgical interventions involving coronary vasculature. Full article