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Anatomy Without Frontiers, a Systemic Morpho-Functional Approach

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Anatomy Without Frontiers, a Systemic Morpho-Functional Approach ANATOMY WITHOUT FRONTIERS, A SYSTEMIC MORPHO-FUNCTIONAL APPROACH - HABILITATION THESIS - HÎNGANU MARIUS VALERIU, MD, PhD 2019 CONTENTS Abbreviations 2 SECTION I Abstract 3 Rezumat 5 SECTION II Chapter 1. Professional, scientific and academic achievements 7 1.1. Professional achievements 7 1.2. Academic activity 7 1.3. Scientific activities 8 1.4. Achievements in scientific publications field 10 Chapter 2 Scientific and professional achievements 11 2.1. Anatomical substrate of superficial musculoaponeurotic system of the face 12 2.1.1. State of the art 12 2.1.2. Scientific context and motivation 15 2.1.3. Material and methods 17 2.1.4. Results 18 2.1.5. Discussions 35 2.1.6. Conclusions 51 2.2. Anatomical substrate of phonatory apparatus 52 2.2.1. State of the art 52 2.2.2. Scientific context and motivation 53 2.2.3. Material and methods 54 2.2.4. Results 57 2.2.5. Discussions 66 2.2.5. Conclusions 80 2.3. Anatomical substrate of neovasculogenesis processes in colorectal cancers 81 2.3.1. State of the art 81 2.3.2. Material and methods 83 2.3.3. Results 84 2.3.4. Discussions 88 2.3.5. Conclusions 96 2.4. Fields for future research projects 97 2.4.1. Future research projects 97 2.4.2. Implementation plan 99 2.4.3. The anticipated impact of implementing new research directions on the academic career and the personal international visibility 99 2.4.4. Further ongoing research projects 100 2.4.5.1. Directions and principles for further research SMAS Chapter 3 – References 103 1 ABBREVIATIONS AAMV - maximum axial amplitude of valleculae ASMV - maximum sagittal amplitude of valleculae CBCT - Cone-beam Computed Tomography CRC - colorectal cancer DAP - anteroposterior diameter of glottis DAP/DMG - anterior posterior glotic diameter DAT - arytenoid diameter DC - Maximum distance between vocal cords DECV - distance between the top of the epiglottis and the vertebral column DEH - distance between the top of the epiglottis and the body of the hyoid bone DEL - distance between the top of the epiglottis and the base of the tongue DPF - maximum opening of the oropharyngeal isthmus in the palatopharyngeus muscles DPG - maximum opening of the oropharyngeal isthmus in the palatoglossus muscles EMVI - extramural vascular invasion GCV - thickness of the vocal folds GMD - Glottal maximum diameter GP - skeletotopic projection of glottis HIC - infraglotic floor height HIG - Height of infra-glottal floor HVC - height of the vocal folds ITL - Interarytenoidian distance LCV - lenght of the vocal folds LIT - interarytenoid diameter MIG - The length between the voice processes MLH - maximum laryngeal height mLH - minimum laryngeal height MP - mimed phonation MVD - microvessel density PVP - the position of the palatine veil SMAS – superficial musculo-aponeurotic system of the face STI - inferior temporal septum STS - superior temporal septum VCL - Vocal cords length before and after mucosal removal VIG - Volume of infraglottal floor VPP - skeletotopic projection of the palatine veil free edge 2 SECTION I ABSTRACT The applying for improvement professional standards in the academic career is compulsory and ensures the quality of the educational system.The current standards required for academic and medical performance focus on the awareness of continuous updated training, the integration of modern teaching and researching methods to qualify for high educational level achievements. Academic career is a complex challenge and relies on perseverance and desire for self-refinement, receptivity to new ideas and concepts, flexibility, dynamism and critical evaluation. It has significant impact upon the entire academic community and it must blend harmoniously with solid scientific knowledge, availability and pleasure to communicate with others, desire to be part of a team, capacity to create and coordinate functional team works, ability to identify and motivate human resources. The Habilitation Thesis, which synthesizes my postdoctoral professional, academic and scientific activity is structured in three major sections, according to the The National Council for Attestation of University Titles, Diplomas and Certificates (CNATDCU) recommendations and criteria. The paper presents the overview of my pursuits in the interest domains. It is entitled “Anatomy without frontiers, a systemic morpho-functional approach” and presents my research in the field of anatomy and especially the clinical anatomy. Regarding the already mentioned criteria I have structured the thesis into two main parts. Section I, the first part contains the Abstract of the Habilitation Thesis. Section II, the second and last part contains a detailed description of the professional, scientific and