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Advances in Human Anatomy: Research Development and Innovative Medical Training

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 52375

Special Issue Editor

Prof. Dr. Stefano Ratti

E-Mail Website
Guest Editor
Cellular Signaling Laboratory, Anatomy Centre, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
Interests: oncology; rare diseases; cellular signaling; ADLD; glioma

Special Issue Information

Dear Colleagues,

Human anatomy is fundamental for medical education. The rise of new mini-invasive techniques, technological devices and digital technologies requires a constant and advanced study of the human body in order to obtain precise and effective results. Indeed, the training on the cadaver is essential to guarantee basic and specialized medical training for different categories of health professionals and to test and develop new medical technologies and techniques. The importance of gross anatomy studies is translational between different medical fields and it combines the most innovative technologies (augmented reality, new surgical mini-invasive techniques, 3D printed scaffold, morphology, functional morphology, robotic devices, tissue engineering, cellular and molecular approaches, molecular anthropology and many others) with gross anatomy and basic sciences. Certainly, the possibility of gross anatomy studies is directly related to the generosity of the donators that decide to adhere to a body donation program.

Moreover, the study of the potentialities of human anatomy is not only related to the development of new techniques, but also to the upgrade of the teaching and learning models that combine an old technique, such as the cadaveric dissection, with the new methods of education (tutor-based medical teaching, graphic medicine, online teaching, manual and procedural skill-based learning). The spectrum of human anatomy is truly very broad, as it involves students from the first years of Medical Schools (Medicine and Surgery, Physiotherapy, Motor and Sport Sciences, Dentistry, Pharmacology and many others) to experienced physicians and many different health professionals.

Therefore, research development and medical training are strictly related and interconnected with human anatomy and body donation programs, guaranteeing medical improvement and advances with translational and innovative approaches.

Papers addressing these topics are invited for this Special Issue, especially those combining a high academic standard, coupled with a practical focus on the potentiality of human anatomy in research development and medical training.

Dr. Stefano Ratti
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • human anatomy
  • cadaver dissection
  • surgical technologies
  • medical training
  • teaching innovations
  • body donation program
  • molecular anthropology
  • sports and anatomy
  • morphology and functional morphology
  • history of medicine

Published Papers (17 papers)

