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Sample records for pterygopalatine fossa ppf

  1. Pterygopalatine Fossa: Not a Mystery!

    Science.gov (United States)

    Derinkuyu, Betul Emine; Boyunaga, Oznur; Oztunali, Cigdem; Alimli, Ayse Gul; Ucar, Murat

    2017-05-01

    The pterygopalatine fossa is an important anatomic crossroads that is connected with numerous intra- and extracranial spaces via foramina and fissures. Although this fossa is small, its central location in the skull base and its communications provide clinical, radiological, and anatomical significance. In this pictorial review, we aimed to describe the radiologic anatomy of the pterygopalatine fossa, as well as to give some pathologic examples to better understand this major conduit. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa

    Directory of Open Access Journals (Sweden)

    Ordones, Alexandre Beraldo

    2014-01-01

    Full Text Available Objective To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and developed a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1 year postoperatively. Conclusion This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.

  3. Preliminary results on a study to locate the pterygopalatine fossa using mathematical formulae.

    Science.gov (United States)

    du Plessis, M; Navsa, N; Bosman, M C

    2010-11-01

    Blocking the contents of the pterygopalatine fossa (PPF) has been shown to be effective in treating most orofacial pain including that associated with trigeminal neuralgia. However, the technique is not widely used, and we propose it to be due to the vague descriptions of the techniques in the literature. The aim of this study was therefore to achieve an alternative method of locating the PPF. One hundred and sixty skulls from the department of Anatomy, University of Pretoria, were used. Distinct landmarks (both anthropometric and clinical) accompanied by existing and new anthropometric measurements were used to define the location of the PPF. Regression analysis was used to measure the reliability of predicting the location of the PPF. From the results, two mathematical formulae were devised (one for each side). These formulae were tested on 47 cadavers by inserting a needle at the calculated points after which the areas where dissected to determine whether or not the needle had entered the PPF. Our results showed an accuracy of 65.2% on the right and 54.4% on the left. In conclusion, improvement in the accuracy of the technique could aid in the management of various pain disorders as well as pain management during surgery.

  4. 3D printing the pterygopalatine fossa: a negative space model of a complex structure.

    Science.gov (United States)

    Bannon, Ross; Parihar, Shivani; Skarparis, Yiannis; Varsou, Ourania; Cezayirli, Enis

    2017-08-30

    The pterygopalatine fossa is one of the most complex anatomical regions to understand. It is poorly visualized in cadaveric dissection and most textbooks rely on schematic depictions. We describe our approach to creating a low-cost, 3D model of the pterygopalatine fossa, including its associated canals and foramina, using an affordable "desktop" 3D printer. We used open source software to create a volume render of the pterygopalatine fossa from axial slices of a head computerised tomography scan. These data were then exported to a 3D printer to produce an anatomically accurate model. The resulting 'negative space' model of the pterygopalatine fossa provides a useful and innovative aid for understanding the complex anatomical relationships of the pterygopalatine fossa. This model was designed primarily for medical students; however, it will also be of interest to postgraduates in ENT, ophthalmology, neurosurgery, and radiology. The technical process described may be replicated by other departments wishing to develop their own anatomical models whilst incurring minimal costs.

  5. Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach

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    Nedim Özer

    2013-01-01

    Full Text Available The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery units with low rates of complications and morbidity. A few cases of accidental displacement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. In this paper, a case of a maxillary third molar accidentally displaced into the pterygopalatine fossa is presented, and the removal of the tooth via intraoral approach is described.

  6. Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain.

    Science.gov (United States)

    Nader, Antoun; Kendall, Mark C; De Oliveria, Gildasio S; Chen, Jeffry Q; Vanderby, Brooke; Rosenow, Joshua M; Bendok, Bernard R

    2013-01-01

    Patients presenting with facial pain often have ineffective pain relief with medical therapy. Cases refractory to medical management are frequently treated with surgical or minimally invasive procedures with variable success rates. We report on the use of ultrasound-guided trigeminal nerve block via the pterygopalatine fossa in patients following refractory medical and surgical treatment. To present the immediate and long-term efficacy of ultrasound-guided injections of local anesthetic and steroids in the pterygopalatine fossa in patients with unilateral facial pain that failed pharmacological and surgical interventions. Academic pain management center. Prospective case series. Fifteen patients were treated with ultrasound-guided trigeminal nerve block with local anesthetic and steroids placed into the pterygopalatine fossa. All patients achieved complete sensory analgesia to pin prick in the distribution of the V2 branch of the trigeminal nerve and 80% (12 out of 15) achieved complete sensory analgesia in V1, V2, V3 distribution within 15 minutes of the injection. All patients reported pain relief within 5 minutes of the injection. The majority of patients maintained pain relief throughout the 15 month study period. No patients experienced symptoms of local anesthetic toxicity or onset of new neurological sequelae. Prospective case series. We conclude that the use of ultrasound guidance for injectate delivery in the pterygopalatine fossa is a simple, free of radiation or magnetization, safe, and effective percutaneous procedure that provides sustained pain relief in trigeminal neuralgia or atypical facial pain patients who have failed previous medical interventions.

  7. Radio-anatomical Study of the Greater Palatine Canal and the Pterygopalatine Fossa in a Lebanese Population: A Consideration for Maxillary Nerve Block

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    Georges Aoun

    2016-01-01

    Full Text Available Aim: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF, in a Lebanese population using cone-beam computed tomography (CBCT technology. Materials and Methods: CBCT images of 79 Lebanese adult patients (38 females and 41 males were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically. Results: In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively. Conclusion: Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides; however, the GPC-PPF length does not significantly vary according to gender and side.

  8. Ultrasound-Guided Pulsed Radiofrequency Application via the Pterygopalatine Fossa: A Practical Approach to Treat Refractory Trigeminal Neuralgia.

    Science.gov (United States)

    Nader, Antoun; Bendok, Bernard R; Prine, Jeremy J; Kendall, Mark C

    2015-01-01

    Although pharmacological therapy is the primary treatment modality for trigeminal neuralgia associated pain, ineffective analgesia and dose limiting side effects often prompt patients to seek alternative pharmacological solutions such as interventional nerve blockade. Blockade of the Gasserian ganglion or its branches is an effective analgesic procedure for trigeminal neuralgia, traditionally performed using fluoroscopy or CT imaging. Ultrasonography allows point of care and real time visualization of needle placement within the surrounding anatomical structures. The use of ultrasonography with pulsed radiofrequency therapy for trigeminal neuralgia has not been reported. Our case is a 66-year-old male suffering from trigeminal neuralgia for 4 years that was refractory to pharmacologic therapy. Neurological examination was normal with no sensory deficit. Imaging showed no vascular compression or mass involving the trigeminal nerve. A diagnostic ultrasound-guided trigeminal nerve block via the pterygopalatine fossa with 4 mL of bupivacaine 0.25% and 4 mg dexamethasone provided immediate pain relief (100%) with sustained analgesia >50% at 2 weeks. Pain relief was not sustained at one month, with return to pretreatment symptoms. A series of injections were performed with similar intermittent analgesic effectiveness. The decision was made that the patient was a suitable candidate for pulsed radiofrequency application in the pterygopalatine fossa. We successfully used an alternative approach through the pterygopalatine fossa to treat trigeminal neuralgia using ultrasound guidance in an office setting. Our case demonstrates the utility of ultrasound-guidance pulsed radiofrequency treatment in the pterygopalatine fossa as a potential alternative to other percutaneous techniques for patients with medical refractory trigeminal neuralgia.

  9. Sectional and applied anatomy of pterygopalatine fossa far operative approach%翼腭窝手术入路的断层与应用解剖学研究

    Institute of Scientific and Technical Information of China (English)

    郑海宁; 吴樾; 吕杨波; 于涌; 刘庚辰; 王平; 李云生; 翟丽东

    2009-01-01

    Objective: To supply the evidence of applied anatomy of new operative route of pterygopalatine fossa with improved ceUoidin embedding techniques. Methods: Take the anterior bases of 30 specimens of dead adult heads first. Then,after series of processes like decalcification and dehydration we make three-dimensional continued thin sections of 0.25 mm. At the same time we measure 80 sides of cardaveric heads. Results: The appearance of pterygopalatine fossa is multiplex,except for triangle,there are arc-shape、transverse"S"-shape,chock-shape ,"L"shape,dumbbell-shape,cosh-shapc,assurgent narrow strip shape. The thickness of medial wall ofpterygopalatiue fessa in middle nasal meatus is (1.95±0.66) mm (left),(1.97±0.74) mm(right).The distance from posterior edge of the aperture of maxillary sinus to pterygopalatine fossa is (11.25±1.95) mm(left) (11.22±1.96) mm (right). Conchision: The now approach of the operation doesn't pass maxillary sinus,the instruments can be used to go in the middle nasal meatus until the medial wall of pterygopalatine fossa,then open the thin piece ofboue,enter the pterygopalatine fossa directly.%目的:用改进火棉胶包埋技术,为翼腭窝新型手术入路提供应用解剖学依据.方法:固定成人尸头标本30例,取其前颅底.标本经脱钙、脱水等系列处理,分别行三维连续薄切片,厚度0.25 mm.同时对80侧干燥骨进行测量.结果:翼腭窝形态多样,除有三角形外,还有弧形、横置"S"形、楔形、"L"形、哑铃形、短棒状或斜向外上的窄长条形.翼腭窝在中鼻道处内侧壁厚度为(1.95±0.66)mmm(左),(1.97±0.74)mm(右).在中鼻道处上颌窦口后缘至翼腭窝距离(11.25±1.95)mm(左),(11.22±1.96)mm(右).结论:新型手术入路不经过上颌窦,运用器械从中鼻道深入至翼腭窝的内侧壁深度,打开薄骨板,直接进入翼腭窝,由此处入路手术创伤小、出血少、安全、术后并发症少.

  10. Anatomical and clinical appraisal of the pterygopalatine ganglion

    NARCIS (Netherlands)

    Oomen, K.P.Q.

    2011-01-01

    The anatomy of the pterygopalatine ganglion (PPG) and its branches is related to pain syndromes Cluster headache (CH) and Sluder’s neuralgia (SN). In order to gain more insight in these syndromes, we conducted an anatomical and clinical study of the PPG. A search for new neural structures in the PPF

  11. Trends in Surgery and Diagnosis of Benign and Malignant Tumors of the pterygopalatine Fossa%翼腭窝及翼腭窝邻近结构中良、恶性肿瘤的诊断与外科处理

    Institute of Scientific and Technical Information of China (English)

    翦新春

    2012-01-01

    翼腭窝区域的手术因为位置深在、解剖结构复杂,使得发生在该区域的肿瘤切除具有臣大的挑战性.当翼腭窝的肿瘤累及上颌骨、进入上颌窦,腮腺深叶的肿瘤扩展进入翼腭窝时,广泛的切除通常是必要的.随着影像学、病理诊断学、外科技术、手术器械和重建技术的进步,颅底外科已成为多学科外科医师关注的热点.本文就翼腭窝及翼腭窝邻近结构中良、恶性肿瘤的诊断与外科处理进行系统的论述.%Surgical management in the pterygopalatine fossa region presents anatomic and surgical problems related to the difficulty of access. When a tumor in the pterygopalaline fossa involves the maxilla and extends into the maxillary sinus, and a tumor in the deep lobe of the parotid gland extends into the pterygopalatine fossa, extensive resection is often necessary. With the advancements in imageology, diagnostic technology, diagnostic pathology, surgical technology and instrumentation, reconstructive techniques, the surgery of the lateral cranial base or the middle cranial base is now receiving significant attention progress, and interest. The objective of the paper was to provide an overview of contemporary strategies for the management of tumors in the pterygopalatine fossa and adjacent structures.

  12. Fossa Regia

    OpenAIRE

    Ferchiou, N.

    2012-01-01

    Comme toutes les questions de frontière, le problème de la Fossa Regia est loin de se limiter au simple tracé d’une ligne de démarcation entre deux pays ou deux provinces. En fait, il touche à des aspects les plus divers, tels que la politique menée par les protagonistes de l’époque, – que ce soit les rois numides ou Rome, – les opérations militaires, les institutions municipales et juridiques, la pertica de la colonie de Carthage, le droit des gens et du sol, l’assiette foncière, la répartit...

  13. Mangala Fossa

    Science.gov (United States)

    2002-01-01

    (Released 29 May 2002) The Science Today's THEMIS release captures Mangala Fossa. Mangala Fossa is a graben, which in geologic terminology translates into a long parallel to semi-parallel fracture or trough. Grabens are dropped or downthrown areas relative to the rocks on either side and these features are generally longer than they are wider. There are numerous dust devil trails seen in this image. In the lower portion of this image several dust devil tracks can be seen cutting across the upper surface then down the short stubby channel and finally back up and over to the adjacent upper surface. Some dust avalanche streaks on slopes are also visible. The rough material in the upper third of the image contains a portion of the rim of a 90 km diameter crater located in Daedalia Planum. The smooth crater floor has a graben (up to 7 km wide) and channel (2 km wide) incised into its surface. In the middle third and right of this image one can see ripples (possibly fossil dunes) on the crater floor material just above the graben. The floor of Mangala Fossa and the southern crater floor surface also have smaller linear ridges trending from the upper left to lower right. These linear ridges could be either erosional (yardangs) or depositional (dunes) landforms. The lower third of the scene contains a short stubby channel (near the right margin) and lava flow front (lower left). The floor of this channel is fairly smooth with some linear crevasses located along its course. One gets the impression that the channel floor is mantled with some type of indurated material that permits cracks to form in its surface. The Story In the Daedalia Plains on Mars, the rim of an old eroded crater rises up, a wreck of its former self (see context image at right). From the rough, choppy crater rim (top of the larger THEMIS image), the terrain descends to the almost smooth crater floor, gouged deeply by a trough, a channel, and the occasional dents of small, scattered craters. The deep

  14. La Fossane de Buffon, Fossa fossa (Schreber)

    NARCIS (Netherlands)

    Jentink, F.A.

    1899-01-01

    The type-specimen of Buffon’s Fossane, Fossa Fossa (Schreber) had been presented in 1761 by Monsieur Poivre to the Cabinet du Roi: it was a stuffed skin, with the jaws and the bones of the legs. The animal measured 17 pouces from the tip of the nose to the origin of the tail, the tail measuring 8½

  15. La Fossane de Buffon, Fossa fossa (Schreber)

    NARCIS (Netherlands)

    Jentink, F.A.

    1899-01-01

    The type-specimen of Buffon’s Fossane, Fossa Fossa (Schreber) had been presented in 1761 by Monsieur Poivre to the Cabinet du Roi: it was a stuffed skin, with the jaws and the bones of the legs. The animal measured 17 pouces from the tip of the nose to the origin of the tail, the tail measuring 8½ p

  16. PPF1 May Suppress Plant Senescence via Activating TFL1 in Transgenic Arabidopsis Plants

    Institute of Scientific and Technical Information of China (English)

    Da-Yong Wang; Qing Li; Ke-Ming Cui; Yu-Xian Zhu

    2008-01-01

    Senescence, a sequence of biochemical and physiological events, constitutes the final stage of development In higher plants and is modulated by a variety of environmental factors and intemal factors. PPF1 possesses an important biological function in plant development by controlling the Ca2+ storage capacity within chloroplasts. Here we show that the expression of PPF1 might play a pivotal role in negatively regulating plant senescence as revealed by the regulation of overexpression and suppression of PPF1 on plant development. Moreover, TFL1, a key regulator in the floral repression pathway, was screened out as one of the downstream targets for PPF1 in the senescence-signaling pathway. Investigation of the senescence-related phenotypes in PPF1(-) tfl1-1 and PPF1(+) tfl1-1 double mutants confirmed and further highlighted the relation of PPF1 with TFL1 in tranegenic plants. The activation of TFL1 expression by PPF1 defines an important pathway possibly essential for the negative regulation of plant senescence in transgenic Arabidopsis.

  17. Tantalus Fossae

    Science.gov (United States)

    2002-01-01

    (Released 25 June 2002) The Science Tantalus Fossae is a set of long valleys on the eastern side of Alba Patera. These valleys are referred to as grabens and are formed by extension of the crust and faulting. When large amounts of pressure or tension are applied to rocks on timescales that are fast enough that the rock cannot respond by deforming, the rock breaks along faults. In the case of a graben, two parallel faults are formed by extension of the crust and the rock in between the faults drops downward into the space created by the extension. Numerous sets of grabens are visible in this THEMIS image, trending from north-northeast to south-southwest. Because the faults defining the graben are formed parallel to the direction of the applied stress, we know that extensional forces were pulling the crust apart in the west-northwest/east-southeast direction. The large number of grabens around Alba Patera is generally believed to be the result of extensional forces associated with the uplift of Alba Patera. Also visible in this image are a series of linearly aligned pits, called a pit chain. The pits are not the result of impact cratering, but are similar to sinkholes on Earth. Sinkholes are typically formed by the removal of rock (commonly limestone) underground by groundwater -- when enough rock is removed, the overlying rock becomes too heavy to be supported, and it collapses, forming a pit. Unlike sinkholes, however, the pit chains near Alba Patera were likely formed when empty underground lava tubes collapsed, accounting for the presence and alignment of many pits. Numerous channel features are also observed in the image, and follow the local topographic slope, which is downhill to the east-southeast. One of these, a long channel in the center of the image, nicely demonstrates the complex relations possible between geologic features. The geologist's rule of superposition says that a feature on top of (superposing) another feature, or cutting across another

  18. Stereology of the pterygopalatine ganglion of the rat.

    Science.gov (United States)

    Costa, W S; Morais, R; Mandarim-De-Lacerda, C A

    1992-01-01

    The right pterygopalatine ganglia (PG) of 9 male Wistar-strain rats were dissected, embedded in Epon (3 specimens) or paraffin (6 specimens), and prepared for stereological examination under light microscopy. The perikarya were quantitatively characterized, and the ganglionic volume was determined. Stereology is an efficient method for the quantitative evaluation of the perikarya of the PG. The results(expressed as mean +/- standard deviation) were: a) areal fraction occupied by the perikarya = 53.8 +/- 7.4%; b) the perikaryal surface area per volume = 0.101 +/- 0.013 microns-1; c) the number of perikarya per volume x 10(-5) = 5.26 +/- 0.99 microns-3; d) the mean profile area of the perikarya (apk) = 505.93 +/- 78.29 microns 2; e) the mean perikaryal volume (vpk) = 9,179.33 +/- 1,533.52 microns 3; and f) the ganglionic volume = 0.210 +/- 0.127 mm3. The low coefficient of variation the apk and vpk values suggests the presence of only one population of neurons in the PG of the rat. The number of perikarya in the PG is about 11,046 per ganglion. As compared to analogous data in the otic ganglion of the rat, the PG did not show statistically significant stereological differences, but the relatively higher number of neurons found in the PG is probably associated with the higher functional activity of this ganglion.

  19. Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension

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    Sadr-Hoseini S M

    2003-11-01

    Full Text Available Rhinocerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery."nMaterials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied."nResults: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1 facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2 involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3 involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients."nConclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek

  20. Posterior Fossa Syndrome

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    Serhan Kupeli

    2014-08-01

    Full Text Available Posterior fossa syndrome is defined as the temporary and complete loss of speech after posterior fossa surgery which is not related to cerebellar hemorrhage, infection of the cerebellum, degenerative or neoplastic diseases of the cerebellum. In this review, we aimed to outline the incidence of posterior fossa syndrome, to define the risk factors for posterior fossa syndrome, to describe accompanying neurobehavioural and psychologic problems and to speculate about the etiologic mechanisms. The diagnosis of medulloblastoma and midline location of the tumor are important risk factors for the development of posterior fossa syndrome. These findings support the hypothesis that temporary ischemia and edema due to retracted and largely manipulated dentate nuclei and superior cerebellar pedincles may be the cause of mutism. Informing the family and the patient about the posterior fossa syndromemust be a component of the preoperative interview and patients who developed posterior fossa syndrome should be followed for accompanying neurobehavioural and psychologic problems even after mutism improved. [Archives Medical Review Journal 2014; 23(4.000: 636-657

  1. Morphology, topography and cytoarchitectonics of the pterygopalatine ganglion in Egyptian spiny mouse (Acomys cahirinus, Desmarest).

    Science.gov (United States)

    Szczurkowski, Aleksander; Kuder, Tadeusz; Nowak, Elzbieta; Kuchinka, Jacek

    2002-01-01

    Using the thiocholine method of Koelle and Friedenwald and histological techniques the pterygopalatine ganglion in Egyptian spiny mouse (Acomys cahirinus, Desmarest) was studied. The ganglion was found to be a single irregular cluster of neurocytes, situated on the medial surface of the maxillary nerve. The ganglion is composed of oval, elliptical and sometimes fusiform ganglionic neurones in compact arrangement without a thick connective-tissue capsule.

  2. Development of 3D PPF/DEF scaffolds using micro-stereolithography and surface modification.

    Science.gov (United States)

    Lan, Phung Xuan; Lee, Jin Woo; Seol, Young-Joon; Cho, Dong-Woo

    2009-01-01

    Poly(propylene fumarate) (PPF) is an ultraviolet-curable and biodegradable polymer with potential applications for bone regeneration. In this study, we designed and fabricated three-dimensional (3D) porous scaffolds based on a PPF polymer network using micro-stereolithography (MSTL). The 3D scaffold was well fabricated with a highly interconnected porous structure and porosity of 65%. These results provide a new scaffold fabrication method for tissue engineering. Surface modification is a commonly used and effective method for improving the surface characteristics of biomaterials without altering their bulk properties that avoids the expense and long time associated with the development of new biomaterials. Therefore, we examined surface modification of 3D scaffolds by applying accelerated biomimetic apatite and arginine-glycine-aspartic acid (RGD) peptide coating to promote cell behavior. The apatite coating uniformly covered the scaffold surface after immersion for 24 h in 5-fold simulated body fluid (5SBF) and then the RGD peptide was applied. Finally, the coated 3D scaffolds were seeded with MC3T3-E1 pre-osteoblasts and their biologic properties were evaluated using an MTS assay and histologic staining. We found that 3D PPF/diethyl fumarate (DEF) scaffolds fabricated with MSTL and biomimetic apatite coating can be potentially used in bone tissue engineering.

  3. The pterygopalatine ganglion and its role in various pain syndromes: from anatomy to clinical practice.

    Science.gov (United States)

    Piagkou, Maria; Demesticha, Theano; Troupis, Theodore; Vlasis, Konstantinos; Skandalakis, Panayiotis; Makri, Aggeliki; Mazarakis, Antonios; Lappas, Dimitrios; Piagkos, Giannoulis; Johnson, Elizabeth O

    2012-06-01

    The postsynaptic fibers of the pterygopalatine or sphenopalatine ganglion (PPG or SPG) supply the lacrimal and nasal glands. The PPG appears to play an important role in various pain syndromes including headaches, trigeminal and sphenopalatine neuralgia, atypical facial pain, muscle pain, vasomotor rhinitis, eye disorders, and herpes infection. Clinical trials have shown that these pain disorders can be managed effectively with sphenopalatine ganglion blockade (SPGB). In addition, regional anesthesia of the distribution area of the SPG sensory fibers for nasal and dental surgery can be provided by SPGB via a transnasal, transoral, or lateral infratemporal approach. To arouse the interest of the modern-day clinicians in the use of the SPGB, the advantages, disadvantages, and modifications of the available methods for blockade are discussed.▪

  4. Clay at Nili Fossae

    Science.gov (United States)

    2006-01-01

    This image of the Nili Fossae region of Mars was compiled from separate images taken by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) and the High-Resolution Imaging Science Experiment (HiRISE), two instruments on NASA's Mars Reconnaissance Orbiter. The images were taken at 0730 UTC (2:30 a.m. EDT) on Oct. 4, 2006, near 20.4 degrees north latitude, 78.5 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36 to 3.92 micrometers, and shows features as small as 18 meters (60 feet) across. HiRISE's image was taken in three colors, but its much higher resolution shows features as small as 30 centimeters (1 foot) across. CRISM's sister instrument on the Mars Express spacecraft, OMEGA, discovered that some of the most ancient regions of Mars are rich in clay minerals, formed when water altered the planet's volcanic rocks. From the OMEGA data it was unclear whether the clays formed at the surface during Mars' earliest history of if they formed at depth and were later exposed by impact craters or erosion of the overlying rocks. Clays are an indicator of wet, benign environments possibly suitable for biological processes, making Nili Fossae and comparable regions important targets for both CRISM and HiRISE. In this visualization of the combined data from the two instruments, the CRISM data were used to calculate the strengths of spectral absorption bands due to minerals present in the scene. The two major minerals detected by the instrument are olivine, a mineral characteristic of primitive igneous rocks, and clay. Areas rich in olivine are shown in red, and minerals rich in clay are shown in green. The derived colors were then overlayed on the HiRISE image. The area where the CRISM and HiRISE data overlap is shown at the upper left, and is about 5 kilometers (3 miles) across. The three boxes outlined in blue are enlarged to show how the different minerals in the scene match up with different landforms. In the image at the upper right

  5. Epidural hematomas of posterior fossa

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    Radulović Danilo

    2004-01-01

    Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

  6. 成人翼腭管CBCT测量研究%Examination the Pterygopalatine Canal of Adult with CBCT

    Institute of Scientific and Technical Information of China (English)

    于天平; 侯敏

    2013-01-01

    目的:研究成人翼腭管的解剖形态,为经翼腭管行上颌神经阻滞麻醉提供指导.方法:利用锥体束CT(CBCT)观测200个正常国人翼腭管的解剖形态.结果:矢状面上翼腭管的走行有四类:1)斜线形,向前下方走行,此类型最为多见,所占比例为89.25%;2)突向前方的弧形,此类型所占比例为5.25%,占第二位;3)折线形,占3.25%.4)突向后方的弧形,此类型最为少见,占2.25%.翼腭管的形态有3类:1)上窄下宽的喇叭口状,此形态最为多见,占88%;2)上下径较一致管状,此形态较为少见,比例占10%;3)不规则形,约占2%.翼腭管的长度平均为(15.76±2.32) mm,翼腭管与颌平面的夹角平均为(55.77±3.37)°.结论:通过CBCT可明确观测翼腭管的形态,对临床有定位指导作用.%Objective:To provide guidance for maxillary nerve block anesthesia through pterygopalatine canal.Methods:We examined the anatomy of the pterygopalatine canal using data obtained from CBCT scans of 200 normal Chinese.Results:In the sagittal plane,four pathways were observed:1) Diagonal form,the pterygopalatine canal travels in an anterior-inferior direction,the most common pathway,it occurred in 89.25 % ;2) Arc,Convex to the front,this pathway occurred in 5.25 %;3)Fold line shape,this pathway occurred in 3.25 %;4)Arc,Convex to the behind,this pathway occurred in 2.25%.There are three shapes of the pterygopalatine canal:1) bellbottom shape,the most common shapes,the top diameter are less than the below,(88%) ;2) tubular,the top diameter are same to the below,(10%) ;3)irregular shape,(2%).The average length of the pterygopalatine canal was (15.76±2.32)mm.The mean angle between the pterygopalatine and the occlusion plane were (55.77±3.37)°.Conclusion:Using CBCT,we are able to observe the exact shape of the pterygopalatine canal.It will play an important role to guide the clinical operation in the future.

  7. Transgênicos - Plantas Produtoras de Fármacos (PPF Trangenics - Plant-Based Drugs (PBD

    Directory of Open Access Journals (Sweden)

    Daniele Rachidi da Rocha

    2011-07-01

    Full Text Available As Plantas Produtoras de Fármacos (PPF representam a 4ª onda de vegetais geneticamente modificados. Neste caso, com a tecnologia sendo empregada para desenvolver e produzir vacinas e/ou produtos farmacêuticos, a partir de plantas transgênicas. Esta tecnologia, como todas as inovações científicas, vem acompanhada de riscos. Porém, o conhecimento atual disponível sobre seu uso não permite ainda conclusões definitivas sobre o caráter dos riscos, sua significância e sua probabilidade de causar, ou não, sérios danos. A análise de risco deve servir de base para a implementação de inovações tecnocientíficas. Os parâmetros devem ser avaliados, precauções especiais devem ser tomadas, a pesquisa deve ser conduzida de forma detalhada e também precisa ter amplo alcance quanto aos riscos potenciais por ser uma inovação. O presente artigo revisou a aplicabilidade desta nova tecnologia com relação ao gerenciamento do risco e a uma contenção que vise a segurança de uso, a manipulação e o comércio para os seres humanos.Plant-Based Drugs - PBD - represent the 4th generation of genetically-modified plants and in this case the technology is used to develop and produce pharmaceuticals vaccines and/or products from transgenic seeds. This technology, like all scientific innovations, has inherent risks. However, the current knowledge available about the use of this technology means that no firm conclusions can be drawn about the nature of the risks involved, as well as their significance and the likelihood of causing serious damage or not. Risk analysis should be the starting premise prior to any implementation of techno-scientific innovations. The parameters must be evaluated and precautions taken and research must be conducted in a detailed and broad-ranging manner with respect to the potential risks of any innovation. This article analyzed the applicability of this new technology, as well as risk management and containment in order

  8. Cadaveric study of fossa ovalis

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    Kanani SD

    2014-12-01

    Full Text Available Introduction: The interatrial septum of heart presents the fossa ovale, an oval depression above and to the left of the orifice of the inferior vena cava. Atrial septal defect is one of the most common but least severe congenital heart diseases in adult. Patent foramen ovale is a hemodynamically insignificant interatrial communication present in >25% of the adult population. Material and Methods: This cross sectional study was conducted on 40 cadavers with age range of 60 to 80 years in the dissection laboratory of various medical colleges of ahmedabad, Gujarat, India. Standard dissection method was used and foramen ovale was observed after opening up the right atrium and data about the situation, shape, floor and margin of foramen ovale was noted. Result and Observation: Commonest position of fossa ovalis was the middle of the interatrial wall followed by mouth of the inferior caval vein and mouth of the superior caval vein. In 33 hearts the fossa was oval and in 07 hearts it was round. The floor was very thick 19, moderately thick in 13 and thin in 08. Two hearts had fenestrated floor. Conclusion: Patients with isolated atrial septal defects (ASD have benefited from important recent advances in the diagnosis, evaluation, & management of their conditions. More studies are necessary to address several unresolved issues related to patent foramen ovale for benefit of patients.

  9. Posterior Fossa Tumor in Children

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    Seyed Mahmoud TABATABAEI

    2012-06-01

    Full Text Available How to Cite this Article: Tabatabaei SM, Seddighi A, Seddighi AS. Posterior Fossa Tumor in Children. Iran. J. Child. Neurol 2012;6(2: 19-24. Objective Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. Materials & Methods All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Results Our series consisted of 84 patients (52 males, 32 females. Cerebellar symptoms were the most common cause of presentation (80.9% followed by headache (73.8% and vomiting (38.1%. The most common histology was medulloblastoma (42.8% followed by cerebellar astrocytoma (28.6%, ependymoma (14.3%, brainstem glioma (7.2% and miscellaneous pathologies (e.g., dermoid,  andtuberculoma (7.2%. Conclusion The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies.References 1. Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between

  10. Geometric morphometrics of hominoid infraspinous fossa shape.

    Science.gov (United States)

    Green, David J; Serrins, Jesse D; Seitelman, Brielle; Martiny, Amy R; Gunz, Philipp

    2015-01-01

    Recent discoveries of early hominin scapulae from Ethiopia (Dikika, Woranso-Mille) and South Africa (Malapa) have motivated new examinations of the relationship between scapular morphology and locomotor function. In particular, infraspinous fossa shape has been shown to significantly differ among hominoids. However, this region presents relatively few homologous landmarks, such that traditional distance and angle-based methods may oversimplify this three-dimensional structure. To more thoroughly assess infraspinous fossa shape variation as it relates to function among adult hominoid representatives, we considered two geometric morphometric (GM) approaches--one employing five homologous landmarks ("wireframe") and another with 83 sliding semilandmarks along the border of the infraspinous fossa. We identified several differences in infraspinous fossa shape with traditional approaches, particularly in superoinferior fossa breadth and scapular spine orientation. The wireframe analysis reliably captured the range of shape variation in the sample, which reflects the relatively straightforward geometry of the infraspinous fossa. Building on the traditional approach, the GM results highlighted how the orientation of the medial portion of the infraspinous fossa differed relative to both the axillary border and spine. These features distinguished Pan from Gorilla in a way that traditional analyses had not been able to discern. Relative to the wireframe method, the semilandmark approach further distinguished Pongo from Homo, highlighting aspects of infraspinous fossa morphology that may be associated with climbing behaviors in hominoid taxa. These results highlight the ways that GM methods can enhance our ability to evaluate complex aspects of shape for refining and testing hypotheses about functional morphology.

  11. Are Homo sapiens nonsupranuchal fossa and Neanderthal suprainiac fossa convergent traits?

    Science.gov (United States)

    Nowaczewska, Wioletta

    2011-04-01

    The autapomorphic status of the Neanderthal suprainiac fossa was recently confirmed. This was a result of a detailed analysis of the internal bone composition in the area of the suprainiac depression on Neanderthal and Homo sapiens specimens. However, while anatomical differences between Neanderthal suprainiac fossa and the depression in the inion region of the occipital bone of fossil and recent Homo sapiens have been discussed in detail, the etiology of these structures has not been resolved. In this article, the hypothesis that the Homo sapiens non-supranuchal fossa and the Neanderthal suprainiac fossa both formed to maintain the optimal shape of the occipital plane (to minimize strain on the posterior cranial vault) is tested. First, the variation in the expression of the fossa above inion in the crania of recent Homo sapiens from European, African, and Australian samples was examined, and the degree of structural similarity between these depressions and the Neanderthal suprainiac fossa was assessed. Next, the relationship between the shape of the occipital squama in the midsagittal plane and two particular features (the degree of the occipital torus development and the occurrence of a depression in the inion region that is not the supranuchal fossa) were analyzed. Based on the results, it is suggested that the Homo sapiens non-supranuchal fossa and Neanderthal suprainiac fossa are convergent traits.

  12. Giant prostatic fossa with misleading radiographic features.

    Science.gov (United States)

    Stenzl, A; Fuchs, G J

    1989-01-01

    The long-term complication of a perforation of the prostatic capsule during transurethral resection of the prostate is described. Calcifications in a giant prostatic fossa led to initially misleading radiologic findings.

  13. Striae in the popliteal fossa (image)

    Science.gov (United States)

    Striae in the popliteal fossa: Striae or stretch marks result from stretching of the skin, or other influences such as Cushing's syndrome. Most pregnant women experience striae at some point during their ...

  14. Nitrergic nerves derived from the pterygopalatine ganglion innervate arteries irrigating the cerebrum but not the cerebellum and brain stem in monkeys.

    Science.gov (United States)

    Ayajiki, Kazuhide; Kobuchi, Shuhei; Tawa, Masashi; Okamura, Tomio

    2012-01-01

    The functional roles of the nitrergic nerves innervating the monkey cerebral artery were evaluated in a tension-response study examining isolated arteries in vitro and cerebral angiography in vivo. Nicotine produced relaxation of arteries by stimulation of nerve terminals innervating isolated monkey arteries irrigating the cerebrum, cerebellum and brain stem. Relaxation of arteries induced by nicotine was abolished by treatment with N(G)-nitro-L-arginine, a nitric oxide synthase inhibitor, and was restored by addition of L-arginine. Cerebral angiography showed that electrical stimulation of the unilateral greater petrosal nerve, which connects to the pterygopalatine ganglion via the parasympathetic ganglion synapse, produced vasodilatation of the anterior, middle and posterior cerebral arteries in the stimulated side. However, stimulation failed to produce vasodilatation of the superior and anterior-inferior cerebellar arteries and the basilar artery in anesthetized monkeys. Therefore, nitrergic nerves derived from the pterygopalatine ganglion appear to regulate cerebral vasomotor function. In contrast, circulation in the cerebellum and brain stem might be regulated by nitrergic nerves originating not from the pterygopalatine ganglion, but rather from an unknown ganglion (or ganglia).

