RESUMO
El foramen venoso es una estructura inconstante que se encuentra posterior al foramen redondo y medial al foramen oval, y da paso a una vena que anastomosa al plexo venoso pterigoideo con el seno cavernoso. La existencia de éste foramen puede ser motivo de complicaciones clínicas, entre ellas que es una potencial vía de acceso al seno cavernoso de trombos infectados y constituye una posible falsa vía durante la rizotomía percutánea del trigémino pudiendo puncionar la vena y ocasionar hematomas subdurales. Se utilizó la colección de cráneos del Departamento de Anatomía de la Facultad de Medicina UANL. Se observó la frecuencia y se midieron los siguientes parámetros del foramen: Ancho y largo; en la cara interna de la base del cráneo se midieron las distancias a: foramen redondo, foramen oval, plano sagital mediano y entre forámenes venosos; en la cara externa de la base del cráneo se midieron las distancias con: foramen oval, plano sagital medio y entre los forámenes venosos. Las medidas fueron llevadas a cabo por tres observadores distintos a través de medición directa con vernier y con microfotografías con escalas milimétricas. Se encontró una frecuencia del 20 por ciento con medidas medias de 1,66mm de largo, 1,06mm de ancho; en la cara interna de la base del cráneo: 11,31mm de distancia al foramen redondo, 4,13mm al foramen oval, 17,75mm al plano sagital medio y 31,91mm entre los forámenes; en la cara externa de la base: 2,50mm al foramen oval, 19,54mm al plano sagital medio y 36,05mm entre forámenes venoso. La distancia al foramen oval varía en la cara interna y la cara externa de la base del cráneo debido a un trayecto oblicuo del foramen que tiende a aproximarse al foramen oval y por tanto a separarse del plano sagital medio. Los forámenes derechos fueron generalmente más grandes.
Foramen venosum (foramen Vesalius) is an inconstant structure which is located posterior to the foramen rotundum and medial to the foramen ovale, and it gives pace to an emissary vein that communicates the plexus pterigoideus and the sinus cavernosus. The existence of this anatomical structure can be of interest in certain procedures like percutaneous trigeminal rhizotomy where this foramen can be the cause of a false pathway and be punctured causing a subdural hematoma. It also can be an access to the sinus cavernosus for infected thrombus coming from dental and facial infections. For this study the skull collection of the Anatomy Department, Faculty of Medicine UANL, was used. We observed the frequency and measured the following parameters: Length and width; in the basis cranii we measured: Distances to the foramen rotundum, foramen ovale, planum medianum and between two foramina venosum (one on each side). In basis cranii externa we measured: distances to foramen ovale, planum medianum, and between two foramina venosum. Three independent observers blinded among them, measured the parameters using a Vernier and microphotographs with milimetrical scales. A 20 percent frequency was found and the following median measures: Length 1.66mm, width 1.06mm; basis cranii: distance to foramen rotundum 11.31mm, distance to foramen ovale 4.13mm, distance to planum medianum 17.75mm and 31.91mm between both foramina venosum. Basis cranii externa: distance to foramen ovale 2.49mm, distance to planum medianum 19.54mm and distance between foramenina venosum 36.05. The distance to the foramen ovale varies between basis cranii and basis cranii externa because the foramen has an oblique trajectory and it approximates to the foramen ovale (from superior to inferior) and separates from the planum medianum. It was found bilaterally only in one skull. There are differences between the left and right foramens, the latter being generally larger.