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Research

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13 pages, 3796 KiB  
Article
Multishell Diffusion MR Tractography Yields Morphological and Microstructural Information of the Anterior Optic Pathway: A Proof-of-Concept Study in Patients with Leber’s Hereditary Optic Neuropathy
by David Neil Manners, Laura Ludovica Gramegna, Chiara La Morgia, Giovanni Sighinolfi, Cristiana Fiscone, Michele Carbonelli, Martina Romagnoli, Valerio Carelli, Caterina Tonon and Raffaele Lodi
Int. J. Environ. Res. Public Health 2022, 19(11), 6914; https://doi.org/10.3390/ijerph19116914 - 5 Jun 2022
Cited by 3 | Viewed by 1956
Abstract
Tractography based on multishell diffusion-weighted magnetic resonance imaging (DWI) can be used to estimate the course of myelinated white matter tracts and nerves, yielding valuable information regarding normal anatomy and variability. DWI is sensitive to the local tissue microstructure, so tractography can be [...] Read more.
Tractography based on multishell diffusion-weighted magnetic resonance imaging (DWI) can be used to estimate the course of myelinated white matter tracts and nerves, yielding valuable information regarding normal anatomy and variability. DWI is sensitive to the local tissue microstructure, so tractography can be used to estimate tissue properties within nerve tracts at a resolution of millimeters. This study aimed to test the applicability of the method using a disease with a well-established pattern of myelinated nerve involvement. Eight patients with LHON and 13 age-matched healthy controls underwent tractography of the anterior optic pathway. Diffusion parameters were compared between groups, and for the patient group correlated with clinical/ophthalmological parameters. Tractography established the course of the anterior optic pathway in both patients and controls. Localized changes in fractional anisotropy were observed, and related to estimates of different tissue compartments within the nerve and tract. The proportion of different compartments correlated with markers of disease severity. The method described allows both anatomical localization and tissue characterization in vivo, permitting both visualization of variation at the individual level and statistical inference at the group level. It provides a valuable adjunct to ex vivo anatomical and histological study of normal variation and disease processes. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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19 pages, 8171 KiB  
Article
Infra-Temporal and Pterygo-Palatine Fossae Tumors: A Frontier in Endoscopic Endonasal Surgery—Description of the Surgical Anatomy of the Approach and Report of Illustrative Cases
by Matteo Zoli, Giacomo Sollini, Fulvio Zaccagna, Viscardo Paolo Fabbri, Lorenzo Cirignotta, Arianna Rustici, Federica Guaraldi, Sofia Asioli, Caterina Tonon, Ernesto Pasquini and Diego Mazzatenta
Int. J. Environ. Res. Public Health 2022, 19(11), 6413; https://doi.org/10.3390/ijerph19116413 - 25 May 2022
Cited by 1 | Viewed by 3736
Abstract
Infratemporal and pterygopalatine fossae (ITF and PPF) represent two complex paramedian skull base areas, which can be defined as jewelry boxes, containing a large number of neurovascular and osteomuscular structures of primary importance. They are in close communication with many craniofacial areas, such [...] Read more.
Infratemporal and pterygopalatine fossae (ITF and PPF) represent two complex paramedian skull base areas, which can be defined as jewelry boxes, containing a large number of neurovascular and osteomuscular structures of primary importance. They are in close communication with many craniofacial areas, such as nasal/paranasal sinuses, orbit, middle cranial fossa, and oral cavities. Therefore, they can be involved by tumoral, infective or inflammatory lesions spreading from these spaces. Moreover, they can be the primary site of the development of some primitive tumors. For the deep-seated location of ITF and PPF lesions and their close relationship with the surrounding functional neuro-vascular structures, their surgery represents a challenge. In the last decades, the introduction of the endoscope in skull base surgery has favored the development of an innovative anterior endonasal approach for ITF and PPF tumors: the transmaxillary-pterygoid, which gives a direct and straightforward route for these areas. It has demonstrated that it is effective and safe for the treatment of a large number of benign and malignant neoplasms, located in these fossae, avoiding extensive bone drilling, soft tissue demolition, possibly unaesthetic scars, and reducing the risk of neurological deficits. However, some limits, especially for vascular tumors or lesions with lateral extension, are still present. Based on the experience of our multidisciplinary team, we present our operative technique, surgical indications, and pre- and post-operative management protocol for patients with ITF and PPF tumors. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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10 pages, 3766 KiB  
Article
Three-Dimensional CBCT Based Evaluation of the Maxillary Sinus by Facial Index
by Jeong-Hyun Lee and Jong-Tae Park
Int. J. Environ. Res. Public Health 2022, 19(9), 5040; https://doi.org/10.3390/ijerph19095040 - 21 Apr 2022
Cited by 4 | Viewed by 1651
Abstract