  15. Trochanteric fossa or piriform fossa of the femur : Time for standardised terminology?

    NARCIS (Netherlands)

    Moein, C. M. S. Ansari; Gerrits, P. D.; ten Duis, H. J.

    2013-01-01

    Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in

  16. Trochanteric fossa or piriform fossa of the femur : Time for standardised terminology?

    NARCIS (Netherlands)

    Moein, C. M. S. Ansari; Gerrits, P. D.; ten Duis, H. J.

    2013-01-01

    Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in

  17. Trochanteric fossa or piriform fossa of the femur: time for standardised terminology?

    Science.gov (United States)

    Ansari Moein, C M S; Gerrits, P D; ten Duis, H J

    2013-06-01

    Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in this review study. The trochanteric fossa, a deep depression at the base of the femoral neck is indicated as 'piriform fossa' in the vast majority of the publications. Other publications indicate the insertion site of the tendon of the piriformis muscle on the greater trochanteric tip as 'piriform fossa'. As a result of recurrent terminology error and consistent reproductions of it, the recommended entry point in literature is confusing and seems to need standardisation. The piriform fossa does not appear to exist in the femoral region. The trochanteric fossa is the standard entry point which most surgeons recommend for facilitating a standard straight intramedullary nail, as is in line with the medullary canal. The greater trochanteric tip is the lateral entry point for intramedullary nails with a proximal lateral bend.

  18. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  19. Herniographic appearance of the lateral inguinal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Kesek, P.

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do.

  20. New concepts on posterior fossa malformations

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

    2008-06-15

    A full description of the embryology of the posterior fossa (PF) is beyond the scope of this review; several recent publications are recommended. Specific aspects of the processes involved are, however, reviewed as a background to malformations that involve defects or errors occurring at critical stages during the embryogenesis of the PF structures. (orig.)

  1. MORPHOMETRIC ANALYSIS OF GLENOID FOSSA OF SCAPULA

    Directory of Open Access Journals (Sweden)

    Sangeeta

    2015-06-01

    Full Text Available The study was conducted on sixty scapulae obtained from the department of Anatomy, Government Medical College, Jammu. The shape of the glenoid cavity was observed in all the scapulae. It was inverted comma shaped, tear drop shaped, oval and round shaped. T he shape on the two sides was compared. Morphometry of the glenoid cavity was done and compared on right and left side. The dimensions of the glenoid fossa provide important information for designing and fitting of glenoid component for shoulder arthroplas ty. An understanding of variations of glenoid cavity is essential for evaluating pathological conditions like osseous Bankart lesions and osteochondral defects. INTRODUCTION: Shoulder arthroplasty is a common mode of treatment to treat shoulder pathologies like shoulder arthritis. Knowledge about the shape and morphological parameters is essential for success of shoulder arthroplasty as otherwise there would be loosening of the joint necessisitating the need for revision surgery. The articular surfaces for shoulder joint are the glenoid cavity (or fossa of scapula and head of humerus. The glenoid fossa is a shallow ovoid depression on the lateral angle of the scapula. It is also called as the glenoid cavity or the head of the scapula. There is variation in the shape of the glenoid fossa. The glenoid rim presents a small notch on its anterior and upper part . (1 The glenoid notch prevents the attachment of fibrocartilaginous glenoidal labrum to the glenoidal rim, which can be detach ed leading to Bankart, s les ion . (2 A knowledge of the shape and morphometry of glenoid fossa is essential for treat ing glenohumeral osteoarthritis . (3 Morphometric analysis of glenoid fossa is also essential when total shoulder prosthesis has to be used. It is also essential for eva luating Bankart lesion, osteochondral defects, shoulder instability etc. Thorough scanning of available literature revealed that there is dearth of literature regarding

  2. [Cochlear implantation through the middle fossa approach].

    Science.gov (United States)

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

    2001-01-01

    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

  3. [Synovial sarcoma of the infratemporal fossa].

    Science.gov (United States)

    Tamarit Conejeros, José Manuel; Estrems Navas, Paloma; Estellés Ferriol, Enrique; Dalmau Galofre, José

    2010-01-01

    Synovial sarcoma is the fourth most common type of sarcoma. It is usually found in the knee or ankle joints, and is exceptional in the head and neck. Most cases are diagnosed in men between 20 and 40 years of age. Diagnosis is often casual due to the infrequent nature of this tumour and its non-specific clinical and radiological characteristics. Confirmation is therefore based on immunohistochemistry and electron microscopy techniques. We report a case of biphasic sinovial sarcoma located in the infratemporal fossa treated at our hospital and we make a review of the literature. Copyright © 2009 Elsevier España, S.L. All rights reserved.

  4. Maxillary tooth displacement in the infratemporal fossa.

    Science.gov (United States)

    Roshanghias, Korosh; Peisker, Andre; Zieron, Jörg Olaf

    2016-01-01

    Wisdom tooth operations are sometimes accompanied by complications. This case report shows complications during upper jaw third molar removal. Expectable problems during oral surgery should be planned to be solved in advance. Displacement of the third molar during oral surgeries as a considerable complication is rarely discussed scientifically. A good design of flap, adequate power for extraction, and clear view on the surgical field are crucial. Three-dimensional radiographic diagnostics in terms of cone beam computed tomography is helpful after tooth displacement into the infratemporal fossa.

  5. Maxillary tooth displacement in the infratemporal fossa

    Directory of Open Access Journals (Sweden)

    Korosh Roshanghias

    2016-01-01

    Full Text Available Wisdom tooth operations are sometimes accompanied by complications. This case report shows complications during upper jaw third molar removal. Expectable problems during oral surgery should be planned to be solved in advance. Displacement of the third molar during oral surgeries as a considerable complication is rarely discussed scientifically. A good design of flap, adequate power for extraction, and clear view on the surgical field are crucial. Three-dimensional radiographic diagnostics in terms of cone beam computed tomography is helpful after tooth displacement into the infratemporal fossa.

  6. Posterior fossa involvement in a recurrent gliosarcoma

    Directory of Open Access Journals (Sweden)

    Srikant Balasubramaniam

    2012-01-01

    Full Text Available Gliosarcoma (GSM is a WHO grade 4 tumor and a variant of glioblastoma multiforme with predilection for the temporal lobe. We record, perhaps the first case in literature, of a temporal lobe GSM with recurrence involving the posterior fossa. A 50-year-old man presented to us with headache, vomiting, and lethargy of relatively recent onset. Magnetic resonance imaging revealed a well-circumscribed lesion in the left temporal lobe for which left temporal craniotomy with radical excision of the tumor was performed. Histopathology was suggestive of GSM. He presented to us within a month of the first surgery with a large recurrence involving the temporal lobe. He underwent a second surgery with radical excision of the tumor. Histopathology was confirmatory of GSM. He was administered concomitant chemotherapy and radiotherapy. Within a fortnight of starting adjuvant therapy, the bone flap started bulging and a repeat computed tomography scan revealed a large recurrence extending into the posterior fossa. The patient′s relatives refused consent for third surgery and he finally succumbed on postoperative day 21. GSMs are aggressive tumors that have a temporal lobe predilection, but they may present anywhere in the brain. Detailed studies on larger cohort of cases are needed to understand the true nature of these biphasic tumors.

  7. Acute Spontaneous Posterior Fossa Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Osama Shukir Muhammed Amin

    2014-02-01

    Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient’s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

  8. An unusual foreign body in the infratemporal fossa

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    Sharad Ramdas

    2016-01-01

    Full Text Available Infratemporal fossa injuries are uncommon and often go undetected presenting later with complications. We present a case of an infratemporal fossa penetrating injury with a ball point spring following a vehicular accident. Post-traumatic trismus even following supposedly trivial injury in the area should raise suspicion of possible injury in this location.

  9. A STUDY OF POSTERIOR FOSSA MALFORMATIONS: MR IMAGING

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    Ravi

    2015-02-01

    Full Text Available AIMS AND OBJECTIVES: The aim of our study is to describe the imaging findings of various posterior fossa malformations and to evaluate the supratentorial abnormalities associated with posterior fossa malformations. MATERIALS AND METHODS: MR images of 30 patients wi th posterior fossa malformations detected in the department of Radiodiagnosis, BMCRI over a period of two years, from December 2012 to December 2014 were evaluated retrospectively. The various posterior fossa malformations were evaluated. Associated suprat entorial abnormalities were noted. RESULTS: 30 patients with posterior fossa malformations were included in the study. The age group of patients ranged from 1year to 53years. There were 18 males and 12 females. The various posterior fossa malformations det ected were Dandy Walker malformation (1 case, Dandy Walker variant (2 cases, mega cisterna magna (8 cases, arachnoid cysts (5 cases, Chiari 1 malformation (5 cases, Chairi 2 malformation (2 cases, Joubert malformation (1 case, lipoma (2 cases, verm ian and/or cerebellar hypoplasia without posterior fossa CSF collection or cyst (4 cases. Associated supratentorial abnormalities were seen in 8 cases . CONCLUSION: MRI is the imaging modality of choice in the evaluation of posterior fossa malformations. I t is very important to know the imaging findings of these malformations and to have knowledge about the various supratentorial and spinal abnormalities associated with them so as to provide an accurate diagnosis which is very essential for predicting the p rognosis and planning further management.

  10. Morphometric analysis of posterior fossa and foramen magnum

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    Gautam Kanodia

    2012-01-01

    Full Text Available Introduction: Configuration and size of the foramen magnum and posterior fossa plays an important role in the pathophysiology of the posterior fossa and craniovertebral junction disorders. This study is aimed to find out various dimensions of the foramen magnum and posterior fossa. Materials and Methods: This is a prospective study of 100 consecutive normal computerized tomography (CT scans of posterior fossa and 100 dry adult skulls without any bony abnormality. The posterior fossa volume was calculated by abc/2 in method 1 and by advanced work station of CT scan in method 2. Various dimensions of posterior fossa and foramen magnum were also studied. Results: Age ranged from 16 to 89 years with a mean of 51.3 years. Mean height of posterior fossa were 3.01 cm (±0.22 and 3.52 (±0.43 cm in dry skull and CT scan group, respectively (P 0.05. All the dimensions of posterior fossa and foramen magnum were larger in male as compared to female. Mean anteroposterior (AP, transverse diameter and surface area of the foramen magnum were 3.31 (±0.35 cm, 2.76 (±0.31 cm, and 729.15 (±124.87 mm 2 , respectively, in CT scan group as compared to 3.41 (±0.29 cm, 2.75 (±0.25 cm, and 747.67 (±108.60 mm 2 , respectively, in dry skull group. Conclusion: Normal values of posterior fossa and foramen magnum could serve as a future reference. Dry skull dimensions could be different from CT scan measurement. More studies are needed as there could be variations in dimensions in different regions in India

  11. Morphometric analysis of posterior fossa and foramen magnum.

    Science.gov (United States)

    Kanodia, Gautam; Parihar, Vijay; Yadav, Yad R; Bhatele, Pushp R; Sharma, Dhananjay

    2012-09-01

    Configuration and size of the foramen magnum and posterior fossa plays an important role in the pathophysiology of the posterior fossa and craniovertebral junction disorders. This study is aimed to find out various dimensions of the foramen magnum and posterior fossa. This is a prospective study of 100 consecutive normal computerized tomography (CT) scans of posterior fossa and 100 dry adult skulls without any bony abnormality. The posterior fossa volume was calculated by abc/2 in method 1 and by advanced work station of CT scan in method 2. Various dimensions of posterior fossa and foramen magnum were also studied. Age ranged from 16 to 89 years with a mean of 51.3 years. Mean height of posterior fossa were 3.01 cm (±0.22) and 3.52 (±0.43) cm in dry skull and CT scan group, respectively (P 0.05). All the dimensions of posterior fossa and foramen magnum were larger in male as compared to female. Mean anteroposterior (AP), transverse diameter and surface area of the foramen magnum were 3.31 (±0.35) cm, 2.76 (±0.31) cm, and 729.15 (±124.87) mm(2), respectively, in CT scan group as compared to 3.41 (±0.29) cm, 2.75 (±0.25) cm, and 747.67 (±108.60) mm(2), respectively, in dry skull group. Normal values of posterior fossa and foramen magnum could serve as a future reference. Dry skull dimensions could be different from CT scan measurement. More studies are needed as there could be variations in dimensions in different regions in India.

  12. PHACE syndrome in antenatally diagnosed posterior fossa anomaly

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    Seema Pavaman Sindgikar

    2014-01-01

    Full Text Available PHACE is a neurocutaneous syndrome, an acronym to describe patients with facial segmental hemangiomas and other malformations. We describe a newborn antenatally diagnosed to have posterior fossa anomaly and subsequently as PHACE syndrome.

  13. Mature posterior fossa teratoma mimicking infratentorial meningioma: a case report.

    Science.gov (United States)

    Coulibaly, O; El Kacemi, I; Fatemi, N; Gana, R; Saïdi, A; Maaqili, R; Jiddane, M; Bellakhdar, F

    2012-02-01

    Intracranial teratomas are congenital neoplasms mostly diagnosed in the pediatric hood and usually involve supratentorial midline structures. These teratomas, especially those involving the posterior fossa are an uncommon and representing less than 0.5% of all intracranial tumors. We report a case of mature posterior fossa teratoma in an adult patient diagnosed in the 4th decade of life. This lesion was taken for a huge infratentorial meningioma.

  14. Patient adaptable cerebellar retractor system: Use in posterior fossa surgery

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    Hamid Borghei-Razavi

    2015-06-01

    Full Text Available A new patient adaptable dual use soft tissue spreader and cerebellar retractor system designed for use during surgery of the posterior fossa is described. We found that this new retractor design allowed for excellent exposure, plus greater freedom and dexterity during the posterior fossa surgery. This novel instrument is an improvement over the existing instrument, because it provided more force/power transmission from pins/connectors to the brain spatula via the shorter flexible arm.

  15. Functional morphology of the Neandertal scapular glenoid fossa.

    Science.gov (United States)

    Macias, Marisa E; Churchill, Steven E

    2015-01-01

    Neandertals and Homo sapiens are known to differ in scapular glenoid fossa morphology. Functional explanations may be appropriate for certain aspects of glenoid fossa morphology; however, other factors--e.g., allometry, evolutionary development--must be addressed before functional morphology is considered. Using three-dimensional geometric morphometrics, shape of the scapular glenoid fossa was compared among Neandertals, early and recent modern humans, chimpanzees, orangutans, Australopithecus afarensis, and Au. sediba. Permutation analysis revealed that side, sex, and lifestyle did not correlate with shape. Of the features we found to differ between groups, anterior glenoid rim morphology and fossa curvature did not correlate with the aforementioned shape variables; thus, a functional explanation is appropriate for these components of glenoid fossa shape. Shared morphology among recent humans and chimpanzees (to the exclusion of Neandertals and orangutans) suggests independent forces contributing to these morphological configurations. Potential explanations include adaptations to habitual behavior and locomotor adaptations in the scapulae of recent humans and chimpanzees; these explanations are supported by clinical and experimental literature. The absence of these morphological features in Neandertals may support the lack of these selective forces on their scapular glenoid fossa morphology.

  16. Mandibular nerve entrapment in the infratemporal fossa.

    Science.gov (United States)

    Piagkou, Maria N; Demesticha, T; Piagkos, G; Androutsos, G; Skandalakis, P

    2011-05-01

    The posterior trunk of the mandibular nerve (V(3)) comprises of three main branches. Various anatomic structures may entrap and potentially compress the mandibular nerve branches. A usual position of mandibular nerve (MN) compression is the infratemporal fossa (ITF) which is one of the most difficult regions of the skull base to access surgically. The anatomical positions of compression are: the incomplete or complete ossified pterygospinous (LPs) or pterygoalar (LPa) ligament, the large lamina of the lateral plate of the pterygoid process and the medial fibres of the lower belly of the lateral pterygoid (LPt). A contraction of the LPt, due to the connection between nerve and anatomic structures (soft and hard tissues), might lead to MN compression. Any variations of the course of the MN branches can be of practical significance to surgeons and neurologists who are dealing with this region, because of possibly significant complications. The entrapment of the MN motor branches can lead to paresis or weakness in the innervated muscle. Compression of the sensory branches can provoke neuralgia or paraesthesia. Lingual nerve (LN) compression causes numbness, hypoesthesia or even anaesthesia of the mucous of the tongue, anaesthesia and loss of taste in the anterior two-thirds of the tongue, anaesthesia of the lingual gums, as well as pain related to speech articulation disorders. Dentists should be very suspicious of possible signs of neurovascular compression in the region of the ITF.

  17. Microsurgical anatomy of the posterior fossa cisterns.

    Science.gov (United States)

    Matsuno, H; Rhoton, A L; Peace, D

    1988-07-01

    The microsurgical anatomy of the posterior fossa cisterns was examined in 15 cadavers using 3X to 40X magnification. Liliequist's membrane was found to split into two arachnoidal sheets as it spreads upward from the dorsum sellae: an upper sheet, called the diencephalic membrane, which attaches to the diencephalon at the posterior edge of the mamillary bodies, and a lower sheet, called the mesencephalic membrane, which attaches along the junction of the midbrain and pons. Several other arachnoidal membranes that separate the cisterns were identified. These include the anterior pontine membrane, which separates the prepontine and cerebellopontine cisterns; the lateral pontomesencephalic membrane, which separates the ambient and cerebellopontine cisterns; the medial pontomedullary membrane, which separates the premedullary and prepontine cisterns; and the lateral pontomedullary membrane, which separates the cerebellopontine and cerebellomedullary cisterns. The three cisterns in which the arachnoid trabeculae and membranes are the most dense and present the greatest obstacle at operation are the interpeduncular and quadrigeminal cisterns and the cisterna magna. Numerous arachnoid membranes were found to intersect the oculomotor nerves. The neural and vascular structures in each cistern are reviewed.

  18. MRI of the fetal posterior fossa

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    Adamsbaum, Catherine; Andre, Christine; Merzoug, Valerie; Ferey, Solene [St Vincent de Paul Hospital, Department of Radiology, Paris Cedex 14 (France); Moutard, Marie Laure [St Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Quere, Marie Pierre [CHU, Department of Radiology, Nantes (France); Lewin, Fanny [St Vincent de Paul Hospital, Maternity Department, Paris (France); Fallet-Bianco, Catherine [Ste Anne Hospital, Department of Neuropathology, Paris (France)

    2005-02-01

    MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

  19. Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa

    Directory of Open Access Journals (Sweden)

    Takafumi Nishizaki

    2011-05-01

    Full Text Available Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve.

  20. Spontaneous defects between the mastoid and posterior cranial fossa.

    Science.gov (United States)

    Rereddy, Shruthi K; Mattox, Douglas E

    2016-01-01

    Conclusions Spontaneous defects between the mastoid and the posterior cranial fossa are exceedingly rare. Patients with these lesions may have a lower BMI compared to those with middle cranial fossa encephaloceles, but are otherwise demographically similar. This study recommends repair via a transtemporal approach to allow for examination of the entire posterior face of the temporal bone. Objective To describe cases of spontaneous posterior cranial fossa defects. Methods This study reviewed all cases of spontaneous posterior fossa defects presenting to a tertiary referral center over the last decade and described clinical presentation, imaging, operative findings, and outcomes. We also compared these lesions to those previously reported in the literature as well as the more common spontaneous encephaloceles of the middle cranial fossa. Results This study identified five cases with a mean age of 61.4 years, female-to-male ratio of 4:1, and a mean BMI of 31. Three cases presented with spontaneous pneumocephalus, one with CSF otorrhea, and one as an incidental imaging finding. Four defects were found medial to the sigmoid sinus and one was in the lateral retrosigmoid air cells.

  1. Fossa navicularis magna detection on cone-beam computed tomography

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    Syed, Ali Z. [Dept. of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland(United States); Mupparapu, Mel [Div. of Radiology, University of Pennsylvania School of Dental Medicine, Philadelphia (United States)

    2016-03-15

    Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed.

  2. Atypical Isolated Infections of the Infratemporal Fossa: A Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Sien Hui Tan

    2015-09-01

    Full Text Available Introduction: Atypical infratemporal fossa infections are rare and potentially fatal.   Case Report: A case of an aspergillosis localized in the infratemporal fossa and another case of tuberculosis of the infratemporal fossa originating from the maxillary sinus, is described. The first patient was immunocompromised and showed symptoms of facial numbness; whereas the other was an immunocompetent man who complained of trigeminal neuralgia type pain. It was difficult to differentiate between infection and tumour despite the utilization of computed tomography scans and magnetic resonance imaging.   Conclusion:  These cases illustrate the need for a high index of suspicion; in addition to endoscopic confirmation and histopathology to establish precise diagnosis and early intervention.

  3. Preliminary investigation on the reduction of plantar loading pressure with different insole materials (SRP--Slow Recovery Poron, P--Poron, PPF--Poron +Plastazote, firm and PPS--Poron+Plastazote, soft).

    Science.gov (United States)

    Tong, Jasper W K; Ng, Eddie Y K

    2010-03-01

    The aim of this study is to investigate the amount of pressure reduction for different padding and insole materials commonly used in the podiatry clinic. Plantar pressure were taken for 5 subjects without insoles fitted (BF) in their daily sports shoes, and thereafter with 4 pairs of simple insoles (6.4 mm thick) each as follow: SRP - Slow Recovery Poron, P - Poron, PPF - Poron+Plastazote (firm) and PPS - Poron+Plastazote (soft). In addition, subjects were also tested with semi-compressed felt (SCF) padding with a 1st metatarsophalangeal joint (MTPJ) aperture cut-out bilaterally. Minimum, maximum, mean pressure and peak pressure at the hallux, 1st, 2nd, 3rd/4th and 5th MTPJ across both feet were analysed. Repeated measures ANOVA with post hoc Bonferroni paired wise comparison was used to test for any statistical significance at the 95% confidence level for all pressure data. PPF was significant in reducing the minimum (p<0.005) and mean pressure (p<0.03) when compared to BF. This accounted for approximately 28% and 27% pressure reduction in minimum and mean pressure respectively. Peak pressure on the 1st MTPJ locality showed significant reduction of 37% and 29% with the use of SCF (p<0.004) and PPF (p<0.004), respectively. All 4 commonly used insole materials were able to reduce pressure across the whole foot with PPF achieving significance. Off-loading the 1st MTPJ would still be best achieved with the commonly used plantar metatarsal pad of SCF with the aperture cut-out design. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  4. Interconnecting the posterior and middle cranial fossae for tumors that traverse Meckel's cave.

    Science.gov (United States)

    Cheung, S W; Jackler, R K; Pitts, L H; Gutin, P H

    1995-03-01

    Meckel's cave is an avenue for tumor to spread between the posterior and middle cranial fossae. The most common neoplasms that traverse this channel are trigeminal schwannomas and meningiomas. The classic approach to address disease in both cranial fossae involves separate craniotomies. Recent innovations in skull base surgery have made it possible to perform a single opening with simultaneous exposure of the posterior and middle fossae, without undue brain retraction. Tumors with a large middle fossa component and a smaller posterior fossa portion are exposed via subtemporal craniotomy with petrosectomy and tentorium division. However, tumors with a large posterior fossa component and a smaller middle fossa portion in the setting of serviceable hearing are addressed with retrosigmoid craniotomy and petrosectomy. For bilobed tumors with substantial components in both fossae, subtemporal craniotomy combined with varying degrees of transtemporal petrosectomy and tentorium division is employed. The evolution of techniques to address tumors that traverse Meckel's cave is reviewed and a treatment algorithm is proposed.

  5. Tumors of the posterior cranial fossa; Tumoren der hinteren Schaedelgrube

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    Papanagiotou, P.; Politi, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

    2016-11-15

    Various types of brain tumor can occur in the region of the posterior fossa. Brain metastases in adults are the most common malignancies at this localization. Ependymomas, medulloblastomas and pilocytic astrocytomas occur mostly in children and only rarely in adults. Other tumors that occur in the posterior fossa are meningiomas, schwannomas, hemangioblastomas, brain stem gliomas and epidermoid tumors. Due to the fact that the various tumors of the posterior fossa have different treatment approaches and prognoses, an accurate and specific diagnosis is mandatory. This review discusses the imaging aspects by computed tomography (CT) and magnetic resonance imaging (MRI) of the most frequent tumors of the posterior fossa. (orig.) [German] Im Bereich der hinteren Schaedelgrube treten verschiedene Typen von Hirntumoren auf, wobei Hirnmetastasen bei Erwachsenen die haeufigsten Malignitaeten in dieser Region darstellen. Ependymome, Medulloblastome und pilozytische Astrozytome kommen meistens bei Kindern und nur selten bei Erwachsenen vor. Weitere Tumoren der hinteren Schaedelgrube sind Meningeome, Schwannome, Haemangioblastome, Hirnstammgliome und Epidermoide. Da die verschiedenen Tumoren der hinteren Schaedelgrube unterschiedliche Behandlungsansaetze sowie Prognosen haben, ist eine genaue und spezifische Diagnose obligatorisch. Dieser Review diskutiert die bildgebenden CT- und MRT-Aspekte der haeufigsten Tumoren der hinteren Schaedelgrube. (orig.)

  6. Midline suboccipital burr hole for posterior fossa craniotomy.

    Science.gov (United States)

    Grover, Keshav; Sood, Sandeep

    2010-07-01

    Posterior fossa craniotomy is generally done starting with two lateral burr holes. Single midline burr hole is often avoided for the fear of injury to the venous sinuses. In this paper, we retrospectively evaluated the risk of dural tear or venous sinus injury with the latter approach. Patients who had a posterior fossa craniotomy at the Children's Hospital of Michigan between 2003 and 2009 were analyzed. Seventy-one patients had been operated for a posterior fossa lesion, and 154 had a Chiari I decompression. Suboccipital craniotomy was performed utilizing a starting midline suboccipital burr hole. The craniotomy was completed using Midas Rex with B1 footplate starting laterally from the burr hole and then over to the foramen magnum including the foramen magnum lip. Inpatients who had a tumor resection, the bone flap was replaced and secured with plates on both sides. One patient had a dural tear along the inferior aspect of the craniotomy not extending into the foramen magnum. There was no instance of venous sinus injury or undue bleeding from the burr hole. none of the patients had an infection requiring removal of the bone flap. This paper confirms the safety of utilizing midline burr hole for starting a posterior fossa craniotomy.

  7. Longitudinal cerebellar diffusion tensor imaging changes in posterior fossa syndrome

    Directory of Open Access Journals (Sweden)

    Sean D. McEvoy, MD

    2016-01-01

    Full Text Available Posterior fossa syndrome is a severe transient loss of language that frequently complicates resection of tumors of the cerebellum. The associated pathophysiology and relevant anatomy to this language deficit remains controversial. We performed a retrospective analysis of all cerebellar tumor resections at Seattle Children's Hospital from 2010 to 2015. Diffusion tensor imaging was performed on each of the patients as part of their clinical scan. Patients included in the study were divided into groups based on language functioning following resection: intact (N = 19, mild deficit (N = 19, and posterior fossa syndrome (N = 9. Patients with posterior fossa syndrome showed white matter changes evidenced by reductions in fractional anisotropy in the left and right superior cerebellar peduncle following resection, and these changes were still evident 1-year after surgery. These changes were greater in the superior cerebellar peduncle than elsewhere in the cerebellum. Prior to surgery, posterior fossa patients did not show changes in fractional anisotropy however differences were observed in mean and radial diffusivity measures in comparison to other groups which may provide a radiographic marker of those at greatest risk of developing post-operative language loss.

  8. Polymorphous low-grade adenocarcinoma of the nasal fossa.

    Science.gov (United States)

    González-Lagunas, Javier; Alasà-Caparrós, Cristian; Vendrell-Escofet, Gerard; Huguet-Redecilla, Pere; Raspall-Martin, Guillermo

    2005-01-01

    An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient.

  9. STUDY OF POSTERIOR FOSSA TUMORS BY HIGH RESOLUTION MRI

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    Sree Hari

    2016-01-01

    Full Text Available INTRODUCTION Magnetic Resonance Imaging (MRI is the imaging modality used for the assessment of infratentorial neoplasms. Although Computed Tomography (CT provides better demonstration of small or subtle calcifications within tumors. OBJECTIVES Study is done to assess the potential of MRI in characterisation of different tumors in posterior fossa by evaluating various unenhanced and gadolinium enhanced sequences and to compare high resolution FSE MRI sequences with routine FSE MRI sequences in diagnosing posterior fossa brain tumors. Also correlate findings on Magnetic Resonance Imaging with Pathological diagnosis. MATERIALS AND METHODS A total of 52 patients were diagnosed by CT brain as having posterior fossa brain for a year of 2 years were included in the study. In all studies MR imaging was performed with a clinical 1.5 T system (General electrical medical systems. A dedicated phased-array coil was used. RESULTS The age group ranged from 1 year to 60 years, majority were between 1 to 20 years (39%. Slight male preponderance was seen (males 29, females 23. Commonest tumor encountered in our study was vestibular schwannoma. DWI alone can differentiate different pediatric posterior fossa brain tumors. One case of pilocytic astrocytoma showed solid lesion instead of typical cystic lesion with mural nodule. One case AT-RT showed 2 lesions one in cerebrum, one in CP angle. Common feature being intra-axial lesion involving cerebellum. MRI was able to predict diagnosis in 50 of the 52 tumors. CONCLUSION Magnetic Resonance Imaging was found to be a highly sensitive imaging procedure and method of choice for posterior fossa brain tumors.

  10. [Fracture of the glenoid fossa without mandibular condylar dislocation or fracture: two case reports].

    Science.gov (United States)

    Şahan, Murat; Derin, Serhan; Beydilli, Halil; Çullu, Neşet

    2014-01-01

    The mandibular condyle region which protects the middle cranial fossa from facial and jaw traumas has an excellent osteomuscular structure. Condylar structures reduce or limit the force of trauma. Most importantly, the condylar neck is the weakest part of the mandible and is easily fractured without dislocation. Generally, this mechanism prevents condylar penetration into the middle cranial fossa; however, there are condylar penetration into the middle cranial fossa can be rarely. Glenoid fossa fractures without mandibular condylar fracture and dislocation can be made. In this article, we present two cases to assess the isolated glenoid fossa fractures of the temporal bone.

  11. Tissue interaction is required for glenoid fossa development during temporomandibular joint formation.

    Science.gov (United States)

    Wang, Ying; Liu, Chao; Rohr, Joseph; Liu, Hongbing; He, Fenglei; Yu, Jian; Sun, Cheng; Li, Lu; Gu, Shuping; Chen, YiPing

    2011-11-01

    The mammalian temporomandibular joint (TMJ) develops from two distinct mesenchymal condensations that grow toward each other and ossify through different mechanisms, with the glenoid fossa undergoing intramembranous ossification while the condyle being endochondral in origin. In this study, we used various genetically modified mouse models to investigate tissue interaction between the condyle and glenoid fossa during TMJ formation in mice. We report that either absence or dislocation of the condyle results in an arrested glenoid fossa development. In both cases, glenoid fossa development was initiated, but failed to sustain, and became regressed subsequently. However, condyle development appears to be independent upon the presence of the forming glenoid fossa. In addition, we show that substitution of condyle by Meckel's cartilage is able to sustain glenoid fossa development. These observations suggest that proper signals from the developing condyle or Meckel's cartilage are required to sustain the glenoid fossa development.

  12. Langerhans' cell histiocytosis of the temporal fossa: A case report

    Science.gov (United States)

    LIANG, CHEN; LIANG, QIANLEI; DU, CHANGWANG; ZHANG, XIAODONG; GUO, SHIWEN

    2016-01-01

    Langerhans' cell histiocytosis (LCH) is a rare disease with a wide spectrum of clinical manifestations, varying from an isolated lesion to systemic involvement. The etiology of this disease remains to be elucidated. The present study reports a case of LCH with temporal fossa localization in an 8-year-old male patient, who had exhibited left temporal pain and headache for 1 month. Physical examination revealed slight exophthalmos and conjunctival hemorrhage in the patient's left eye, and non-contrast computed tomography imaging of the head revealed a soft tissue mass with unclear margins located in the left temporal fossa, as well as a wide bony defect. Magnetic resonance imaging revealed a heterogeneously contrast-enhanced mass near the left temporal pole, which eroded into the patient's left orbit and maxillary sinus. The lesion was totally excised and confirmed to be LCH through biopsy. PMID:27073529

  13. Children's vomiting following posterior fossa surgery: A retrospective study

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    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  14. Diffusion tensor imaging of midline posterior fossa malformations

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    Widjaja, Elysa; Blaser, Susan; Raybaud, Charles [Hospital for Sick Children, Diagnostic Imaging, Toronto, ON M5G 1X8 (Canada)

    2006-06-15

    Diffusion tensor imaging and tractography have been used to evaluate a variety of brain malformations. However, these studies have focused mainly on malformations involving the supratentorial compartments. There is a paucity of data on diffusion tensor imaging of posterior fossa malformations. To describe the color vector maps and modified or abnormal tracts of midline posterior fossa malformations. Diffusion tensor imaging was performed in one patient with rhombencephalosynapsis and two with Joubert syndrome. Color vector maps of fractional anisotropy were used to place a region of interest for seed point of fiber tracking. The vermis was severely hypoplastic or absent in rhombencephalosynapsis and Joubert syndrome. In rhombencephalosynapsis, vertically oriented fibers were visualized in the midportion of the cerebellum. The location of the deep cerebellar nuclei could be inferred from the amiculum and were medially located in rhombencephalosynapsis. In the two patients with Joubert syndrome, the horizontally arranged superior cerebellar peduncles were well demonstrated on the color vector maps. Failure of the superior cerebellar peduncles to decussate in the mesencephalon was also well demonstrated on both color vector maps and tractography. The deep cerebellar nuclei were more laterally located in Joubert syndrome. The use of tractography in midline posterior fossa malformations expands our understanding of these malformations. (orig.)

