No abstract

The spinal accessory nerve (SAN) exhibits variant anatomy in its relation to the internal jugular vein (IJV) as well as the sternocleidomastoid muscle (SCM). These variations are important in locating the nerve during surgical neck procedures to avoid its inadvertent injury. These variations, however, are not conserved among different populations and data from the Kenyan setting are partly elucidated. This study, therefore, aims to determine the variant anatomical relationship of the SAN to the SCM and IJV in a select Kenyan population. Forty cadaveric necks were studied bilaterally during routine dissection and the data collected were analyzed using SPSS version 21. Means and modes were calculated for the point of entry of the SAN into the posterior triangle of the neck as well as for its relation to the SCM. Side variations for both of these were analyzed using Student's t-test. Data relating the SAN to the IJV were represented in percentages and side variations were analyzed using the chi-square test. The SAN point of entry into the posterior triangle of the neck was 5.38 cm (3.501–8.008 cm) on the left side and 5.637 cm (3.504–9.173 cm) on the right side ( p = 0.785) from the mastoid process. The nerve perforated the SCM in four cases (10%) on the left side and in eight cases (20%) on the right ( p = 0.253). The SAN lay predominantly medial to the IJV on both sides of the neck, 87.5% on the left side of the neck versus 82.5% on the right ( p = 0.831). In conclusion, the variant relation of the SAN to the IJV and SCM as observed in this setting is an important consideration during radical neck procedures and node biopsies.

Background Hypoplasia of cerebral arteries predisposes to stroke and cerebral aneurysms which have an increased incidence in sub-Saharan Africa. The frequency and pattern of cerebral artery hypoplasia, however, shows population variations, and data from the African population remain scanty. Objectives This study aimed to determine the percentage of hypoplasia in the anterior, middle, and posterior cerebral, anterior and posterior communicating, basilar, and vertebral arteries. Materials and Methods Sections of the basilar, vertebral, posterior, and anterior communicating arteries and anterior, middle, and posterior cerebral arteries were taken, processed for histology, and examined with a light microscope at ×40. The images of the vessels were taken by a photomicroscope and circumference analyzed with the aid of Scion image analyzer. The average diameter of 10 sections was taken to be the diameter of the artery in analysis. Hypoplasia was then defined as internal diameter ≤1 mm. Photographs of representative samples of asymmetry were taken, data were analyzed using SPSS, and gender differences were analyzed using the Student's test. Results were presented in tables. Results Two hundred and eighteen formalin-fixed brains of adult Kenyans at the Department of Human Anatomy, University of Nairobi, were studied. Of the 218, 48 brains (22%) did not have vessels with any form of hypoplasia while 170 (78%) did have vessels. Of these, anterior circulation hypoplasia (anterior cerebral artery and posterior communicating artery) was seen in 100 brains (46%) and posterior circulation hypoplasia (middle and posterior cerebral, basilar, and vertebral arteries) in 69 brains (32%). Conclusion Cerebral arterial hypoplasia is frequent in the select adult Kenyan population.

Study design: Descriptive cross-sectional study. Objective: To determine the variations in origin of the LA and its relationship to surgical landmarks. Background: The Lingual artery (LA) is a branch of the External Carotid Artery (ECA) that constitutes the principal supply to structures within the oral cavity and floor of the mouth. Knowledge of its variant anatomy is therefore vital during radiological and surgical procedures performed in the head and neck region since they may predispose it and other branches of the ECA to iatrogenic injury. There is, however, a dearth of regional data on the same. Materials and Methods: A total of 70 LA dissections were performed bilaterally on 35 human cadavers. The borders of the carotid triangle were identified after which the external carotid artery and its branches were exposed. The pattern of origin and the diameter of the LA was noted and distances from its origin to the CB, GCHB and the HN were measured. Similar measurements were carried out for any variant trunks. Data was collected and analyzed using SPSS (IBM version 27). A paired t-test was used to compare side differences. Representative photos of the vessel and its variations were taken. Results: The LA was found to be present in all cadavers dissected and was bilaterally symmetrical in 43% of cases. Four (4) types of branching patterns were encountered in the present study, the most commonly observed being the solitary LA followed by the LFT, TLT and finally the TLFT. The average diameter was least in the solitary pattern and greatest in the TLT. In relation to the CB, the solitary LA originated at a distance of 1.51 ± 0.89 cm while the LFT, TLT and TLFT originated at a distance of 1.80 ± 0.73 cm, 1.02 ± 0.64 cm and 1.25 ± 0.01 cm respectively from the CB. The mean distance from the origin of the LA to the GCHB was least in the TLT and greatest in the TLFT. With reference to the hypoglossal nerve, the LA was at an average, 0.82 ± 0.15 cm from the HN for the solitary pattern, 1.34 ± 0.86 cm for the LFT, 1.34 ± 0.90 cm for the TLT and 1.38 ± 0.93 cm for the TLFT. Conclusion: The LA in the Kenyan population exhibited a high frequency of variation in comparison to other populations regarding its pattern of origin and relationship to landmarks such as the CB, GCHB and HN. These findings may provide further insight into the understanding of the vascular anatomy to the radiologist and the surgeon to avert complications and improve overall treatment outcome.

Introduction Inadequate professional and medical exposure and misconceptions about plastic surgery have not only been linked to students’ poor knowledge and attitude toward it, but also bias against the selection of plastic surgery as a specialty. This assertion is yet to be tested and confirmed in our setting. This study therefore aimed to determine the knowledge and attitude of medical students toward plastic surgery. Methods One hundred and eight (108) students between their 3rd and 4th year of study were randomly recruited and handed structured questionnaires on knowledge and attitude toward plastic surgery. Data were then analyzed using SPSS and represented in percentages, medians, and means. Mann-Whitney and Kruskal–Wallis tests were done to assess for significant statistical differences based on gender grouping and year of study, respectively. A p-value ≤ 0.05 was considered significant at a 95% confidence interval. Results Majority of the students had some awareness about plastic surgery since, a majority (88%) identified plastic surgery with cosmetics and identified trauma as the main condition handled by plastic surgeons. Sixty-four percent (64%) acknowledged the risks associated with plastic surgery and 79.6% noted the presence of the procedures in Kenya. When assessing attitude, 62% reported that they did not want to pursue plastic surgery in the future, 75% would not consider plastic surgery done on them and 77% of the respondents felt embarrassed to undergo the surgery if their family knew while another 77% felt embarrassed if their friends knew. It is worth noting that 55% had their initial exposure to plastic surgery through information from the media sources. Mann-Whitney test done to assess for gender differences only revealed significant difference (p-value = 0.009) on assessing for the availability of plastic surgery procedures in Kenya. Kruskal–Wallis test did not reveal any significant differences based on year of study. Conclusion Data from our study suggest that students have some awareness about plastic surgery but have a poor attitude toward it.