The maxillary sinus growth is initiated 3 months after birth, and it grows lateral and inferior until the pneumatization of the alveolar bone occurs. The facial skeleton has recently been determined as affecting the maxillary sinus, prompting additional studies on changes in the [...] Read more.
The maxillary sinus growth is initiated 3 months after birth, and it grows lateral and inferior until the pneumatization of the alveolar bone occurs. The facial skeleton has recently been determined as affecting the maxillary sinus, prompting additional studies on changes in the size of the maxillary sinus. This study aimed to determine the size of the maxillary sinus using a 3D program after categorizing South Korean adults according to their facial index (FI) classification. The participants of this study were 60 patients in their 20s, who visited the orthodontic department of Dankook University Dental Hospital (approval no. DUDH IRB 2015-12-022). The CBCT of the patients were extracted and measured as 3D images using Mimics (version 22.0, Materialise, Leuven, Belgium). Upon categorizing the subjects based on their FI classification, they were grouped into the mesoprosopic, leptoprosopic, and hyperleptoprosopic types. A one-way ANOVA was performed to evaluate the mean differences of the maxillary sinus, depending on the FI classification. In this study, the maxillary sinus tended to be wider in those with mesoprosopic type, and tended to be higher in the hyperleptoprosopic type, suggesting a need for clinicians to focus to the shape of the face during clinical treatments. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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9 pages, 1867 KiB  
Article
Effectiveness of Ultrasound Cardiovascular Images in Teaching Anatomy: A Pilot Study of an Eight-Hour Training Exposure
by Mariam Haji-Hassan, Tudor Călinici, Tudor Drugan and Sorana D. Bolboacă
Int. J. Environ. Res. Public Health 2022, 19(5), 3033; https://doi.org/10.3390/ijerph19053033 - 4 Mar 2022
Cited by 2 | Viewed by 1598
Abstract
The present study aimed to evaluate the students’ progress in evaluating ultrasound (US) and cadaveric cardiac images and long-time retention of information. First-year medical students were invited to participate in four two-hour online lectures during one week voluntarily. The students were trained to [...] Read more.
The present study aimed to evaluate the students’ progress in evaluating ultrasound (US) and cadaveric cardiac images and long-time retention of information. First-year medical students were invited to participate in four two-hour online lectures during one week voluntarily. The students were trained to recognize cardiovascular anatomical structures on US and cadaveric images during the intervention. The participants’ abilities to identify specific anatomical structures were tested before, immediately after and six months after the training. A group of second-year students without US training participated as a control group and filled the same test once. Ninety-one first-year students agreed to participate, and forty-nine completed all three tests. The performances in the correct identification of cardiovascular structures on the US images significantly improved after the training but significantly decreased after six months. In the intervention group, the accurate identification of cardiovascular structures was significantly higher on cadaveric images (80% vs. 53%, p-value < 0.0001, n = 91 at post-training; 70% vs. 33%, p-value < 0.0001, n = 49 at 6 months after training). The correct answers percentage score in the control group varied from 6.7% to 66.7% for US cardiovascular anatomical without a significant difference than the intervention group (p-value = 0.7651). First-year students’ knowledge of heart US anatomy proved less effective than cadaveric images, significantly improved after training and decreased over time, indicating the need for repetition reinforcement. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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13 pages, 3886 KiB  
Article
Early Morphological Changes of the Rectus Femoris Muscle and Deep Fascia in Ullrich Congenital Muscular Dystrophy
by Patrizia Sabatelli, Luciano Merlini, Alberto Di Martino, Vittoria Cenni and Cesare Faldini
Int. J. Environ. Res. Public Health 2022, 19(3), 1252; https://doi.org/10.3390/ijerph19031252 - 23 Jan 2022
Cited by 3 | Viewed by 2635
Abstract
Ullrich congenital muscular dystrophy (UCMD) is a severe form of muscular dystrophy caused by the loss of function of collagen VI, a critical component of the muscle-tendon matrix. Magnetic resonance imaging of UCMD patients’ muscles shows a peculiar rim of abnormal signal at [...] Read more.