  15. Middle fossa approach: Applications in temporal bone lesions.

    Science.gov (United States)

    Domenech Juan, Iván; Cruz Toro, Paula; Callejo Castillo, Ángela; Moya, Rafael; Merán Gil, Jorge L; Bartel, Ricardo

    2016-01-01

    The middle fossa approach is a surgical technique that is very useful for lateral skull base surgery. However, it is true that it has limited surgical indications and implementation due to its technical complexity. We present our experience in 10 patients in whom the middle fossa approach was the treatment of choice because of the extent of the injury and complexity of the lesion or process. Despite the complexity of the cases, there was no mortality associated with surgery. Postoperative complications were found in 2 patients who presented an epidural hematoma and a cortico-subcortical hematoma. Hearing function was preserved in 5 patients out of the 7 who had adequate hearing at the time of surgery. House/Brackmann I-II facial nerve function was achieved in 8 patients; the remaining 2 had no deterioration of the nerve function. In 9 out of 10 patients, the surgery achieved complete solution of the lesion. The middle fossa approach is a safe and reliable surgical technique. It gives us great control and exposure of different skull base processes. We consider its knowledge of great importance, because it may be the only viable surgical alternative in some specific patients. That is the reason why it is important to learn this approach and know about it in our specialty. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  16. MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS

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    S. M. Abdollahzadeh-Hosseini

    2006-06-01

    Full Text Available Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedures were determined. Fisher exact test was employed to compare the frequency of postoperative complications in different groups. A total of 108 patients with age ranging from 3 months to 18 years and a male to female ratio of 1.5 comprised the study population. Ninety-nine cases had hydrocephalus at the time of diagnosis and 81 patients underwent preoperative shunting. Of the remaining 18 patients, 13 underwent external ventricular drainage at tumor operation session plus preoperative corticosteroid therapy. The rest of the patients got no primary treatment for hydrocephalus. Three of these 5 patients had postoperative shunting after tumor removal, but the other 2 remained shunt free. The rate of postoperative complications including cerebrospinal fluid leakage and septic meningitis were significantly lower in patients with preoperative shunting. The results of this study are in favor of those that approve the effect of preoperative shunting in decreasing postoperative complications. This is well established when the tumor size is big or when the diagnosis of posterior fossa tumor is made in later stages or when hydrocephalus is severe. It could be concluded that preoperative shunting can decrease the rate of postoperative complications.

  17. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

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    Colin Ng

    2015-01-01

    Full Text Available Antecubital fossa lesions are uncommon conditions that present to the orthopaedic clinic. Furthermore, the radius bone is an uncommonly reported location for an osteochondroma, especially when presenting with a concurrent reactive bicipitoradial bursitis. Osteochondromas are a type of developmental lesion rather than a true neoplasm. They constitute up to 15% of all bone tumours and up to 50% of benign bone tumours. They may occur as solitary or multiple lesions. Multiple lesions are usually associated with a syndrome known as hereditary multiple exostoses (HME. Malignant transformation is known to occur but is rare. Bicipitoradial bursitis is a condition which can occur as primary or secondary (reactive pathology. In our case, the radius bone osteochondroma caused reactive bicipitoradial bursitis. The differential diagnosis of such antecubital fossa masses is vast but may be narrowed down through a targeted history, stepwise radiological investigations, and histological confirmation. Our aim is to ensure that orthopaedic clinicians keep a wide differential in mind when dealing with antecubital fossa mass lesions.

  18. A rare complication following maxillary third molar extraction: infratemporal fossa abscess

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    Görkem Müftüoğlu

    2012-10-01

    Full Text Available

    Infratemporal fossa abscess formation is a very rare and life threatening condition and also its differential diagnosis is a very difficult process. Infratemporal fossa abscess following the non-infected, asymptomatic, erupted maxillary third molar extraction in a young and healthy patient is an unexpected and unusual complication.

    A 25 years old, male patient with a significant infratemporal fossa abscess and his treatment protocol was presented in this case report.

  19. Tratamento cirúrgico da cisticircose da fossa craniana posterior

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    Pedro Garcia Lopes

    1971-03-01

    Full Text Available A cisticercose, um dos mais sérios problemas parasitológicos do sistema nervoso, apresenta, quando localizada na fossa posterior, um quadro clínico dramático, no qual predomina a hipertensão intracraniana. Foram estudados neste trabalho, 70 pacientes com cisticercose de fossa craniana posterior, atendidos no Serviço de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de 1945 a 1968. Considerando-se a grande diversidade existente em torno das técnicas de tratamento cirúrgico, foi objetivo deste trabalho o estudo dos resultados obtidos nestes pacientes, nos quais várias técnicas foram empregadas. As cirurgias paliativas que derivam o trânsito do líquido cefalorraqueano para regiões extracranianas, quando comparadas aos outros tipos de cirurgias utilizados, foram as que proporcionaram maior índice de recuperação, exigiram menos reoperações, além de terem sido acompanhadas de menor número de complicações, bem como de menor mortalidade pós-operatória. Por outro lado, a neurocisticercose geralmente é um processo difuso, encontrando-se parasitas em várias regiões do encéfalo e/ou aracnoidite, conforme comprovou-se, também, entre os casos ora reunidos e que vieram a falecer. Baseando-se nestes fatos, não se justificam as derivações intracranianas e, a não ser eventualmente, a abordagem direta do parasita. Os casos estudados permitem cone- tatar, portanto, que as derivações extracranianas, por sua simplicidade e eficácia, apresentam-se, atualmente, como a terapêutica cirúrgica mais propriada à cisticercose de fossa craniana posterior.

  20. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H. [Dept. of Medical Imaging, National Taiwan University Hospital, Taipei (Taiwan)

    2001-05-01

    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  1. Tratamento cirúrgico da cisticircose da fossa craniana posterior Surgical treatment of cysticercosis in posterior cranial fossa

    Directory of Open Access Journals (Sweden)

    Pedro Garcia Lopes

    1971-03-01

    Full Text Available A cisticercose, um dos mais sérios problemas parasitológicos do sistema nervoso, apresenta, quando localizada na fossa posterior, um quadro clínico dramático, no qual predomina a hipertensão intracraniana. Foram estudados neste trabalho, 70 pacientes com cisticercose de fossa craniana posterior, atendidos no Serviço de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de 1945 a 1968. Considerando-se a grande diversidade existente em torno das técnicas de tratamento cirúrgico, foi objetivo deste trabalho o estudo dos resultados obtidos nestes pacientes, nos quais várias técnicas foram empregadas. As cirurgias paliativas que derivam o trânsito do líquido cefalorraqueano para regiões extracranianas, quando comparadas aos outros tipos de cirurgias utilizados, foram as que proporcionaram maior índice de recuperação, exigiram menos reoperações, além de terem sido acompanhadas de menor número de complicações, bem como de menor mortalidade pós-operatória. Por outro lado, a neurocisticercose geralmente é um processo difuso, encontrando-se parasitas em várias regiões do encéfalo e/ou aracnoidite, conforme comprovou-se, também, entre os casos ora reunidos e que vieram a falecer. Baseando-se nestes fatos, não se justificam as derivações intracranianas e, a não ser eventualmente, a abordagem direta do parasita. Os casos estudados permitem cone- tatar, portanto, que as derivações extracranianas, por sua simplicidade e eficácia, apresentam-se, atualmente, como a terapêutica cirúrgica mais propriada à cisticercose de fossa craniana posterior.Cysticercosis is one of the most severe parasitic diseases of the nervous system. When located in the posterior fossa, it presents a dramatic picture of intracranial hypertension. Seventy patients of cysticercosis in posterior cranial fossa have been studied, all of them attended at the Neurosurgery Service of the University of São Paulo

  2. Resection in the popliteal fossa for metastatic melanoma

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    Botti Gerardo

    2007-01-01

    Full Text Available Abstract Background Traditionally metastatic melanoma of the distal leg and the foot metastasize to the lymph nodes of the groin. Sometimes the first site of nodal disease can be the popliteal fossa. This is an infrequent event, with rare reports in literature and when it occurs, radical popliteal node dissection must be performed. Case presentation We report a case of a 36-year old man presented with diagnosis of 2 mm thick, Clark's level II-III, non ulcerated melanoma of the left heel, which developed during the course of the disease popliteal node metastases, after a superficial and deep groin dissection for inguinal node involvement. Five months after popliteal lymph node dissection he developed systemic disease, therefore he received nine cycles of dacarbazine plus fotemustine. To date (56 months after prior surgery and 11 months after chemotherapy he is alive with no evidence of disease. Conclusion In case of groin metastases from melanoma of distal lower extremities, clinical and ultrasound examination of ipsilateral popliteal fossa is essential. When metastatic disease is found, radical popliteal dissection is the standard of care. Therefore knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.

  3. Malignant schwannoma of the infratemporal fossa: a case report.

    Science.gov (United States)

    Touati, Mohamed Mliha; Darouassi, Youssef; Chihani, Mehdi; Al Jalil, Abdelfettah; Tourabi, Khalid; Lakouichmi, Mohamed; Essadi, Ismail; Bouaity, Brahim; Ammar, Haddou

    2015-07-04

    Malignant schwannomas or neurofibrosarcomas are rare nerve tumors of unknown etiology. These neoplasms are highly aggressive with a marked propensity for local recurrence and metastatic spread. Their management continues to be a challenge for pathologists and surgeons. Maxillofacial locations are very exceptional. We report the case of a patient with unusual malignant schwannoma of the infratemporal fossa discovered at a late evolving stage. A 56-year-old woman, of Moroccan nationality, presented to our hospital in 2013 with a large right-sided hemifacial swelling that had evolved over the previous 4 months, with a limitation of mouth opening, nasal obstruction and episodes of epistaxis. A CT scan and MRI showed a large and invasive tumor occupying her right infratemporal fossa and maxillary sinus, with sphenoidal, ethmoidonasal, nasopharyngeal and intraorbital extension. A nasal endoscopic biopsy was performed. Immunohistochemical examination concluded a diagnosis of malignant schwannoma, and a palliative radiotherapy was decided; however, our patient died 10 days later. Malignant schwannoma of paranasal sinuses and the anterior skull base is a rare tumor that involves a high rate of local invasion. The prognosis is poorer compared to that occurring in the trunk and extremities.

  4. [Primitive aspergillosis of the posterior cerebral fossa in immunocompetent patient].

    Science.gov (United States)

    Seffar, M; Tligui, H; Kabbaj, H; Agoumi, A; Rifi, L; Alaoui, A E; Harmouch, A; Jiddane, M; Sefiani, S

    2011-03-01

    Cerebral aspergillosis arises in the great majority of cases during an invasive aspergillosis with hematogene scattering from the lung hurts. The cerebral, not rare location is one of the worse criteria forecast during the invasive aspergillosis. We report the case of patient who was hospitalized in the neurosurgery department for syndrome of increased intracranial pressure, hemiparesis and cerebellar syndrome in febrile context. The radiological exploration objectified a collection of the posterior fossa. A stereotactic biopsy was performed. It collected fragments biopsy and pus. The pathological and microbiological analysis allowed the identification of Aspergillus fumigatus. The originality of this observation comes from the rare location in the posterior fossa of aspergillosis and because the patient is immunocompetent and no primary location is found. The patient presents however a viral hepatitis B of fortuitous discovery. He is put under treatment by amphotericin B. The evolution is marked by meningitis comment-diversion. Antibiotics are prescribed, and then the patient is operated for total ablation of the tumor. He dies following an osmolar coma associated with thrombopenia and a secondary renal insufficiency due to his treatment by the amphotericin B.

  5. Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts - Implication for aetiology

    Energy Technology Data Exchange (ETDEWEB)

    Redla, Sridhar; Husami, Yahya; Colquhoun, Iain R

    2001-10-01

    Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed. Redla, S., Husani, Y. and Colquhoun, I.R. (2001)

  6. Incidence of Clavicular Rhomboid Fossa in Northeastern Thais: An Anthropological Study

    Science.gov (United States)

    Sampannang, Apichakan; Tuamsuk, Panya; Kanpittaya, Jaturat

    2016-01-01

    The rhomboid fossa of clavicle is used to determine the age and sex in anthropology and forensic sciences. The variant types of rhomboid fossa on inferior surface have been reported in many races except in Thais. This study therefore was aimed at classifying the types of the rhomboid fossa in Northeastern Thais. The identified 476 Northeastern Thais dried clavicles (270 males and 206 females) were observed and recorded for the types of rhomboid fossa. The results showed that Thai-rhomboid fossa could be classified into 4 types: Type 1: smooth; Type 2: flat; Type 3: elevated; and Type 4: depressed, respectively. The incidences of rhomboid fossa were as follows: Type 1: 0.21%; Type 2: 19.75%; Type 3: 76.26%; and Type 4: 3.78%, respectively. Additionally, it was found that the percentage of Type 4 (11.84%) was much greater than that of female (1.94%) compared to other types. This incidence of rhomboid fossa types especially Type 4 may be a basic knowledge to be used in sex identification. The high incidence of rhomboid fossa in both sexes of Northeastern Thai clavicles was Type 3 (elevated type). PMID:27648305

  7. Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts--implication for aetiology.

    Science.gov (United States)

    Redla, S; Husami, Y; Colquhoun, I R

    2001-10-01

    Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed.

  8. Dural-based infantile hemangioma of the posterior fossa: Case report

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    Hakeem J Shakir

    2016-01-01

    Conclusion: Although hemangiomas are benign entities, our patient′s lesion was in the posterior fossa causing compression and hydrocephalus that necessitated resection. We encourage others to consider the possibility of hemangioma in the differential diagnosis of dural-based posterior fossa lesions in infants.

  9. Epidermoid cyst of the posterior fossa: a case report Cisto epidermoide da fossa posterior: relato de caso

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    Eduardo Cambruzzi

    2011-02-01

    Full Text Available Epidermoid cysts of the central nervous system are uncommon conditions, which are frequently located in the cerebellopontine angle and around the pons. They are covered with keratinized squamous epithelium and keratin lamella, which give its contents a soft, white-pearly appearance. Epidermoid cysts are mostly originated from malformations, presumably associated with surface elements of the nervous system ectoderm during the closure of the neural groove or formation of secondary cerebral vesicles. The authors describe a case of epidermoid cyst in the posterior fossa causing hydrocephalus and review morphologic and diagnostic criteria of this lesion.Os cistos epidermoides do sistema nervoso central (SNC são condições incomuns, estando localizados mais frequentemente no ângulo pontocerebelar e ao redor da ponte. Eles são revestidos por epitélio escamoso queratinizado e lamelas de queratina, tornando seu conteúdo branco-perolado e pastoso. Os cistos epidermoides são, na maioria das vezes, originados de malformações, possivelmente associados ao entremeio de elementos superficiais do ectoderma do SNC durante o fechamento da placa neural, ou formação das vesículas cerebrais secundárias. Os autores descrevem um caso de cisto epidermoide da fossa posterior determinando hidrocefalia e revisam critérios morfológicos e diagnósticos dessa lesão.

  10. Ondine's curse after posterior fossa decompression: report of one case

    Institute of Scientific and Technical Information of China (English)

    XU Lun-shan; XU Min-hui

    2001-01-01

    A case of Ondine's curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and 1year of repetitively ictal nausea. The diagnosis of Arnold-Chiari malformations was established. Results: The patient underwent suboccipital craniectomy and C1-3 laminectomy. In addition to this decompression measure, a fascial graft was sutured between the edges of the dural incision. Postoperatively, the patient lost automatic control of her respiration during sleep and became hypercapnic and hypoxemic. Assisted ventilation was initiated. Conclusion: Ondine's curse is possibly due to insensitivity of central chemoreceptors to carbon dioxide resulting in defective control of minute ventilation.Propofol is not recommended in cases of Ondine's curse, and assisted ventilation until the restoration of automatic control of respiration can be of value. Oxygen inspiration alone is rather harmful than beneficial.

  11. Hematoma extradural da fossa posterior: relato de sete casos

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    Mauro A. Oliveira

    1993-06-01

    Full Text Available Hematomas da fossa posterior são complicação incomum de traumatismo cra-nioencefálico. Quase invariavelmente eles ocorrem após traumatismo da região occipital e estão associados com fraturas de crânio. O diagnóstico e tratamento dessa patologia tem sido grandemente favorecido pela tomografia computadorizada. Na presente série, a maioria dos pacientes teve evolução aguda, indicando o risco potencial de um tratamento conservador. Nossos resultados (29% de mortalidade são similares àqueles previamente relatados para outras séries dessas lesões.

  12. Posterior fossa malformations: main features and limits in prenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Garel, Catherine [Hopital d' Enfants Armand-Trousseau, Department of Radiology, Paris (France)

    2010-06-15

    Posterior fossa (PF) malformations are commonly observed during prenatal screening. Their understanding requires knowledge of the main steps of PF development and knowledge of normal patterns in US and MR imaging. The vast majority of PF malformations can be strongly suspected by acquiring a midline sagittal slice and a transverse slice and by systematically scrutinizing the elements of the PF: cerebellar vermis, hemispheres, brainstem, fourth ventricle, PF fluid spaces and tentorium. Analysis of cerebellar echogenicity and biometry is also useful. This review explains how to approach the diagnosis of the main PF malformations by performing these two slices and answering six key questions about the elements of the PF. The main imaging characteristics of PF malformations are also reviewed. (orig.)

  13. Fractures of the nasolacrimal fossa and canal: CT findings and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chae Kyung; Lee, Hyeon Kyeong; Lee, Jong Hwa; Ku, Kwan Min; Choi, Dae Seob; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo; Han, Jae Sik; Kim, Mi Woon [Dongguk Univ., College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    This study was aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidence of nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of the nasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associated complications, clinical records were reviewed were reviewed. Three types of fracture were identified: avulsion, comminuted,and linear. Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and 21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa, ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving the nasolacrimal canal were comminuted and four were linear;all nasolacrimal fractures were associated with other facial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid);the remaining four were simple and unilateral. Nasolacrimal sac and duct-related complications were documented in only two patients; they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the probvlem was resolvced by conservative treatment without surgery. Fractures of the nasolacrimal fossa and canal were accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all were associated with avulsion fractures of the nasolacrimal fossa.=20.

  14. [Monitoring of intracranial pressure difference between supra- and infratentorial spaces after posterior fossa tumor removal (case report)].

    Science.gov (United States)

    Oshorov, A V; Savin, I A; Goriachev, A S; Popugaev, K A; Lubnin, A Iu

    2011-01-01

    A clinical example shows that after a neurosurgical operation in posterior fossa there could appear intracranial pressure difference between supra- and infratentorial spaces. This difference develops due to pressure rise in posterior fossa and maintenance of this hypertension postoperatively. Hypertension in posterior fossa and intracranial difference are accompanied by brainstem reactions and temporary neurological disorders. While the pressure difference decreases and ICP in posterior fossa normalizes the neurological symptoms disappear. ICP in supratentorial space not necessarily correlates with ICP in infratentorial space. In some cases it is necessary to measure ICP in infratentorial space after posterior fossa surgery.

  15. Assessment of growth dynamics of human cranium middle fossa in foetal period.

    Science.gov (United States)

    Skomra, Andrzej; Kędzia, Alicja; Dudek, Krzysztof; Bogacz, Wiesław

    2014-01-01

    Available literature analysis demonstrated smallness of studies of cranial base. The goal of the study was to analyse the medial fossa of the human cranium in the foetal period against other fossae. Survey material consisted of 110 human foetuses at a morphological age of 16-28 weeks of foetal life, CRL 98-220 mm. Anthropological, preparation method, reverse method and statistical analysis were utilized. The survey incorporated the following computer programmes: Renishaw, TraceSurf, AutoCAD, CATIA. The reverse method seems especially interesting (impression with polysiloxane (silicone elastomer of high adhesive power used in dentistry) with 18 D 4823 activator. Elicited impression accurately reflected complex shape of cranium base. On assessing the relative rate of cranium medial fossa, the rate was found to be stable (linear model) for the whole of the analysed period and is 0.19%/week, which stands for the gradual and steady growth of the middle fossa in relation to the whole of the cranium base. At the same time, from the 16th till 28th week of foetal life, relative volume of the cranium middle fossa increases more intensively than cranium anterior fossa, whereas the cranium middle fossa volume as compared with the cranium posterior fossa is definitely slower. In the analysed period, the growth rate of the cranium base middle fossa was bigger in the 4th and 5th weeks than in the 6th and 7th weeks of foetal life. The investigations revealed cranium base asymmetry of the left side. Furthermore, the anterior fossae volume on the left side is significantly bigger than the one of the fossae on the right side. Volume growth rate is more intensive in the 4th and 5th than in the 6th and 7th weeks of foetal life. In the examined period, the relative growth rate of cranium base middle fossa is 0.19%/week and it is stable - linear model. The study revealed correlations in the form of mathematical models, which enabled foetuses age assessment.

  16. [Chondroblastoma of the Temporal Bone Removed Using a Middle Cranial Fossa Approach].

    Science.gov (United States)

    Ishioka, Kaoru; Kanzaki, Jin; Harada, Tatsuhiko; Takanashi, Yoshihiro; Shinonaga, Masamichi; Kitamura, Hajime

    2015-03-01

    We report a case of chondroblastoma of the middle cranial fossa, probably arising from the (infra) mandibular fossa, and expanding to the attic and external auditory canal that was successfully removed using a middle cranial fossa approach. No recurrences occurred during an 8-year postoperative follow-up period. Initial biopsy findings suggested a pathological diagnosis of giant cell tumor that was later confirmed to be a chondroblastoma based on an immunohistochemical study of S-100. This case study suggests a profound understanding of the clinical features, histopathological characteristics, and possible treatment. of chondroblastoma.

  17. Hypopharynx and larynx defect repair after resection for pyriform fossa cancer with a platysma skin flap.

    Science.gov (United States)

    Cai, Qian; Liang, Faya; Huang, Xiaoming; Han, Ping; Pan, Yong; Zheng, Yiqing

    2015-02-01

    We used a platysma skin flap to repair larynx and hypopharynx defects to improve postoperative laryngeal function in patients with pyriform fossa cancer. Larynx-sparing surgery and postoperative radiotherapy were used in 10 patients with pyriform fossa cancer. The surgical approaches of lymph node dissection of the neck, vertical partial laryngectomy, and pyriform fossa resection were adopted, and a platysma skin flap was used to repair the resulting defects. In this group, the overall 3-year survival rate was 75% according to the Kaplan-Meier analysis, and the local control rate was 90%. Additionally, all patients were able to speak fluently with mild-to-moderate hoarseness. The tracheal tube was removed in all cases. Laryngeal fistulas were observed in 1 patient during radiotherapy. In conclusion, a platysma skin flap can be used to rebuild the larynx and hypopharynx in larynx-sparing resection for pyriform fossa cancer. These patients can obtain good postoperative function in swallowing, breathing, and pronunciation.

  18. Posterior fossa giant tumefactive perivascular spaces: 8-year follow-up in an adolescent

    Directory of Open Access Journals (Sweden)

    Byron C Branch

    2015-01-01

    Conclusion: This case supports prior literature on supratentorial GTPS suggesting that the natural history of GTPS is mostly benign. Identification of GTPS in the posterior fossa could prevent the patient from unnecessary surgery or other aggressive treatment modalities.

  19. 3DCRT for posterior fossa: Sparing of surrounding organs at risk

    Directory of Open Access Journals (Sweden)

    Azza Helal

    2014-12-01

    Conclusion: 3DCRT using parallel opposed fields is recommended for posterior fossa irradiation boost as it minimizes the exit dose to all structures other than the cochlea, however its mean dose was within the tolerance.

  20. TRANSIENT MUTISM AND SPEECH DISORDERS AFTER POSTERIOR-FOSSA SURGERY IN CHILDREN WITH BRAIN-TUMORS

    NARCIS (Netherlands)

    KINGMA, A; MOOIJ, JJA; Metzemaekers, JDM; Leeuw, JA

    1994-01-01

    Four patients aged 5 to 9 years with large tumours located in the posterior fossa (PNET, ependymoma or astrocytoma) are presented. Patients received standard neuropsychological assessments, including speech evaluation, prior to surgery. Following tumour resection these 4 children developed transient

  1. A strategy for designing multi-taxa specific reference gene systems. example of application--ppi phosphofructokinase (ppi-PPF) used for the detection and quantification of three taxa: maize (Zea mays), cotton (Gossypium hirsutum) and rice (Oryza sativa).

    Science.gov (United States)

    Chaouachi, Maher; Giancola, Sandra; Romaniuk, Marcel; Laval, Valérie; Bertheau, Yves; Brunel, Dominique

    2007-10-03

    In the first part of the paper, we report the description of a new strategy for the development of a plant reference gene system that can be used for genetically modified organism (GMO) analysis. On the basis of in silico research for candidate genes, the design of degenerate primers allowed the obtention of genomic sequences of the selected gene ppi-phosphofructokinase ( ppi-PPF) for nine taxa in which GMOs have been developed. The comparison and the analysis of inter- and intraspecies sequence variability were performed using a large number of species and cultivars. As an example of application following the detection of single nucleotide polymorphism, we designed specific conventional and real-time polymerase chain reaction tests for the detection and quantification of three taxa, namely, maize, cotton, and rice. This system was highly specific and sensitive. The gene copy number conservation among different cultivars was analyzed and confirmed with a sequencing step. This reference gene system is adequate for use in routine assays for the quantification of GMOs. We then explain briefly the constraints faced and propose recommendations when designing a reference gene system depending on the species to be targeted.

  2. Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Rueckriegel, Stefan M., E-mail: rueckriegel.s@nch.uni-wuerzburg.de [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Driever, Pablo Hernaiz [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Bruhn, Harald [Department of Radiology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Department of Radiology, Klinikum der Friedrich-Schiller-Universitaet, Erlanger (Germany)

    2012-03-01

    Purpose: Therapy and tumor-related effects such as hypoperfusion, internal hydrocephalus, chemotherapy, and irradiation lead to significant motor and cognitive sequelae in pediatric posterior fossa tumor survivors. A distinct proportion of those factors related to the resulting late effects is hitherto poorly understood. This study aimed at separating the effects of neurotoxic factors on central nervous system metabolism by using H-1 MR spectroscopy to quantify cerebral metabolite concentrations in these patients in comparison to those in age-matched healthy peers. Methods and Materials: Fifteen patients with World Health Organization (WHO) I pilocytic astrocytoma (PA) treated by resection only, 24 patients with WHO IV medulloblastoma (MB), who additionally received chemotherapy and craniospinal irradiation, and 43 healthy peers were investigated using single-volume H-1 MR spectroscopy of parietal white matter and gray matter. Results: Concentrations of N-acetylaspartate (NAA) were significantly decreased in white matter (p < 0.0001) and gray matter (p < 0.0001) of MB patients and in gray matter (p = 0.005) of PA patients, compared to healthy peers. Decreased creatine concentrations in parietal gray matter correlated significantly with older age at diagnosis in both patient groups (MB patients, p = 0.009, r = 0.52; PA patients, p = 0.006, r = 0.7). Longer time periods since diagnosis were associated with lower NAA levels in white matter of PA patients (p = 0.008, r = 0.66). Conclusions: Differently decreased NAA concentrations were observed in both PA and MB groups of posterior fossa tumor patients. We conclude that this reflects a disturbance of the neurometabolic steady state of normal-appearing brain tissue due to the tumor itself and to the impact of surgery in both patient groups. Further incremental decreases of metabolite concentrations in MB patients may point to additional harm caused by irradiation and chemotherapy. The stronger decrease of NAA in MB

  3. Cerebellar mutism syndrome in children with brain tumours of the posterior fossa

    OpenAIRE

    Wibroe, Morten; Cappelen, Johan; Castor, Charlotte; Clausen, Niels; Grillner, Pernilla; Gudrunardottir, Thora; Gupta, Ramneek; Gustavsson, Bengt; Heyman, Mats; Holm, Stefan; Karppinen, Atte; Klausen, Camilla; Lonnqvist, Tuula; Mathiasen, Rene; Nilsson, Pelle

    2017-01-01

    Background Central nervous system tumours constitute 25% of all childhood cancers; more than half are located in the posterior fossa and surgery is usually part of therapy. One of the most disabling late effects of posterior fossa tumour surgery is the cerebellar mutism syndrome (CMS) which has been reported in up to 39% of the patients but the exact incidence is uncertain since milder cases may be unrecognized. Recovery is usually incomplete. Reported risk factors are tumour type, midline lo...

  4. Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.

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    Devi B

    2000-10-01

    Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

  5. Acoustic interaction between the right and left piriform fossae in generating spectral dips.

    Science.gov (United States)

    Takemoto, Hironori; Adachi, Seiji; Mokhtari, Parham; Kitamura, Tatsuya

    2013-10-01

    It is known that the right and left piriform fossae generate two deep dips on speech spectra and that acoustic interaction exists in generating the dips: if only one piriform fossa is modified, both the dips change in frequency and amplitude. In the present study, using a simple geometrical model and measured vocal tract shapes, the acoustic interaction was examined by the finite-difference time-domain method. As a result, one of the two dips was lower in frequency than the two independent dips that appeared when either of the piriform fossae was occluded, and the other dip was higher in frequency than the two dips. At the lower dip frequency, the piriform fossae resonated almost in opposite phase, while at the higher dip frequency, they resonated almost in phase. These facts indicate that the piriform fossae and the lower part of the pharynx can be modeled as a coupled two-oscillator system whose two normal vibration modes generate the two spectral dips. When the piriform fossae were identical, only the higher dip appeared. This is because the lower mode is not acoustically coupled to the main vocal tract enough to generate an absorption dip.

  6. Evaluation of Non-Watertight Dural Reconstruction with Collagen Matrix Onlay Graft in Posterior Fossa Surgery

    Science.gov (United States)

    Lobo, Bjorn; Lim, Joshua; Sade, Burak; Oya, Soichi; Lee, Joung H.

    2016-01-01

    Objective Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction. Methods We conducted a retrospective review of operations performed by the senior author from 2004–2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations. Wound complications such as CSF leak, infection, pseudomeningocele, and aseptic meningitis were noted. Fisher's exact test was performed to assess risk factor association with specific complications. Results Incisional CSF leak rate was 8.3% and non-incisional CSF leak rate was 3.6%. Incidence of aseptic meningitis was 7.1% and all cases resolved with steroids alone. Incidence of palpable and symptomatic pseudomeningocele in follow-up was 10.7% and 3.6% respectively. Postoperative infection rate was 4.8%. Previous surgery was associated with pseudomeningocele development (p<0.05). Conclusion When primary dural closure after posterior fossa surgery is undesirable or not feasible, non-watertight dural reconstruction with collagen matrix resulted in incisional CSF leak in 8.3%. Incidence of pseudomeningocele, aseptic meningitis, and wound infection were within acceptable range. Data from this study may be used to compare alternative methods of dural reconstruction in posterior fossa surgery. PMID:26885286

  7. MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation

    Energy Technology Data Exchange (ETDEWEB)

    Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan); Shakudo, Miyuki [Osaka City General Hospital, Department of Radiology, Osaka (Japan); Tanaka, Hiroyuki [Hyogo College of Medicine, Department of Gynecology, Nishinomiya (Japan); Minagawa, Kyoko [Hyogo College of Medicine, Department of Pediatrics, Nishinomiya (Japan)

    2007-12-15

    Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

  8. 28 CASES OF TRAUMATIC POSTERIOR FOSSA EXTRA DURAL HEMATOMA OUR EXPERIENCE : CASE SERIES

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    Hayagriva

    2015-04-01

    Full Text Available A retrospective study of 28 1 cases of traumatic posterior fossa Extra dural hematoma 2,3 in K ing George Hospital, V isakhapatnam from A ugust 2012 to February 2015 . This study was aimed to present the experience in treating patients with traumatic posterior fossa extra dural hematoma 2 and to discuss the clinical features, risk factors 4 and outcome . 5 Posterior fossa e xtradural hematoma 2,3 uncommon but potentially fatal condition. The incidence of posterior fossa extra dural hematoma 2,3 among intracranial extra dural hematomas has been reported 4% to 7%. Occipital skull bone fracture with venous sinus bleeding that resulted in a posterior fossa extradural haematoma . 2 low Gcs [or] hematoma more than 10ml were subjected to evacuation . Since the volume of the posterior fossa 6 is small, patients deteriorate early because of compression of vital structures in the brain stem, development of obstructive hydrocephalus, which is visible in the CT scan in only thirty percent of cases

  9. The management of right iliac fossa pain - is timing everything?

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-01-31

    BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.

  10. Neuropsychological improvement after posterior fossa arachnoid cyst drainage.

    Science.gov (United States)

    Cuny, M L; Pallone, M; Piana, H; Boddaert, N; Sainte-Rose, C; Vaivre-Douret, L; Piolino, P; Puget, S

    2017-01-01

    Posterior fossa arachnoid cysts (PFAC) are mostly considered as benign lesions of the cerebellum. Although many studies have shown the major role of the cerebellum in modulating movement, language, cognition, and social interaction, there are few studies on the cognitive impact and surgical decompression of PFAC. We present the cases of two brothers successively diagnosed with PFAC and neuropsychological delay. After multidisciplinary discussion with the boys' parents, it was decided to drain these lesions. Clinical signs, cerebral images, and neuropsychological status were assessed on admission and then 1 and 3 years after surgery. At presentation, both children had mild cerebellar signs, associated with cognitive and visual-motor impairments and academic regression. CT scans revealed retrovermian cysts, which were shunted. Post-operatively, both brothers demonstrated improved visual-motor skills and behavior. At follow-up, we observed disappearance of dysarthria and academic delay and significant improvement in cognition especially at the intelligence scale and in language. Fine motor skills had improved but remained slower than the average and writing skills appeared limited. Except for PFAC which impair cerebrospinal fluid circulation or which are responsible for a significant mass effect, most PFAC are usually considered as "asymptomatic" and do not require surgical treatment. The two cases reported herein suggest that these lesions might be responsible for some associated but potentially reversible neuropsychological impairment. In the future, clinical assessment should include neuropsychological evaluation to help inform decision for surgical decompression in these children with PFAC.

  11. 3-D simulation of posterior fossa reduction in Chiari I

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    Yvens Barbosa Fernandes

    2016-05-01

    Full Text Available ABSTRACT We proposed a 3D model to evaluate the role of platybasia and clivus length in the development of Chiari I (CI. Using a computer aided design software, two DICOM files of a normal CT scan and MR were used to simulate different clivus lengths (CL and also different basal angles (BA. The final posterior fossa volume (PFV was obtained for each variation and the percentage of the volumetric change was acquired with the same method. The initial normal values of CL and BA were 35.65 mm and 112.66º respectively, with a total PFV of 209 ml. Ranging the CL from 34.65 to 29.65 – 24.65 – 19.65, there was a PFV decrease of 0.47% – 1.12% – 1.69%, respectively. Ranging the BA from 122.66º to 127.66º – 142.66º, the PFV decreased 0.69% – 3.23%, respectively. Our model highlights the importance of the basal angle and clivus length to the development of CI.

  12. Prevalence of clinically important posterior fossa emissary veins on CT angiography

    Directory of Open Access Journals (Sweden)

    Yeliz Pekcevik

    2014-01-01

    Full Text Available Purpose: We assessed the prevalence of the clinically important posterior fossa emissary veins detected on computed tomography (CT angiography. Materials and Methods: A total of 182 consecutive patients who underwent 64-slice CT angiography were retrospectively reviewed to determine the clinically important posterior fossa emissary veins. Results: Of 166 patients, the mastoid emissary vein (MEV was not identified in 37 (22.3% patients. It was found bilaterally in 82 (49.4% and unilaterally in 47 (28.3% patients. Only six patients had more than one MEV that were very small (5 mm veins. The posterior condylar vein (PCV was not identified in 39 (23.5% patients. It was found bilaterally in 97 (58.4% and unilaterally in 30 (18.1% patients. Only 15 patients had a very large (>5 mm PCV. The petrosquamosal sinus (PSS was identified only in one patient (0.6% on the left side. The occipital sinus was found in two patients (1.2%. Conclusions: The presence of the clinically important posterior fossa emissary veins is not rare. Posterior fossa emissary veins should be identified and systematically reported, especially prior to surgeries involving the posterior fossa and mastoid region.

