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Pictorial Essay Eponyms in Head and Neck Anatomy and Radiology Fernando Martín Ferraro1*, Hernán Chaves2*, Federico Martín Olivera Plata3,4*, Luis Ariel Miquelini1,3*, Suresh K. Mukherji5 1 Imaging Service, Hospital Británico, Ciudad Autónoma de Buenos Aires, Argentina 2 Imaging Department, Dr. Raúl Carrea Institute for Neurological Research (FLENI), Ciudad Autónoma de Buenos Aires, Argentina 3Imaging Service, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina 4 Magnetic Resonance and Computed Tomography Service, Centro Médico Deragopyan, Ciudad Autónoma de Buenos Aires, Argentina 5 Radiology Department, Michigan State University, East Lansing, USA Abstract The use of eponyms in medical language is frequent. While it is commonly thought that eponyms are on their way to extinction, this is not entirely true. There is dissent between those who believe that their use should be abandoned and those who advocate that eponyms make unmemorable terms memorable, convey complex concepts and promote an interest in the history of medicine. We feel part of this second group, and our intention is to make a review of eight eponyms linked to head and neck anatomy and radiology. We believe that this approach can be useful for the education of medical students, residents and diagnostic imaging specialists. Keywords Radiology; Eponyms; Anatomy; Head and neck; History of medicine Introduction for which they are known. Eponyms are illustrated by figures of dissections, radiological images and pictures. We believe When we look up the word eponym in Spanish (epónimo) that this approach can be useful for the education of medical in the dictionary of the Spanish Royal Academy, we find the students, residents and diagnostic imaging specialists. following definition: “A person or thing after whom or after 1 which a town, city, disease, etc. is named” Johann Christian Rosenmüller The use of eponyms in medical language is frequent. Histori- 7,8 cally, family names of recognized physicians have been used (1771-1820) to refer to anatomical structures, diseases and syndromes, usually as a tribute.2 Johann Christian Rosenmüller (Fig. 1) was born on May 25, Even if it is commonly thought that eponyms in medicine are 1771, in Hildburghausen, Germany. His father, Johann Georg on their way to extinction, this is not entirely true, and their Rosenmüller, was a known protestant theologian. His broth- use is present in 2% of titles in current publications.3 There is er, Ernst Friedrich Karl Rosenmüller, followed his father’s foot- dissent between those who believe that the use of eponyms steps and gained great recognition. All three were at Leipzig should be abandoned and those who advocate that eponyms University from 1794 until their deaths. There is no mention make unmemorable terms memorable, convey complex con- of Rosenmüller’s mother in the literature reviewed. cepts, and promote an interest in the history of medicine.4-7 In 1792, Rosenmüller began his studies in medicine at Erlan- We feel part of this latter group, and our intention is to make gen University, receiving his doctorate in 1797 at the Univer- a review of eight eponyms linked to head and neck anatomy sity of Leipzig, and being appointed associate professor of and radiology, putting greater emphasis on the original ar- anatomy and surgery at Leipzig in 1802. He was the Dean of ticles and circumstances that determined their appearance, Leipzig University between 1812 and 1820. He was the au- and less emphasis on the anatomical structures and diseases thor of various dissertations, articles and books. However, his 72 Rev. Argent. Radiol. 2018;82(2): 72-82 F. Ferraro et al. Fig. 1. Portrait of Johann Christian Rosenmüller. Fig. 2. Anatomic preparation with arteries stained red and veins stained blue. The right fossa of Rosenmüller is being indi- cated (arrow), located immediately over the longus colli muscle most important work was a handbook of anatomy published (arrowhead). Reprinted with permission from the editor. Copy- in 1808.9 This handbook was 700 pages in length, covering right© 2016 Fronteras de Medicina. All rights reserved. various parts of the human body. This is where Rosenmüller first described the pharyngeal recess or fossa of Rosenmüller (Figs. 2 and 3). It was in this handbook that he also described the palpebral portion of the lacrimal gland or Rosenmüller gland and the organ of Rosenmüller, a structure of the me- sosalpinx. Rosenmüller also specialized in speleology, the scientific study of caves, including their make-up, structure, and life forms. In 1796, he published a book describing remarkable caves in the Muggendorf area, including one that is currently known as Rosenmüller’s cave, and which can be visited nowadays. His collection of fossil bones resides in the Museum of Natu- ral Sciences in Berlin. He never married, and he died of a heart attack at the age of 49. Charles