Introduction: The brachial plexus is responsible for the innervation to the upper limb and some parts of the thorax. variations in the branching of the brachial plexus are common and have been reported in 65.3% of the population. The variations (Atypical communication) of brachial plexus have significant clinical and surgical importance.Methods: In this study 10 upper limbs which belonged to 5 adult human cadavers of known sex are used.Results: In the present study, three cases (in two cadavers) of 10 cases (in fi cadavers) have connections between the musculocutaneous and median nerve and seven cases are normal.Conclusion: Knowledge about the connections between the musculocutaneous nerve and the median nerve could be very useful in surgical operations on the humerus bone and shoulder joint. So, the more information we could collect about these structures and their variations, the safer the surgical operations could be done.

Statement of Problem: Variation in paranasal sinus anatomy as shown on computed tomographic scans is of potential significance for it may pose risks during surgery or predispose to certain pathologic conditions. Purpose: The aim of this study was to assess the relative frequency and concurrence of variations in paranasal sinus anatomy in a given population and to compare the results with previous investigations conducted on different populations. Materials and Methods: All patients over 16 years of age referred to Valiasr hospital, Tehran, Iran, with paranasal sinus tomographic scans and a clinical diagnosis of chronic sinusitis were considered for this study. After excluding those with altered anatomy (iatrogenic or pathologic), scans of unaltered patients were meticulously analyzed for variations in sinus anatomy. Findings were recorded on the patient’s data sheet. The distance between the maxillary sinus floor and the alveolar ridge at the level of the 1st molar was recorded. All findings were analyzed, and tested with Chi square, where applicable. Results: Overall 143 patients were analyzed (48.3% male and 51.7% female). The frequency of major sinus variations was: Agger nasi cell in 56.7%, Haller cell in 3.5%, Onodi cell in 7%, nasal septal deviation in 63%, Concha bullosa in 35%, and dental anomalies in 4.9% of the studied cases. The distance between the upper alveolar ridge and maxillary sinus floor was 0-30mm (mean 12.16) on the right, and 0-52mm (mean 12.20) on the left. Conclusion: The frequency of Anatomic variations in sinus anatomy may be related to race and heredity. A lower number of cases in addition to the use of low yield imaging may explain the discrepancies observed between our results and other investigations. The findings of the present study were based on computed tomography.      

Background: Over the past decades, instruments and techniques of the transsphenoidal approach have improved greatly. All of these procedures, whether microscopic or endoscopic, must pass through the sphenoid sinus to reach the lesions. The sphenoid sinus is surrounded by several vital Anatomical structures. Knowing the details of the anatomy of the sphenoid sinus and the extent of pneumatization can guide the surgeon through difficult corners of this approach.Purpose: This work aimed to determine the incidence of the different Anatomical variations of the sphenoid sinus in Iranian patients with pituitary adenomas as detected by preoperative MRI and CT scans.Methods: Preoperative CT scan and MRI of 64 adult patients with pituitary adenomas were retrospectively reviewed regarding degree of pneumatization and septation of the sphenoid sinus.Results: Regarding the degree of pneumatization, there were 34 cases with sellar type (59.4%), 10 patients with presellar type (15.6%), and 16 cases with conchal type (25%). Regarding degree of septation, no absence of septum observed in any of our cases. A single intersphenoid septum observed in 18 of cases (28.1%), and 46 of cases had more than one intersphenoid septum (71.9%). Also, one onodi cell was identified.Conclusion: Enrichment of the knowledge of the sphenoid sinus Anatomic variation would aid in reducing complications. Surgeons must meticulously study the preoperative imaging to become familiar with the nuances and variations unique to each case and proceed accordingly to decrease the risk of complications.

Background: This study was designed to determine the prevalence of concomitant Anatomic variation of paranasal sinuses inpatients with antrochoanal polyp (ACP). Materials and Methods: Among patients referred by their clinicians for standard computedtomography scan of paranasal sinuses septal deviation, concha bullosa, and retention cyst were evaluated in both patients with ACP aswell as in a control group.Results: Of the 17 patients with ACP, fifteen patients (88.2%) had septal deviation and two patients (11.8%)had concha bullosa. None of the patients with ACP had retention cyst or hypertrophic turbinate. Of the 78 patients in controlgroup, twenty‑nine (37.2%) had septal deviation, six (7.7%) had concha bullosa, seven (8.9%) had retention cyst, and one (1.2%) hadhypertrophic turbinate. Septal deviation in patients with ACP has higher incidence (P<0.001).Conclusion: This study showed thatseptal deviation is an Anatomic variation which is significantly concomitant with ACP. Larger studies are needed to show the role ofother Anatomic variations in patients with ACP.

Background: Sinus endoscopic surgery requires sufficient Anatomical knowledge of the area. The objective of this study was to determine the variations of Anatomic landmarks in patients undergoing functional endoscopic sinus surgery. Patients and Methods: This retrospective study was based on reviewing the recorded video tapes obtained during operation of 100 patients with chronic sinusitis or other sinonasal diseases who underwent endoscopic sinus surgery. At the beginning of each operation, both nasal cavities were reviewed by 0 and 30 degrees, 4 millimeter telescope. Anatomic structures of the lateral nasal wall was viewed and findings were recorded on VHS videotapes. These videotapes were re-evaluated later. Results: The following data were obtained by reviewing these Anatomic variations in 170 nasal cavities in 100 patients: Middle turbinate: typical (70%), concha bullosa (10%), sagittal cleft (4.5%), lateral displacement (5%), lateral bending (4.5%), medial bending (3%), medial displacement (3%) and transverse cleft (0%). Uncinate process: typical (82%) and medially rotated (18%). Bulla ethmoidalis: balloon shaped (typical) (60%), sausage shape (22%) and flat (18%). Accessory ostium: round (67%) and oval (33%). Sphenoid sinus ostium: oval (50%), slit (35%) and round (15%). Conclusion: This study attempted to determine the Anatomic variations of the lateral nasal wall. Knowledge of these variations is important for differentiating pathologic conditions from normal Anatomic variations and offers a safer and more effective endoscopic sinus surgery with less complications.