  13. Acute posterior fossa epidural hematoma in a newborn infant with Menkes disease.

    Science.gov (United States)

    Takeuchi, Satoru; Horikawa, Masahiro; Wakamatsu, Hajime; Hashimoto, Jyunya; Nawashiro, Hiroshi

    2014-02-01

    Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. A male infant with a condition diagnosed with Menkes disease by prenatal testing was born at 39 weeks via vacuum extraction. The patient presented with a mild tremor at 2 days after delivery. A brain computed tomography (CT) scan showed an acute EDH in the posterior fossa, extending into the occipitoparietal area. Three-dimensional CT and bone window CT scan revealed several accessory bones, diastasis of 1 accessory suture, a communicated fracture, and a linear fracture in the occipital bone. Furthermore, a bone fragment from a communicated fracture displaced toward the inside. The patient was treated conservatively for EDH because of his good general condition. The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones.

  14. Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report

    Directory of Open Access Journals (Sweden)

    Abdel-Aziz Mosaad

    2012-06-01

    Full Text Available Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Conclusions Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

  15. Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery

    Directory of Open Access Journals (Sweden)

    Verena Heymanns

    2016-07-01

    Full Text Available Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8% in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark, Gelfoam® (Pfizer Inc., New York, NY, USA and polymethylmethacrylate (osteoclastic craniotomy. The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.

  16. Clival osteomyelitis resulting from spread of infection through the fossa navicularis magna in a child

    Energy Technology Data Exchange (ETDEWEB)

    Prabhu, Sanjay P.; Zinkus, Timothy [Children' s Hospital Boston and Harvard Medical School, Division of Neuroradiology, Department of Pediatric Radiology, Boston, MA (United States); Cheng, Alan G. [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States); Stanford University School of Medicine, Department of Otolaryngology, Head and Neck Surgery, Stanford, CA (United States); Rahbar, Reza [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States)

    2009-09-15

    The fossa navicularis is a notch-like bone defect in the basiocciput that has been hitherto considered as an anatomical variant of the clivus and not previously described as a potential source of clival or skull base pathology. We report the imaging findings in a 5-year-old child who presented acutely with a retropharyngeal abscess and osteomyelitis of the clivus. Imaging after treatment revealed a ''notch-like'' defect in the anterior clivus consistent with a fossa navicularis. Based on these appearances, we postulate that the lymphoid tissue of the pharyngeal tonsil residing in the fossa navicularis served as a route through which infection spread and subsequently developed into clival osteomyelitis, which is a rare diagnosis. This case is unique, and we believe that the presence of this variant in young children may be important and is not merely an anatomical curiosity. (orig.)

  17. Primitive neuroectodermal tumors in the posterior fossa: excluding medulloblastoma based on pathology

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Jin; Kim, Tae Hun; Kim, Yong Joo; Kang, Duk Sik; Shon, Youn Kyung [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of); Kim, Sun Young [College of Medicine, Youngnam University, Daegu (Korea, Republic of)

    1992-01-15

    Four children, with histopathologically confirmed posterior fossa primitive neuroectodermal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are not specific for primitive neuroectodermal tumors, as similar findings are seen in medulloblastoma, ependymoma and other tumors. Therefore, we think that the primitive neuroectodermal tumors should be included in the differential diagnosis when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.

  18. Hydrothermal formation of Clay-Carbonate alteration assemblages in the Nili Fossae region of Mars

    CERN Document Server

    Brown, Adrian J; Baldridge, Alice M; Crowley, James K; Bridges, Nathan T; Thomson, Bradley J; Marion, Giles M; Filho, Carlos R de Souza; Bishop, Janice L

    2014-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) has returned observations of the Nili Fossae region indicating the presence of Mg- carbonate in small (<10km sq2), relatively bright rock units that are commonly fractured (Ehlmann et al., 2008b). We have analyzed spectra from CRISM images and used co-located HiRISE images in order to further characterize these carbonate-bearing units. We applied absorption band mapping techniques to investigate a range of possible phyllosilicate and carbonate minerals that could be present in the Nili Fossae region. We also describe a clay-carbonate hydrothermal alteration mineral assemblage in the Archean Warrawoona Group of Western Australia that is a potential Earth analog to the Nili Fossae carbonate-bearing rock units. We discuss the geological and biological implications for hydrothermal processes on Noachian Mars.

  19. CT evaluation of tumorous lesion extending in and into the infratemporal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Ariji, Yoshiko; Ariji, Eiichiro; Moriguchi, Shinji; Kanda, Shigenobu (Kyusyu Univ., Fukuoka (Japan). Faculty of Dentistry)

    1990-04-01

    Twenty patients with tumorous lesions extending in and into the infratemporal fossa were examined by CT at the Department of Dental Radiology, Kyusyu University Dental Hospital during the period from March, 1985 to September, 1988. They ranged in age from 6 to 75 years (mean, 52.7 years). Eleven were males. CT images of these patients were analyzed in detail and the results include: CT appearances of extension in and into the infratemporal fossa were classified into four types according to the primary site. Further, in cases of tumors originating in the oral cavity the appearances were subclassified into three types. In 17 of 20 patients (85%), bone involvement adjacent to the infratemporal fossa was detected by CT. The changes on CT images were considered to reflect clinical signs, such as trismus and sensory changes involving the fifth nerve (the second and the third division) and others. (author).

  20. Delayed removal of a maxillary third molar from the infratemporal fossa.

    Science.gov (United States)

    Gómez-Oliveira, Guillermo; Arribas-García, Ignacio; Alvarez-Flores, Modesto; Gregoire-Ferriol, Johanna; Martínez-Gimeno, Carlos

    2010-05-01

    Removal of an impacted superior third molar is usually a simple and uncomplicated procedure for an Oral and Maxillofacial Surgeon. Nevertheless, complications are possible and include infection, facial swallowing, trismus, wound dehiscence, root fracture or even orosinusal fistula. Iatrogenic displacement into the infratemporal fossa is frequently mentioned but rarely reported. This anatomical fossa includes several important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopalatine nerve, the coronoid process of the mandible and the pterygoid muscles. Recommended treatment includes immediate surgical removal if possible or initial observation and secondary removal, as necessary, because of infection, limited mandibular movement, inability to extract the tooth, or the patient's psychological unease. Sometimes, the displaced tooth may spontaneously migrate inferiorly and becomes accessible intraorally. This report describes the location and secondary surgical removal of a left maxillary third molar displaced into the infratemporal fossa, two weeks after first attempt at extraction.

  1. Right Cardiac Catheterization Using the Antecubital Fossa Vein in Korean Patients

    Science.gov (United States)

    Lee, Sang Hyun; Lee, Dae Sung; Lee, Soo Yong; Hwang, Jongmin; Chon, Min Ku; Hwang, Ki Won; Kim, Jeong Su; Park, Yong Huyn; Kim, June Hong

    2016-01-01

    Background and Objectives Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. Subjects and Methods The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications). Results We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group. Conclusion Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients. PMID:27014351

  2. The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai [Catholic University College of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a nonenhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. Clinically, the lesions of the lacrimal gland and fossa are found as palpable masses in the superior lateral aspect of the orbit, and these lesions constitute about 5-13% of all of the orbital masses confirmed by biopsy. Many different pathological entities arise from the lacrimal gland and fossa, and as each of them requires a different therapeutic approach, the radiological characterization of each lesion is important. Approximately, half of the lacrimal gland masses are tumors of epithelial origin and the rest are lesions that arise from lymphoid or inflammatory diseases. Pseudotumors, metastatic masses and developmental cysts may also occur in the lacrimal fossa. This paper aims to discuss the radiologic findings of the lesions that are found in

  3. Intraoperative precautionary insertion of external ventricular drainage catheters in posterior fossa tumors presenting with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Hosam A.M. Habib

    2014-12-01

    Conclusion: Intra-operative insertion of EVD catheter during surgery of posterior fossa tumors, as it allows better control of the ICT during surgery if needed, provides a life saving emergency CSF drainage outlet if tumor resection fails to resolve HC or for the occurrence of de novo HC, and finally it provides adequate control of CSF leak in cases with supratentorial ventriculomegaly, where the use of lumbar drains may be hazardous. Intraoperative drainage prevents possible complications met with early CSF diversion. But the application of this technique should better be restricted to midline posterior fossa tumors related to the ventricular system.

  4. Unusual anatomical detection of a third molar in the infratemporal fossa.

    Science.gov (United States)

    Corega, C; Vaida, L; Festila, D; Bertossi, D

    2013-01-01

    Third molar presence in the infratemporal fossa is a rare event and it has been reported previously only two times in the literature, except for the cases which arise from complications occurring during the extraction of the impacted upper third molar. Due to the presence of important vessel bundles and nerves in this area, third molar removal requires a correct surgical management in order to avoid many possible serious side effects. We report an unusual case of upper third molar detected in the infratemporal fossa, which has been thoroughly investigated radiologically and removed through a safe surgical approach.

  5. Circumscribed changes in the cranial vault in extracerebral accumulations of fluid in the middle cranial fossa

    Energy Technology Data Exchange (ETDEWEB)

    Trittmacher, S.; Purmann, H.; Hunsdiek, F.; Schmid, A.; Traupe, H.

    1988-11-01

    On the basis of 26 cases with extracerebral fluid accumulation in the middle cranial fossa the bony changes occurring in this connection are described and discussed in respect of their aetiology. If there are bony accompanying reactions, two entities can be observed on principle: One group shows thinning and protrusion of the temporal squama, raising of the lesser wing of the sphenoid bone and protrusion of the greater wing of the sphenoid bone. The second group is associated with thickening of the temporal squama and of the lesser and greater wing of the sphenoid bone without showing any change in volume of the middle cranial fossa. (orig./GDG).

  6. Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood; Avaliacao textural por ressonancia magnetica dos tumores da fossa posterior em criancas

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Joelson Alves dos; Costa, Maria Olivia Rodrigues da; Otaduy, Maria Concepcion Garcia; Lacerda, Maria Teresa Carvalho de; Leite, Claudia da Costa [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: joelson_alves@ig.com.br; Matsushita, Hamilton [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2004-08-01

    Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

  7. The purpose of this study is to determine the clinical usefulness of Valsalva maneuver (VM) to evaluate piriform-fossae lesions on helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Shoji; Yasuda, Shigeo; Kimura, Shinjiro; Ito, Hisao [Chiba Univ. (Japan). Hospital; Fujimoto, Hajime; Nasu, Katsuhiro; Motoori, Ken

    1997-07-01

    Forty-four patients who were suspected hypopharyngeal carcinoma underwent both conventional CT under quiet breath holding and helical CT under Valsalva maneuver (VMCT). All patients successfully performed Valsalva maneuver during image acquisition. Normal piriform fossae were dilated well under VM. Five fossae involved by hypopharyngeal carcinoma were poorly dilated on VMCT. In conclusion VMCT is a supportive method to evaluate piriform fossae. If piriform fossae lesions were suspected on conventional CT, VMCT should be performed. (author)

  8. Posterior fossa vermian cystic schwannoma mimicking as pilocytic astrocytoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Alok Umredkar

    2011-01-01

    Full Text Available Intraparenchymal schwannomas are rare and most of the reported cases are in supratentorial region with frontal lobe being most common. Infratentorial location is very rare. We report a posterior fossa midline large cystic schwannoma with mural nodule mimicking as pilocytic astrocytoma. The pathogenesis and neuroradiological findings of intraparenchymal schwannomas are discussed with review of the related literature.

  9. Posterior fossa syndrome in a patient with an ornithine transcarbamylase deficiency

    NARCIS (Netherlands)

    Nedermeijer, S. C M; Van Den Hout, J.; Geleijns, C.; De Klerk, H.; Catsman-Berrevoets, C. E.

    2015-01-01

    The posterior fossa syndrome (PFS) is a well-known clinical entity and mainly occurs in children. Ornithine transcarbamylase deficiency (OTC) is the most common urea cycle disorder, which occurs in an estimated 1 per 50.000 live births in Japan. Symptoms are mostly due to hyperammonemia and include

  10. Posterior fossa syndrome: Review of the behavioral and emotional aspects in pediatric cancer patients.

    Science.gov (United States)

    Lanier, Jane C; Abrams, Annah N

    2017-02-15

    Medulloblastoma, the most common malignant brain tumor of childhood, occurs in the posterior fossa, the part of the intracranial cavity that contains the brainstem and the cerebellum. The cerebellum is involved in many complex aspects of human behavior and function, and when it is disrupted or insulted, this can lead to significant sequelae in children with posterior fossa tumors. A constellation of impairing and distressing symptoms, including mutism, ataxia/hypotonia, and emotional lability, develops in approximately 25% of children after the surgical resection of posterior fossa tumors. These symptoms may impede treatment and frequently require intervention in order for children to be able to participate in their care. The eventual recovery of speech occurs for most, but with slowly improving dysarthria over many months. Behavioral changes and emotional lability also occur. This phenomenon has been classified differently by different investigators over the past 35 years. For the purposes of this article, the term posterior fossa syndrome is used to refer to the neuropsychiatric and behavioral features that compose this condition. The current review summarizes the development of the clinical understanding of this phenomenon with a focus on near- and long-term psychosocial and psychiatric implications. Also, clinical examples of the presentation, management, and lasting implications of this syndrome are provided. This review is intended to be a resource for clinicians who treat affected children. Cancer 2017;123:551-559. © 2016 American Cancer Society. © 2016 American Cancer Society.

  11. Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia

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    S Rai

    2012-01-01

    Full Text Available Idiopathic CD4 lymphocytopenia (ICL is a rare disorder which is often diagnosed as HIV-negative AIDS in the light of poor immunity and AIDS-defining illnesses. We present a case of a 50-year-old male who presented with a midline posterior fossa tumour with ICL diagnosed as cerebellar cryptococcoma.

  12. Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia.

    Science.gov (United States)

    Rai, S; Marak, R S K; Jain, S; Dhole, T N

    2012-01-01

    Idiopathic CD4 lymphocytopenia (ICL) is a rare disorder which is often diagnosed as HIV-negative AIDS in the light of poor immunity and AIDS-defining illnesses. We present a case of a 50-year-old male who presented with a midline posterior fossa tumour with ICL diagnosed as cerebellar cryptococcoma.

  13. Cranial nerve assessment in posterior fossa tumors with fast imaging employing steady-state acquisition (FIESTA).

    Science.gov (United States)

    Mikami, Takeshi; Minamida, Yoshihiro; Yamaki, Toshiaki; Koyanagi, Izumi; Nonaka, Tadashi; Houkin, Kiyohiro

    2005-10-01

    Steady-state free precession is widely used for ultra-fast cardiac or abdominal imaging. The purpose of this work was to assess fast imaging employing steady-state acquisition (FIESTA) and to evaluate its efficacy for depiction of the cranial nerve affected by the tumor. Twenty-three consecutive patients with posterior fossa tumors underwent FIESTA sequence after contrast agent administration, and then displacement of the cranial nerve was evaluated. The 23 patients with posterior fossa tumor consisted of 12 schwannomas, eight meningiomas, and three cases of epidermoid. Except in the cases of epidermoid, intensity of all tumors increased on FIESTA imaging of the contrast enhancement. In the schwannoma cases, visualization of the nerve became poorer as the tumor increased in size. In cases of encapsulated meningioma, all the cranial nerves of the posterior fossa were depicted regardless of location. The ability to depict the nerves was also significantly higher in meningioma patients than in schwannoma patients (PFIESTA sequence offers similar contrast to other heavily T2-weighted sequences, it facilitated a superior assessment of the effect of tumors on cranial nerve anatomy. FIESTA sequence was useful for preoperative simulations of posterior fossa tumors.

  14. Snapshot quiz - recurrent right iliac fossa pain in the patient with a previous history of appendicitis.

    Science.gov (United States)

    Aris Chandran, Johan; Cobb, Will A; Keeler, Barrie D; Soin, Bob

    2015-06-01

    A low threshold for computed tomography (CT) scanning in patients with previous appendicectomy and right iliac fossa pain helps facilitate timely diagnosis and exclusion of other differential diagnoses. Here, we present a rare cause which has significant medicolegal ramifications and is accurately diagnosed with CT.

  15. Posterior fossa syndrome in a patient with an ornithine transcarbamylase deficiency

    NARCIS (Netherlands)

    Nedermeijer, S. C M; Van Den Hout, J.; Geleijns, C.; De Klerk, H.; Catsman-Berrevoets, C. E.

    2015-01-01

    The posterior fossa syndrome (PFS) is a well-known clinical entity and mainly occurs in children. Ornithine transcarbamylase deficiency (OTC) is the most common urea cycle disorder, which occurs in an estimated 1 per 50.000 live births in Japan. Symptoms are mostly due to hyperammonemia and include

  16. Modified folding radial forearm flap in soft palate and tonsillar fossa reconstruction.

    Science.gov (United States)

    Kang, Hyun Gu; Park, Myong Chul; Lim, Hyoseob; Kim, Joo Hyoung; Lee, Il Jae

    2013-03-01

    Wide excision of cancer arising from the tonsillar fossa and soft palate has several functional sequelae (e.g., speech, swallowing, chewing, and breathing) that require surgical restoration of the pharyngeo-palatal structure and optimal velopharyngeal function. For this purpose, several kinds of surgical procedures have been introduced. Our method to reconstruct the tonsillar fossa and soft palate entails folding the flaps and reconstructions at the same time as the oral and nasal planes, with some modifications.Patient 1 was a 64-year-old man with left soft palate cancer. After wide excision of the tumor, the defect size of the nasal floor was 3 × 3 cm, and that of soft palate and tonsillar fossa was 8 × 5 cm. Patient 2 was a 49-year-old man with left tonsil cancer. The defect size of the nasal floor was 3 × 3 cm, and that of left lateral wall of the tonsillar fossa was 8 × 3 cm. For reconstruction of oral, nasal, and tonsillar plane, we designed the flap fit to the defect site, especially cutting of the edge of the square plane of the flap to a round shape.Both patients achieved good functional recovery without surgical complications. The average speech intelligibility score in the 2 patients was 10. Swallowing functional score was 4 in both patients. Creative reconstruction with modified radial forearm free flap for tonsillar and soft palate area makes it possible to restore velopharyngeal function to levels close to the preoperative condition.

  17. A new morphometric method for the sella turcica and the hypophyseal fossa and its clinical relevance.

    Science.gov (United States)

    Venieratos, D; Anagnostopoulou, S; Garidou, A

    2005-11-01

    The sella turcica and the hypophyseal fossa should be considered different entities, the latter being part of the former. Their morphology and dimensions correlate to some extent with those of the contained pituitary gland and have, for this reason, attracted the interest of anatomists and radiologists. With the application of MRI, however, these data are of limited use in the diagnosis of pituitary disorders, although they remain valuable with regard to a microsurgical approach to the hypophysis. The proposed morphometric method was applied to 20 dry skulls. We first made casts of the corresponding sellae. Their volumes were then measured by immersion. The frontal section of each hypophyseal fossa was obtained through its deepest point and magnified. The Cartesian co-ordinates of the contour of the section were used to evaluate the corresponding area and centroid. The volume of each fossa was finally obtained by the use of Pappus' theorem applied to solids of rotation. The volumes of the sellae obtained as above ranged from 460 mm3 to 1570 mm3 with a mean value of 835 mm3. These figures are comparable to those reported from previous authors. To our knowledge the method described has enabled a close approximation of the volumes of the hypophyseal fossae to be made for the first time. These volumes ranged from 24 mm3 to 300 mm3, with a mean value of 157 mm3. Similar numerical methods might be applicable in vivo by the use of MR imaging.

  18. Interrelationship of middle cranial fossa parameters and dimensional characteristics of human cerebral cranium in various craniotypes

    Directory of Open Access Journals (Sweden)

    Khurchak U.A.

    2011-12-01

    Full Text Available The research goal is to study the interrelation between the linear dimensions of the middle cranial fossa, and linear and angular parameters of the human cerebral cranium depending on the basilar angle. Materials and methods: The research work has included 100 skulls of adults divided into three craniotypes. The craniotopometric method has taken into account parameters with further calculation of average values. correlation model has been formed. Results: The study of correlation characteristics of middle cranial fossa linear dimensions with cerebral cranium linear and angular parameters has shown different interrelation of craniotypes according to the strength and direction. Conclusion: It has been found out that a definite degree of interrelation has been observed in platibasilar craniotypes. Direct interrelation of middle cranial fossa length, length and width of sella turcica fracture has been observed in flexibasilar craniotypes. The interrelation of parameters studied in mediobasilar craniotypes has been determined in a lesser degree. Other dimension middle cranial fossa and sella turcica fracture are subjected to greater variability

  19. Cerebellar mutism syndrome in children with brain tumours of the posterior fossa

    DEFF Research Database (Denmark)

    Wibroe, Morten; Cappelen, Johan; Castor, Charlotte

    2017-01-01

    , the clinical course and strategies for prevention and treatment are yet to be determined.Methods: This observational, prospective, multicentre study will include 500 children with posterior fossa tumours. It opened late 2014 with participation from 20 Nordic and Baltic centres. From 2016, five British centres...

  20. Applied anatomy of the anterior cranial fossa: what can fracture patterns tell us?

    Science.gov (United States)

    Stephens, J R; Holmes, S; Evans, B T

    2016-03-01

    The skull base is uniquely placed to absorb anteriorly directed forces imparted either via the midfacial skeleton or cranial vault. A variety of skull base fracture classifications exist. Less well understood, however, is fracture extension beyond the anterior cranial fossa (ACF) into the middle and posterior cranial fossae. The cases of 81 patients from two UK major trauma centres were studied to examine the distribution of fractures across the skull base and any relationship between the vector of force and extent of skull base injury. It was found that predominantly lateral force to the craniofacial skeleton produced a fracture that propagated beyond the ACF into the middle cranial fossa in 77.4% of cases, significantly more (P<0.001) than for predominantly anterior force (12.0%). Fractures were significantly more likely to propagate into the posterior fossa with a lateral vector of impact compared to an anterior vector (P=0.049). This difference in energy transfer across the skull base may, in part, be explained by the local anatomy. The more delicate central ACF acts as a 'crumple zone' in order to absorb force. Conversely, no collapsible interface exists in the lateral aspect of the ACF, thus the lateral ACF behaves like a 'buttress', resulting in increased energy transfer. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Computed tomographic study of posterior cranial fossa, foramen magnum, and its surgical implications in Chiari malformations.

    Science.gov (United States)

    Iqbal, Showkathali; Robert, Ambooken P; Mathew, Dominic

    2017-01-01

    The aim of this study is to measure the height and volume of the bony part of the posterior cranial fossa (PCF) and the surface area of the foramen magnum (FM) using computed tomography (CT) scans and to correlate our clinical findings with the available current literature. This cross-sectional study was conducted in a tertiary care referral hospital in the Southern part of India during the period from January 2015 to August 2015. A total of 100 CT scans of the suspected head injury patients were collected retrospectively form the basis for this study. The height, volume of PCF and the anteroposterior (AP), transverse diameter, and surface area of the FM were measured. The values of all parameters were subjected to statistical analysis using SPSS version 16. The age of the patients were ranged between 18 and 70 years with the mean age of 41.22 ± 13.93 years. The dimensions of the posterior fossa and FM were larger in males compared to females. The mean height of the posterior fossa was 38.08 (±4.718) mm (P = 0.0001), and the mean volume of the posterior fossa was 157.23 (±6.700) mm(3) (P = 0.0001). The mean AP, transverse diameter, and the surface area of the FM were 33.13 (± 3.286) mm, 29.01 (± 3.081) mm, and 763.803 (±138.276) mm(2), respectively. The normal dimensions of the posterior fossa and FM were less in females than males and were useful to radiologists and neurosurgeons to better their diagnostic inferences, as well as to determine the proper treatment options in Chiari malformation type I (CMI) and other posterior fossa anomalies. The posterior fossa tissue volume can be reliably measured in patients with CMI using our method. More studies were required because there were variations in dimensions among individuals of different races in different regions of the world.

  2. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  3. Spontaneous sphenoid wing meningoencephaloceles with lateral sphenoid sinus extension: the endoscopic transpterygoid approach.

    Science.gov (United States)

    Ajlan, Abdulrazag; Achrol, Achal; Soudry, Ethan; Hwang, Peter H; Harsh, Griffith

    2014-10-01

    Spontaneous meningoencephalocele (SME) of the sphenoid wing is a rare cause of cerebrospinal fluid (CSF) leakage. Surgical closure of the fistula is usually required. The approach taken depends on the location of the defect and the extension of the meningoencephalocele. The endoscopic transpterygoid approach may be useful. We prospectively analyzed the three cases of SME of the sphenoid wing with lateral sphenoid sinus extension treated endoscopically at Stanford over the last 3 years with regard to imaging findings, operative technique, and operative morbidity. In our three cases, the extent of pterygopalatine fossa (PPF) exposure undertaken, complete in one and partial in two, depended on the defect site. Follow-up ranged from 17 to 25 months. The fistula was completely closed in all three cases. Extant literature reports a 97% rate of successful closure (N = 65 of 67, with a mean follow-up of 25 months) and no major complications. Endoscopic transpterygoid repair is a useful, safe alternative to traditional approaches for repair of SME of the sphenoid wing. Its feasibility depends on the site of the defect, which can be identified by preoperative imaging. Larger PPF exposure and postoperative lumbar drainage of CSF can be useful and have a low risk of morbidity.

  4. Properties of the Medussae Fossae Formation and its relation to the volcanic history of Mars

    Science.gov (United States)

    Ivanov, Anton B.; Cantini, Federico

    2016-10-01

    Medussae Fossae (MFF) is a well known formation, stretching west of Tharsis volanoes. It is characterized as a relatively young Amazonian units (Amm, Amu), due to widespread signs of erosion. Earth based imaging radar observations at 3.5 cm [1] and 12 cm [2] have discovered a dark radar feature (Stealth), which roughly correlates with the MFF outline.Recent investigations [3], suggested that the unit emplacement is in fact during Hesperian period, but it is composed of material that can be easily eroded. It is not clear when the erosion happened and if it is a continuing process. Hypotheses on MFF formation range from volcanic material emplacement (ash flow tuffs or pyroclastic materials) to an ice-rich dusty mantle, deposited during high obliquity.In this work, we will present the latest observations of the East Medussae Fossae formation by the long wavelength MARSIS radar, continuing the work reported in [4], as well as complementing data surveyed by SHARAD data in [5]. The MARSIS radar has detected strong subsurface interfaces in the areas of Gordi and Eumenides Dorsae at depths up to 1.5km. We will present our analysis of the data, inferring the dielectric properties of the material to constrain properties of the material constituting the Medusae Fossae formation. We will also demonstrate an efficient user interface to work with MARSIS data inside a Geographical Information System (GIS).The research leading to these results has received funding from the European Unions Seventh Framework Programme (FP7/2007-2013) under iMars grant agreement 607379.[1] D. Muhleman, et al., "Radar images of mars," Science, vol. 253, no. 5027, 1991.[2] J. K. Harmon, et al., "Arecibo radar imagery of Mars: The major volcanic provinces," Icarus, vol. 220, aug 2012.[3] L. Kerber, et al., "The dispersal of pyroclasts from Apollinaris Patera, Mars: Implications for the origin of the Medusae Fossae Formation," Icarus, vol. 216, nov 2011.[4] T. R. Watters, et al., "Radar Sounding of the

  5. Decrypting the Formation Conditions of the Basement Carbonate-Bearing Rocks at Nili Fossae

    Science.gov (United States)

    Brown, A. J.

    2015-12-01

    The Nili Fossae region is the site of a number of proposed Landing Sites for the Mars 2020 Rover. A distinguishing feature of many of these sites is the access to large exposures of carbonate (Ehlmann et al. 2008). Serpentinization has been proposed as a formation mechanism of these carbonates, including carbonated (Brown et al. 2010, Viviano, et al. 2013) and low temperature, near surface serpentinization. The potential for carbonated serpentization at Nili Fossae links the region to Earth analogs in terrestrial greenstone belts such as the Pilbara in Western Australia, where talc-carbonate bearing komatiite cumulate units of the Dresser Formation overlie the siliceous, stromatolite-bearing Strelley Pool Chert unit (Van Kranendonk and Pirajno, 2004). If a similar relationship exists on Mars, investigations of rocks stratigraphically beneath the carbonate-bearing units at Nili Fossae ("the basement rocks") may provide the best chance to examine well preserved organic material from the Noachian. This hypothesis is testable by Mars 2020. In preparation for the the Mars 2020 landing site, we are examining the thermodynamic relationships that favor formation of serpentine and talc-carbonate and different pressures and temperatures in the crust (Barnes 2007). This will allow us to constrain the low grade metamorphism required to replicate the proposed models of serpentinisation and help us understand the regional metamophic gradient that is critical to furthering our knowledge of the ancient rocks of Nili Fossae. Refs:Barnes, S. J. "Komatiites: Petrology, Volcanology, Metamorphism, and Geochemistry." S.E.G. 13 (2007): 13. Brown, A. J., et al.. "Hydrothermal Formation of Clay-Carbonate Alteration Assemblages in the Nili Fossae Region of Mars." EPSL 297 (2010): 174-82. Ehlmann, B. L. et al. "Orbital Identification of Carbonate-Bearing Rocks on Mars." Science 322, no. 5909 1828-32. Van Kranendonk, M.J., and F. Pirajno. "Geochemistry of Metabasalts and Hydrothermal

  6. Morphometric analysis of posterior fossa in Indian CP angle acoustic schwannoma patients.

    Science.gov (United States)

    Patibandla, Mohana Rao; Panigrahi, Manas K; Gurram, Paniraj L; Thotakura, Amit Kumar; Kulkarni, Dilip

    2016-01-01

    To study the morphometry of posterior fossa in Indian CP angle schwannoma patients in order to know its influence on the extent of excision of the CP angle acoustic schwannomas. One hundred cases of cerebellopontine angle schwannomas treated surgically by the senior author and 20 controls between January 2006 and June 2011 were consecutively investigated with computed tomography (CT) using the high-resolution CT bone windows before surgery. Evaluation of anatomic parameters of the petrous bone and posterior fossa cavity were done in all patients and controls. Data were entered in Excel software and were analyzed using NCSS software. All possible regression analysis was done to select the important variables to be included in the model to predict the excision of tumor with these variables. A prediction model was developed defining the binary outcome as total excision or subtotal excision as dependent variable and the morphometric data and grading of tumor as independent variables. Interpetrous distance (IP) is the distance between the two petrous apices. Sigmoid distance (IS) distance is the distance between the two sigmoid points. Sigmoid point is the point at which the scalloped impression of the sigmoid sinus straightens to join the occipital bone posteriorly. SAG is the distance between the mid IP point and the mid-point on the inner wall of the occipital bone. The PM angle was 47.8±4.14 degrees (38-58), the PA angle was 42.68±4.47 degrees (34-53), the IP distance was 2.07±0.13 cm (1.5-2.8), the sagittal diameter of posterior fossa was 6.22±0.73 cm (5.1-9.8) and the intersigmoid distance was 9.45±0.73 cm (7.4-11). There was no significant gender difference in the posterior fossa morphometry between patients and controls. Inter-sigmoid distance and the petrous-apex angle were more in the Indians when compared to the European population mentioned in the Mathies and Samii study. The posterior fossa morphological parameters of the Indian and European population

  7. Interrelation of posterior cranial fossa parameters and size characteristics of human skull in different craniotypes

    Directory of Open Access Journals (Sweden)

    Bukreeva E.G.

    2011-03-01

    Full Text Available The aim of this work was to study the correlation between the linear dimensions of the posterior cranial fossa and linear and angular parameters of the skull, depending on the magnitude of basilar angle. Material studies provided one hundred skulls of adult humans, divided into three craniotypes. Used by craniotopometric method measurements of these parameters with subsequent calculation of estimated average values and drawing the correlation model. The results showed that the most intimate degree of multidirectional communication studied parameters were observed in platibasilar craniotype have flexibasilar craniotype strong positive dependence is present in the width of the posterior fossa, the mediobasilar craniotipe connection parameters predominantly moderate and mild. Dimensions cerebellar pits exposed to greater variability

  8. Relationship between external and histologic features of progressive stages of caries in the occlusal fossa

    DEFF Research Database (Denmark)

    Ekstrand, K R; Kuzmina, I; Bjørndal, L;

    1995-01-01

    The material comprised 140 extracted maxillary third molars. The central fossa area was examined with a stereomicroscope (SM) (x16) and macroscopically (M) under standardized conditions after cleaning and air-drying. Signs of caries were classified using a detailed scoring system involving 12 (SM...... and the internal enamel and dentine reactions. The data did not support routine usage of radiographic examination for occlusal caries diagnosis.......The material comprised 140 extracted maxillary third molars. The central fossa area was examined with a stereomicroscope (SM) (x16) and macroscopically (M) under standardized conditions after cleaning and air-drying. Signs of caries were classified using a detailed scoring system involving 12 (SM...... highly correlated (rs = 0.90). Dentinal changes were also highly correlated with enamel changes (rs = 0.85). The histologic classifications in conjunction with the macroscopical observations made it possible to demonstrate a clear relationship between the external degree of caries progression...

  9. [Thyroid adenoma in the piriform fossa: a case report and literature review].

    Science.gov (United States)

    Huang, X T; Ma, B; Liu, M B; Zhang, Y; Huang, D L; Chen, L

    2017-02-07

    Objective: To explore the clinical characteristics of case of thyroid adenoma in the piriform fossa, and review the literatures of the congentital thyroid gland abnormality. Methods: A 44-year-old male had foreign body feeling in his pharynx for 3 years. A mass in his left piriform fossa was detected by the clinical and imaging examination. Biopsy report that the mass was thyroid papillary carcinoma. The resection of tumor with partial back thyroid cartilage through lateral neck and pharyngeal approach was performed. Results: The surgical wound healed in first-stage and no any surgical complication occurred. With postoperative pathological and immunohistochemical examination, the mass was finally diagnosed as thyroid gland adenoma. Staining for cytokerantin19 was negative. Conclusion: The symptomatic and neoplastic abnormal thyroid gland should be excised, but asymptomtic, non-neoplastic and functional abnormal thyroid gland should be retained with regular follow up.

  10. The role of the basal cisterns in the development of posterior fossa skull base meningiomas

    Directory of Open Access Journals (Sweden)

    Florian Ioan Stefan

    2016-09-01

    Full Text Available Meningiomas account for more than 30% of all intracranial brain tumors, with 25% of them originating somewhere along the skull base and about 20% of these located in the posterior fossa. The intimate relation of these tumors with neural and vascular structures make them difficult to treat, both surgically and nonsurgically. Their treatment is further hampered by the lack of definitive recommendations, which is partially due to the fact that there is no general accepted model of classification. The present report proposes a new concept of classification of posterior fossa skull base meningiomas, one that takes into account the intimate relation of these tumors with arachnoid structures, simplifies the overcrowded landscape of their systematization and can be extended to oher skull base locations.

  11. Delayed removal of maxillary third molar displaced into the infratemporal fossa

    Directory of Open Access Journals (Sweden)

    Bruno Tochetto Primo

    2014-04-01

    Full Text Available Third molar extraction is a common procedure and it is rarely associated with complications. One complication that may be associated with this procedure is displacement of the tooth into the infratemporal fossa, an anatomical structure that contains the temporalis muscle, medial and lateral pterygoid muscles, the pterygoid plexus, the maxillary artery and its branches, the mandibular nerve and its branches, and the chorda tympani. The present case report illustrates delayed surgical removal of a maxillary third molar that was displaced into the infratemporal fossa, via the intraoral access and under local anesthesia. Despite the rarity of this complication, oral and maxillofacial surgeons should be aware of its management and able to choose the optimal technique, taking into account the patient's signs and symptoms as well as the knowledge and experience of the surgeon.