Ullrich congenital muscular dystrophy (UCMD) is a severe form of muscular dystrophy caused by the loss of function of collagen VI, a critical component of the muscle-tendon matrix. Magnetic resonance imaging of UCMD patients’ muscles shows a peculiar rim of abnormal signal at the periphery of each muscle, and a relative sparing of the internal part. The mechanism/s involved in the early fat substitution of muscle fiber at the periphery of muscles remain elusive. We studied a muscle biopsy of the rectus femoris/deep fascia (DF) of a 3-year-old UCMD patient, with a homozygous mutation in the COL6A2 gene. By immunohistochemical and ultrastructural analysis, we found a marked fatty infiltration at the interface of the muscle with the epimysium/DF and an atrophic phenotype, primarily in fast-twitch fibers, which has never been reported before. An unexpected finding was the widespread increase of interstitial cells with long cytoplasmic processes, consistent with the telocyte phenotype. Our study documents for the first time in a muscle biopsy the peculiar pattern of outside-in muscle degeneration followed by fat substitution as already shown by muscle imaging, and an increase of telocytes in the interstitium of the deep fascia, which highlights a potential involvement of this structure in the pathogenesis of UCMD. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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13 pages, 12541 KiB  
Article
Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study
by Carlo Biz, Carla Stecco, Alberto Crimì, Carmelo Pirri, Michele Fosser, Caterina Fede, Chenglei Fan, Pietro Ruggieri and Raffaele De Caro
Int. J. Environ. Res. Public Health 2022, 19(3), 1110; https://doi.org/10.3390/ijerph19031110 - 19 Jan 2022
Cited by 14 | Viewed by 7415
Abstract
There is disagreement regarding the description of the patellofemoral ligaments (PFLs), considered by some authors as capsular thickening and by others as independent ligaments. It was hypothesised that the PFLs and retinacula are structures with different histological features. The aim of this study [...] Read more.
There is disagreement regarding the description of the patellofemoral ligaments (PFLs), considered by some authors as capsular thickening and by others as independent ligaments. It was hypothesised that the PFLs and retinacula are structures with different histological features. The aim of this study was to describe the stabilising structures of the patella in detail and to determine if the PFLs and retinacula are different and separable structures from a macroscopic, microscopic and imaging viewpoint. An anatomical study was performed on eight knees from five cadavers (mean age, 56.2 years; range, 35–63 years), and a histological study was conducted on specimens from nine patients having a mean age of 65 years (range 35–84 years) who had undergone surgical knee procedures. The imaging study was based on 100 MRIs (96 patients). The mean age was 46 years (range 16–88), and the study analysed the capsular-ligamentous structures. In the medial compartment, the layers and structures were as follows: superficial layer, medial retinaculum; intermediate layer, Medial Collateral Ligament (MCL), Posterior Oblique Ligament (POL) and Medial Patellofemoral Ligament (MPFL); deep layer, deep part of the MCL and joint capsule. In the lateral compartment, the layers and structures were the following: superficial layer, lateral retinaculum; intermediate layer, Lateral Collateral Ligament (LCL) and Lateral Patellofemoral Ligament (LPFL); deep layer, joint capsule. All of the knees examined presented a clearly distinguishable MPFL and LPFL separable from the capsular layer. Histological study: there was a higher density of nerve fibres in retinacula compared to ligaments (p = 0.0034) and a higher content of elastic fibres in retinacula (p < 0.0005). In imaging, there was no difference between medial and lateral retinaculum thickness (p > 0.05). In conclusion, both the lateral and medial compartment can be described using the three-layer scheme. PFLs and retinacula are separate structures both macroscopically and according to imaging analysis. The retinacula respond to their specific function with a higher nerve fibre content and higher number of elastic fibres compared to the ligaments. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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14 pages, 6718 KiB  
Article
AEducaAR, Anatomical Education in Augmented Reality: A Pilot Experience of an Innovative Educational Tool Combining AR Technology and 3D Printing
by Laura Cercenelli, Alessia De Stefano, Anna Maria Billi, Alessandra Ruggeri, Emanuela Marcelli, Claudio Marchetti, Lucia Manzoli, Stefano Ratti and Giovanni Badiali
Int. J. Environ. Res. Public Health 2022, 19(3), 1024; https://doi.org/10.3390/ijerph19031024 - 18 Jan 2022
Cited by 20 | Viewed by 3056
Abstract
Gross anatomy knowledge is an essential element for medical students in their education, and nowadays, cadaver-based instruction represents the main instructional tool able to provide three-dimensional (3D) and topographical comprehensions. The aim of the study was to develop and test a prototype of [...] Read more.
Gross anatomy knowledge is an essential element for medical students in their education, and nowadays, cadaver-based instruction represents the main instructional tool able to provide three-dimensional (3D) and topographical comprehensions. The aim of the study was to develop and test a prototype of an innovative tool for medical education in human anatomy based on the combination of augmented reality (AR) technology and a tangible 3D printed model that can be explored and manipulated by trainees, thus favoring a three-dimensional and topographical learning approach. After development of the tool, called AEducaAR (Anatomical Education with Augmented Reality), it was tested and evaluated by 62 second-year degree medical students attending the human anatomy course at the International School of Medicine and Surgery of the University of Bologna. Students were divided into two groups: AEducaAR-based learning (“AEducaAR group”) was compared to standard learning using human anatomy atlas (“Control group”). Both groups performed an objective test and an anonymous questionnaire. In the objective test, the results showed no significant difference between the two learning methods; instead, in the questionnaire, students showed enthusiasm and interest for the new tool and highlighted its training potentiality in open-ended comments. Therefore, the presented AEducaAR tool, once implemented, may contribute to enhancing students’ motivation for learning, increasing long-term memory retention and 3D comprehension of anatomical structures. Moreover, this new tool might help medical students to approach to innovative medical devices and technologies useful in their future careers. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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17 pages, 2404 KiB  
Article
Near-Peer Teaching in Human Anatomy from a Tutors’ Perspective: An Eighteen-Year-Old Experience at the University of Bologna
by Ester Orsini, Marilisa Quaranta, Giulia Adalgisa Mariani, Sara Mongiorgi, Lucio Cocco, Anna Maria Billi, Lucia Manzoli and Stefano Ratti
Int. J. Environ. Res. Public Health 2022, 19(1), 398; https://doi.org/10.3390/ijerph19010398 - 30 Dec 2021
Cited by 10 | Viewed by 1928
Abstract
The University of Bologna School of Medicine in 2003 adopted a near-peer teaching (NPT) program with senior medical students teaching and assisting younger students in human anatomy laboratories. This study aimed to evaluate the effectiveness and outcomes of this program—unique on the Italian [...] Read more.
The University of Bologna School of Medicine in 2003 adopted a near-peer teaching (NPT) program with senior medical students teaching and assisting younger students in human anatomy laboratories. This study aimed to evaluate the effectiveness and outcomes of this program—unique on the Italian academic panorama—from the tutors’ perspective. An anonymous online survey was administered to all those who acted as peer tutors in the period from 2003 to 2021; it evaluated tutors’ perceptions regarding the influence of the tutoring experience on their skillset gains, academic performance, and professional career. Furthermore, tutors were asked to express their views on the value of cadaver dissection in medical education and professional development. The overall perception of the NPT program was overwhelmingly positive and the main reported benefits were improved long-term knowledge retention and academic performance, improved communication, team-working and time management skills, and enhanced self-confidence and motivation. Most tutors strongly believed that cadaver dissection was an invaluable learning tool in medical education, helped them to develop professionalism and human values, and positively influenced the caring of their future patients. Nearly all the participants highlighted the importance of voluntary body donation for medical education and research. The present results supported the thesis that tutors themselves benefited from the act of teaching peers; this impactful experience equipped them with a wide range of transferable skills that they could draw on as future educators and healthcare professionals. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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12 pages, 1253 KiB  
Article
Flaminio Rota: Fame and Glory of a 16th Century Anatomist without Scientific Publications
by Gianfranco Natale, Paola Soldani, Marco Gesi and Emanuele Armocida
Int. J. Environ. Res. Public Health 2021, 18(16), 8772; https://doi.org/10.3390/ijerph18168772 - 19 Aug 2021
Cited by 3 | Viewed by 1898
Abstract
Academic activity is intrinsically composed of two aspects: teaching and research. Since the 20th century, the aphorism “publish or perish” has overwhelmingly established itself in the academic field. Research activity has absorbed more attention from the professors who have neglected teaching activity. In [...] Read more.
Academic activity is intrinsically composed of two aspects: teaching and research. Since the 20th century, the aphorism “publish or perish” has overwhelmingly established itself in the academic field. Research activity has absorbed more attention from the professors who have neglected teaching activity. In anatomical sciences, research has focused mainly on ultrastructural anatomy and biochemical aspects, far removed from the topics addressed to medical students. Will today’s anatomists be rewarded by their choice? To generate a forecast, we should entrust what history has already taught us. For this analysis, an example was taken, concerning the fate that history reserved for the anatomy teachers of the University of Bologna in the second half of the 16th century. Thanks to Vesalius (1514–1564), experimentation on the human body replaced the old dogmatic knowledge, and didactic innovation was one with research. Some figures were highly praised despite their poor scientific production. The present article focuses on the figure of Flaminio Rota, who was highly esteemed by his colleagues in spite of no significant scientific activity. Reasons for this paradox are examined. Then, history also whispers to us: publish, but without perishing in the oblivion of students. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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Review

