VARIATIONS OF FISSURES AND LOBES IN ADULT HUMAN LUNGS: A CADAVERIC STUDY  FROM TELANGANA Tallapaneni Sreekanth . MD,   Associate   Professor,   Department   of   Anatomy,   Shadan   Institute   of   Medical   Sciences,   Teaching   Hospital   &   Research   Center,   Peerancheeruvu,   Near Arramaisamma Temple, Hyderabad, Telangana, India. Address   for   Correspondence:   Dr.   Tallapaneni   Sreekanth,   Associate   Professor,   Department   of   Anatomy,   Shadan   Institute   of   Medical   Sciences,   Teaching Hospital   &   Research   Center,   Peerancheeruvu,   Near   Arramaisamma   Temple,   Hyderabad,   Telangana,   India.   Mobile   No:   70934   49309,   91006   83056.   E-Mail:   anatomysreekanth18@yahoo.com ABSTRACT Background   and   Aims:    The   complete   classical      fissures   of   the   lung   hold   the   lobes   together   only   at      the   hilum,      enabling   the   lobes   to   move   on   each   other during   respiration.      The   position   of   the   fissures   can   be   used   as   reliable   land   marks   in   specifying   the   pathological   lesions   in   the   lungs.   The   present   study         is conducted   on   the   lung   specimens   for   better   understanding   of   the   morphology   of   their   fissures   and   lobes.      Also         to   compare   the   variations   present   with   the previous   studies, and to correlate with the possible clinical implications. Materials   and   Methods:    In   the   present   study   thirty   pairs   of   lungs   were   used   that   were   obtained      from   the   formalin   fixed   cadavers.      All   the   specimens   were meticulously observed for the patterns of the  lobes and fissures.  All the variations were noted and pictures were taken. Results:    thirty   pairs   of   lungs   were   studied.      14(46.67%)   right   sided   lung   specimens   and   22(73.33%)   left   sided   lung   specimens      showed   fissures   and   lobes according   to   the   standard   description   of   anatomy   text   books.      16   (53.33%)   right   sided   lung   specimens   and   8(26.67%)   left   sided   lung   specimens      showed variant   pattern   of   fissures   and   lobes.   2   (6.66%)right   sided   lungs   showed      Incomplete   oblique   fissure.   3   (10%)   right   sided   lungs   showed      absence   of horizontal   fissure   and   7   (23.33%)   showed   incomplete   horizontal   fissures.      3   (10%)   lungs   showed      Presence   of   accessory   fissures.      6   (20%)   left   sided   lung specimens showed incomplete oblique fissure and  2 (6.66%) showed  accessory fissures. Conclusion:          The   results   of   the   present   study   and   their   comparison   with   the   earlier   studies   clearly   shows   that   there   is   a   wide   range   of   difference   in   the occurrence   of   accessory   fissures,   major   and   minor   fissures   between   and   among   different   populations.      Prior   awareness   of   the   existence   of   incomplete major   fissures   or   their   absence,   and   the   presence   of   accessory   fissures   of   the   lungs      is   an   essential   prerequisite   for   the   C.T.   surgeons   planning   for   segmental resections or lobectomies,  the pulmonologists diagnosing   and the Radiologists reporting the chest radio graphs,  C.T. and M.R.I. scans. KEY WORDS:  Accessory Fissures, Incomplete Fissure, Absence Of Fissure. References 1 . Shah P, Johnson D, Standring S. Throax. In: Gray’s Anatomy. 39 th  ed. Edinburgh: Chruchill Livingstone: 2005.p. 1068-9. 2 . Godwin JD, Tarver RD .  Accessory Fissures of the Lung. Am J Roentgenol, 1984;144:39-47. 