  12. Effects of friction massage of the popliteal fossa on blood flow velocity of the popliteal vein

    Science.gov (United States)

    Iwamoto, Koji; Mizukami, Masafumi; Asakawa, Yasutsugu; Endo, Yusuke; Takata, Yuichi; Yoshikawa, Kenichi; Yoshio, Masaharu

    2017-01-01

    [Purpose] Friction massage (friction) of the popliteal fossa is provided for the purpose of relieving pain related to circulatory disorders by improving venous flow in the lower legs. The purpose of this study is to verify the effects of enhancing the venous flow based on measuring the blood flow velocity of the popliteal vein before and after providing friction to the patients. [Subjects and Methods] Fifteen healthy male university students participated in the study. The Doppler ultrasonography (DU) was used to measure the blood flow velocity of the popliteal vein, in order to verify the effects of enhancing the venous flow by comparing the measured values before and after a friction massage. [Results] The result of comparing the blood flow velocity before and after providing friction showed that there was a significant increase after friction. [Conclusion] This study proved that friction to the popliteal fossa is effectively enhances venous flow by increasing the blood flow velocity in the popliteal vein.

  13. Canals in the Roof of the Pharynx :Anatomic Study and their Clinical Meaning

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    1 IntroductionThe palatovaginal canal and the vomerovaginal canal are small canals which connect the roof of the nasopharynx to the posterior wall of the pterygopalatine fossa. The pterygopalatine fossa represents a major pathway for spread of malignant tumors and infections. In most of the classic anatomy texts brief descriptions of the palatovaginal canal and the vomerovaginal canal are provided. There is still a scarcity of studies comparing the radiologic and microdissection findings~([1]). The aim of t...

  14. Primary meningeal melanocytoma of the anterior cranial fossa: a case report and review of the literature

    OpenAIRE

    2012-01-01

    Abstract Background Primary meningeal melanocytoma is a rare neurological disorder. Although it may occur at the base of the brain, it is extremely rare at the anterior cranial fossa. Case presentation A 27-year-old man presented with headache and diplopia at our department. Fundoscopy showed left optic nerve atrophy and right papilledema consistent with Foster-Kennedy syndrome. Neurological exams were otherwise normal. A left frontal irregular space-occupying lesion was seen on magnetic reso...

  15. Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination

    Science.gov (United States)

    Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

    2003-06-01

    In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

  16. Unusual presentation of a dermoid cyst in the ischiorectal fossa. Magnetic resonance imaging and ultrasound appearances

    Energy Technology Data Exchange (ETDEWEB)

    Choudur, H.N. [Hamilton General Hospital, Department of Radiology, Hamilton, ON (Canada); Hamilton General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); Hunjan, J.S.; Howey, J.M. [Hamilton General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); DeNardi, F. [Henderson General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada)

    2009-09-15

    The ischiorectal fossa may give rise to a wide variety of pathological entities, although it is composed of relatively few structures. Developmental cysts are included among the list. Large epidermoid cysts in the ischiorectal fossa have been previously described (Fujimoto et al., Clin Imaging 17:146-148, 1993; Ng et al., Can J Surg 49:435-436, 2006). However, to the best of our knowledge, there is no published case in the English literature of a dermoid cyst within the ischiorectal fossa. Using magnetic resonance (MR) imaging and a subsequent ultrasound-guided biopsy, we were able to offer a focused differential that included a dermoid cyst within the ischiorectal fossa in a 55-year-old man presenting with a painful mass on the buttocks. Hair and fatty components were obtained by targeted ultrasound-guided biopsy. On MR imaging, the mass was seen to be well circumscribed and registered a heterogeneous T1-weighted signal that corresponded to layers of fat and debris on short-tau inversion recovery (STIR) imaging. A well-defined ball of fat was noted centrally within the lesion, with a speckled low T1 and low T2 signal within it. Hair admixed with fat was obtained from it by targeted ultrasound-guided biopsy. There was no enhancement of the lesion after administration of gadolinium. On ultrasound, the lesion was well circumscribed and heterogeneous; the echogenic area corresponded to the fat signal seen on magnetic resonance imaging (MRI). The lower level echoes within the lesion corresponded to the debris seen on MRI. The central rounded area of speckling, registering fine posterior shadowing corresponded to the hairy contents obtained by the targeted ultrasound-guided biopsy. A differential diagnosis of all lipomatous lesions was included in the pre-biopsy report: fat necrosis within a lipoma; well-differentiated liposarcoma; myxoid liposarcoma and dermoid cyst. Histopathological diagnosis following complete surgical resection was that of a dermoid cyst. (orig.)

  17. A nomenclature for vertebral fossae in sauropods and other saurischian dinosaurs.

    Directory of Open Access Journals (Sweden)

    Jeffrey A Wilson

    Full Text Available BACKGROUND: The axial skeleton of extinct saurischian dinosaurs (i.e., theropods, sauropodomorphs, like living birds, was pneumatized by epithelial outpocketings of the respiratory system. Pneumatic signatures in the vertebral column of fossil saurischians include complex branching chambers within the bone (internal pneumaticity and large chambers visible externally that are bounded by neural arch laminae (external pneumaticity. Although general aspects of internal pneumaticity are synapomorphic for saurischian subgroups, the individual internal pneumatic spaces cannot be homologized across species or even along the vertebral column, due to their variability and absence of topographical landmarks. External pneumatic structures, in contrast, are defined by ready topological landmarks (vertebral laminae, but no consistent nomenclatural system exists. This deficiency has fostered confusion and limited their use as character data in phylogenetic analysis. METHODOLOGY/PRINCIPAL FINDINGS: We present a simple system for naming external neural arch fossae that parallels the one developed for the vertebral laminae that bound them. The nomenclatural system identifies fossae by pointing to reference landmarks (e.g., neural spine, centrum, costal articulations, zygapophyses. We standardize the naming process by creating tripartite names from "primary landmarks," which form the zygodiapophyseal table, "secondary landmarks," which orient with respect to that table, and "tertiary landmarks," which further delineate a given fossa. CONCLUSIONS/SIGNIFICANCE: The proposed nomenclatural system for lamina-bounded fossae adds clarity to descriptions of complex vertebrae and allows these structures to be sourced as character data for phylogenetic analyses. These anatomical terms denote potentially homologous pneumatic structures within Saurischia, but they could be applied to any vertebrate with vertebral laminae that enclose spaces, regardless of their developmental

  18. HiRISE views enigmatic deposits in the Sirenum Fossae region of Mars

    OpenAIRE

    2010-01-01

    HiRISE images together with other recent orbital data from Mars define new characteristics of enigmatic Hesperian-aged deposits in Sirenum Fossae that are mostly 100–200 m thick, drape kilometers of relief, and often display generally low relief surfaces. New characteristics of the deposits, previously mapped as the “Electris deposits,” include local detection of meter-scale beds that show truncating relationships, a generally light-toned nature, and a variably blocky, weakly indurated appear...

  19. Triad of torticollis, photophobia and epiphora in a child with a posterior fossa tumor

    Directory of Open Access Journals (Sweden)

    Buijsrogge, Michiel

    2014-11-01

    Full Text Available [english] A 7-month-old Caucasian girl presented with an acquired, spasmodic torticollis to the right side with the head tilted downwards, photophobia and epiphora. Diagnostic work-out revealed a posterior fossa pilocytic astrocytoma. The symptoms improved after surgical resection. There is evidence of internuclear connections between cranial nerves II, V and VII acting as important mechanisms in this triad (Okamoto et al. 2010.

  20. Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients

    OpenAIRE

    Han-Song Sheng; Chao-Guo You; Liang Yang; Nu Zhang; Jian Lin; Fen-Chun Lin; Mao-De Wang

    2017-01-01

    Purpose: Posterior fossa epidural hematomas (PFEDH) are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgical procedure less invasive by treating selected pediatric patients with trephination mini-craniectomy. Methods: We retrospectively reviewed the clinical courses, radiological findings, surgical procedures, and prognoses of the pediatric patients who were treated in our department...

  1. Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Pollo, C.; Porchet, F. [Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland); Meuli, R. [Department of Radiology, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland)

    2003-08-01

    A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

  2. Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours

    Energy Technology Data Exchange (ETDEWEB)

    Warmuth-Metz, M.; Solymosi, L. [Abteilung fuer Neuroradiologie, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Kuehl, J. [Paediatric Oncology, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Krauss, J. [Paediatric Neurosurgery, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany)

    2004-03-01

    In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

  3. The supraclavicular fossa ultrasound view for central venous catheter placement and catheter change over guidewire.

    Science.gov (United States)

    Kim, Se-Chan; Klebach, Christian; Heinze, Ingo; Hoeft, Andreas; Baumgarten, Georg; Weber, Stefan

    2014-12-23

    The supraclavicular fossa ultrasound view can be useful for central venous catheter (CVC) placement. Venipuncture of the internal jugular veins (IJV) or subclavian veins is performed with a micro-convex ultrasound probe, using a neonatal abdominal preset with a probe frequency of 10 Mhz at a depth of 10-12 cm. Following insertion of the guidewire into the vein, the probe is shifted to the right supraclavicular fossa to obtain a view of the superior vena cava (SVC), right pulmonary artery and ascending aorta. Under real-time ultrasound view, the guidewire and its J-tip is visualized and pushed forward to the lower SVC. Insertion depth is read from guidewire marks using central venous catheter. CVC is then inserted following skin and venous dilation. The supraclavicular fossa view is most suitable for right IJV CVC insertion. If other insertion sites are chosen the right supraclavicular fossa should be within the sterile field. Scanning of the IJVs, brachiocephalic veins and SVC can reveal significant thrombosis before venipuncture. Misplaced CVCs can be corrected with a change over guidewire technique under real-time ultrasound guidance. In conjunction with a diagnostic lung ultrasound scan, this technique has a potential to replace chest radiograph for confirmation of CVC tip position and exclusion of pneumothorax. Moreover, this view is of advantage in patients with a non-p-wave cardiac rhythm were an intra-cardiac electrocardiography (ECG) is not feasible for CVC tip position confirmation. Limitations of the method are lack of availability of a micro-convex probe and the need for training.

  4. Geologic Mapping of the Medusae Fossae Formation on Mars and the Northern Lowland Plains of Venus

    Science.gov (United States)

    Zimbelman, J. R.

    2009-01-01

    This report summarizes the status of mapping projects supported by NASA grant NNX07AP42G, through the Planetary Geology and Geophysics (PGG) program. The PGG grant is focused on 1:2M-scale mapping of portions of the Medusae Fossae Formation (MFF) on Mars. Also described below is the current status of two Venus geo-logic maps, generated under an earlier PGG mapping grant.

  5. Geologic Mapping of the Medusae Fossae Formation, Mars, and the Northern Lowland Plains, Venus

    Science.gov (United States)

    Zimbelman, J. R.

    2010-01-01

    This report summarizes the status of mapping projects supported by NASA grant NNX07AP42G, through the Planetary Geology and Geophysics (PGG) program. The PGG grant is focused on 1:2M-scale mapping of portions of the Medusae Fossae Formation (MFF) on Mars. Also described below is the current status of two Venus geologic maps, generated under an earlier PGG mapping grant.

  6. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

    2011-11-15

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  7. Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases.

    Science.gov (United States)

    Lesser, Juan Carlos Cisneros; Brito Neto, Rubens Vuono de; Martins, Graziela de Souza Queiroz; Bento, Ricardo Ferreira

    2017-01-01

    Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.

  8. Pattern of recurrence in children with midline posterior fossa malignant neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Wootton-Gorges, S.L.; Foreman, N.K.; Albano, E.A.; Dertina, D.M.; Nein, P.K.; Shukert, B.; Cesario, K.B.; Gage, S.; Rumack, C.M.; Strain, J.D. [Children' s Hospital, Department of Radiology, Denver, CO (United States)

    2000-02-01

    Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

  9. The supraorbital keyhole approach with eyebrow incisions for treating lesionsin the anterior fossa and sellar region

    Institute of Scientific and Technical Information of China (English)

    张懋植; 王磊; 张伟; 齐巍; 王嵘; 韩小弟; 赵继宗

    2004-01-01

    Background Keyhole surgery has developed since the 1990s as a less invasive therapeutic strategy for intracranial lesions, initially for the treatment of intracranial aneurysms. The purpose of this study was to describe and evaluate the results of surgical treatment of lesions in the anterior fossa and sellar region via a supraorbital keyhole approach using eyebrow incisions. Methods Between April 1994 and July 2003, 54 patients with lesions in the anterior fossa and sellar region were operated on via the supraorbital keyhole approach. The surgical results were studied retrospectively and compared with that of patients with lesions at the same locations but treated via a conventional subfrontal approach.Results No significant difference in curative effect was found between the conventional subfrontal approach and the supraorbital keyhole approach. However, the supraorbital approach required a much smaller skin incision, causing less surgical trauma, while achieving excellent surgical exposure and good recovery.Conclusion The supraorbital keyhole approach using an eyebrow incision is safe, effective, and both suitable and convenient for treating lesions in the anterior fossa and sellar region, with almost no adverse consequences on the facial features of patients.

  10. Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

    Directory of Open Access Journals (Sweden)

    Kamal Kataria

    2012-05-01

    Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

  11. Temporomandibular joint ankylosis after condylar dislocation into the middle cranial fossa: A case report.

    Science.gov (United States)

    Zamorano, G M; Nuñez, L F; Alvarez, L A; Otayza, F A; Fernández, M A; Donoso-Hofer, F

    2016-11-01

    Dislocation of the mandibular condyle into the middle cranial fossa after a trauma is a rare event. The lack of appropriate treatment can lead to ankylosis of the temporomandibular joint (TMJ). We report about a case of TMJ ankylosis following intracranial dislocation of the mandibular condyle through the roof of the articular fossa. A 9-year-old patient was referred for a severe limitation of mouth opening that began progressively one year before. A history of chin injury due to an accidental fall was found. Preoperative CT scan showed a TMJ ankylosis on the right side combined with a dislocation of the mandibular condyle into the middle cranial fossa. Treatment consisted in an intracranial resection of the mandibular condyle, partial removal of the ankylosis block and TMJ arthroplasty. Our case is the second case of TMJ ankylosis following intracranial dislocation of the mandibular condyle and treated with arthroplasty alone published in the English literature. There is no consensus regarding the pathophysiology of TMJ ankylosis and regarding the attitude towards the ankylosis block. In our case, no recurrence was noticed after a one-year follow-up. An interdisciplinary approach is needed, including maxillofacial surgeon, neurosurgeon, physiotherapist and orthodontist. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. BIOGENIC AMINE CONTENT AND CHEMICAL AND PHYSICAL FEATURES OF ITALIAN FORMAGGIO DI FOSSA

    Directory of Open Access Journals (Sweden)

    S Rea

    2010-06-01

    Full Text Available Formaggio di Fossa is an Italian traditional cheese of the Montefeltro area (Emilia Romagna and Marche regions characterized by a particular step of ripening that is carried out into pits (infossamento borne in the sandstone. Since the XIV century, the inhabitants were used to set food, especially cereals and cheese, into pits to preserve them during winter and to protect them from invaders. The aim of the present work is to study physical and chemical features of this product with particular reference to the presence of the most important biogenic amines ( -Phenylethylamine, putrescine, cadaverine, histamine, tyramine, spermine and spermidine, compared with a control cheese fully ripened in factory. Formaggio di Fossa showed higher values of Aw, pH, humidity, proteins, pH 4,6-soluble nitrogen (NCN and water soluble nitrogen (NPN and much lower amounts of fat. Much higher amounts of total biogenic amines were detected in Formaggio di Fossa than in control cheese, where their concentration was very low. Cadaverine, putrescine and tyramine were the most concentrated biogenic amines. Nevertheless, thyramine was present at levels suggested as compatible with GMPs. Histamine was detected at low amounts, far from potentially toxic levels.

  13. Packing of renal fossa: Useful technique for intractable bleeding after open pyelolithotomy surgery

    Directory of Open Access Journals (Sweden)

    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone surgery in peripheral hospitals. Several studies have shown the usefulness of temporary packing to control bleeding in liver injuries and following open heart operations. Packing of the renal fossa with laparotomy pads in unstable patients, and transferring the patient to the surgical intensive care unit (ICU is also described in trauma but not in controlling bleeding after open pyelolithotomy .This study comprises of three such patients whose kidneys were salvaged by a simple procedure of temporary packing of renal fossa for period of 24-48 hours who had developed life threatening haemorrhage after open pyelolithotomy. This technique is simple and worth trying especially for surgeons who are contemplating nephrectomy as prolonged packing has not lead to any compromise in renal functions. The aim of this manuscript is very limited and clear. Packing is not a licence to carry out open pyelolithotomy without proper expertise and local backup or resources. Principles of safe and ethical surgical practice should never be violated as it can lead to medico legal complications.

  14. Analysis of mandibular condylar and glenoid fossa fractures with computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ogura, Ichiro; Sasaki, Yusuke; Kaneda, Takashi [Nihon University School of Dentistry at Matsudo, Department of Radiology, Matsudo, Chiba (Japan)

    2014-04-15

    The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using χ{sup 2} test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. (orig.)

  15. Elevated bulk-silica exposures and evidence for multiple aqueous alteration episodes in Nili Fossae, Mars

    Science.gov (United States)

    Amador, Elena S.; Bandfield, Joshua L.

    2016-09-01

    The Nili Fossae region of Mars contains some of the most mineralogically diverse bedrock on the planet. Previous studies have established three main stratigraphic units in the region: a phyllosilicate-bearing basement rock, a variably altered olivine-rich basalt, and a capping rock. Here, we present evidence for the localized alteration of the northeast Nili Fossae capping unit, previously considered to be unaltered. Both near-infrared and thermal-infrared spectral datasets were analyzed, including the application of a method for determining the relative abundance of bulk-silica (SiO2) over surfaces using thermal emission imaging system (THEMIS) images. Elevated bulk-silica exposures are present on surfaces previously defined as unaltered capping rock. Given the lack of spectral evidence for phyllosilicate, hydrated silica, or quartz phases coincident with the newly detected exposures-the elevated bulk-silica may have formed under a number of aqueous scenarios, including as a product of the carbonation of the underlying olivine-rich basalt under moderate water: rock scenarios and temperatures. Regardless of formation mechanism, the detection of elevated bulk-silica exposures in the Nili Fossae capping unit extends the history of aqueous activity in the region to include all three of the main stratigraphic units.

  16. Middle fossa arachnoid cysts and inner ear symptoms: Are they related?

    Science.gov (United States)

    Proimos, E; Chimona, Ts; Memtsas, Z; Papadakis, Ce

    2014-04-01

    Arachnoid cysts most frequently occur in the middle cranial fossa and when they are symptomatic, patients present with central nervous symptoms. Nevertheless, a large proportion of arachnoid cysts are incidentally diagnosed during neuroimaging in cases with nonspecific symptoms. The cases of two males with middle cranial fossa arachnoid cysts with nonspecific inner ear symptoms were retrospectively reviewed. The first patient presented with mild headache, nausea, vertigo, unsteadiness, and tinnitus on the left ear while the second patient's main complaint was left sided tinnitus. Both patients (initially managed for peripheral disorders) underwent a thorough clinical and electrophysiological evaluation. Because of the patients' persistent clinical symptoms, and indications of CNS disorder in the first case, neuroimaging by brain MRI was performed revealing a middle cranial fossa arachnoid cyst in both patients. Occasionally, patients with arachnoid cysts may present with mild, atypical or intermittent and irrelevant symptoms which can mislead diagnosis. Otorhinolaryngologists should be aware of the fact that atypical, recurrent or intermittent symptoms may masquerade a CNS disorder. Hippokratia 2014; 18 (2):168-171.

  17. The use of wavelet filters for reducing noise in posterior fossa Computed Tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Pita-Machado, Reinado [Centro de Ingeniería Clínica. Guacalote y Circunvalación, Santa Clara 50200 (Cuba); Perez-Diaz, Marlen, E-mail: mperez@uclv.edu.cu; Lorenzo-Ginori, Juan V., E-mail: mperez@uclv.edu.cu; Bravo-Pino, Rolando, E-mail: mperez@uclv.edu.cu [Centro de Estudios de Electrónica y Tecnologías de la Información (CEETI), Universidad Central Marta Abreu de las Villas, Carretera a Camajuaní, km. 5 1/2 Santa Clara 54830 (Cuba)

    2014-11-07

    Wavelet transform based de-noising like wavelet shrinkage, gives the good results in CT. This procedure affects very little the spatial resolution. Some applications are reconstruction methods, while others are a posteriori de-noising methods. De-noising after reconstruction is very difficult because the noise is non-stationary and has unknown distribution. Therefore, methods which work on the sinogram-space don’t have this problem, because they always work over a known noise distribution at this point. On the other hand, the posterior fossa in a head CT is a very complex region for physicians, because it is commonly affected by artifacts and noise which are not eliminated during the reconstruction procedure. This can leads to some false positive evaluations. The purpose of our present work is to compare different wavelet shrinkage de-noising filters to reduce noise, particularly in images of the posterior fossa within CT scans in the sinogram-space. This work describes an experimental search for the best wavelets, to reduce Poisson noise in Computed Tomography (CT) scans. Results showed that de-noising with wavelet filters improved the quality of posterior fossa region in terms of an increased CNR, without noticeable structural distortions.

  18. Miocene-Pliocene mantle depletion event in the northern Fossa Magna, western NE Japan

    Science.gov (United States)

    Okamura, Satoshi; Inaba, Mitsuru; Adachi, Yoshiko; Shinjo, Ryuichi

    2016-07-01

    New isotopic and trace element data presented here imply a temporal change in magma sources and thermal conditions beneath the northern Fossa Magna of NE Japan from the Miocene to the Pliocene. Less radiogenic 176Hf/177Hf and 143Nd/144Nd, high Zr/Hf, and little or no Hf anomaly characterize the Early Miocene volcanism in the northern Fossa Magna region. The mantle wedge consisted of chemically heterogeneous mantle source. Based on out isotope proxies, we propose that during the onset of subduction, influx of hot asthenospheric mantle provided sufficient heat to partially melt newly subducting sediment. Geochemical modeling demonstrates that slab-derived melt mixed with mantle wedge produces the observed isotopic and trace elemental characteristics. In the Middle Miocene, the injection of hot and depleted asthenospheric material replaced the mantle beneath the northern Fossa Magna region of NE Japan. This caused the isotopic signature of the rocks to change from enriched to depleted. Then, the mantle wedge was gradually cooled during the Middle Miocene to the Pliocene with back-arc opening ending in the Late Miocene. Slab surface temperatures were still high enough for sediments to melt but not too high (<∼780 °C) to lose zircon as a residual phase. The Late Miocene and Pliocene volcanism at the post stage of the back-arc opening is best explained by a partial melting of subducted metasediment saturated with trace quantities of zircon and rutile.

  19. Management of the stricture of fossa navicularis and pendulous urethral strictures

    Science.gov (United States)

    Singh, Shrawan K.; Agrawal, Santosh K.; Mavuduru, Ravimohan S.

    2011-01-01

    Objective: Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods: The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results: Etiology of stricture is shifting from infective to inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions: Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising. PMID:22022062

  20. Computed tomographic Assessment of Lateral Lamella of Cribiform Plate and Comparison of Depth of Olfactory Fossa

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    M Bista

    2010-06-01

    Full Text Available INTRODUCTION: Endoscopic sinus surgery is an upcoming branch in rhinological practice but with some major risks since it has to play around the skull base area. Lateral lamella of cribriform plate is the thinnest area of the skull base. Thus this study is undertaken to evaluate the height of lateral lamella of cribriform plate and the depth of olfactory fossae by the help of computed tomographic images. METHODS: Computed tomographic study of 50 patients was done in Advanced Imaging and Diagnostic center, Kathmandu Medical College. Coronal sections at the centre of infra-orbital foramina were taken as reference slide. The height of cribriform plate point was subtracted from the height of medial ethmoidal roof point to measure the length of lateral lamella of cribriform plates on both sides. RESULTS: The median height of LLCP in 100 slides was 2.8 mm. LLCP height was 0 to 3.9 mm in 86 slides, 4 to 7 mm in 12 slides and greater than 7mm in 2 slides. The LLCP length was greater in right side in 28 (56% patients and was greater in left side in 19 (38% patients. It was equal in both sides in only three patients (6%. CONCLUSIONS: As regards the length of LLCP; 0 to 3.9 mm length was most common. The olfactory fossa depth was more in the right side compared to the left side. Thus, right side is more vulnerable to injury during surgery. Thus adequate caution has to be exercised by the rhinological surgeon during endoscopic sinus surgery. Keywords: lateral lamella of Cribriform plate, medical ethmoidal roof, olfactory fossa.

  1. Avian cerebellar floccular fossa size is not a proxy for flying ability in birds.

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    Stig A Walsh

    Full Text Available Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex (VOR. Because gaze stabilization is a critical aspect of flight, some authors have suggested that the flocculus is enlarged in flying species. Whether this can be further extended to a floccular expansion in highly maneuverable flying species or floccular reduction in flightless species is unknown. Here, we used micro computed-tomography to reconstruct "virtual" endocranial casts of 60 extant bird species, to extract the same level of anatomical information offered by fossils. Volumes of the floccular fossa and entire brain cavity were measured and these values correlated with four indices of flying behavior. Although a weak positive relationship was found between floccular fossa size and brachial index, no significant relationship was found between floccular fossa size and any other flight mode classification. These findings could be the result of the bony endocranium inaccurately reflecting the size of the neural flocculus, but might also reflect the importance of the flocculus for all modes of locomotion in birds. We therefore conclude that the relative size of the flocculus of endocranial casts is an unreliable predictor of locomotor behavior in extinct birds, and probably also pterosaurs and non-avian dinosaurs.

  2. Hearing preservation surgery for vestibular schwannoma: experience with the middle fossa approach.

    Science.gov (United States)

    DeMonte, Franco; Gidley, Paul W

    2012-09-01

    In the early 1960s William F. House developed the middle fossa approach for the removal of small vestibular schwannomas (VSs) with the preservation of hearing. It is the best approach for tumors that extend laterally to the fundus of the internal auditory canal, although it does have the potential disadvantage of increased facial nerve manipulation, especially for tumors arising from the inferior vestibular nerve. The aim of this study was to monitor the hearing preservation and facial nerve outcomes of this approach. A prospective database was constructed, and data were retrospectively reviewed. Between December 2004 and January 2012, 30 patients with small VSs underwent surgery via a middle fossa approach for hearing preservation. The patients consisted of 13 men and 17 women with a mean age of 46 years. Tumor size ranged from 7 to 19 mm. Gross-total resection was accomplished in 25 of 30 patients. Preoperative hearing was American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Class A in 21 patients, Class B in 5, Class C in 3, and undocumented in 1. Postoperatively, hearing was graded as AAO-HNS Class A in 15 patients, Class B in 7, Class C in 1, Class D in 2, and undocumented in 5. Facial nerve function was House-Brackmann (HB) Grade I in all patients preoperatively. Postoperatively, facial nerve function was HB Grade I in 28 patients, Grade III in 1, and Grade IV in 1. There were 3 complications: CSF leakage in 1 patient, superficial wound infection in 1, and extradural hematoma (asymptomatic) in 1. The overall hearing preservation rate of at least 73% and HB Grade I facial nerve outcome of 93% in this cohort are in keeping with other contemporary reports. The middle fossa approach for the resection of small VSs with hearing preservation is a viable and relatively safe option. It should be considered among the various options available for the management of small, growing VSs.

  3. Postoperative Pediatric Cerebellar Mutism After Posterior Fossa Surgery: A Case Report.

    Science.gov (United States)

    Chao, Jerry Y; Liu, Che; Shetty, Naveen; Shah, Ushma

    2017-04-15

    Cerebellar mutism syndrome (CMS) is a common complication of posterior fossa surgery that can confound the postanesthetic examination and have long-lasting impacts. There is confusion surrounding its precise description, diagnostic features, and associated morbidity. Here, we discuss the most up-to-date knowledge of CMS drawing from a clinical case in the context of 3 new reports: (1) an international consensus paper presenting a new proposed working definition by the Iceland Delphi Group, (2) a knowledge update by Gadgil et al, (3) and a review of neuroimaging-based data elucidating the etiology of CMS by Patay.

  4. ModFossa: A library for modeling ion channels using Python.

    Science.gov (United States)

    Ferneyhough, Gareth B; Thibealut, Corey M; Dascalu, Sergiu M; Harris, Frederick C

    2016-06-01

    The creation and simulation of ion channel models using continuous-time Markov processes is a powerful and well-used tool in the field of electrophysiology and ion channel research. While several software packages exist for the purpose of ion channel modeling, most are GUI based, and none are available as a Python library. In an attempt to provide an easy-to-use, yet powerful Markov model-based ion channel simulator, we have developed ModFossa, a Python library supporting easy model creation and stimulus definition, complete with a fast numerical solver, and attractive vector graphics plotting.

  5. Slit-like jugular foramen due to abnormal bone growth at jugular fossa

    Directory of Open Access Journals (Sweden)

    Budhiraja V

    2010-05-01

    Full Text Available An abnormal unilateral blockage of the jugular foramen by a bone growth converting it into a slit was noted in a skull during osteology demonstration classes for medical undergraduates. The left jugular foramen was narrowed by a thick bony projection filling the jugular fossa. This kind of narrowing of the foramen might results in neurovascular symptoms as it transmits important cranial nerves and internal jugular vein. Injury of ninth, tenth and eleventh cranial nerves can occur due to narrowing of jugular foramen know as Vernet’s syndrome is discussed along with case.

  6. Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, David A. [Department of Pediatric Imaging, Children' s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201 (United States); Adler, Brent H. [Department of Radiology, Children' s Radiological Institute, Columbus Children' s Hospital, Columbus, Ohio (United States); Forsythe, Robert C. [Department of Pediatrics, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States); Mutabagani, Khaled; Teich, Steven [Department of Surgery, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States)

    2003-05-01

    A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

  7. Neurenteric cyst of the anterior cranial fossa: case report and literature review.

    Science.gov (United States)

    Little, Mark W; Guilfoyle, Mathew R; Bulters, Diederik O; Scoffings, Daniel J; O'Donovan, Dominic G; Kirkpatrick, Peter J

    2011-07-01

    Intracranial neurenteric cysts are rare congenital lesions that typically occur in the posterior fossa. We report a case of a 70-year-old gentleman presenting with gait disturbance, found to have a neurenteric cyst primarily arising from and expanding the sella turcica. A review of the literature revealed 27 reports of supratentorial neurenteric cysts. Clinical presentation, radiological characteristics, treatment, prognosis and embryological origin are discussed. Intracranial neurenteric cysts should be included in the differential with any well-demarcated cystic lesion without enhancement on magnetic resonance imaging (MRI). Complete surgical excision is the treatment of choice, with good prognosis.

  8. Cisticercose do quarto ventrículo simulando neoplasia da fossa posterior a cintilografia cerebral: relato de um caso

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    Sydney F. de Morais-Rego

    1978-12-01

    Full Text Available É relatado o caso de uma criança de 12 anos de idade apresentando quadro de hipertensão endocraniana e síndrome cerebelar, cujos exames neurológico e neuroradiológicos foram sugestivos de neoplasia de fossa posterior. A cintilografia cerebral mostrou um quadro compatível com a existência de tumor da fossa posterior, da linha mediana, mais provavelmente meduloblastoma ou astrocitoma. Pela intervenção cirúrgica foi verificado tratar-se de cisticercose, sendo removido um cisto do 4ºventrícuio. Os autores sugerem que em áreas geográficas com alta prevalência de neurocisticercose na população infantil a hipótese da forma pseudotumoral seja lembrada, quando da tentativa de caracterização do tipo de lesão da fossa posterior, detectada pela cintilografia cerebral.

  9. The complex arrangement of an "aorto-jejunal paraduodenal" fossa, as revealed by dissection of human posterior parietal peritoneum.

    Science.gov (United States)

    Barberini, Fabrizio; Zani, Augusto; Ripani, Maurizio; Di Nitto, Valentina; Brunone, Francesca

    2007-01-01

    Peritoneal fossae derive from normal or anomalous coalescence of the peritoneum during fetal development, or from the course of retroperitoneal vessels. Clinically, internal abdominal hernias may be housed inside these fossae. In this report from an autopsy, a singular peritoneal fossa was delimited superiorly by an arcuate serous fold, raised up by the inferior mesenteric vein, and infero-posteriorly by two (right and left) avascular folds, extending from the abdominal aorta to the jejunum. The right fold reached the duodeno-jejunal flexure, which was located on the right side of the aorta. The left fold subdivided into two, anterior and posterior, secondary folds. The anterior fold reached the superior edge of the first jejunal loop, and the posterior fold turned medially to connect with the inferior edge of the proximal limb of the same loop. This fossa consisted of three recesses: superior, Located behind the subserous vascular arch, antero-inferior and postero-inferior, separated by interposition of the left posterior secondary fold, between the jejunum and aorta. The complex arrangement of this fossa suggests that it might have originated from a coalescence arising beyond the duodeno-jejunal flexure and including the first jejunal loop, and from the subserous course of the inferior mesenteric vein. Because of displacement to the right of the flexure, processes of coalescence in a location normally occupied by the ascending duodenum might have occurred in a similar pattern for the jejunum, involving the mesoduodenum and the proximal part of the mesentery. Labyrinthine fossae like this might cause strangulation of internal abdominal hernias and hinder intraoperative maneuvers.

  10. Assessment of condyle and glenoid fossa morphology using CBCT in South-East Asians.

    Directory of Open Access Journals (Sweden)

    May Al-koshab

    Full Text Available Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians.CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years. i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF.No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese.The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population.

  11. Primary meningeal melanocytoma of the anterior cranial fossa: a case report and review of the literature

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    Lin Bowen

    2012-07-01

    Full Text Available Abstract Background Primary meningeal melanocytoma is a rare neurological disorder. Although it may occur at the base of the brain, it is extremely rare at the anterior cranial fossa. Case presentation A 27-year-old man presented with headache and diplopia at our department. Fundoscopy showed left optic nerve atrophy and right papilledema consistent with Foster-Kennedy syndrome. Neurological exams were otherwise normal. A left frontal irregular space-occupying lesion was seen on magnetic resonance imaging (MRI, and enhancement was shown on contrast-enhanced computed tomography (CT scan. CT angiography (CTA revealed vascular compression around the lesion. Prior to surgery, meningioma was diagnosed and gross tumor removal was performed. On postoperative pathohistological exam, the tumor proved to be a meningeal melanocytoma, WHO grade I. No skin melanoma was found. After surgery, the patient received radiation therapy. No tumor was seen on follow-up MR images six months after surgery. The patient was well after two and a half years, and there was no tumor recurrence on the follow-up CT. Conclusions This case of primary meningeal melanocytoma located at the anterior cranial fossa is very rare. Although primary meningeal melanocytoma is benign, it may behave aggressively. Complete surgical resection is curative for most cases. Radiation therapy is important to prevent relapse of the tumor, especially in cases of incomplete surgical resection.

  12. Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

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    Steggerda, S.J.; Smits-Wintjens, V.E.H.J.; Verbon, P.; Walther, F.J. [Leiden University Medical Centre, Department of Neonatology, Leiden (Netherlands); Bruine, F.T. de [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Wezel-Meijler, G. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Isala Hospital, Department of Neonatology, Zwolle (Netherlands)

    2015-09-15

    We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

  13. Pathology, treatment and management of posterior fossa brain tumors in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Bonner, K.; Siegel, K.R.

