2022 VCOM Research Retreat Program

Abstracts

Geometric Morphometric Analysis of Clival Anatomy with Application in Approaches to the Posterior Cranial Fossa Presenter: Jonathan Millard, PhD Co-Authors: Kaivon Kouhestani*; Amanda Swaak*; Alexandra Luna*; Chelsea Bengson*; Benjamin Mann* INTRODUCTION: The posterior cranial fossa is an area of intense neurosurgical interest. The natural anatomical variability of the basicranial skeleton has been well described using dry skeletal collections; however, geometric analyses of soft tissues have not been thoroughly reported. The primary aims of this research are to quantify and characterize the three-dimensional relationships of the abducens (CN VI) and hypoglossal (CN XII) nerves in relationship to salient bony landmarks. METHODS: Typical dissection techniques were used to reveal the posterior cranial fossa on 34 formalin-fixed whole-body donors. A Microscribe® i+ 3D Digitizer Portable Coordinate Measuring Machine was used to register the location of eight 3D landmarks. Data were analyzed with MorphoJ v1.07a. Principal component (PC) analysis was used to explore variability in landmark configurations. RESULTS. PC analysis revealed four loadings capturing a total of 79.08% of the total shape variation in the sample. PC1 accounted for 31.55% of the shape variation and indicates a strong displacement in the inferolateral/superomedial axis of the CN VI dural meatus. PC2 captured 25.61% of the total shape variation and demonstrated lateral/medial displacement of all clival landmarks. There was a statistically significant difference between males and females along PC2 (p=.02). CONCLUSIONS: The lollipop diagram for PC1 shows substantial variability of CN VI’s penetration of the dura mater. This result is seen accompanied by a more superior and medial jugular tubercle. Interestingly, CN XII’s relative trajectory was very consistent along the first principal component. Graphical results of PC2 suggest a more platybasic morphology, with widened clival features and inferiorly recessed parasellar landmarks. In summary, CN VI is highly variable in its exit from the posterior cranial fossa, particularly when compared to CN XII egression. These findings should be considered when drilling the jugular tubercle. Future directions should include consideration of the geometric situation of Dorello's canal. We created and deployed an infectious disease surveillance web-based application based on an existing, operational system in use to track clinical patient encounters by medical trainees, thus providing real-time feedback on each student’s individual progress. This system, called CREDO (Clinical Rotation Evaluation and Documentation Organizer, https://credo.education/signage.html), has been in operation for over 3 years and has captured over 4 million diagnostic and procedural entries using WHO ICD-10 codes. Patient encounter information is gathered from over 1,300 clinics and hospitals across the Appalachian and Delta region states and Central America and the Caribbean (Honduras, El Salvador and the Dominican Republic). On our four campuses, we have over 6,000 users who have documented over 2,000,000 patient encounters. These system’s user interface runs on any browser-based hardware from a PC to smartphone. Data collection is centralized on a HIPAA compliant multi-instance cloud with a variety of spatial and temporal readouts, graphics, reports and automated alerts. A Syndromic Surveillance Tool for Early Detection and Monitoring of Emerging Infectious Diseases Presenter: Skip Garner, PhD Co-Authors: Cameron Sumpter, BS; Gabrielle Bruzda, DO; Fred Rawlins, DO

*VCOM Student