Bell (1774-1842)10 Charles Bell (Fig. 4) is remembered as a neurophysiologist. However, he was a man of many talents: anatomist, draught- sman, writer, lecturer, surgeon and museum-builder. He was Fig. 3. Axial T2-weighted magnetic resonance (MR) image. born in 1774, the fourth son of an Edinburgh clergyman who The patient presented with a plugged right ear sensation and died when Charles was only 5 years old. His mother not only hearing loss. A lesion was occupying and obstructing the took charge of his upbringing but also stimulated his other right fossa of Rosenmüller (arrow) associated with ipsilateral serous otitis (arrowhead). The lesion was diagnosed as squa- talents, such as drawing. mous nasopharyngeal carcinoma. Rev. Argent. Radiol. 2018;82(2): 72-82 73 Eponyms in Head and Neck Anatomy and Radiology Charles attended philosophy lectures while assisting his 5 and 6).11 This concept differs from the modern definition of brother John in his school of anatomy. He contributed text Bell’s palsy, which is reversible and idiopathic (Fig. 7). Bell died and drawings to his brother’s work “The Anatomy of the Hu- suddenly on April 29, 1842. man Body” and published the work “A System of Dissec- tions” under his own name in 1814. Bell had a special inter- 7,12 est in the Vth and VIIth cranial nerves, as he could not clearly Primo Dorello (1872-1963) differentiate their functions. Such differentiation was clarified by his colleague Herbert Mayo. Bell’s original description of Primo Dorello (Fig. 8) was born in Narni, Italy, in 1872. He facial palsy, in a letter to a colleague could not have been studied medicine at Rome University and obtained his degree more accurate: “…The face is twisted to the right side. The in 1897, remaining there as an Assistant Professor in the De- left nostril does not move in respiration. The eye-lids of the partment of Normal Human Anatomy. In 1903, he published left side are not closed when he attempts to wink, although his most well-known paper, entitled “Considerations on the the eye-ball is turned up, his left cheek is relaxed, and the cause of transient paralysis of the abducent in middle ear forehead on the left side unruffled…” inflammation” (Fig. 9).13 The paper describes Dorello’s canal, The original description of Charles Bell’s palsy was based on a depression bounded laterally by the petrous apex and me- two patients with irreversible facial nerve dysfunction: a se- dially by the superolateral portion of the clivus. The superior vere infection and a postoperative sequel of a skull base tu- margin of the canal is formed by the petrosphenoidal liga- mor resected by Bell himself. This description is included in ment (Figs. 10 and 11). Although he was credited with the the publication entitled: “On the nerves: giving an account discovery of this canal, the canal had been first described in of some experiments on their structure and functions, which 1859 by Wenzel Gruber, who is remembered by the eponym lead to a new arrangement of the system”, a classic of neu- Gruber’s ligament or petrosphenoidal ligament.14 rology, published in Philosophical Transactions in 1821 (Figs. In recent decades, various microsurgical anatomy studies have Fig. 4. Portrait of Charles Bell. Reprinted with permission Fig. 5. Drawing from the original article published by Charles from the editor. Copyright© 2016 Fronteras de Medicina. All Bell in 1821, where there is a description of the nerves of the rights reserved. face, and in particular, of the facial nerve. 74 Rev. Argent. Radiol. 2018;82(2): 72-82 F. Ferraro et al. allowed a more accurate description of the boundaries and contents of that topography known as the petroclival venous confluence, which includes Dorello’s canal.15 Dorello was nom- inated for the Nobel Prize in Physiology or Medicine in 1939. He was also interested in anthropology and photography. He produced stereoscopic negatives on glass of Italian architecture and city landscapes. He died in Bologna at the age of 90. Fig. 8. Portrait of Primo Dorello. Fig. 6. Anatomical preparation of a left hemiface showing the extracranial segment of the facial nerve (arrow) crossing the superficial temporal artery (arrowhead). Fig. 7. Axial T1-weighted MR image after contrast administra- tion. The patient presented with left labial commissure drop and impaired hearing on the right side. Post-contrast enhance- ment of the canalicular, labyrinthine, geniculate ganglion and left tympanic segments of the facial nerve was identified, be- ing pathognomonic of idiopathic facial palsy (or Bell’s palsy). The scan showed a hyperintense rounded focal lesion in the right internal auditory canal, consistent with vestibular nerve schwannoma, the main differential diagnosis of Bell’s palsy. Fig. 9. Primo Dorello’s original article. Rev. Argent. Radiol. 2018;82(2): 72-82 75 Eponyms in Head and Neck Anatomy and Radiology Fig.

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