    1988-04-01

    Brain tumors are the second most common childhood malignancy. Between 1975 and 1985, 462 newly diagnosed patients were treated at the Children's Hospital of Philadelphia; 207 (45%) tumors arose in the posterior fossa and 255 (55%) appeared supratentorially. A wide variety of histological subtypes were seen, each requiring tumor-specific treatment approaches. These included primitive neuroectodermal tumor (n = 86, 19%), astrocytoma (n = 135, 30%), brainstem glioma (n = 47, 10%), anaplastic astrocytoma (n = 32, 7%), and ependymoma (n = 30, 6%). Because of advances in diagnostic abilities, surgery, radiotherapy, and chemotherapy, between 60% and 70% of these patients are alive today. Diagnostic tools such as computed tomography and magnetic resonance imaging allow for better perioperative management and follow-up, while the operating microscope, CO/sub 2/ laser, cavitron ultrasonic aspirator and neurosurgical microinstrumentation allow for more extensive and safer surgery. Disease specific treatment protocols, utilizing radiotherapy and adjuvant chemotherapy, have made survival common in tumors such as medulloblastoma. As survival rates increase, cognitive, endocrinologic and psychologic sequelae become increasingly important. The optimal management of children with brain tumors demands a multidisciplinary approach, best facilitated by a neuro-oncology team composed of multiple subspecialists. This article addresses incidence, classification and histology, clinical presentation, diagnosis, pre-, intra- and postoperative management, long-term effects and the team approach in posterior fossa tumors in childhood. Management of specific tumor types is included as well. 57 references.

  14. Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs

    Directory of Open Access Journals (Sweden)

    Luciana Cristina dos Santos Silva

    2012-08-01

    Full Text Available INTRODUCTION: There is no study relating magnetic resonance imaging (MRI to ultrasound (US findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US. METHODS: Fifty-four patients (mean age 41.6±13.5years from an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma. RESULTS: Forty-seven (87% of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%, MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1% of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis. CONCLUSIONS: Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.

  15. High precision locations of long-period events at La Fossa Crater (Vulcano Island, Italy

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    Salvatore Rapisarda

    2009-06-01

    Full Text Available Since the last eruption in 1888-90, the volcanic activity on Vulcano Island (Aeolian Archipelago, Italy has been limited to fumarolic degassing. Fumaroles are mainly concentred at the active cone of La Fossa in the northern sector of the island and are periodically characterized by increases in temperature as well as in the amount of both CO2 and He. Seismic background activity at Vulcano is dominated by micro-seismicity originating at shallow depth (<1-1.5 km under La Fossa cone. This seismicity is related to geothermal system processes and comprises long period (LP events. LPs are generally considered as the resonance of a fluid-filled volume in response to a trigger. We analyzed LP events recorded during an anomalous degassing period (August-October 2006 applying a high precision technique to define the shape of the trigger source. Absolute and high precision locations suggest that LP events recorded at Vulcano during 2006 were produced by a shallow focal zone ca. 200 m long, 40 m wide and N30-40E oriented. Their occurrence is linked to magmatic fluid inputs that by modifying the hydrothermal system cause excitation of a fluid-filled cavity.

  16. Right iliac fossa abscess as first manifestation of perforated adenocarcinoma of sigmoid: a rare case report

    Institute of Scientific and Technical Information of China (English)

    Mohammad Hossein Hajisadeghizadeh; Hamid Reza Soltani. G; Seyed Mohammad Reza Mortazavizadeh; Fatemeh Akhiri A

    2012-01-01

    Colorectal cancer usually present with known symptoms while there are less common manifestation including abscess formation which can be intra or extra peritoneal. A 60-year-old Caucasian male with a history of RLQ abdominal pain, nausea, vomiting and anorexia from 15 days ago referred to surgery ward. Ultrasound showed a hypoachoic lesion with diameters 50 mm × 70 mm in RLQ of abdomen and a round echogenic area in right lobe of liver with diameter 15 mm. The findings were revealed an abscess located in right iliac fossa then local drainage of abscess was performed. Four days later the patient was re-admitted because of severe abdominal distention and lack of bowel movement. Laparoscopy was performed before proceeding with further examinations, due to the poor general condition of the patient. The sigmoid was adherent into the abdominal wall and mild intestinal loop distention and apple-core view was observed during operation. Can-cer of sigmoid complicated by a right iliac fossa abscess was diagnosed and Hartman colestomy was undertaken. At the last follow-up examination 3 months after operation, the patient was in good health with no clinical evidence of recurrence.

  17. [Acute epidural hematoma of the posterior fossa in a case of von Willebrand's disease].

    Science.gov (United States)

    Takenaka, N; Mine, T; Ikeda, E; Iwai, H; Kusano, S

    1988-01-01

    A rare case of acute epidural hematoma of the posterior fossa associated with von Willebrand's disease is reported. A 9-year-old boy fell down and hit his occipital region against a floor. Soon after he came home and slept, but three hours later he began to vomit and became drowsiness. He visited our hospital and his Glasgow Coma Scale showed 13 points. CT scan on admission showed acute epidural hematoma of left posterior fossa and contusional hematoma in the right temporal lobe. The bleeding time was over 18 minutes. He had been suspected to be suffering from von Willebrand's disease two years ago. Then fresh blood, fresh frozen plasma and anti-hemophilic globulin were prepared. Ten hours after injury, the operation was begun. Fresh epidural hematoma existed as a clot beyond transverse sinus. During the procedure of dural tenting suture, diffuse bleeding from bone, muscle, subcutaneous tissue and dura occurred and it was difficult to stop the bleeding. By using fresh blood and anti-hemophilic globulin, the bleeding was controlled, and then the operation was achieved. In the postoperative course a new epidural hematoma was found in the left temporal region and a new but asymptomatic retinal hemorrhage was found in his right eye. He was discharged without any neurological deficits 25 days after operation.

  18. Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip : a randomized controlled study with in-depth functional outcome results

    NARCIS (Netherlands)

    Moein, C. M. Ansari; ten Duis, H. J.; Oey, P. L.; de Kort, G. A. P.; van der Meulen, W.; van der Werken, Chr

    2011-01-01

    In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients

  19. Cerebellar mutism syndrome in children with brain tumours of the posterior fossa.

    Science.gov (United States)

    Wibroe, Morten; Cappelen, Johan; Castor, Charlotte; Clausen, Niels; Grillner, Pernilla; Gudrunardottir, Thora; Gupta, Ramneek; Gustavsson, Bengt; Heyman, Mats; Holm, Stefan; Karppinen, Atte; Klausen, Camilla; Lönnqvist, Tuula; Mathiasen, René; Nilsson, Pelle; Nysom, Karsten; Persson, Karin; Rask, Olof; Schmiegelow, Kjeld; Sehested, Astrid; Thomassen, Harald; Tonning-Olsson, Ingrid; Zetterqvist, Barbara; Juhler, Marianne

    2017-06-21

    Central nervous system tumours constitute 25% of all childhood cancers; more than half are located in the posterior fossa and surgery is usually part of therapy. One of the most disabling late effects of posterior fossa tumour surgery is the cerebellar mutism syndrome (CMS) which has been reported in up to 39% of the patients but the exact incidence is uncertain since milder cases may be unrecognized. Recovery is usually incomplete. Reported risk factors are tumour type, midline location and brainstem involvement, but the exact aetiology, surgical and other risk factors, the clinical course and strategies for prevention and treatment are yet to be determined. This observational, prospective, multicentre study will include 500 children with posterior fossa tumours. It opened late 2014 with participation from 20 Nordic and Baltic centres. From 2016, five British centres and four Dutch centres will join with a total annual accrual of 130 patients. Three other major European centres are invited to join from 2016/17. Follow-up will run for 12 months after inclusion of the last patient. All patients are treated according to local practice. Clinical data are collected through standardized online registration at pre-determined time points pre- and postoperatively. Neurological status and speech functions are examined pre-operatively and postoperatively at 1-4 weeks, 2 and 12 months. Pre- and postoperative speech samples are recorded and analysed. Imaging will be reviewed centrally. Pathology is classified according to the 2007 WHO system. Germline DNA will be collected from all patients for associations between CMS characteristics and host genome variants including pathway profiles. Through prospective and detailed collection of information on 1) differences in incidence and clinical course of CMS for different patient and tumour characteristics, 2) standardized surgical data and their association with CMS, 3) diversities and results of other therapeutic interventions

  20. Soft tissue injury related to choice of entry point in antegrade femoral nailing : piriform fossa or greater trochanter tip

    NARCIS (Netherlands)

    Moein, CMA; Verhofstad, MHJ; Bleys, RLAW; van der Werken, C

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  1. Soft tissue injury related to choice of entry point in antegrade femoral nailing: piriform fossa or greater trochanter tip

    NARCIS (Netherlands)

    Moein, C.M.A.; Verhofstad, M.H.J.; Bleys, R.L.A.W.; van der Werken, C.

    2005-01-01

    Intramedullary nailing through the piriform fossa results in some cases in toss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musc

  2. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    Science.gov (United States)

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  3. Technical review of target volume delineation on the posterior fossa tumor: an optimal head and neck position

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Min; Lee, Sang Wook; Ahn, Seung Do; Kim, Jong Hoon; Yi, Byong Yong; Ra, Young Shin; Ghim, Thad; Choi, Eun Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2003-03-01

    To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy, A CT simulator and 3D conformal radiotherapy planning system was used for the posterior fossa boost treatment of a 13-year-old medulloblastoma patient. He was placed in the prone position and immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning performed using non-coplanar conformal beams. The CT scans, and treatment in the prone position, were performed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium. In addition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. A posterior fossa boost, in the prone position, is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

  4. Relationships Between the Medusae Fossae Formation (MFF), Fluvial Channels, and the Dichotomy Boundary Southeast of Nicholson Crater, Mars

    Science.gov (United States)

    Bradley, B. A.; Sakimoto, S. E. H.

    2001-01-01

    We use Mars Global Surveyor's Mars Orbiter Laser Altimeter (MOLA) and Mars Orbiter Camera (MOC) data to investigate the Medusae Fossae Formation (MFF) and its relationship to fluvial channels southeast of Nicholson Crater. In this area the MFF shows small-scale layering and is draped over Labou Vallis. Additional information is contained in the original extended abstract.

  5. Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns.

    Science.gov (United States)

    Eguchi, T; Taoka, T; Nikaido, Y; Shiomi, K; Fujimoto, T; Otsuka, H; Takeuchi, H

    1996-06-01

    Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre- and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space.

  6. The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children

    Institute of Scientific and Technical Information of China (English)

    Duo Chen; Xiangtai Wei; Qiang Yin; Junhong Guan; Weiran Pan; Chenglin Wang; Yunhui Liu

    2009-01-01

    OBIECTIVE To analyze and discuss about the clinical characteristics,pathological types,surgical modalities and techniques,and postoperative complications in children with tumor of posterior cranial fossa.METHODS Retrospective study was conducted on 102 cases of pediatric tumor of posterior cranial fossa,admitted and treated in our hospital during the period of January 1996 to January 2007.All patients underwent microscopic surgical treatment.Fiftyeight were male and 44 cases were female.The age ranged from 9months to 14 years old,with an average of 6.1±0.5 of age.Cranial CT or MRI examination was conducted before and after the surgery on all patients.RESULTS The primary manifestations for this group of patients were increased intracranial pressure and/or ataxia.Postoperative pathological diagnoses showed:46 cases of medulloblastoma,43cases of astrocytoma,11 cases of ependymoma(including 1 case of degenerative ependymoma),1 case of dermoid cvst,and 1 case of teratoma.In this group of the patients,radical surgery was used in 68 cases and subtotal surgical removal used in 31 cases,while surgical removal of large Section was performed on 3 cases.There were no deaths from surgery reported.Ninety-one cases showed significant symptomatic improvement when compared with preoperative conditions,while 11 cases showed either no improvement or more severely affected afterward.For 6 cases,postoperative ventriculoperitoneal shunt was performed within 7 days to 2 months after the surgery.Sixty-three patients gained follow-up for 3 to 60 months in duration.Thirty-nine patients regained normal life and were able to learn well,while there were 7 patients who could not live normally on their own.During the follow-up period,there were 17 cases of recurrence and 7 cases of death.In 23 cases of medulloblastoma in children with age of 3 Years old or above,2 cases who underwent surgical removal of intracranial ependymoma received small dosage of postoperative X-ray radiotherapy on the the

  7. Displacement of the glenoid fossa: a cephalometric evaluation of growth during treatment.

    Science.gov (United States)

    Agronin, K J; Kokich, V G

    1987-01-01

    Pretreatment and posttreatment lateral cephalograms of 175 orthodontically treated patients were evaluated to determine the change in position of articulare. The sample was arbitrarily subdivided according to the direction of facial growth during treatment (vertical, V; horizontal, H; intermediate, H/V) measured at pogonion. The cephalograms were superimposed on anterior cranial base and a Cartesian coordinate system was devised to measure changes in the position of articulare over time. The results clearly show that articulare is displaced posteriorly and inferiorly during craniofacial development with treatment. Significant differences in the amount of displacement were noted between groups. Patients with vertical growth patterns showed significantly greater posterior displacement of articulare than patients with horizontal growth patterns. Because articulare represents the point of intersection of the temporal bone and the neck of the condyle, this investigation suggests that the temporal bone and glenoid fossa are displaced posteriorly during facial development with treatment and that the amount of displacement can affect mandibular position.

  8. Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia

    Directory of Open Access Journals (Sweden)

    Vijay P Joshi

    2013-01-01

    Full Text Available Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia.

  9. Frontal sinus mucocele with intracranial extension associated with osteoma in the anterior cranial fossa.

    Science.gov (United States)

    Sakamoto, Hiroki; Tanaka, Toshihide; Kato, Naoki; Arai, Takao; Hasegawa, Yuzuru; Abe, Toshiaki

    2011-01-01

    A 70-year-old man presented with a rare case of paranasal osteoma with secondary mucocele extending intracranially, manifesting as a generalized convulsion. Computed tomography showed a large calcified tumor adjacent to the cystic mass in the left frontal lobe. He underwent left frontal craniotomy, and the cystic lesion was totally removed. Histological examination confirmed the diagnosis of osteoma and mucocele. The giant paranasal sinus osteoma prevented growth of the mucocele into orbital recess and extension into the orbital space and paranasal sinus. The mucocele disrupted the dura in the anterior cranial fossa, resulting in a giant cystic intracranial lesion. Frontal osteoplastic craniotomy was effective for exposing both lesions and plastic repair of the dural perforation to prevent cerebrospinal fluid leakage and secondary infection.

  10. Correlation of Acute and Late Brainstem Toxicities With Dose-Volume Data for Pediatric Patients With Posterior Fossa Malignancies.

    Science.gov (United States)

    Nanda, Ronica H; Ganju, Rohit G; Schreibmann, Edward; Chen, Zhengjia; Zhang, Chao; Jegadeesh, Naresh; Cassidy, Richard; Deng, Claudia; Eaton, Bree R; Esiashvili, Natia

    2017-06-01

    Radiation-induced brainstem toxicity after treatment of pediatric posterior fossa malignancies is incompletely understood, especially in the era of intensity modulated radiation therapy (IMRT). The rates of, and predictive factors for, brainstem toxicity after photon RT for posterior fossa tumors were examined. After institutional review board approval, 60 pediatric patients treated at our institution for nonmetastatic infratentorial ependymoma and medulloblastoma with IMRT were included in the present analysis. Dosimetric variables, including the mean and maximum dose to the brainstem, the dose to 10% to 90% of the brainstem (in 10% increments), and the volume of the brainstem receiving 40, 45, 50, and 55 Gy were recorded for each patient. Acute (onset within 3 months) and late (>3 months of RT completion) RT-induced brainstem toxicities with clinical and radiographic correlates were scored using Common Terminology Criteria for Adverse Events, version 4.0. Patients aged 1.4 to 21.8 years underwent IMRT or volumetric arc therapy postoperatively to the posterior fossa or tumor bed. At a median clinical follow-up period of 2.8 years, 14 patients had developed symptomatic brainstem toxicity (crude incidence 23.3%). No correlation was found between the dosimetric variables examined and brainstem toxicity. Vascular injury or ischemia showed a strong trend toward predicting brainstem toxicity (P=.054). Patients with grade 3 to 5 brainstem toxicity had undergone treatment to significant volumes of the posterior fossa. The results of the present series demonstrate a low, but not negligible, risk of brainstem radiation necrosis for pediatric patients with posterior fossa malignancies treated with IMRT. No specific dose-volume correlations were identified; however, modern treatment volumes might help limit the incidence of severe toxicity. Additional work investigating inherent biologic sensitivity might also provide further insight into this clinical problem. Copyright

  11. Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão Transillumination-guided study of the endoscopic anatomy of the lacrimal fossa

    Directory of Open Access Journals (Sweden)

    Luiz Artur Costa Ricardo

    2010-02-01

    Full Text Available A dacriocistorrinostomia é o tratamento de escolha para a obstrução do aparelho lacrimal. No final do século passado, o desenvolvimento da instrumentação endoscópica em cirurgia nasossinusal tornou viável sua realização por via endonasal. Entretanto, variações anatômicas tornam difícil a reprodutibilidade de uma técnica de abordagem endonasal. OBJETIVO: Estudar a anatomia endoscópica da fossa lacrimal através da transiluminação do canalículo comum. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram dissecadas 40 vias lacrimais de 20 cadáveres humanos, constando três etapas: 1 - identificação e dilatação do canalículo lacrimal. 2 - introdução do feixe de fibra óptica; 3 - dissecção endoscópica do saco lacrimal, descrevendo sua posição. RESULTADOS: A posição mais frequente do saco lacrimal foi entre a borda livre do corneto médio e sua inserção e imediatamente abaixo desta. A linha maxilar foi visualizada em 95% dos casos. A septoplastia foi necessária em 12,5%, uncifectomia em 35% e turbinectomia média em 7,5%. CONCLUSÃO: embora o saco lacrimal tenha mostrado uma localização mais frequente, sua posição variou consideravelmente. A transiluminação do canalículo comum mostrou-se útil, resolvendo o problema da variabilidade anatômica.Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. AIM: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. STUDY DESIGN: experimental. MATERIALS AND METHODS: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 - Optic fiber beam

  12. Signs of potential renewal of eruptive activity at La Fossa (Vulcano, Aeolian Islands)

    Science.gov (United States)

    Montalto, A.

    1996-04-01

    Since the end of the last magmatic eruption (1890), activity of La Fossa (southern Tyrrhenian Sea, Italy) has consisted of fumarolic emissions of fluctuating intensity. Fluids are discharged principally at two fumarolic fields located in the northern rim of the active crater and at the beach sited at its northern foot. Increased thermal, seismic and geochemical activity has been recorded since 1978, when an earthquake of M=5.5 occurred in the region. This paper combines available geophysical and geochemical information in order to develop a tentative interpretation of two episodes of apparent unrest which occurred in 1985 and 1987 1988, enhancing the risk of renewal of the eruptive activity. The 1985 unrest consisted essentially of a sharp build up of the internal pressure in the shallow hydrothermal system, which was induced by the injection of hot gases of magmatic origin. The crater fumaroles displayed significant increases in CO2 and other acid species, but their outlet temperature did not change. Conversely, the 1987 1988 episode was characterized by appreciable modifications at the crater fumaroles, with only secondary effects at the fumarole system of the beach. The sliding of part of the eastern flank of the La Fossa cone into the sea occurred on 20 April 1988, when the region was affected by crustal dilatation producing a seismic sequence of relatively high intensity. Both episodes of unrest were accompanied by increases of local microseismic activity, which affected the nothern sector of the island in 1985, and the southern one in 1988. Finally, a phase of appreciable areal contraction was detected in 1990, probably due to the effect of the cooling and crystallization of magma at relatively shallow depths, accompanying the increased thermal activity at the crater fumaroles. Regional tectonic stress seems to play an important role in the transition of the volcanic system from a phase of relative stability to a phase of apparent unrest, inducing the heating

  13. Curative analysis of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa

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    Yu-xiang MA

    2015-07-01

    Full Text Available Objective  The article analyzed the curative effect of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa to explore reasonable operation method.  Methods  Clinical data of 61 patients with non-solid hemangioblastoma who underwent surgeries in Tianjin Huanhu Hospital during July 2007 and June 2014 were retrospectively analyzed. According to surgical approaches and the situation of foramen magnum and atlas, these patients were divided into 5 groups: midline approach opening foramen magnum and atlas (Group A, midline approach without opening foramen magnum and atlas (Group B, paramedian approach opening foramen magnum and atlas (Group C, paramedian approach without opening foramen magnum and atlas (Group D, retrosigmoid approach (Group E. By collecting clinical symptoms, imaging findings, surgical records and postoperative complications, the surgical results and occurrence of postoperative complications were summarized and reasonable operation method was discussed.  Results  Among 61 patients, total resection was achieved in 56 cases (91.80%, and partial resection was achieved in 5 cases (8.20% . The postoperative remission rate of 43 cases with hydrocephalus was 79.07% (34/43. Intracranial infection was the most common postoperative complication, accounting for 22.95% (14/61. There was significant difference in occurrence rate of intracranial infection among 4 subgroups: opening or not opening the foramen magnum and atlas with or without restoring bone flap (Z = 16.269, P = 0.001. In the subgroup of not opening foramen magnum and atlas with restoring bone flap, the infection rate, which accounted for 6.90% (2/29, was the lowest.  Conclusions  The surgical treatment options for non-solid hemangioblastoma in posterior fossa should be done according to patients' condition, and performed by a professional group. If conditions allow, not to open the foramen magnum and atlas, as well as intraoperative

  14. Hydrology and Sedimentology of a Series of Dam-Breach Paleolakes at Idaeus Fossae, Mars

    Science.gov (United States)

    Salese, F.; Di Achille, G.; Ori, G. G.

    2014-12-01

    We report on the identification and geological study of a nearly 300-km-long valley system located westward of Idaeus Fossae, in Tempe Terra, Mars. The valley apparently originates from a subsided area surrounding the ejecta of a relatively fresh crater and after about 25 km from its source area enters a series of dam-breach paleolakes. The lake chain consists of six open basins (with associated fan-shaped sedimentary deposits) and covers an area of about 2500 sq. km over a E-W stretch of about 100 km. The latter lakes are interconnected and were likely coeval and drain eastward into a main 20-km-diameter crater-lake forming a complex and multilobate deltaic deposit whose front lies at about 1800-1820 m below the martian datum. The deltaic deposit is about 8-km-long and morphologically resembles the Jezero delta, showing a well-developed distributary pattern with evidence of channel switching on the delta plain. The floor of the crater-lake is not incised by the main valley, however a breach area is present along the eastern crater rim and consists of two spillover channels at about the same elevation of the crater inlet (-1820 m). These latter channels connect the crater lake to the eastward portion of the valley continuing towards Idaeus Fossae with a more than 180-km-long complex pattern of anabranching channels . We used high-resolution imagery and topography (HRSC, and CTX and HiRISE stereo pairs) to derive a geological-geomorphological map of the area and to understand its evolution. The extension and morphology of the observed fluvio-lacustrine features suggest relatively long-term (>103 yrs) formation timescales as also supported by the presence of the main fan delta in the central open basin. The overall water source for the 300-km-long fluvial system is unclear, though the occurrence of many rampart craters and the relationships between their ejecta and the channels suggest that subsurface volatiles might have also played an important role.

  15. Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa.

    Science.gov (United States)

    Gedik, Gonca Kara; Sari, Oktay; Köktekir, Ender; Akdemir, Gökhan

    2017-04-01

    Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms. Copyright © 2017. Published by Elsevier Taiwan.

  16. Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa

    Directory of Open Access Journals (Sweden)

    Gonca Kara Gedik

    2017-03-01

    Full Text Available Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms.

  17. Evaluation of articular cartilage thickness of the humeral head and the glenoid fossa by MR arthrography: anatomic correlation in cadavers

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, L.R. [Univ. of California, San Diego, CA (United States). Veterans Affairs Medical Center]|[Kaohsiung Veterans General Hospital (Taiwan, Province of China). Dept. of Radiology]|[National Yang-Ming Univ., Taipei (Taiwan, Province of China). Dept. of Radiology; Kwak, S.; Kim, Y.S.; Chou, D.S.W.; Muhle, C.; Skaf, A.; Trudell, D.; Resnik, D. [Univ. of California, San Diego, CA (United States). Veterans Affairs Medical Center

    1998-09-01

    To evaluate the accuracy of MR arthrography in determining the thickness of articular cartilage of the humeral head and glenoid fossa. Results. The correlation coefficients for MR arthrographic measurement versus anatomic measurement of the cartilage thickness were 0.7324 and 0.8757 for humeral head and glenoid fossa, respectively. With regard to the humeral head, there was a tendency to overestimate regions of thin cartilage and underestimate regions of thick cartilage. This tendency was not found in the assessment of glenoid cartilage. The mean of the absolute value of MR-anatomic differences was similar on the glenoid side (0.27 mm) and the humeral side (0.29 mm). The accuracy of measurement was significantly better on the glenoid side (Fisher`s r-to-Z transformation: Z=5.21, P=0.000001). (orig.)

  18. Longitudinal MRI assessment: the identification of relevant features in the development of Posterior Fossa Syndrome in children

    Science.gov (United States)

    Spiteri, M.; Lewis, E.; Windridge, D.; Avula, S.

    2015-03-01

    Up to 25% of children who undergo brain tumour resection surgery in the posterior fossa develop posterior fossa syndrome (PFS). This syndrome is characterised by mutism and disturbance in speech. Our hypothesis is that there is a correlation between PFS and the occurrence of hypertrophic olivary degeneration (HOD) in lobes within the posterior fossa, known as the inferior olivary nuclei (ION). HOD is exhibited as an increase in size and intensity of the ION on an MR image. Intra-operative MRI (IoMRI) is used during surgical procedures at the Alder Hey Children's Hospital, Liver- pool, England, in the treatment of Posterior Fossa tumours and allows visualisation of the brain during surgery. The final MR scan on the IoMRI allows early assessment of the ION immediately after the surgical procedure. The longitudinal MRI data of 28 patients was analysed in a collaborative study with Alder Hey Children's Hospital, in order to identify the most relevant imaging features that relate to the development of PFS, specifically related to HOD. A semi-automated segmentation process was carried out to delineate the ION on each MRI. Feature selection techniques were used to identify the most relevant features amongst the MRI data, demographics and clinical data provided by the hospital. A support vector machine (SVM) was used to analyse the discriminative ability of the selected features. The results indicate the presence of HOD as the most efficient feature that correlates with the development of PFS, followed by the change in intensity and size of the ION and whether HOD occurred bilaterally or unilaterally.

  19. Improved Visualization and Assessment of Condylar Position in the Glenoid Fossa for Different Occlusions: A CBCT Study.

    Science.gov (United States)

    Kaur, Amandeep; Natt, Amanpreet S; Mehra, Simranjeet K; Maheshwari, Karan; Singh, Gagandeep; Kaur, Amanjot

    2016-08-01

    The position of the condyle in the glenoid fossa plays an important role in the stability of occlusion after orthodontic treatment. Cone beam computed tomography (CBCT) provides an optimal imaging of the osseous components of the temporomandibular joint (TMJ) and give a full size truly three-dimensional (3D) description in real anatomical size. The present study aimed to visualize and compare the position of condyle in the glenoid fossa for different occlusions by using CBCT Materials and methods: Cone beam computed tomographic images of 45 subjects, aged 18 to 42 years, were evaluated. Subjects were equally divided into three groups according to the A point, nasion, B point (ANB) angle. In the sagittal plane, condyle is positioned nonconcen-trically; positioned anteriosuperiorly in class I and III occlusions and lies posteriosuperiorly in class II occlusion. In the frontal plane, condyle is positioned centrally (mediolaterally) in all the three types of occlusions. In the axial plane, the parameters showed significant difference between the different occlusions. No statistical significant distinction could be made in the position of the condyle when comparing the right and left joints. The position of condyle in glenoid fossa influences sagittal, transverse, and vertical relationships of the jaws which eventually contribute to development of various malocclusions. Nonconcentricity is the feature of the condyle in the sagittal plane in different malocclusions. An important consideration in orthodontic treatment is the recognition of the importance that the dentition should be in harmony with the related musculoskeletal structures. Therefore, the condylar position is an important concern in maintaining or restoring temporomandibular harmony with the dentition and the position of the condyle in the glenoid fossa plays an important role in the stability of occlusion after orthodontic treatment.

  20. Torsion of an Abdominal-Wall Pedunculated Lipoma: A Rare Differential Diagnosis for Right Iliac Fossa Pain

    OpenAIRE

    2013-01-01

    Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a r...

  1. PPF-reinforced, ESP-lightened gypsum plaster

    Directory of Open Access Journals (Sweden)

    García Santos, A.

    2009-03-01

    Full Text Available A new construction material has been obtained by adding aggregate to gypsum plaster which, without reducing the bending strength of plain gypsum plaster without aggregates, lowers its density, and consequently the weight of the construction elements made from the agglomerated material, by half.The aggregates used were expanded polystyrene beads and short polypropylene fibre.The new material addresses one of the issues of cardinal interest in construction materials and construction element research, namely the need to lighten materials so as to ease the burden on buildings’ bearing structures while facilitating assembly of construction units, by a single worker wherever possible.With a water / binder ratio of 0.7 and 2% (by weight of plaster of expanded polystyrene and 2% of polypropylene fibre aggregates, the decline in density achieved was 50,88% over plain gypsum plaster and 32.88% over plasterboard.Se ha obtenido un nuevo material de construcción aditivando el yeso o la escayola, mediante la incorporación de agregados, de modo que sin reducir la resistencia a flexotracción de una escayola sin ningún tipo de adición, reduce su densidad a la mitad, y por tanto, el peso de los elementos constructivos que puedan realizarse basándose en él.El material está compuesto por una adición de gránulos de poliestireno expandido y fibras cortadas de polipropileno.El nuevo material incide sobre aquellos aspectos de más interés en el campo de la investigación en construcción, en donde se intenta reducir el peso de los materiales, de modo que se grave lo menos posible la estructura resistente de las edificaciones, a la par que se facilitan los procedimientos de montaje de las unidades constructivas, al poder ser manejadas por un solo operario.La escayola, con relación de agua/conglomerante de 0,7, y con adiciones del 2% en peso (sobre la cantidad de escayola, tanto de poliestireno expandido como de fibras de polipropileno, permite reducir la densidad en un 50,88% sobre los valores de una escayola sin ningún tipo de adición y de un 32,88% con respecto a las placas de yeso laminado.

  2. I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery

    Directory of Open Access Journals (Sweden)

    Chaoliang Tang

    2015-01-01

    patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients. Methods. Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT or I-gel facilitated endotracheal tube intubation (Group TI. Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared. Results. Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P<0.05 versus Group TT. Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasma β-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI. Conclusion. Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery.

  3. Fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa: case report with radiological findings.

    Science.gov (United States)

    Lee, D H; Kim, S K; Joo, Y E; Lim, S C

    2012-02-01

    We report an extremely rare case of a fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa. A 62-year-old woman was referred for evaluation of a mass lesion in the left sphenoid sinus and infratemporal fossa. Endoscopic examination of the nasal cavity was unremarkable. Computed tomography showed a non-enhancing, expansile mass with calcifications in the sphenoid and infratemporal fossa; T2-weighted magnetic resonance imaging revealed marked hypointense signals within the sphenoid sinus mass, with an intermediate signal intensity. A presumptive diagnosis of a mucocele was made. During surgery, a profuse amount of yellow fluid was drained from the mucocele. Clay-like material was noted within the mucocele, corresponding to the hypointense magnetic resonance imaging signals; this was identified as aspergillus on histopathological examination. Radiological findings for a fungus ball within a mucocele can be similar to those for allergic fungal sinusitis, which shows mixed low and high attenuation on computed tomography and low-signal intensity on T2-weighted magnetic resonance imaging, within an expansile, cystic lesion. Although an association between a fungus ball and a mucocele is rare in the paranasal sinuses, this disease entity should be considered in the differential diagnosis of expansile, cystic sinus lesions.

  4. Estenose da fossa intercondilar após estabilização articular com retalho de fáscia lata em cães Intercondylar fossa stenosis after joint stabilization using a fascial strip in dogs

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    André Luis Selmi

    2012-01-01

    Full Text Available Determinaram-se os índices de largura da fossa intercondilar (FI, após transecção do ligamento cruzado cranial em nove cães adultos submetidos à estabilização articular com retalho de fáscia lata. Os joelhos foram alocados em dois grupos, sendo o joelho direito (GI submetido à incisuroplastia troclear (ITR e posterior estabilização articular, e o joelho esquerdo submetido somente à substituição ligamentar (GC. Cada grupo foi dividido em três subgrupos correspondentes aos momentos de eutanásia aos 30, 90 e 180 dias de pós-operatório. Os índices de largura da FI foram determinados, macroscópica e radiograficamente, pela mensuração da abertura cranial da FI nos terços cranial, médio e caudal, e indexados em relação à largura epicondilar. Observou-se aumento significativo dos índices macroscópicos e radiográficos nas articulações do GI, sendo estes estatisticamente diferentes daqueles das articulações de GC. Não foi observada estenose intercondilar nos joelhos de GC após a estabilização articular. Conclui-se que a estabilização articular com retalho de fáscia lata preveniu a estenose da fossa intercondilar, e que a ITR promoveu o alargamento permanente dessa estrutura.Intercondylar fossa width indexes (IFWI were determined in nine adult dogs submitted to intercondylar notchplasty (IN after transection of the cranial cruciate ligament (CCL followed by a fascial strip stabilization. The right stifle was submitted to IN followed by fascial strip reconstruction of the CCL (GI while in the left stifle IN was not performed (GC. Each group was then divided into three subgroups which corresponded to time of euthanasia at 30, 90 and 180 days after surgery. IFWI were determined, both macroscopically and radiographically, by measuring the cranial outlet of the intercondylar fossa in relation to the epicondylar width. A significant increase was observed in indexes of GI following IN, and these differed from indexes of

  5. Imaging of lesions in the posterior cranial fossa using single photon emission computed tomography

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    Kawakami, Michiro; Uesugi, Yasuo; Higashikawa, Masahiko; Ochi, Mari; Makimoto, Kazuo; Takahashi, Hiroaki; Shin, Akinori; Utsunomiya, Keita; Akagi, Hiroaki

    1988-10-01

    Lesions in the posterior cranial fossa were visualized by single photon emission computed tomography (SPECT) with /sup 123/I-IMP (N-isopropyl-p-/sup 123/I-iodoamphetamine) and /sup 99m/Tc-HM-PAO (/sup 99m/Tc-hexametylpropyleneamine oxime). It is generally held that these radiopharmaceuticals penetrate the walls of cerebral blood vessels and that their accumulations in the brain tissue may reflect the cerebral blood flow. Six patients with lesions in the central nervous system all showed wider areas of abnormality in SPECT than in X-ray CT, indicating a larger lesion of blood flow disturbance. In the next series of 11 patients with vertigo or dizziness of unknown etiology, eight had abnormal findings in the scan with /sup 123/I-IMP as did four of the nine in the scan with /sup 99m/Tc-HM-PAO. Thus, most patients with dizziness of unknown etiology may have some vertebral blood flow disorder, which in some cases is not clearly diagnosed by conventional vestibular examinations or even by X-ray CT scan. The accuracy of the diagnostic measures for otoneurological problems awaits further studies of their sensitivity and specificity.