Assuntos
Humanos , Masculino , Feminino , Crânio/anatomia & histologia , Crânio/irrigação sanguínea , Forame Oval/anatomia & histologia , Forame Oval/patologia , Fossa Craniana Média/anatomia & histologia , Fossa Craniana Média/crescimento & desenvolvimento , Fossa Craniana Média/patologia , Osso Esfenoide/anatomia & histologia , Osso Esfenoide/patologia , México/etnologiaAssuntos
Neoplasias Faciais/diagnóstico , Sarcoma Sinovial/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Criança , Fossa Craniana Média/patologia , Diagnóstico Diferencial , Neoplasias Faciais/patologia , Feminino , Seguimentos , Humanos , Queratina-1/análise , Queratina-3/análise , Mucina-1/análise , Proteínas Proto-Oncogênicas c-bcl-2/análise , Rabdomiossarcoma Embrionário/diagnóstico , Sarcoma Sinovial/patologia , Neoplasias de Tecidos Moles/patologia , Vimentina/análiseRESUMO
OBJECTIVE: To present an alternative technique of endoscope-controlled microneurosurgery for the treatment of middle fossa epidermoid cysts. METHODS: The three operations described were performed through an approximately 2-cm diameter temporal craniotomy after a straight skin incision was made. Resection was then performed under the magnification of a 30-degree rigid endoscope, which mandated the use of exclusively conventional microsurgical instruments. RESULTS: Total resection was accomplished in all three patients with large middle fossa epidermoid cysts through a small temporal corticectomy, without damage to neurovascular structures. CONCLUSION: This procedure allowed the association of a smaller craniotomy, better cosmetic results, and minor retraction of the brain to wide resection of the tumor and satisfactory functional outcomes.
Assuntos
Encefalopatias/patologia , Encefalopatias/cirurgia , Fossa Craniana Média/patologia , Fossa Craniana Média/cirurgia , Cisto Epidérmico/patologia , Cisto Epidérmico/cirurgia , Microcirurgia/métodos , Neuroendoscopia/métodos , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Procedimentos Neurocirúrgicos/métodos , Resultado do TratamentoRESUMO
OBJECTIVES: To describe a case of mandibular condyle intrusion into the middle cranial fossa in a young child and to systematically review the literature pertaining to this condition. STUDY DESIGN: The diagnostic procedures comprised clinical examination, health history, and both magnetic resonance imaging and computerized tomography. A systematic review of the literature from PubMed, Medline, and Web of Science databases from 1960 to 2005 was made and a total of 55 cases in 51 references were found, of which 36 were described in detail. CONCLUSIONS: Prompt diagnosis of mandibular condyle intrusion into the middle cranial fossa is essential to minimize complications. Advanced imaging modalities of computed tomography and magnetic resonance imaging are indicated.
Assuntos
Fossa Craniana Média/patologia , Côndilo Mandibular/patologia , Traumatismos Mandibulares/patologia , Acidentes de Trânsito , Pré-Escolar , Assimetria Facial/etiologia , Feminino , Humanos , Luxações Articulares/patologia , Imageamento por Ressonância Magnética , Má Oclusão/etiologia , Traumatismos Mandibulares/complicações , Amplitude de Movimento Articular , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: There are few reports on the outcome of surgical treatment of TGN without vascular compression. METHODS: Between 1984 and 2004, 668 patients underwent MVD for TGN. In 21 patients (3.1%), vascular compression was absent. The surgical strategy in these cases involved the following: (1) dissection and exposure of the entire trigeminal nerve root; (2) slight neurapraxia with bipolar tips at the trigeminal nerve root; and (3) isolation of trigeminal nerve with Teflon sponge fragments. RESULTS: The patients' (female/male, 20:1) ages ranged from 33 to 77 years. Their right side was the most frequently involved (61.9%). Their mean duration of pain before treatment was 7.6 years (range = 1-20 years). At surgical exploration, vascular compression or anatomical abnormalities were absent in 15 patients (71.4%), arachnoidal thickening was present in 5 (23.8%), and fiber dissociation of the trigeminal nerve was present in 1 (4.8%). Mean follow-up after surgery was 17.7 months (range = 4-65 months). Immediate relief from pain occurred in all 21 patients. On Kaplan-Meier analysis, recurrence was maintained at 14.8% for 12, 24, and 36 months, increasing to 43.2% at 48 months. Permanent hypoesthesia was present in 6 patients (28.6%), whereas loss of corneal reflex was observed transiently in 1 (4.8%). Motor function of the trigeminal nerve was intact in all patients. No other complication was found. CONCLUSION: The proposed surgical plan of standard MVD plus slight trigeminal nerve root neurapraxia is a safe and effective management option for TGN without vascular compression.