Jump to: Research, Other

11 pages, 3559 KiB  
Review
Surgical Training on Ex Vivo Ovine Model in Otolaryngology Head and Neck Surgery: A Comprehensive Review
by Matteo Fermi, Francesco Chiari, Francesco Mattioli, Marco Bonali, Giulia Molinari, Matteo Alicandri-Ciufelli, Lukas Anschuetz, Ignacio Javier Fernandez and Livio Presutti
Int. J. Environ. Res. Public Health 2022, 19(6), 3657; https://doi.org/10.3390/ijerph19063657 - 19 Mar 2022
Cited by 4 | Viewed by 2050
Abstract
Background: Nowadays, head and neck surgical approaches need an increased level of anatomical knowledge and practical skills; therefore, the related learning curve is both flat and long. On such procedures, surgeons must decrease operating time as much as possible to reduce the time [...] Read more.
Background: Nowadays, head and neck surgical approaches need an increased level of anatomical knowledge and practical skills; therefore, the related learning curve is both flat and long. On such procedures, surgeons must decrease operating time as much as possible to reduce the time of general anesthesia and related stress factors for patients. Consequently, little time can be dedicated for training skills of students and young residents in the operating theater. Fresh human cadavers offer the most obvious surrogate for living patients, but they have several limitations, such as cost, availability, and local regulations. Recently, the feasibility of using ex vivo animal models, in particular ovine ones, have been considered as high-fidelity alternatives to cadaveric specimens. Methods: This comprehensive review explores all of head and neck otolaryngology applications with this sample. We analyzed studies about ear surgery, orbital procedures, parotid gland and facial nerve reanimation, open laryngeal and tracheal surgery, microlaryngoscopy procedures, laryngotracheal stenosis treatment, and diagnostic/operative pediatric endoscopy. For each different procedure, we underline the main applications, similarities, and limitations to human procedures so as to improve the knowledge of this model as a useful tool for surgical training. Results: An ovine model is easily available and relatively inexpensive, it has no limitations associated with religious or animal ethical issues, and it is reliable for head and neck surgery due to similar consistencies tissues and neurovascular structures with respect to humans. However, some other issues should be considered, such as differences about some anatomical features, the risk of zoonotic diseases, and the absence of bleeding during training. Conclusion: This comprehensive review highlights the potentials of an ex vivo ovine model and aims to stimulate the scientific and academic community to further develop it for other applications in surgical education. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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9 pages, 312 KiB  
Review
From Tutoring Gross Anatomy to Pancreatic Surgery Innovation
by Alberto Balduzzi and Giovanni Marchegiani
Int. J. Environ. Res. Public Health 2022, 19(1), 359; https://doi.org/10.3390/ijerph19010359 - 30 Dec 2021
Viewed by 1487
Abstract
The training for pancreatic surgery still is not conducted according to standardized protocols, and academic programs differ between countries and hospitals. Moreover, due to recent technological innovations such as minimally invasive and robotic surgery, and the broader indications for complex pancreatic procedures due [...] Read more.
The training for pancreatic surgery still is not conducted according to standardized protocols, and academic programs differ between countries and hospitals. Moreover, due to recent technological innovations such as minimally invasive and robotic surgery, and the broader indications for complex pancreatic procedures due to the use of neoadjuvant chemotherapy, training is continuously redefining itself. The historical paradigm of “see one, do one, teach one” has been challenged and might have become obsolete. Finally, the rising number of surgical residents along with the limited time required practicing during residency might represent a major limitation to becoming an independent surgeon. Gross anatomy is a solid practice for the active learning of human anatomy during medical school. With regards to the pancreas, it offers a unique opportunity to both actively study the pancreatic gland anatomy during dissection and simulate actual surgical procedures. A critical review of the literature was conducted, aiming to assess the role of gross anatomy in surgical training and possible future perspectives. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
13 pages, 3576 KiB  
Review
Three-Dimensional Virtual Anatomy as a New Approach for Medical Student’s Learning
by Anna Bartoletti-Stella, Valentina Gatta, Giulia Adalgisa Mariani, Pietro Gobbi, Mirella Falconi, Lucia Manzoli, Irene Faenza and Sara Salucci
Int. J. Environ. Res. Public Health 2021, 18(24), 13247; https://doi.org/10.3390/ijerph182413247 - 16 Dec 2021
Cited by 15 | Viewed by 4716
Abstract
Most medical and health science schools adopt innovative tools to implement the teaching of anatomy to their undergraduate students. The increase in technological resources for educational purposes allows the use of virtual systems in the field of medicine, which can be considered decisive [...] Read more.
Most medical and health science schools adopt innovative tools to implement the teaching of anatomy to their undergraduate students. The increase in technological resources for educational purposes allows the use of virtual systems in the field of medicine, which can be considered decisive for improving anatomical knowledge, a requisite for safe and competent medical practice. Among these virtual tools, the Anatomage Table 7.0 represents, to date, a pivotal anatomical device for student education and training medical professionals. This review focuses attention on the potential of the Anatomage Table in the anatomical learning process and clinical practice by discussing these topics based on recent publication findings and describing their trends during the COVID-19 pandemic period. The reports documented a great interest in and a positive impact of the use of this technological table by medical students for teaching gross anatomy. Anatomage allows to describe, with accuracy and at high resolution, organ structure, vascularization, and innervation, as well as enables to familiarize with radiological images of real patients by improving knowledge in the radiological and surgical fields. Furthermore, its use can be considered strategic in a pandemic period, since it ensures, through an online platform, the continuation of anatomical and surgical training on dissecting cadavers. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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9 pages, 11473 KiB  
Review
The Cadaveric Studies and the Definition of the Antero-Lateral Ligament of the Knee: From the Anatomical Features to the Patient-Specific Reconstruction Surgical Techniques
by Giacomo Dal Fabbro, Piero Agostinone, Gian Andrea Lucidi, Nicola Pizza, Nicolò Maitan, Alberto Grassi and Stefano Zaffagnini
Int. J. Environ. Res. Public Health 2021, 18(23), 12852; https://doi.org/10.3390/ijerph182312852 - 6 Dec 2021
Cited by 2 | Viewed by 4292
Abstract
Cadaver studies represented a milestone in surgical orthopaedic research, and still today they play a crucial role in the achievement of new knowledge about joint disease behaviour and treatment. In this review, an overview of the cadaver studies available in the literature about [...] Read more.
Cadaver studies represented a milestone in surgical orthopaedic research, and still today they play a crucial role in the achievement of new knowledge about joint disease behaviour and treatment. In this review, an overview of the cadaver studies available in the literature about the anatomy, role, and treatment of the antero-lateral ligament (ALL) of the knee was performed. The aim of the review was to describe and gain more insight into the part of in vitro study in understanding knee joint anatomy and biomechanics, and in developing surgical reconstruction techniques. The findings of the review showed that cadaver studies had, and will continue to have, a key role in the research of knee joint biomechanics and surgical reconstruction. Moreover, they represent a powerful tool to develop and test new devices which could be useful in clinical and surgical practice. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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Other