  6. Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus.

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    Verit, Ayhan; Savas, Murat; Ciftci, Halil; Unal, Dogan; Yeni, Ercan; Kaya, Mete

    2006-02-01

    Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.

  7. [Ethmoid sinus mucocele penetrating to the orbit and anterior cranial fossa - case report].

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    Paradowska-Opałka, Beata; Kawczyński, Maciej; Jaworowska, Ewa

    2013-01-01

    Paranasal sinus mucocele is the cystic formation lined by inflammatory changed mucoperiosteum. This is slow-growing pathology with a tendency to bone erosion. The symptoms are dependent on the direction of the penetration, and are as follows: increasing headaches, deformations of frontal or orbital region, ophthalmic manifestations such as lacrimation, decreased visual acuity, exophthalmos, ocular movement limitation, diplopia. The most common location of the mucocele is fronto-ethmoid region. The most useful diagnostic tests are a magnetic resonance imaging (MRI) and a computed tomography (CT) which show the progress of the disease and bone destructions. Surgery is the only method of treatment (external approach or FESS). This paper reports the case of a 74-year-old woman with ethmoid mucocele penetrating into the orbit, frontal sinus and anterior cranial fossa with compression of frontal lobe of the brain. The patient underwent CT and MRI and was treated with endoscopic intranasal marsupialization of the cyst. There are no clinical signs of disease recurrence 7 months after surgery. The endoscopic surgical management in treatment of sinus mucocele is a good alternative to the operation from external approach because of its low invasiveness, low complication risk, rapid healing and good therapeutic effects. Copyright © 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  8. Origin of the Medusae Fossae Formation, Mars: Insights from a synoptic approach

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    Mandt, Kathleen E.; de Silva, Shanaka L.; Zimbelman, James R.; Crown, David A.

    2008-12-01

    The geologic origin of the Medusae Fossae Formation (MFF) has remained a mystery despite three decades of research. To better constrain its formation, an in-depth analysis of observations made in the literature was combined with a new survey of over 700 Mars Orbiter Camera narrow-angle images of the MFF to identify morphologic characteristics and material properties that define this formation as a whole. While previous work has identified clear agreement on some characteristics, our analysis identifies yardangs, collapse features, and layering as pervasive features of the MFF. Whereas collapse features and layering may implicate several different physical and chemical processes, yardangs provide vital information on material properties that inform about mechanical properties of the MFF lithology. Aspect ratios of megayardangs range from 3:1 to 50:1, and slope analyses reveal heights of up to 200 m with cliffs that are almost vertical. Other yardangs show lower aspect ratios and topographic profiles. These characteristics coupled to the presence of serrated margins, suggest that MFF lithology must be of weakly to heavily indurated material that lends itself to jointing. The characteristics and properties of the MFF are inconsistent with those of terrestrial pyroclastic fall deposits or loess, but are in common with large terrestrial ignimbrites, a hypothesis that explains all key observations with a single mechanism. Yardang fields developed in regionally extensive ignimbrite sheets in the central Andes display morphologic characteristics that correlate with degree of induration of the host lithology and suggest an origin by pyroclastic flow for the MFF.

  9. HiRISE views enigmatic deposits in the Sirenum Fossae region of Mars

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    Grant, John A.; Wilson, Sharon A.; Noe Dobrea, Eldar; Fergason, Robin L.; Griffes, Jennifer L.; Moore, Jeffery M.; Howard, Alan D.

    2010-01-01

    HiRISE images together with other recent orbital data from Mars define new characteristics of enigmatic Hesperian-aged deposits in Sirenum Fossae that are mostly 100-200 m thick, drape kilometers of relief, and often display generally low relief surfaces. New characteristics of the deposits, previously mapped as the "Electris deposits," include local detection of meter-scale beds that show truncating relationships, a generally light-toned nature, and a variably blocky, weakly indurated appearance. Boulders shed by erosion of the deposits are readily broken down and contribute little to talus. Thermal inertia values for the deposits are ˜200 J m -2 K -1 s -1/2 and they may incorporate hydrated minerals derived from weathering of basalt. The deposits do not contain anomalous amounts of water or water ice. Deflation may dominate degradation of the deposits over time and points to an inventory of fine-grained sediment. Together with constraints imposed by the regional setting on formation processes, these newly resolved characteristics are most consistent with an eolian origin as a loess-like deposit comprised of redistributed and somewhat altered volcanic ash. Constituent sediments may be derived from airfall ash deposits in the Tharsis region. An origin directly related to airfall ash or similar volcanic materials is less probable and emplacement by alluvial/fluvial, impact, lacustrine, or relict polar processes is even less likely.

  10. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

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    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.

  11. Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients.

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    Sheng, Han-Song; You, Chao-Guo; Yang, Liang; Zhang, Nu; Lin, Jian; Lin, Fen-Chun; Wang, Mao-De

    2017-08-01

    Posterior fossa epidural hematomas (PFEDH) are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgical procedure less invasive by treating selected pediatric patients with trephination mini-craniectomy. We retrospectively reviewed the clinical courses, radiological findings, surgical procedures, and prognoses of the pediatric patients who were treated in our departments for traumatic PFEDH from January 2010 to January 2015. During this period, a total of 17 patients were surgically treated for PFEDH and 7 were managed with trephination mini-craniectomy for hematoma evacuation. The outcomes were good in all 7 patients as evaluated with Glasgow Outcome Score. There was no mortality in this series. The on average 30-month clinical follow-up showed that patients experienced satisfactory recoveries without complications. Our results suggest that trephination mini-craniectomy is a safe surgical technique for selected PFEDH patients with moderate hematoma volume and stabilized neurological functions. However, standard craniectomy is recommend when there are rapid deteriorations in patients' neurological functions or the hematomas are large and exerted severe mass effects. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  12. Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases

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    Kueker, W. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Mull, M. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Thron, A. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany)

    1997-08-01

    Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab.

  13. Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases

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    MR Etemadifar

    2005-05-01

    Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

  14. Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy

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    Brian O’Sullivan

    2012-01-01

    Full Text Available Tumefactive fibroinflammatory lesion (TFIL is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in tumor size was noted over the course of years and she is free of disease after more than 11 years of follow-up. The major longterm side effect this patient developed was an expected unilateral radiation-induced retinopathy, due to the close proximity of the lesion to the orbit. The dilemma of treatment of benign disease with radiation with potential long-term complications is discussed and a review of the literature on TFIL is presented.

  15. Dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour.

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    Cornwell, Petrea L; Murdoch, Bruce E; Ward, Elizabeth C; Morgan, Angela

    2003-01-01

    The current case report provides a comprehensive description of the persistent dysarthria and dysphagia evident in a 7.5 year old child treated for recurrent posterior fossa tumour (PFT). AC was assessed on a comprehensive perceptual and instrumental test battery incorporating all components of the speech production system (respiration, phonation, resonance, articulation and prosody) 2 years and 4 months following completion of her treatment. The nature of her swallowing impairment was investigated through the use of videofluoroscopic evaluation of swallowing (VFS). A mild dysarthria with ataxic and LMN components was identified, although overall speech intelligibility was not affected. A moderate dysphagia was also identified with impairment in all three phases of the swallowing process; oral preparatory, oral and pharyngeal. Dysarthria and dysphagia as persistent sequelae in children treated for PFT have implications for the long-term management of these children. The need for appropriate treatment regimes, as well as pre-surgical counselling regarding dysarthria and dysphagia as possible outcomes following surgery are highlighted.

  16. A report of the anesthesia in posterior fossa operations in the sitting position in 55 patients

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    Jahanguiri B

    1994-04-01

    Full Text Available In this survey, 55 patients were studied in a period of six years for having the anesthesia in the sitting position. In this position, the surgeon will had a better access to the location, whose damages have been sustained, so less damages would be given to the healthy tissues. For the patients, due to their critical general conditions, one week prior to giving anesthesia to the posterior fossa, operation in the sitting position the right ventriculoatiral shunt was placed. For preventing the fall of blood pressure, a bandage was placed in the lower limbs after inducing anesthesia and changing supine position to sitting position. Before the induction, central venous pressure was measured for treating the air embolism. The head of catheter was placed inside the right atrial. Premedications such as atropine, pethidine, and inductive agents like thiopenton, and muscle relaxants, maintained with halothane and nitrous oxide. All of the patients endured this condition without the fall of blood pressure and air embolism

  17. Cerberus Fossae and Elysium Planitia Lavas, Mars: Source Vents, Flow Rates, Edifice Styles and Water Interactions

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    Sakimoto, S. E. H.; Gregg, T. K. P.

    2004-01-01

    The Cerberus Fossae and Elysium Planitia regions have been suggested as some of the youngest martian surfaces since the Viking mission, although there was doubt whether the origins were predominantly volcanic or fluvial. The Mars Global Surveyor and Mars Odyssey Missions have shown that the region is certainly young in terms of the topographic preservation and the youthful crater counts (e.g. in the tens to a few hundred million yrs.). Numerous authors have shown that fluvial and volcanic features share common flow paths and vent systems, and that there is evidence for some interaction between the lava flows and underlying volatiles as well as the use by lavas and water of the same vent system. Given the youthful age and possible water-volcanism interaction environment, we'd like constraints on water and volcanic flux rates and interactions. Here, we model ranges of volcanic flow rates where we can well-constrain them, and consider the modest flow rate results results in context with local eruption styles, and track vent locations, edifice volumes, and flow sources and data.

  18. High-resolution MRI of cranial nerves in posterior fossa at 3.0 T

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    Zi-Yi Guo; Jing Chen; Qi-Zhou Liang; Hai-Yan Liao; Qiong-Yue Cheng; Shui-Xi Fu; Cai-Xiang Chen; Dan Yu

    2013-01-01

    Objective:To evaluate the influence of high-resolution imaging obtainable with the higher field strength of3.0T on the visualization of the brain nerves in the posterior fossa.Methods:In total,20 nerves were investigated onMRI of12 volunteers each and selected for comparison, respectively, with theFSE sequences with5 mm and2 mm section thicknesses and gradient recalled echo(GRE) sequences acquired with a3.0-T scanner.TheMR images were evaluated by three independent readers who rated image quality according to depiction of anatomic detail and contrast with use of a rating scale.Results:In general, decrease of the slice thickness showed a significant increase in the detection of nerves as well as in the image quality characteristics. ComparingFSE andGRE imaging, the course of brain nerves and brainstem vessels was visualized best with use of the three-dimensional(3D) pulse sequence.Conclusions:The comparison revealed the clear advantage of a thin section.The increased resolution enabled immediate identification of all brainstem nerves.GRE sequence most distinctly and confidently depicted pertinent structures and enables3D reconstruction to illustrate complex relations of the brainstem.

  19. Sleep Apnea Syndrome after Posterior Fossa Surgery: A Case of Acquired Ondine's Curse

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    Elnaz Faraji rad

    2015-01-01

    Full Text Available Introduction: Ondine’s Curse is a catastrophic but rare condition in adults. It is referred to as a congenital or acquired condition, in which the patient cannot breathe automatically while asleep. Acquired causes of this disease can be any cause affecting the ventrolateral part of the medulla, which is considered to be the breathing center in humans.    Case Report:   A 51-year-old woman, with ataxia and the symptoms and signs of rising Intra-Cranial Pressure, who underwent ventriculoperitoneal shunting and removal of tumour, developed episodic apnea during sleep after surgery and hypercapnia when awake. In her post-operative CT scan, some fine spots of hypodensity in the left lateral part of the medulla were observed. She was managed pharmacologically and underwent tracheotomy. After 50 days, she was discharged from the hospital when she was able to breathe normally.   Conclusion:  Having experience with this condition after resection of a fourth ventricle tumor, it was found that Ondine’s Curse can be considered as one of the complications of  posterior fossa surgery and is curable by proper management.

  20. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo

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    Emin Mehmet Ceylan

    2016-01-01

    Full Text Available Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient’s vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient.

  1. Factors associated with spinal fusion after posterior fossa decompression in pediatric patients with Chiari I malformation and scoliosis.

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    Mackel, Charles E; Cahill, Patrick J; Roguski, Marie; Samdani, Amer F; Sugrue, Patrick A; Kawakami, Noriaki; Sturm, Peter F; Pahys, Joshua M; Betz, Randal R; El-Hawary, Ron; Hwang, Steven W

    2016-12-01

    OBJECTIVE The authors performed a study to identify clinical characteristics of pediatric patients diagnosed with Chiari I malformation and scoliosis associated with a need for spinal fusion after posterior fossa decompression when managing the scoliotic curve. METHODS The authors conducted a multicenter retrospective review of 44 patients, aged 18 years or younger, diagnosed with Chiari I malformation and scoliosis who underwent posterior fossa decompression from 2000 to 2010. The outcome of interest was the need for spinal fusion after decompression. RESULTS Overall, 18 patients (40%) underwent posterior fossa decompression alone, and 26 patients (60%) required a spinal fusion after the decompression. The mean Cobb angle at presentation and the proportion of patients with curves > 35° differed between the decompression-only and fusion cohorts (30.7° ± 11.8° vs 52.1° ± 26.3°, p = 0.002; 5 of 18 vs 17 of 26, p = 0.031). An odds ratio of 1.0625 favoring a need for fusion was established for each 1° of increase in Cobb angle (p = 0.012, OR 1.0625, 95% CI 1.0135-1.1138). Among the 14 patients older than 10 years of age with a primary Cobb angle exceeding 35°, 13 (93%) ultimately required fusion. Patients with at least 1 year of follow-up whose curves progressed more 10° after decompression were younger than those without curve progression (6.1 ± 3.0 years vs 13.7 ± 3.2 years, p = 0.001, Mann-Whitney U-test). Left apical thoracic curves constituted a higher proportion of curves in the decompression-only group (8 of 16 vs 1 of 21, p = 0.002). CONCLUSIONS The need for fusion after posterior fossa decompression reflected the curve severity at clinical presentation. Patients presenting with curves measuring > 35°, as well as those greater than 10 years of age, may be at greater risk for requiring fusion after posterior fossa decompression, while patients less than 10 years of age may require routine monitoring for curve progression. Left apical thoracic curves

  2. The Vindija Neanderthal scapular glenoid fossa: comparative shape analysis suggests evo-devo changes among Neanderthals.

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    Di Vincenzo, Fabio; Churchill, Steven E; Manzi, Giorgio

    2012-02-01

    Although the shape of the scapular glenoid fossa (SGF) may be influenced by epigenetic and developmental factors, there appears to be strong genetic control over its overall form, such that variation within and between hominin taxa in SGF shape may contain information about their evolutionary histories. Here we present the results of a geometric morphometric study of the SGF of the Neanderthal Vi-209 from Vindjia Cave (Croatia), relative to samples of Plio-Pleistocene, later Pleistocene, and recent hominins. Variation in overall SGF shape follows a chronological trend from the plesiomorphic condition seen in Australopithecus to modern humans, with pre-modern species of the genus Homo exhibiting intermediate morphologies. Change in body size across this temporal series is not linearly directional, which argues against static allometry as an explanation. However, life history and developmental rates change directionally across the series, suggesting an ontogenetic effect on the observed changes in shape (ontogenetic allometry). Within this framework, the morphospace occupied by the Neanderthals exhibits a discontinuous distribution. The Vindija SGF and those of the later Near Eastern Neanderthals (Kebara and Shanidar) approach the modern condition and are somewhat segregated from both northwestern European (Neandertal and La Ferrassie) and early Mediterranean Neanderthals (Krapina and Tabun). Although more than one scenario may account for the pattern seen in the Neanderthals, the data is consistent with palaeogenetic evidence suggesting low levels of gene flow between Neanderthals and modern humans in the Near East after ca. 120-100 ka (thousands of years ago) (with subsequent introgression of modern human alleles into eastern and central Europe). Thus, in keeping with previous analyses that document some modern human features in the Vindija Neanderthals, the Vindija G(3) sample should not be seen as representative of 'classic'--that is, unadmixed, pre

  3. Changes in cerebrospinal fluid flow assessed using intraoperative MRI during posterior fossa decompression for Chiari malformation.

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    Bond, Aaron E; Jane, John A; Liu, Kenneth C; Oldfield, Edward H

    2015-05-01

    OBJECT The authors completed a prospective, institutional review board-approved study using intraoperative MRI (iMRI) in patients undergoing posterior fossa decompression (PFD) for Chiari I malformation. The purpose of the study was to examine the utility of iMRI in determining when an adequate decompression had been performed. METHODS Patients with symptomatic Chiari I malformations with imaging findings of obstruction of the CSF space at the foramen magnum, with or without syringomyelia, were considered candidates for surgery. All patients underwent complete T1, T2, and cine MRI studies in the supine position preoperatively as a baseline. After the patient was placed prone with the neck flexed in position for surgery, iMRI was performed. The patient then underwent a bone decompression of the foramen magnum and arch of C-1, and the MRI was repeated. If obstruction was still present, then in a stepwise fashion the patient underwent dural splitting, duraplasty, and coagulation of the tonsils, with an iMRI study performed after each step guiding the decision to proceed further. RESULTS Eighteen patients underwent PFD for Chiari I malformations between November 2011 and February 2013; 15 prone preincision iMRIs were performed. Fourteen of these patients (93%) demonstrated significant improvement of CSF flow through the foramen magnum dorsal to the tonsils with positioning only. This improvement was so notable that changes in CSF flow as a result of the bone decompression were difficult to discern. CONCLUSIONS The authors observed significant CSF flow changes when simply positioning the patient for surgery. These results put into question intraoperative flow assessments that suggest adequate decompression by PFD, whether by iMRI or intraoperative ultrasound. The use of intraoperative imaging during PFD for Chiari I malformation, whether by ultrasound or iMRI, is limited by CSF flow dynamics across the foramen magnum that change significantly when the patient is

  4. Dosimetry and field matching for radiotherapy to the breast and superclavicular fossa

    Science.gov (United States)

    Winfield, Elizabeth

    Radiotherapy for early breast cancer aims to achieve local disease control and decrease loco-regional recurrence rates. Treatment may be directed to breast or chest wall alone or, include regional lymph nodes. When using tangential fields to treat the breast a separate anterior field directed to the axilla and supraclavicular fossa (SCF) is needed to treat nodal areas. The complex geometry of this region necessitates matching of adjacent radiation fields in three dimensions. The potential exists for zones of overdosage or underdosage along the match line. Cosmetic results may be compromised if treatment fields are not accurately aligned. Techniques for field matching vary between centres in the UK. A study of dosimetry across the match line region using different techniques, as reported in the multi-centre START Trial Quality Assurance (QA) programme, was undertaken. A custom-made anthropomorphic phantom was designed to assess dose distribution in three dimensions using film dosimetry. Methods with varying degrees of complexity were employed to match tangential and SCF beams. Various techniques combined half beam blocking and machine rotations to achieve geometric alignment. Matching of asymmetric beams allowed a single isocentre technique to be used. Where field matching was not undertaken a gap between tangential and SCF fields was employed. Results demonstrated differences between techniques in addition to variations within the same technique between different centres. Geometric alignment techniques produced more homogenous dose distributions in the match region than gap techniques or those techniques not correcting for field divergence. For this multi-centre assessment of match plane techniques film dosimetry used in conjunction with a breast shaped phantom provided relative dose information. This study has highlighted the difficulties of matching treatment fields to achieve homogenous dose distribution through the region of the match plane and the degree of

  5. Amyloidoma Involving the Orbit, Meckel's Cave and Infratemporal Fossa: 3T MRI Findings.

    Science.gov (United States)

    Menetti, F; Bartolomei, I; Ambrosini-Spaltro, A; Salvi, F; Agati, R; Leonardi, M

    2009-03-23

    Amyloidoma is a rare lesion characterized by tissue deposition of an abnormal fibrillary protein (amyloid). It is the focal and localized counterpart of systemic amyloidosis, where the deposition of amyloid diffusely involves several organs. The few literature reports of intracranial amyloidomas include lesions involving the pituitary gland, orbit, cerebral hemispheres, temporal bone, cerebellopontine angle and jugular foramen. We describe the case of a 27-year-old woman presenting with painless slowly progressive proptosis of the right eye. The patient underwent a contrast-enhanced CT study of the head, followed by 3T MRI which disclosed a homogeneous mass in the right Meckel's cave and cavernous sinus, extending through an enlarged foramen ovale to the infratemporal fossa. The right optic nerve and ocular muscles were enlarged and infiltrated along with the retrobulbar fat by contrast-enhancing tissue. Thin contrast-enhanced MRI scans through the area of interest showed the mass to extend posterior to the gasserian ganglion, involving the cerebellopontine angle cistern, where the intracisternal parts of the III, V, and VI nerves bilaterally appeared enlarged and showed perineural enhancement. The lesion closely mimicked a malignant tumor with perineural tumor infiltration, so we performed fine needle biopsy of the portion of the lesion near the right foramen ovale under fluoroscopic guidance. Histopathology revealed that the lesion was an amyloidoma. Further clinical and blood examinations, serum chemistry, followed by biopsy of the periumbilical fat showed no signs of systemic amyloidosis or an underlying inflammatory or neoplastic disorder. No further treatment was instituted, follow-up MRI six months later showed no enlargement of the mass.

  6. Posterior cranial fossa single-hole arteriovenous fistulae in children: 14 consecutive cases

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Y.; Weon, Y.C.; Sachet, M.; Mahadevan, J.; Alvarez, H.; Rodesch, G.; Lasjaunias, P. [Service de Neuroradiologie Diagnostique et Therapeutique, CHU de Bicetre, 78 rue du General Leclerc, 94275, Le Kremlin Bicetre (France)

    2004-06-01

    We report 14 consecutive children with 23 posterior cranial fossa arteriovenous fistula (AVF); six had multifocal lesions, involving the supratentorial brain in three and the spinal cord in one. There were two boys and four girls with a family history compatible with hereditary haemorrhagic telangiectasia. The diagnosis was made in infancy in eight cases and in a further six before the age of 12 years; mean age at diagnosis was 3.5 years. The male-to-female ratio was 1.8:1. Presenting features were macrocrania in four cases, haemorrhage or headache in three and nonhaemorrhagic neurological deficits or and cardiac overload in two. Dominant supply to the symptomatic fistula arose from the posterior inferior cerebellar artery in five cases, anterior inferior cerebellar artery in two and the upper basilar artery system in seven. All children were primarily treated by transarterial embolisation. We treated thirteen children (93%) by transarterial embolisation alone; one older child with a history of haemorrhage also underwent radiosurgery. We obtained 100% exclusion of the fistula(e) in six children, 95-80% in five, 80-50% in one and <50% in one. Of the incompletely treated cases, three had conservative management, and two with 80% and one with 60% reduction of their lesion are scheduled for elective treatment; two partially treated case died. There was no morbidity due to the endovascular procedures. Follow-up since referral is 6 months-10 years (mean 4.5 years). Ten children are neurologically normal, two have persistent (pre-existing) neurological deficits and two are dead. (orig.)

  7. Clock face model applied to tibial intraneural ganglia in the popliteal fossa

    Energy Technology Data Exchange (ETDEWEB)

    Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Orthopedics, Rochester, MN (United States); Mayo Clinic, Rochester, MN (United States); Hebert-Blouin, Marie-Noelle [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Maniker, Allen H. [Beth Israel Hospital, Department of Neurosurgery, New York, NY (United States); Amrami, Kimberly K. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2009-07-15

    Tibial intraneural ganglia occurring in the popliteal fossa are often misdiagnosed because of their relative rarity. Their joint connection is typically not recognized and therefore not treated, leading to recurrence. This is a retrospective clinical study. Magnetic resonance images (MRIs) of six patients with confirmed tibial intraneural ganglia arising from the superior tibiofibular joint were analyzed and were compared to ten individuals with normal tibial nerves who were imaged with MRI. All studies were interpreted as left-sided. A previously designed clock face model introduced for peroneal intraneural ganglia was used to describe the superior tibiofibular joint connection (tail sign). A single axial image was sought to determine the normal anatomic and pathologic relationships of the tibial nerve and tibial articular branch to the superior tibiofibular joint. In all patients with intraneural ganglia, a single conventional axial image at the mid-fibular head level could reliably demonstrate: (1) intraneural cyst within the articular branch at the superior tibiofibular joint connection (tail sign) between 8 and 9 o'clock and intraneural cyst within the tibial nerve, (2) the central location of the tibial nerve posterior to the tibia, and (3) popliteus muscle denervation changes and atrophy (popliteus sign). This technique can provide radiologists and surgeons with rapid and reproducible information for diagnosis and treatment planning of tibial intraneural ganglia. Similar to its use with the clock face model in peroneal intraneural ganglia, a standard axial image at the mid-fibular head level can be used to interpret key features of tibial intraneural ganglia and identify the joint connection. Improved identification of the presence of a joint connection will change the therapeutic approach of this pathology and reduce cyst recurrences. (orig.)

  8. Avaliação textural por ressonância magnética dos tumores da fossa posterior em crianças Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood

    Directory of Open Access Journals (Sweden)

    Joelson Alves dos Santos

    2004-08-01

    Full Text Available OBJETIVO: Possibilitar a distinção entre tecidos sãos e patológicos em pacientes da faixa etária pediátrica portadores de tumores da fossa posterior, por meio da análise de parâmetros texturais calculados a partir de imagens de ressonância magnética. MATERIAIS E MÉTODOS: Foram analisados 14 pacientes da faixa etária pediátrica, portadores de tumores da fossa posterior, através da definição dos valores texturais das regiões de interesse representando tecidos sãos e patológicos, com base em imagens de ressonância magnética pesadas em T2 pelo "software" MaZda. RESULTADOS: Houve diferença estatisticamente significativa entre os tecidos normal e tumoral, bem como entre os tecidos presumidamente normais adjacentes e distantes da lesão. Não foi possível a distinção entre edema e tumor. CONCLUSÃO: A avaliação textural por ressonância magnética é uma técnica útil para a determinação de diferenças entre diversos tipos de tecidos, inclusive entre áreas de tecidos presumidamente normais à análise visual.OBJECTIVE: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. MATERIALS AND METHODS: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. RESULTS: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. CONCLUSION: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis.

  9. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares

    Directory of Open Access Journals (Sweden)

    Manoel Antonio de Paiva-Neto

    2010-06-01

    Full Text Available The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%. All tumors were histologically benign. Two patients (8% experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%. One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months, with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações no tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%. Todos os tumores eram histologicamente benignos. Dois pacientes (8% apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%. Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (m

  10. Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hamamoto, Yoshioki; Nakajima, Tamio; Hayashi, Takafumi [Niigata Univ. (Japan). School of Dentistry

    1994-12-01

    Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author).

  11. Normobaric hyperoxia for treatment of pneumocephalus after posterior fossa surgery in the semisitting position: a prospective randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Bujung Hong

    Full Text Available Supratentorial pneumocephalus after posterior fossa surgery in the semisitting position may lead to decreased alertness and other symptoms. We here aimed to prove the efficacy of normobaric hyperoxia on the absorption of postoperative pneumocephalus according to a standardized treatment protocol.We enrolled 44 patients with postoperative supratentorial pneumocephalus (> 30 ml after posterior fossa surgery in a semisitting position. After randomisation procedure, patients received either normobaric hyperoxia at FiO2 100% over an endotracheal tube for 3 hours (treatment arm or room air (control arm. Routine cranial CT scans were performed immediately (CT1 and 24 hours (CT2 after completion of surgery and were rated without knowledge of the therapy arm. Two co-primary endpoints were assessed: (i mean change of pneumocephalus volume, and (ii air resorption rate in 24 hours. Secondary endpoints were subjective alertness (Stanford Sleepiness Scale postoperatively and attention (Stroop test, which were evaluated preoperatively and 24 hours after surgery. The mean change in pneumocephalus volume was higher in patients in the treatment arm as compared to patients in the control arm (p = 0.001. The air resorption rate was higher in patients in the treatment arm as compared to patients in the control arm (p = 0.0015. Differences were more pronounced in patients aged 52 years and older. No difference between patients in treatment arm and control arm was observed for the Stroop test. The distribution of scores in the Stanford Sleepiness Scale differed in the treatment arm as compared to the control arm, and there was a difference in mean values (p = 0.015.Administration of normobaric hyperoxia at FiO2 100% via an endotracheal tube for 3 hours is safe and efficacious in the treatment of pneumocephalus after posterior fossa surgery in the semisitting position. Largest benefit was found in elderly patients and particularly in older men.German Clinical Trials

  12. [Facial nerve function and hearing preservation experience in middle fossa approach removal of small acoustic tumor surgery].

    Science.gov (United States)

    Yu, Jue-bo; Wu, Hao; Huang, Qi; Yang, Jun; Wang, Zhao-yan; Lü, Jing-rong

    2013-10-01

    The aim of this study was to investigate the hearing and facial nerve preservation in the middle fossa approach surgery for the removal of small acoustic tumor (vestibular schwannomas, VS). A prospective database was established, and data were retrospectively reviewed. Between January 2004 and February 2013, 13 patients with acoustic tumor underwent surgery via middle fossa approach for hearing preservation. The patients consisted of six men and seven women with a mean age of 48 years. Tumor size ranged from 0.8 cm to 1.5 cm. Hearing loss was categorized as American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) class A, class B, class C and class D. Facial nerve function was evaluated according to House-Brackmann (HB) Grade I-VI. Gross-total resection was accomplished in 12 of 13 patients. Preoperative hearing as class A in ten, class B in two, and class C in one patient respectively. Postoperatively, hearing was graded as class A in eight patients, class B in 3, and class C in 2 patients. Facial nerve function was House-Brackmann (HB) grade I in twelve patients, grade II in one patient preoperatively. Postoperatively, facial nerve function was HB Grade I in twelve patients and Grade III in one patient. The overall hearing preservation rate was at least 80% (8/10) and HB Grade I facial nerve outcome of 100% (12/12) . All cases were followed up for 0.5 to 5 years, no complications were observed. The middle fossa approach for the resection of small VS with hearing preservation is a viable and relatively option. It should be considered among the various options available for the management of small and growing VS.

  13. New geological insights and structural control on fluid circulation in La Fossa cone (Vulcano, Aeolian Islands, Italy)

    Science.gov (United States)

    Barde-Cabusson, S.; Finizola, A.; Revil, A.; Ricci, T.; Piscitelli, S.; Rizzo, E.; Angeletti, B.; Balasco, M.; Bennati, L.; Byrdina, S.; Carzaniga, N.; Crespy, A.; Di Gangi, F.; Morin, J.; Perrone, A.; Rossi, M.; Roulleau, E.; Suski, B.; Villeneuve, N.

    2009-09-01

    Electric resistivity tomography (ERT), self-potential (SP), soil CO 2 flux, and temperature are used to study the inner structure of La Fossa cone (Vulcano, Aeolian Islands). Nine profiles were performed across the cone with a measurement spacing of 20 m. The crater rims of La Fossa cone are underlined by sharp horizontal resistivity contrasts. SP, CO 2 flux, and temperature anomalies underline these boundaries which we interpret as structural limits associated to preferential circulation of fluids. The Pietre Cotte crater and Gran Cratere crater enclose the main hydrothermal system, identified at the centre of the edifice on the base of low electrical resistivity values (<20 Ω m) and strong CO 2 degassing, SP, and temperature anomalies. In the periphery, the hydrothermal activity is also visible along structural boundaries such as the Punte Nere, Forgia Vecchia, and Palizzi crater rims and at the base of the cone, on the southern side of the edifice, along a fault attributed to the NW main tectonic trend of the island. Inside the Punte Nere crater, the ERT sections show an electrical resistive body that we interpret as an intrusion or a dome. This magmatic body is reconstructed in 3D using the available ERT profiles. Its shape and position, with respect to the Pietre Cotte crater fault, allows replacing this structure in the chronology of the development of the volcano. It corresponds to a late phase of activity of the Punte Nere edifice. Considering the position of the SP, soil CO 2 flux, and temperature maxima and the repartition of conductive zones related to hydrothermal circulation with respect to the main structural features, La Fossa cone could be considered as a relevant example of the strong influence of pre-existing structures on hydrothermal fluid circulation at the scale of a volcanic edifice.

  14. Preoperative diffuse leptomeningeal spread in a medulloblastoma: Paraplegia following surgery for posterior fossa and call for newer management protocols

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    Pravin Salunke

    2011-01-01

    Full Text Available Management of patients with medulloblastoma presenting with multiple metastasis in subarachnoid space preoperatively is unclear. An 11-year-old boy presented with vermian medulloblastoma with an unusually long segment cervico-dorsal lesion and suprasellar lesion. The child underwent a posterior fossa craniotomy (prone position and excision of vermian mass. He developed paraplegia in the immediate postoperative period, the possible causes for which are being discussed. Besides, treatment options for patients presenting with disseminated disease preoperatively have been highlighted. Preoperative chemotherapy to downstage such lesions may be tried and such complications could be avoided.

  15. Torsion of an Abdominal-Wall Pedunculated Lipoma: A Rare Differential Diagnosis for Right Iliac Fossa Pain

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    Daniel Lee John Bunker

    2013-01-01

    Full Text Available Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

  16. Torsion of an abdominal-wall pedunculated lipoma: a rare differential diagnosis for right iliac fossa pain.

    Science.gov (United States)

    Bunker, Daniel Lee John; Ilie, Victor George; Halder, Tushar K

    2013-01-01

    Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

  17. Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia.

    LENUS (Irish Health Repository)

    Sweeney, Kieron J

    2013-02-01

    McLone and Knepper\\'s unified theory of Chiari malformation Type II (CM-II) describes how the loss of CSF via the open posterior neuropore fails to create adequate distending pressure for the developing rhomboencephalic vesicle. The authors of the present article describe the relationship between the posterior fossa volume and intracranial cerebellar volume as being related to the distance from the obex of the fourth ventricle to the myelomeningocele lesion using a common mathematical model, the Hagen-Poiseuille law.

  18. Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM

    Directory of Open Access Journals (Sweden)

    Leodante B. Costa Jr

    2004-03-01

    Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paciente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar.

  19. A new method to explore the spectral impact of the piriform fossae on the singing voice: benchmarking using MRI-based 3D-printed vocal tracts.

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    Bertrand Delvaux

    Full Text Available The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics is introduced. The findings support results in the literature: the piriform fossae create a spectral trough in the region 4-5 kHz and act as formants repellents. Moreover, this study extends those results by demonstrating numerically and perceptually the impact of having large piriform fossae on the sung output.

  20. A new method to explore the spectral impact of the piriform fossae on the singing voice: benchmarking using MRI-based 3D-printed vocal tracts.

    Science.gov (United States)

    Delvaux, Bertrand; Howard, David

    2014-01-01

    The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics) is introduced. The findings support results in the literature: the piriform fossae create a spectral trough in the region 4-5 kHz and act as formants repellents. Moreover, this study extends those results by demonstrating numerically and perceptually the impact of having large piriform fossae on the sung output.

