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Qualitative comparison of anatomical microdissection,

Qualitative comparison of anatomical microdissection, -...

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Surg Radiol Anat (2007) 29:373–378 DOI 10.1007/s00276-007-0225-1 123 ORIGINAL ARTICLE Qualitative comparison of anatomical microdissection, Sihler’s staining and computerized reconstruction methods for visualizing intramuscular nerve branches Nadir Gülekon · Tuncay Peker · Hasan Basri Turgut · A W tap An  l · Mustafa Karaköse Received: 6 September 2006 / Accepted: 28 May 2007 / Published online: 14 June 2007 © Springer-Verlag 2007 Abstract Stating backround This study was designed to examine the entire intramuscular nerve distribution pattern of vari- ous human skeletal muscles in fetuses. Methods In the present study rhomboid major, trapezius, long head of the biceps femoris and masseter muscles were investigated in W ve 18 weeks old fetal cadavers. Anatomi- cal microdissection was applied to one fetal cadaver. In two fetuses, the extramuscular (main), major and minor nerve branches, and anastomosis were examined using Sihler’s staining and labeling. In the remaining two fetuses, consec- utive slices with 0.5 mm interval and 5 m thickness were obtained from each skeletal muscle. These slices were stained with S100 for the demonstration of the nerve W bers and thereafter 3D reconstruction images were constituted using PC software. Results Anatomical microdissection, Sihler’s staining and computerized reconstruction methods were compared to demonstrate the intramuscular nerve distribution pattern. Demonstration of the intramuscular minor nerve branches and anastomosis showed di Y culties in anatomical dissected specimens when compared with three-dimensionally recon- structed images and specimens obtained with Sihler’s stain- ing technique. Nevertheless, anatomical dissection is a simple method whereas Sihler’s technique and computer aided 3D reconstruction are complex methods and take a long time to complete. Conclusion The obtained information exposed that staining technique and the 3D reconstructions appeared to provide better results than did anatomical dissection. Keywords Anatomical dissection · Staining method · 3D reconstruction · Intramuscular innervation Introduction Comprehensive knowledge of neural distribution within viscera or muscles provides important and useful informa- tion about the function of the muscle for anatomists, physi- ologists and clinicians [ 11 ]. Distribution of nerves within the muscles can be demonstrated in 2D with widely used histological methods. However with these methods it becomes di Y cult to perceive the nerve distribution pattern in skeletal muscle in 3D. There are three ways of visualiz- ing and analyzing the route and distribution of a nerve innervating a muscle. First, anatomical dissection has been the most commonly used method up to now [ 3 , 8 , 9 , 17 ]. Second is to render all but neural tissue translucent while staining the neural tissue. This method is known as Sihler’s staining and labeling and was found by Sihler [ 21 ]. The third method is to acquire serial images of histological or anatomical sections. Images of serial macroscopic or
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