3 . Berkmen   T,   Berkmen   YM,   Austin   JH.   Accessory   fissures   of   the   upper   lobe   of   the   left   lung:   CT   and   plain   film   appearance.   AJR   Am   J   Roentgenol 1985;144:39-47. 4 . Rosse C, Gaddum-Rosse P. Hollinshed text book of Anatomy. Philadelphia: Lipincott-Raven;1997:441-61. 5 . Craig SR, Walker WS.  A proposed   anatomical classification of the pulmonary fissures.  J R coll Surg Edinb 1997;422:233-4. 6 . Larsen WJ Sherman LS, Potter SS, Scott WJ. Development  of respiratory system (ch-11) Human Embryology.  3 rd  Edn. 2001. Elsevier. New  York; 125-7. 7 . Sadler TW (ed). Respiratory system (Ch-13). In, Langman’s  Medical Embryology, Philadelphia.  11 th  edn. Lippincot  Williams & Wilkins. 2010:205-6. 8 . Cronin   P,   Gross   BH,   Kelly   AM,   Kazerooni   EA,   Carlos   RC.   Normal   and   accessory   fissures   of   the   lung:   evaluation   with   contiguous   volumetric   thin   section multi detector C.T. Eur J Radiol 2010;75(2):8 9 . Bergman   RA,   Afifi   AK.   Miyauchi   R.   Variations            in   peripheral   segmentation   of   right   lung   and   the   base   of   the   right      and   left   lungs.      In:   illustrated Encyclopedia     of     Human     Anatomic     Variation.     http:www.anatomyatlases.org/AnatomicVariants/OrganSystem/Text/LungsTrachea.Shtml     (28 th      of November, 2010). 1 0 . Medlar EM. Variations  in interlobar  fissures. AJR.1947;57:723-25. 1 1 . Enakshi   Ghosh,   Rituparna   Basu,   Anjana   Dhur,   Anindya   Roy,   Hironmoy   Roy,   Amitava   Biswas.   Variations   of   fissures   and      Lobes   in   Human   Lungs-A Multicentric Cadaveric Study from West Bengal, India. International  Journal of Anatomy. Radiology and Surgery. 2013;2(1):5-8. 1 2 . Varalakshmi,   K.L.,   Nayak,   N.J   and   Sangeetha,   M.   Morphological   Variations   of   Fissures   of   Lung;   an   Anatomical   study.   Indian   Journal   of   applied   Research. 2014;4(|8):467-469. 1 3 . Dutta,   S.,   Mandal,   L.,   Mandal,   Biswis,   J.,   Ray,   A   and   Bandopadhay,   M.   natural   fissures   of   lung-   Anatomical   basis   of   surgical   techniques   and   imaging.     National Journal of Medical Research. 2013;3(2);117-121. 1 4 . Kaul,   N.,   Singh,   V.,   Sethi,   R.   and   Kaul,   V.   anomalous   fissures   and   lobes   of   human   lungs   of   North   Indian   Population   of   Western   U.P.   Journal   of   the anatomical Society  of India. 2014;63:26-30. 1 5 . Meenakshi   S,   Manjunath   KY,   Balasubramanyam   V.   Morphological   variations   of   the   lung   fissures      and   lobes.      Indian   J   Chest   Dis   Allied   Sci   2004;46:179- 82. 1 6 . Bhimai    ND,    Rao    BN,    Sunitha    V.    Morphological    variations    of    lung    –    a    cadaveric    study    in    north    coastal    Andhra    Pradesh.    Int    J    Biol    Med    Res 2011;2(4):1149-52. 1 7 . Ajay    Ratnakarrao    Nene,    Krishna    Swami    Gajendra,    Manchiraju    Venkata    Ramananda    Sarma.    Lungs    Lobes    and    fissures:    a    Morphological    Study. International Journal of Experimental and clinical  Anatomy 2011; 5:30-38. 1 8 . Lydia   S.   Quadros,   Ramesh   Palanichamy   and   Antony   S.   D’souza.   Variations      in   the   lobes   and   fissures   of   lungs-a   study   in   south   Indian   lung   specimens. Eur. J. Anat. 2014;18(1):16-20. 1 9 . Radha k, Durai Pandian K. Fissures and Lobes of Lungs: A Morphological and Anatomical Study. Int J. anat and Res.2015;3(2):995-98. 2 0 . Kent EM, Blades B. the surgical anatomy of the pulmonary lobes.  J Thoraic Surg. 1942;12:18-30.