Investigation of the ischioanal fossa: Application to abscess spread

The location of perianal abscesses and the course of the fistula follow certain patterns, especially in the relationship between external and internal openings. However, it is still not clear how the contents of the ischioanal fossa, especially the fibrous network of fat tissue, affect the route for such diseases. Ten male adult cadavers were selected for the study. Seven horizontal transverse section planes from 1 cm above the pubic symphysis to the inferior border of the lesser trochanter of the femur were recorded after P45 sheet plastination. We observed characteristics of fiber distribution in the ischioanal fossa and its relationship with surrounding structures in every plane. There was a dense strip-type fiber connecting with junction fascia between the obturator internus and gluteus maximus muscles. Close to the levator ani, obturator internus, and gluteus maximus, the fibers were very dense and continuous with the fascia on the surfaces of these three muscles. The function of the fibrous network was considered to be not only the support of fat tissue in the fossa but also cushioning during physiological actions such as defecation. We hope that these morphological results could help to elucidate the passage of fistulae and the locations susceptible to perianal abscesses. Clin. Anat. 30:1029-1033, 2017. © 2017 Wiley Periodicals, Inc.