RESUMO
SUMMARY: The superior laryngeal artery is the primary vessel providing the blood supply to the larynx. Commonly, it is derived from the superior thyroid artery. Different variations in the origin have been described in the current literature; knowledge of such variations is crucial for various surgical interventions of the larynx and surgical procedures in the lateral region of the neck regarding the carotid triangle. It should be noted that radiological studies, such as selective angiography of the thyroid gland, can also be misleading in cases of variations. Herein, we describe a case of bilateral superior laryngeal artery originating directly from the external carotid artery of the neck. The arteries at first have a transverse course and then pierce through the thyrohyoid membrane alongside internal laryngeal nerves. Moreover, we also review the known variations in the origin of the superior laryngeal artery and propose a new classification of all known variations.
RESUMEN: La arteria laríngea superior es el vaso principal que proporciona el suministro de sangre a la laringe. Comúnmente, se deriva de la arteria tiroidea superior. Han sido descritas diferentes variaciones en su origen y el conocimiento de éstas resulta crucial para las intervenciones quirúrgicas realizadas en la laringe, como también en los procedimientos quirúrgicos que se llevan a cabo en la región lateral del cuello, respecto al triángulo carotídeo. Cabe señalar que los estudios radiológicos, como la angiografía selectiva de la glándula tiroides, también pueden ser engañosos en casos de variaciones anatómicas. Aquí, describimos un caso de arteria laríngea superior bilateral que se originaba directamente de la arteria carótida externa. Las arterias al inicio tenían un curso transversal y luego atravezaban la membrana tirohioidea junto con los nervios laríngeos internos. Revisamos también las variaciones conocidas en el origen de la arteria laríngea superior y proponemos una nueva clasificación de todas las variaciones conocidas.
Assuntos
Humanos , Masculino , Idoso , Artérias/anatomia & histologia , Variação Anatômica , Laringe/irrigação sanguíneaRESUMO
There are many factors that may affect the onset of the menopause, particularly cigarette smoking. The purpose of this study was to determine which factors may influence the onset of the menopause in Trinidadian women. A consecutive sample of 384 post-menopausal women attending Chronic Disease Clinics in 12 randomly selected Health Centres in North Trinidad comprised the study population. A pretested interview-type questionnaire was the instrument used to collect the data. Our findings from 379 (98.7 per cent) respondents aged 45 - 81 (mean = 61.5) years showed a mean age at menopause of 49.3 years. There were more women of African (56.3 per cent) than East Indian (28.3 per cent) origin; 84.9 per cent of women were non-smokers, 40 (10.6 per cent) and 17 (4.5 per cent) were smokers and ex-smokers, respectively. The mean age of menopause in Trinidadian women who smoke was reduced by as much as 5 years (49.7 vs 44.6 years), while women who were ex-smokers showed a reduction in the age of onset of the menopause by 3 years (49.7 vs 46.5 years). Chi-squared test showed these differences to be significant (p = 0.00312). However, there were no relationships with nutritional status, parity, chronic disease status or the use of hormonal contraception. It was interesting to note that all the hypertensive women in this sample acquired the disease post-menopause and 95 per cent acquired diabetes mellitus similarly (AU)