Jump to: Research, Review

7 pages, 2404 KiB  
Brief Report
Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approaches at the Arcade of Frohse: A Potential Treatment for Radial Tunnel Syndrome
by Pedro Belón-Pérez, Laura Calderón-Díez, José Luis Sánchez-Sánchez, Miguel Robles-García, Gustavo Plaza-Manzano and César Fernández-de-las-Peñas
Int. J. Environ. Res. Public Health 2022, 19(4), 2476; https://doi.org/10.3390/ijerph19042476 - 21 Feb 2022
Viewed by 2449
Abstract
Entrapment of the radial nerve at the arcade of Frohse could contribute to symptoms in patients with lateral epicondylalgia or radial tunnel syndrome. Our aim was to determine the validity of applying percutaneous electrolysis, targeting the supinator muscle at the Frohse’s arcade with [...] Read more.
Entrapment of the radial nerve at the arcade of Frohse could contribute to symptoms in patients with lateral epicondylalgia or radial tunnel syndrome. Our aim was to determine the validity of applying percutaneous electrolysis, targeting the supinator muscle at the Frohse’s arcade with ultrasound imaging and in a Thiel-embalmed cadaver model (not ultrasound-guiding). Percutaneous electrolysis targeting the supinator muscle was conducted in five healthy volunteers (ultrasound study) and three Thiel-embalmed cadaver forearms. Two approaches, one with the forearm supinated and other with the forearm pronated were conducted. The needle was inserted until the tip reached the interphase of both bellies of the supinator muscle. Accurate needle penetration of the supinator muscle was observed in 100% in both US-imaging and cadaveric studies. No neurovascular bundle of the radial-nerve deep branch was pierced in any insertion. The distance from the tip of the needle to the neurovascular bundle was 15.3 ± 0.6 mm with the forearm supinated, and 11.2 ± 0.6 mm with the forearm pronated. The results of the current study support that percutaneous electrolysis can properly target the supinator muscle with either the forearm in supination or in pronation. In fact, penetration of the neurovascular bundle was not observed in any approach when percutaneous needling electrolysis was performed by an experienced clinician. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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8 pages, 1793 KiB  
Commentary
Robotic Surgery: Rediscovering Human Anatomy
by Antonio Gangemi, Betty Chang, Paolo Bernante and Gilberto Poggioli
Int. J. Environ. Res. Public Health 2021, 18(23), 12744; https://doi.org/10.3390/ijerph182312744 - 3 Dec 2021
Cited by 3 | Viewed by 2490
Abstract
Since its advent, robotic surgery has redefined the operating room experience. It directly addressed and resolved many of the shortcomings of laparoscopic methods while maintaining a minimally invasive approach that brought benefits in cosmesis and healing for patients but also benefits in ergonomics [...] Read more.
Since its advent, robotic surgery has redefined the operating room experience. It directly addressed and resolved many of the shortcomings of laparoscopic methods while maintaining a minimally invasive approach that brought benefits in cosmesis and healing for patients but also benefits in ergonomics and precision for surgeons. This new platform has brought with it changes in surgical training and education, principally through the utilization of virtual reality. Accurate depictions of human anatomy seen through augmented reality allow the surgeon-in-training to learn, practice and perfect their skills before they operate on their first patient. However, the anatomical knowledge required for minimally invasive surgery (MIS) is distinct from current methods of dissection and prosection that inherently cater towards open surgery with large cuts and unobstructed field. It is integral that robotic surgeons are also equipped with accurate anatomical information, heralding a new era in which anatomists can work alongside those developing virtual reality technology to create anatomical training curricula for MIS. As the field of surgery and medicine in general moves to include more and more technology, it is only fitting that the building blocks of medical education follow suit and rediscover human anatomy in a modern context. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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6 pages, 2159 KiB  