academic achievements. The last section is subdivided into three subsections: Chapter 1, 2 and 3. The first one consists of the abridgement of al my professional, scientific and academic achievements gained and succeeded after PhD study. Chapter 2 highlights my scientific and professional achievements in order to reunite the main personal research on the three main study directions: superficial musculoaponeurotic system of the face and neck, canto voice morfofunctional features and neovasculogenesis phenomena in colorectal cancers. Chapter 3 lists the most relevant referrence I have used for this thesis and for the articles included. A considerable number of this references are new ones, from the last 5 years, meaning that the subject and the themes from my thesis are current issues in anatomy. Chapter 1 contains a brief overview of my professional, academic and scientific activities, where I reviewed my studies and the main research topics I have followed after my PhD thesis. It presents a summary of my research, teaching and medical work performed since the doctoral thesis graduation (2010) and contains detailed descriptions of the projects for future research. It is organised in four chapters as follows: academic activity and career overview, research projects and scientific activities, synopsis of the PhD thesis and international visibility. 3 I have described all my research domains and the projects which I have conducted, together withthe results of my academic work. Chapter 2 unites under a systemic vission the most important results of my main research topic; they are materialized in three main study directions: superficial musculoaponeurotic system of the face and neck (SMAS), the anatomical background of the distinctive, particular vocal abilities in the canto voice, radiological, clinical anatomy and histological aspects of paraneoplastic neovasculogenesis processes in case of the colorectal cancers. SMAS research direction came out ofmy doctoral study. The results of this study led to to deepen the knowledge aboutthe new concept of a superficial cervicofacial cover layer, with particular practical features. The direction of study regarding the canto voice has derived from two conjuncted directions:comparative anatomy studies of the morphofunctional mechanisms that work together to determine exceptional vocal abilities are not fully known yet. Our findings in this area were decisive in determinating me to deepen my research of this vast field and I explored the upper segments of the phonatory apparatus through innovative and modern techniques. The study of paraneoplastic neovasculogenesis processes has naturaly stemmed from myclinicalpractise that I have as a general surgery specialist and proctologist. Colorectal cancers are the most common digestive malignant pathologies in my medical field, with a growing incidence on the international scene. In this manuscript I present all my research findings in these three main research directions that I have followed, starting with the scientific context of each of them and related results. This is compulsory because each research direction will be continued and represents a starting point for future research projects. These projects are detailed in the specific 2.4.5. subchapters of this manuscript. Chapter 3 includes a number of 256 bibliographic references which certify the current knowledge and discussions on the topics, the related articles and the thesis itself. 4 REZUMAT Aplicarea standardelor profesionale în cariera academică este obligatorie și asigură creșterea calității sistemului educațional. Standardele actuale necesare pentru performanța academică și medicală se concentrează pe conștientizarea necesității instruirii și actualizării continue a cunoștințelor cât și pe integrarea metodelor moderne de predare și cercetare pentru a se califica pentru realizări de nivel înalt de educație. Cariera academică este o provocare complexă și se bazează pe perseverență și dorință de auto-rafinament, receptivitate la idei și concepte noi, flexibilitate, dinamism și evaluare critică. Ea are un impact semnificativ asupra întregii comunități academice și trebuie să se armonizeze cu cunoștințele științifice solide, disponibilitatea și plăcerea de a comunica cu ceilalți, dorința de a face parte dintr-o echipă, capacitatea de a crea și coordona echipe de cercetare, capacitatea de a identifica și motiva resursa umană. Teza de Habilitare sintetizează activitatea mea profesională, academică și științifică postdoctorală și este structurată în două mari secțiuni, conform recomandărilor și criteriilor Consiliului Național de Atestare a Titlurilor, Diplomelor și Certificatelor Universitare (CNATDCU). Lucrarea prezintă o imagine de ansamblu asupra principalelor domenii de interes ale mele. Ea este intitulată "Anatomia fără frontiere, o abordare sistemică morfo-funcțională"
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