Brief Report
An Ancient Science to Improve Today’s Clinical Practice: Oral Surgery Meets Human Anatomy
by Roberto Pistilli, Lorenzo Bonifazi, Carlo Barausse, Alessandra Ruggeri, Michele Covelli, Maryia Karaban and Pietro Felice
Int. J. Environ. Res. Public Health 2021, 18(22), 11915; https://doi.org/10.3390/ijerph182211915 - 13 Nov 2021
Viewed by 1610
Abstract
Human body dissection was a ubiquitous practice in the past, to better understand anatomy and to develop medicine. Today, its role could still be important to answer everyday clinical queries and help surgeons. The example of the possible lack of anesthesia during symphysis [...] Read more.
Human body dissection was a ubiquitous practice in the past, to better understand anatomy and to develop medicine. Today, its role could still be important to answer everyday clinical queries and help surgeons. The example of the possible lack of anesthesia during symphysis surgeries can emphasize the usefulness of dissection. The mandibular symphysis usually receives innervation from inferior alveolar nerve terminations, but, in some rare cases, a particular anastomosis involves the lingual nerve and the nerve to the mylohyoid. The anatomical knowledge resulting from body dissections could help oral surgeons to understand the reason why the patient could feel pain during the surgery, and ensure performance of the right lingual nerve block to obtain complete anesthesia. This clinical situation shows the educational role of an ancient, yet still valid, practice, human dissection, and the importance of anatomical studies to improve surgical skills, to provide better treatment for the patient. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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7 pages, 1028 KiB  
Brief Report
Is Dry Needling of the Supinator a Safe Procedure? A Potential Treatment for Lateral Epicondylalgia or Radial Tunnel Syndrome. A Cadaveric Study
by César Fernández-de-las-Peñas, Carlos López-de-Celis, Jacobo Rodríguez-Sanz, César Hidalgo-García, Joseph M. Donnelly, Simón A Cedeño-Bermúdez and Albert Pérez-Bellmunt
Int. J. Environ. Res. Public Health 2021, 18(17), 9162; https://doi.org/10.3390/ijerph18179162 - 31 Aug 2021
Cited by 3 | Viewed by 2734
Abstract
The supinator muscle is involved in two pain conditions of the forearm and wrist: lateral epicondylalgia and radial tunnel syndrome. Its close anatomical relationship with the radial nerve at the arcade of Frohse encourages research on dry needling approaches. Our aim was to [...] Read more.
The supinator muscle is involved in two pain conditions of the forearm and wrist: lateral epicondylalgia and radial tunnel syndrome. Its close anatomical relationship with the radial nerve at the arcade of Frohse encourages research on dry needling approaches. Our aim was to determine if a solid filiform needle safely penetrates the supinator muscle during the clinical application of dry needling. Needle insertion of the supinator muscle was conducted in ten cryopreserved forearm specimens with a 30 × 0.32 mm filiform needle. With the forearm pronated, the needle was inserted perpendicular into the skin at the dorsal aspect of the forearm at a point located 4cm distal to the lateral epicondyle. The needle was advanced to a depth judged to be in the supinator muscle. Safety was assessed by measuring the distance from the needle to the surrounding neurovascular bundles of the radial nerve. Accurate needle penetration of the supinator muscle was observed in 100% of the forearms (needle penetration:16.4 ± 2.7 mm 95% CI 14.5 mm to 18.3 mm). No neurovascular bundle of the radial nerve was pierced in any of the specimen’s forearms. The distances from the tip of the needle were 7.8 ± 2.9 mm (95% CI 5.7 mm to 9.8 mm) to the deep branch of the radial nerve and 8.6 ± 4.3 mm (95% CI 5.5 mm to 11.7 mm) to the superficial branch of the radial nerve. The results from this cadaveric study support the assumption that needling of the supinator muscle can be accurately and safely conducted by an experienced clinician. Full article
(This article belongs to the Special Issue Advances in Human Anatomy: Research Development and Innovative Medical Training)
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