  1. Fluid area measurements in the posterior fossa at 11-13 weeks in normal fetuses and fetuses with open spina bifida.

    Science.gov (United States)

    Karl, Katrin; Heling, Kai Sven; Chaoui, Rabih

    2015-01-01

    To measure the area of the intracranial translucency (IT) (syn: 4th ventricle) and the future cisterna magna (CM) in normal fetuses and to compare with fetuses with open spina bifida. In the midsagittal plane of the face of 220 fetuses between 11 and 13 weeks' gestation, the areas of the IT and CM were measured and the sum, defined as the posterior fossa fluid (PFF) area was calculated. Reference ranges were constructed in relation to the crown-rump length. The study group consisted of 21 fetuses with open spina bifida and showed in all cases a single pocket of fluid in the posterior fossa. Fetuses with no fluid in the fossa were excluded. This PFF-area was measured and compared with the reference range of the IT-area and the PFF-area of normal fetuses and Z-scores were calculated. In normal fetuses, a significant increase of the IT-, the CM- and the PFF-area was found as a sign of the expanding posterior fossa. The mean PFF-area increased from 8.55 to 29.72 mm(2) in the observation period. Fetuses with open spina bifida had reduced fluid in the posterior fossa with values ranging between 2.39 and 5.08 mm(2) and significantly lower Z-scores. Fetuses with open spina bifida have an abnormally small posterior fossa at 11-13 weeks' and in cases where the cerebrospinal fluid is still present, the fluid area in the midsagittal plane is reduced when compared to normal fetuses. Area fluid assessment can be an additional useful measurement in suspicious cases for open spina bifida in early gestation. © 2015 S. Karger AG, Basel.

  2. Computed Tomographic Evaluation of Condylar Symmetry and Condyle-Fossa Relationship of the Temporomandibular Joint in Subjects with Normal Occlusion and Malocclusion: A Comparative Study

    Science.gov (United States)

    Ponnada, Swaroopa Rani; Gaddam, Kranthi Praveen Raju; Perumalla, Kiran; Khan, Imran; Mohammed, Naqeed Abdul

    2017-01-01

    Introduction The relationship of the condyle and the mandibular fossa differs in shape with type of malocclusion and skeletal pattern. A review of literature shows till date there are no studies on Temporomandibular Joint (TMJ) condyle-fossa relation to the type of malocclusion based on growth pattern. Computed Tomography (CT) provides optimal imaging of the osseous components of the TMJ. Aim The purpose of this study was to investigate the condyle-fossa relationship and the dimensional and positional symmetries between the right and left condyles in subjects with normal occlusion and malocclusion in different growth patterns utilizing the CT scans of the TMJ. Materials and Methods Sixty subjects with age group of 18-30 years were selected for the study. The sample was divided into three groups based on overbite and growth pattern. The groups included 20 subjects with normal occlusion and average growth pattern, 20 patients with horizontal growth pattern and deep bite, 20 patients with vertical growth pattern and deep bite. The depth of the mandibular fossa, the condyle-fossa relationship, and the concentric position of the condyles were evaluated by the images obtained from the sagittal slices. ANOVA was performed to assess the significance. If it was found significant, post-hoc Tukey’s test was performed to see which two groups were statistically significant. Results No statistically significant difference was found in the anterior joint space and the superior joint space in horizontal and vertical growers with deep bite. Statistically significant (p <0.05) posterior positioning of the condyles was observed (nonconcentric positioning) in vertical growers with deep bite. Conclusion There is a significant change in the position of the condyle in vertical growers compared to average and horizontal growers. Left condyle is more anteriorly placed than the right condyle in all the three groups. There is no significant change in the vertical depth of the mandibular

  3. Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent

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    Sekula L Kathleen

    2005-12-01

    Full Text Available Abstract Background Chiari I malformation (CMI is diagnosed by rigid radiographic criteria along with appropriate clinical symptomatology. The aim of this study was to investigate the dimensions of the posterior cranial fossa in patients without significant tonsillar descent but with symptoms comparable to CMI. Methods Twenty-two patients with signs and symptoms comparable to CMI but without accepted radiographic criteria of tonsillar descent > 3–5 mm were referred to our clinic for evaluation. A history and physical examination were performed on all patients. In reviewing their MRI scans, nine morphometric measurements were recorded. The measurements were compared to measurements from a cohort of twenty-five individuals with cranial neuralgias from our practice. Results For patients with Chiari-like symptomatology, the following statistically significant abnormalities were identified: reduced length of the clivus, reduced length of basisphenoid, reduced length of basiocciput, and increased angle of the tentorium. Multiple morphometric studies have demonstrated similar findings in CMI. Conclusion The current classification of CMI is likely too restrictive. Preliminary morphologic data suggests that a subgroup of patients exists with tonsillar descent less than 3 mm below the foramen magnum but with congenitally hypoplastic posterior fossa causing symptomatology consistent with CMI.

  4. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem

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    Nilton Alves

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.

  5. Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Woo; Cho, Jae Ho; Jang, Han Won; Kim, Dong Sug; Moon, Gi Hak [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

    2004-08-01

    Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed.

  6. Endoscopic approach-routes in the posterior fossa cisterns through the retrosigmoid keyhole craniotomy: an anatomical study.

    Science.gov (United States)

    Kurucz, Peter; Baksa, Gabor; Patonay, Lajos; Thaher, Firas; Buchfelder, Michael; Ganslandt, Oliver

    2016-11-10

    Endoscopy in cerebellopontine angle surgery is an increasingly used technique. Despite of its advantages, the shortcomings arising from the complex anatomy of the posterior fossa are still preventing its widespread use. To overcome these drawbacks, the goal of this study was to define the anatomy of different endoscopic approaches through the retrosigmoid craniotomy and their limitations by surgical windows. Anatomical dissections were performed on 25 fresh human cadavers to describe the main approach-routes. Surgical windows are spaces surrounded by neurovascular structures acting as a natural frame and providing access to deeper structures. The approach-routes are trajectories starting at the craniotomy and pointing to the lesion, passing through certain windows. Twelve different windows could be identified along four endoscopic approach-routes. The superior route provides access to the structures of the upper pons, lower mesencephalon, and the upper neurovascular complex through the suprameatal, superior cerebellar, and infratrigeminal windows. The supratentorial route leads to the basilar tip and some of the suprasellar structures via the ipsi- and contralateral oculomotor and dorsum sellae windows. The central endoscopic route provides access to the middle pons and the middle neurovascular complex through the inframeatal, AICA, and basilar windows. The inferior endoscopic route is the pathway to the medulla oblongata and the lower neurovascular complex through the accessory, hypoglossal, and foramen magnum windows. The anatomy and limitations of each surgical windows were described in detail. These informations are essential for safe application of endoscopy in posterior fossa surgery through the retrosigmoid approach.

  7. A case of symptomatic mass in the right iliac fossa: a Bermuda Triangle which often lies the right diagnosis.

    Science.gov (United States)

    Panarese, Alessandra; Pironi, Daniele; Pontone, Stefano; Vendettuoli, Maurizio; De Cristofaro, Flaminia; Antonelli, Manila; Romani, Annamaria; Filippini, Angelo

    2014-02-24

    Disease of the iliac fossa can often be accompanied by non-specific symptoms and some of these are exclusively caused by the compression of bulky masses of other neighboring structures. In young women a differential diagnosis is a non trivial task as several possible causes have to be taken into account. Thus, intraligamentary tumors, which are extremely rare finding, are frequently confused with uterus, ovary or intestinal tumors. Even if myomas are the most benign tumors of the female genital tract, broad ligament leiomyomas are an unusual finding in women of reproductive age. These tumors are often asymptomatic until they reach a volume likely to cause symptoms related to the mass pressure. An accurate patient's anamnesis and examination serve as a guide to further examinations. Ultrasound is the first line imaging as it can show ovarian or other pelvic mass and doesn't involve exposure to radiations in young patients, who can be pregnant. We describe the clinical presentation and imaging features of a broad ligament leiomyoma, which presented as an inguinal mass in a patient with a right iliac fossa pain. We also report our diagnostic process performing the differential diagnosis with other potential pathologies of RIF. In these cases, a preoperative disease classification discriminating the benign or malignant tumor nature is closely linked to the proper patient management.

  8. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem

    Directory of Open Access Journals (Sweden)

    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.

  9. Differential diagnosis of posterior fossa brain tumors: Multiple discriminant analysis of Tl-SPECT and FDG-PET.

    Science.gov (United States)

    Yamauchi, Moritaka; Okada, Tomohisa; Okada, Tsutomu; Yamamoto, Akira; Fushimi, Yasutaka; Arakawa, Yoshiki; Miyamoto, Susumu; Togashi, Kaori

    2017-08-01

    This study investigated the combined capability of thallium-201 (Tl)-SPECT and fluorine-18-fluoro-deoxy-glucose (FDG)-PET for differential diagnosis of posterior fossa brain tumors using multiple discriminant analysis.This retrospective study was conducted under approval of the institutional review board. In the hospital information system, 27 patients with posterior fossa intra-axial tumor between January 2009 and June 2015 were enrolled and grouped as the following 7 entities: low grade glioma (LGG) 6, anaplastic astrocytoma (AA) 2, glioblastoma (GBM) 3, medulloblastoma (MB) 3, hemangioblastoma (HB) 6, metastatic tumor (Mets) 3, and malignant lymphoma (ML) 4. Tl and FDG uptakes were measured at the tumors and control areas, and several indexes were derived. Using indexes selected by the stepwise method, discriminant analysis was conducted with leave-one-out cross-validation.The predicted accuracy for tumor classification was 70.4% at initial analysis and 55.6% at cross-validation to differentiate 7 tumor entities. HB, LGG, and ML were well-discriminated, but AA was located next to LGG. GBM, MB, and Mets largely overlapped and could not be well distinguished even applying multiple discriminant analysis. Correct classification in the original and cross-validation analyses was 44.4% and 33.3% for Tl-SPECT and 55.6% and 48.1% for FDG-PET.

  10. The Posterior Fossa and Foreign Accent Syndrome: Report of Two New Cases and Review of the Literature.

    Science.gov (United States)

    Keulen, Stefanie; Mariën, Peter; van Dun, Kim; Bastiaanse, Roelien; Manto, Mario; Verhoeven, Jo

    2017-08-01

    Foreign accent syndrome is a rare motor speech disorder that causes patients to speak their language with a non-native accent. In the neurogenic condition, the disorder develops after lesions in the language dominant hemisphere, often affecting Broca's area, the insula, the supplementary motor area and the primary motor cortex. Here, we present two new cases of FAS after posterior fossa lesions. The first case is a 44-year-old, right-handed, Dutch-speaking man who suffered motor speech disturbances and a left hemiplegia after a pontine infarction. Quantified SPECT showed a bilateral hypoperfusion in the inferior lateral prefrontal and medial inferior frontal regions as well as a significant left cerebellar hypoperfusion. Further clinical investigations led to an additional diagnosis of brainstem cognitive affective syndrome which closely relates to Schmahmann's syndrome. The second patient was a 72-year-old right-handed polyglot English man who suffered a stroke in the vascular territory of the left posterior inferior cerebellar artery (PICA) and developed a foreign accent in his mother tongue (English) and in a later learnt language (Dutch). In this paper, we discuss how the occurrence of this peculiar motor speech disorder can be related to a lesion affecting the posterior fossa structures.

  11. Contrecoup fractures of the anterior cranial fossae as a consequence of blunt force caused by a fall.

    Science.gov (United States)

    Hein, P M; Schulz, E

    1990-01-01

    Contrecoup fractures of the base of the skull are regarded as rare in the clinical literature. In our material (n = 171 falls on the same level and on or from stairs), the overall frequency of contrecoup fractures of the anterior cranial fossa in fatal cranio-cerebral trauma due to falls was 12%, as compared to 24% with occipital point of impact of the head. The relationships between the impact site on the head, form of fracture at the point of impact with involvement of the skull cap and/or the base of the skull, coup and contrecoup injuries of the brain, localization of contrecoup fractures in the anterior cranial fossa and the occurrence of monocle and spectacle haematomas display a major variability. Fractures occur in the form of simple fractures and as impression fractures (fracture fragments or fracture boundaries displaced to the inside). Clinical diagnosis is difficult because of the concealed position of the anterior skull base. Contrecoup fractures become of forensic medical significance when symptoms of a frontobasal injury occur for the first time after trauma which has occurred some time in the past and when the question arises as to the causal connection with the original trauma. In investigation of living persons, it may be difficult to decide whether haemorrhages in the region of the orbit and its vicinity result from a direct blunt force or derive from fractures of the base of the skull, especially contrecoup fractures.

  12. Polygonal ridge networks on Mars: Diversity of morphologies and the special case of the Eastern Medusae Fossae Formation

    Science.gov (United States)

    Kerber, Laura; Dickson, James L.; Head, James W.; Grosfils, Eric B.

    2017-01-01

    Polygonal ridge networks, also known as boxwork or reticulate ridges, are found in numerous locations and geological contexts across Mars. Distinguishing the morphologies and geological context of the ridge networks sheds light on their potential as astrobiological and mineral resource sites of interest. The most widespread type of ridge morphology is characteristic of the Nili Fossae and Nilosyrtis region and consists of thin, criss-crossing ridges with a variety of heights, widths, and intersection angles. They are found in ancient Noachian terrains at a variety of altitudes (between -2500 and 2200 m) and geographic locations and are likely to be chemically altered fracture planes or mineral veins. They occur in the same general areas as valley networks and ancient lake basins, but they are not more numerous where these water-related features are concentrated, and can appear in places where th morphologies are absent. Similarly, some of the ridge networks are located near hydrated mineral detections, but there is not a one-to-one correlation. Smaller, light-toned ridges of variable widths have been found in Gale Crater and other rover sites and are interpreted to be smaller versions of the Nili-like ridges, mostly formed by the mineralization of fractures. This type of ridge is likely to be found in many other places on Mars as more high-resolution data become available. Sinus Meridiani contains many flat-topped ridges arranged into quasi-circular patterns. The ridges are eroding from a clay-rich unit, and could be formed by a similar process as the Nili-type ridges, but at a much larger scale and controlled by fractures made through a different process. Hellas Basin is host to a fourth type of ridge morphology consisting of large, thick, light-toned ridges forming regular polygons at several superimposed scales. While still enigmatic, these are most likely to be the result of sediment-filled fractures. The Eastern Medusae Fossae Formation contains large swaths

  13. O papel do acesso via fossa média no tratamento da paralisia facial traumática The role of the middle fossa approach in the management of traumatic facial paralysis

    Directory of Open Access Journals (Sweden)

    Ricardo Ferreira Bento

    2004-08-01

    Full Text Available Há vários aspectos controversos no tratamento da paralisia facial traumática. Um destes é a natureza precisa da intervenção cirúrgica a ser usada, uma vez que a decisão de ser realizada tenha sido feita. FORMA DE ESTUDO: Clínico retrospectivo. OBJETIVOS E MÉTODOS: Entre o período de junho de 1984 e junho de 1993, 220 casos de paralisia facial traumática com boa função coclear foram tratados na Universidade de São Paulo pela seguinte técnica cirúrgica: descompressão dos segmentos mastóideo e timpânico através do acesso transmastoídeo e descompressão do gânglio geniculado e dos 50% distais do segmento labiríntico, usando-se o acesso pela fossa média. Apresentamos uma revisão de literatura e a discussão e resultados de nosso trabalho.Management of traumatic facial paralysis has several controversial aspects. One of these is the precise nature of surgical intervention to be used once the decision to operate has been made. STUDY DESIGN: chart review. AIMS AND METHODS: Between June 1984 and June 1993, 220 cases of traumatic facial paralysis with good cochlear reserve were treated at the University of São Paulo by the following surgical approach: decompression of the tympanic and mastoid segments by the transmastoid approach and decompression of the geniculate ganglion and the distal 50% of the labyrinthine segment by the middle fossa approach. We present a review of the literature and a discussion and results of our management.

  14. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations

    Energy Technology Data Exchange (ETDEWEB)

    Guzinski, Maciej; Waszczuk, Lukasz; Sasiadek, Marek J. [Wroclaw Medical University, Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw (Poland)

    2016-10-15

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. (orig.)

  15. Teratoma of the posterior fossa CT and MR aspects A case. Teratoma de fosa posterior: Aspectos en TC y RM. A proposito de un caso

    Energy Technology Data Exchange (ETDEWEB)

    Pina, J.I.; Feijoo, R.; Lasierra, R.; Medrano, J.; Benito, J.L. de (Hospital Clinico Universitario Zaragoza. (Spain))

    1994-01-01

    The CT and MR findings are reported for a patient diagnosed as having teratoma of the posterior fossa with onset in the form of intracranial hypertension. The objective of this article is to report the detection of the lesion, as well as its origin in the closure defect of the cranial cavity with the formation of a cutaneous fistula, and review the recent literature.

  16. Delayed migration of K-wire into popliteal fossa used for tension band wiring of patellar fracture

    Institute of Scientific and Technical Information of China (English)

    Sanjay Meena; Hira Lal Nag; Senthil Kumar; Nilesh Barwar; Samarth Mittal; Amit Singla

    2013-01-01

    Breakage of K-wires and stainless steel wires which are used for fracture fixation is not uncommon,but migration is rare.We report a case of migration of broken K-wire used for patella tension band wiring to the popliteal fossa.The broken hardware was removed surgically.We would like to suggest that K-wire and wire fixation used for treatment ofpatellar fractures can migrate into the posterior compartment of the knee and cause clinical symptoms.Close clinical and radiological follow-up after internal fixation to identify the presence of hardware breakage or movement and removal of wires once fracture has united can avert such complications.

  17. Edema agudo de pulmão secundário a tumor de fossa posterior: registro de um caso

    Directory of Open Access Journals (Sweden)

    Antonio Cesar G. Borges

    1982-06-01

    Full Text Available É relatada a observação de uma paciente de 44 anos de idade com quadro clínico de edema de pulmão secundário a meningioma situado na fossa posterior. São feitos comentários sobre a importância da gasometria arterial realizada no período pré e pós-operatório e especialmente sobre o gradiente alvéolo-arterial de oxigênio que serve de guia na avaliação clínica do paciente neurocirúrgico, particularmente nos casos de edema pulmonar não cardiogênico.

  18. Posterior fossa decompression with tonsillectomy in 104 cases of basilar impression, Chiari malformation and/or syringomyelia

    Directory of Open Access Journals (Sweden)

    José Alberto Gonçalves da Silva

    2011-10-01

    Full Text Available The prime objective in the surgical treatment of basilar impression (BI, Chiari malformation (CM and/or syringomyelia (SM is based on the restoration of the normal cerebrospinal fluid (CSF dynamics at the craniovertebral junction through the creation of a large artificial cisterna magna. A small suboccipital craniectomy has been emphasized to avoid caudal migration of the hindbrain structures into the vertebral canal. Nevertheless, the results showed downward migration of the hindbrain related to that type of craniectomy. The authors present, otherwise, the results of 104 cases of BI, CM and/or SM, whose surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. A significant upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging.

  19. Laparoscopic repair for a previously unreported form of ventral hernia on the right iliac fossa in an elderly emaciated woman.

    Science.gov (United States)

    Yokoyama, T; Kobayashi, A; Shimizu, A; Motoyama, H; Miyagawa, S

    2015-10-01

    An 81-year-old emaciated woman was admitted to our hospital with a one-year history of recurrent bilateral inguinal swellings. Palpable lumps were observed not only in bilateral groin areas, but also on the right iliac fossa (RIF) of her abdomen. During a planned transabdominal preperitoneal laparoscopic herniorrhaphy, a previously unreported form of ventral hernia was observed at a position lateral and cranial to the right internal inguinal ring, which probably corresponded to the palpable lump on the RIF. The hernia orifice was 2 cm in diameter, and a vascular structure ran through the orifice. The contents of the hernia consisted of fatty tissue arising from the retroperitoneal tissue. Routine exploration revealed orifices of the following hernias: left indirect, right direct, bilateral femoral, bilateral obturator, and right Spigelian hernia. Her postoperative course was uneventful and a mass on the right lower quadrant disappeared after operation.

  20. Intraoperative somatosensory evoked potential recovery following opening of the fourth ventricle during posterior fossa decompression in Chiari malformation: case report.

    Science.gov (United States)

    Grossauer, Stefan; Koeck, Katharina; Vince, Giles H

    2015-03-01

    The most appropriate surgical technique for posterior fossa decompression in Chiari malformation (CM) remains a matter of debate. Intraoperative electrophysiological studies during posterior fossa decompression of Type I CM (CM-I) aim to shed light on the entity's pathomechanism as well as on the ideal extent of decompression. The existing reports on this issue state that significant improvement in conduction occurs after craniotomy in all cases, but additional durotomy contributes a further improvement in only a minority of cases. This implies that craniotomy alone might suffice for clinical improvement without the need of duraplasty or even subarachnoid manipulation at the level of the craniocervical junction. In contrast to published data, the authors describe the case of a 32-year-old woman who underwent surgery for CM associated with extensive cervicothoracic syringomyelia and whose intraoperative somatosensory evoked potentials (SSEPs) did not notably improve after craniotomy or following durotomy; rather, they only improved after opening of the fourth ventricle and restoration of CSF flow through the foramen of Magendie. Postoperatively, the patient recovered completely from her preoperative neurological deficits. To the authors' knowledge, this is the first report of significant SSEP recovery after opening the fourth ventricle in the decompression of a CM-I. The electrophysiological and operative techniques are described in detail and the findings are discussed in the light of available literature. The authors conclude that there might be a subset of CM-I patients who require subarachnoid dissection at the level of the craniocervical junction to benefit clinically. Prospective studies with detailed electrophysiological analyses seem warranted to answer the question regarding the best surgical approach in CM-I decompression.

  1. Three-dimensional assessment of mandibular and glenoid fossa changes after bone-anchored Class III intermaxillary traction

    Science.gov (United States)

    De Clerck, Hugo; Nguyen, Tung; de Paula, Leonardo Koerich; Cevidanes, Lucia

    2013-01-01

    Introduction Conventional treatment for young Class III patients involves extraoral devices designed to either protract the maxilla or restrain mandibular growth. The use of skeletal anchorage offers a promising alternative to obtain orthopedic results with fewer dental compensations. Our aim was to evaluate 3-dimensional changes in the mandibles and the glenoid fossae of Class III patients treated with bone-anchored maxillary protraction. Methods Twenty-five consecutive skeletal Class III patients between the ages of 9 and 13 years (mean age, 11.10 ± 1.1 year) were treated with Class III intermaxillary elastics and bilateral miniplates (2 in the infrazygomatic crests of the maxilla and 2 in the anterior mandible). The patients had cone-beam computed tomography images taken before initial loading and at the end of active treatment. Three-dimensional models were generated from these images, registered on the anterior cranial base, and analyzed by using color maps. Results Posterior displacement of the mandible at the end of treatment was observed in all subjects (posterior ramus: mean, 2.74 ± 1.36 mm; condyles: mean, 2.07 ± 1.16 mm; chin: mean, −0.13 ± 2.89 mm). Remodeling of the glenoid fossa at the anterior eminence (mean, 1.38 ± 1.03 mm) and bone resorption at the posterior wall (mean, −1.34 ± 0.6 mm) were observed in most patients. Conclusions This new treatment approach offers a promising alternative to restrain mandibular growth for Class III patients with a component of mandibular prognathism or to compensate for maxillary deficiency in patients with hypoplasia of the midface. Future studies with long-term follow-up and comparisons with facemask and chincup therapies are needed to better understand the treatment effects. PMID:22748987

  2. Shallow hydrothermal alteration and permeability changes in pyroclastic deposits: a case study at La Fossa cone (Vulcano island, Italy):

    Science.gov (United States)

    Cangemi, Marianna; Madonia, Paolo; Speziale, Sergio; Oliveri, Ygor

    2016-04-01

    La Fossa cone at Vulcano, the southernmost island of the Aeolian volcanic archipelago (Italy), has been characterized by an intense fumarolic activity since its last eruption dated 1888-90. Mineralogical alteration induced by shallow hydrothermal circulation has significantly reduced the permeability of the volcanic products, causing important feedbacks on the circulation of fluids in the shallowest portion of the volcanic edifice. The summit area of the cone is sealed by a quite continuous coating surface, fostering the condensation of hydrothermal fluids inside the volcanic edifice. The combination of fractures and volcano-stratigraphic discontinuities, conveying hydrothermal fluids, makes significant rock volumes prone to slide seaward, as occurred in 1988 during the main unrest experienced by Vulcano island since its last eruption. Similar instability conditions are found over the Forgia Vecchia crater rim area, formed by phreatic activity on the NE flank of the cone, where tensile fracturing and hydrothermal circulation interacts with mutual negative feedbacks. In the behalf of the DPC-INGV V3 Project 2012-15 we investigated the mineralogical composition and the hydraulic conductivity (under saturated conditions) of volcanic deposits potentially prone to hydrothermal fluid circulation, for evaluating their ability in retaining water, creating favourable conditions for gravitational instability. We also measured rainfall rate and volumetric soil moisture content in two automated stations located in different areas, with and without active hydrothermal circulation. We found that hydrothermal alteration transforms volcanic products into clay minerals, significantly reducing permeability of volcanic deposits. Argillified volcanic materials show background water contents, modulated by impulsive increments following rainfalls, higher than unaltered pyroclastic deposits, due to the combination of lower permeability and direct condensation of hydrothermal vapour. The

  3. 颞下经岩前硬膜外入路相关中颅窝显微解剖%Two fans in middle cranial fossa: microsurgical anatomy of middle cranial fossa through subtemporal-transpetrosal extradural approach

    Institute of Scientific and Technical Information of China (English)

    何鹏; 田继辉; 孙涛; 马东明

    2010-01-01

    Objective To study the anatomy of the middle cranial fossa through subtemporaltranspetrosal extradural approach. Methods Fixed in formalin, 20 sides of 10 Chinese adult cadaveric heads were filled with red and blue silica gel. Followed the subtemporal transpetrosal extradural approach,the manipulation was done. The extradural trajectory in middle fossa was exposed laterly to the arcuate eminence (AE) and posteriorly to the superior petrosal sinus. The petroclival region was seen after drilling the bone of Day quadrilateral while preserving the internal auditory canal (IAC), cochlea and internal carotid artery (ICA). The anatomy of middle cranial fossa was studied. Results (1) According to the shape and gasification, the arcuate eminence was classified to there types:Smooth-type, terrace-type and gravel-type. The relationship between arcuate eminence and superior semicircular canal was clear in the former two types. (2) The related structures in middle cranial fossa and petrosal bone could be described and linked systematically by two associated fans:anterior fan centered around the gasserian ganglion, posterior fan centered around the geniculater ganglion.(3)The internal auditory canal was in the posterior fan. The angle between GSPN and AE was 122.7°±7.6°(108.1°~137.5°). The angle between GSPN and interior border of IAC was 46.6°± 4.9°(35.0°~55.2°). Cochlea was located in the angle of GSPN and IAC.Conclusion Easier to be understood and momerized, all structures in the middle cranial fossa through subtemporal-transpetrosal extradural approach could be generalized by two fans.Identification of the interior border of IAC is more important in drilling of petrosal apex than that of the axis of IAC.%目的 利用颞下经岩前硬膜外入路研究中颅窝解剖结构之间的关系.方法 国人成人尸头湿标本10例20侧.模拟颞下经岩前硬膜外入路操作.磨除岩尖骨质,暴露并保留内听道(IAC)、耳蜗(Coch)、颈内动脉(ICA).

  4. Behandling af defaekationsblokade som følge af dyb fossa recto-genitalis med total baekkenbundsrekonstruktion med Prolene-net

    DEFF Research Database (Denmark)

    Møller, P; Monrad, H; Kehlet, H

    1992-01-01

    of the abdominal pain and dependence on morphine in two of the patients. Rectal compression resulting from an abnormally deep recto-genital fossa should be included in the differential diagnostic deliberations in patients with severe constipation and defaecation blockage. Complete reconstruction of the pelvic......The causes of severe defaecation blockage resulting from compression of the rectum and deep recto-genital fossa are reviewed and are illustrated by three patients who had previously undergone hysterectomy and who had incapacitating defaecation blockage and abdominal pain requiring morphine in two...... of the patients. The condition had not been diagnosed despite previous hospital contact for many years in two of the patients. Complete reconstruction of the pelvic floor with prolene net was performed. Subsequent defaecography showed normalization of defaecation without rectal compression and with relief...

  5. Controlateral cavernous syndrome, brainstem congestion and posterior fossa venous thrombosis with cerebellar hematoma related to a ruptured intracavernous carotid artery aneurysm.

    Science.gov (United States)

    Aldea, Sorin; Guedin, Pierre; Roccatagliata, Luca; Boulin, Anne; Auliac, Stéphanie; Dupuy, Michel; Cerf, Charles; Gaillard, Stéphan; Rodesch, Georges

    2011-06-01

    Intracavernous carotid artery aneurysms (ICCAs) are rarely associated with life-threatening complications. We describe a 55-year-old woman who, after the rupture of an intracavernous carotid artery aneurysm, presented with a contralateral cavernous sinus syndrome and severe posterior fossa and spinal cord symptoms. Following parent artery occlusion, thrombosis of the posterior fossa and spinal cord veins caused a progressive worsening of the neurological status to a "locked-in" state. The patient fully recovered with anticoagulation therapy. Comprehension of the pathophysiological mechanism associated with the rupture of ICCA and early diagnosis of the related symptoms are essential in order to plan a correct treatment that includes the management of the aneurysm rupture and of possible complications related to venous thrombosis.

  6. Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images; Evolucao incomum de provavel histoplasmose de sistema nervoso central: de leptomeningite para granuloma da fossa posterior. Relato de caso com imagens por ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Carrilho, Paulo Eduardo Mestrinelli; Alves, Orival [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina. Disciplina de Neurologia e Neurocirurgia]. E-mail: carrilho@certto.com.br; Budant, Manfredo [UNITOM - Unidade de Diagnostico por Imagem, Cascavel, PR (Brazil). Centro de Tomografia; Bozo, Marlon K.; Meirelles, Noel [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina; Bueno, Alexandre Galvao [ANATOM - Instituto de Anatomia Patologica de Cascavel, PR (Brazil)

    2006-01-15

    We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

  7. Location of the sciatic nerve at the popliteal fossa in the adult population: Relationship with gender and anthropometric data studied. Implications for daily practice.

    Science.gov (United States)

    Schiarite, L; Calvo, M; Maggi, G; Abad, A; Gilsanz, F

    2015-12-01

    To determine whether the location of the sciatic nerve (SN) at the popliteal fossa is related to anthropometric variables in the adult population, and to identify possible anatomical variations and their possible implications for clinical practice. Prospective observational study in elective ambulatory surgery patients. Patients were examined using ultrasound, looking at depth, laterality and distance at which the SN bifurcates at the level of the popliteal fossa. These measurements were linked to gender and the anthropometric data of the patients. A total of 62 patients were included, with 124 measurements. A statistically significant association was found between SN depth and the diameter of the thigh measured at 10 cm from the popliteal crease (P<.001). Mean depth: 3.32 ± 0.8 cm, mean laterality: 1.43 ± 0.9 cm, mean SN bifurcation distance: 61.78 ± 12 mm and mean SN diameter: 7.45 ± 1.17 mm. There were no statistical differences when comparing the measured variables with the age and gender. Similar results were obtained between measurements when comparing both lower limbs in the same patient. There was no statistical difference between height and distance at which the SN bifurcates. The depth and laterality of SN are independent of gender, weight and height. The depth at which the SN is located at the level of the popliteal fossa is related to the diameter of the thigh. The bifurcation of SN in popliteal fossa is not related to height. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Identification of hydrated silicate minerals on Mars using MRO-CRISM: Geologic context near Nili Fossae and implications for aqueous alteration

    Science.gov (United States)

    Ehlmann, B.L.; Mustard, J.F.; Swayze, G.A.; Clark, R.N.; Bishop, J.L.; Poulet, F.; Des Marais, D.J.; Roach, L.H.; Milliken, R.E.; Wray, J.J.; Barnouin-Jha, O.; Murchie, S.L.

    2009-01-01

    The Noachian terrain west of the Isidis basin hosts a diverse collection of alteration minerals in rocks comprising varied geomorphic units within a 100,000 km2 region in and near the Nili Fossae. Prior investigations in this region by the Observatoire pour l'Min??ralogie, l'Eau, les Glaces, et l'Activit?? (OMEGA) instrument on Mars Express revealed large exposures of both mafic minerals and iron magnesium phyllosilicates in stratigraphic context. Expanding on the discoveries of OMEGA, the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) aboard the Mars Reconnaissance Orbiter (MRO) has found more spatially widespread and mineralogically diverse alteration minerals than previously realized, which represent multiple aqueous environments. Using CRISM near-infrared spectral data, we detail the basis for identification of iron and magnesium smectites (including both nontronite and more Mg-rich varieties), chlorite, prehnite, serpentine, kaolinite, potassium mica (illite or muscovite), hydrated (opaline) silica, the sodium zeolite analcime, and magnesium carbonate. The detection of serpentine and analcime on Mars is reported here for the first time. We detail the geomorphic context of these minerals using data from high-resolution imagers onboard MRO in conjunction with CRISM. We find that the distribution of alteration minerals is not homogeneous; rather, they occur in provinces with distinctive assemblages of alteration minerals. Key findings are (1) a distinctive stratigraphy, in and around the Nili Fossae, of kaolinite and magnesium carbonate in bedrock units always overlying Fe/Mg smectites and (2) evidence for mineral phases and assemblages indicative of low-grade metamorphic or hydrothermal aqueous alteration in cratered terrains. The alteration minerals around the Nili Fossae are more typical of those resulting from neutral to alkaline conditions rather than acidic conditions, which appear to have dominated much of Mars. Moreover, the mineralogic

  9. Shape variability of the adult human acetabulum and acetabular fossa related to sex and age by geometric morphometrics. Implications for adult age estimation.

    Science.gov (United States)

    San-Millán, Marta; Rissech, Carme; Turbón, Daniel

    2017-03-01

    This study aims to explore shape variability of the acetabulum during the human adult life span, in relation to sex and age. The human acetabular shape was analysed in 682 os coxae from three different documented skeletal collections from the Iberian Peninsula. Two landmarks and thirty-two sliding semi-landmarks were used for the geometric morphometric procedures and a clock-wise standard was used for orientation. The 180° meridian (6:00) line was positioned over the midpoint of the acetabular notch and 36 reference points in 10° increments along the rim were marked. Data showed that size, sex and age significantly influence acetabular shape variation. Sex differences were significant in individuals younger than 65 years old and were characterised by males exhibiting relatively extended acetabular rim profiles from 10:00 to 1:00, narrower acetabular notches, and reduced acetabular fossae. In addition, three main age-related changes occurred to the acetabular shape in both sexes: outer acetabular profile modification, with extension from 10:00 to 1:00 and reduction from 7:00 to 9:00, acetabular notch narrowing, and acetabular fossa reduction. The age-related changes that were observed are shared by both sexes and seem to be related to bone production associated with age. Specifically, age appears to affect the entire border of the lunate surface: the acetabular rim, both acetabular horns, and the outer edge of the acetabular fossa. Furthermore, shape data confirmed the clover-leaf shape of the acetabular fossa in both males and females. These results improve our understanding of acetabular shape, and assist in refining age-estimation methods and enhancing hip surgery and rehabilitation.

  10. Trans aqueductal, third ventricle - Cervical subarachnoid stenting: An adjuvant cerebro spinal fluid diversion procedure in midline posterior fossa tumors with hydrocephalus: The technical note and case series.

    Science.gov (United States)

    Teegala, Ramesh

    2016-01-01

    Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle - Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012. Fifteen clinicoradiological diagnosed cases of midline posterior fossa tumors with hydrocephalus were included in this study. All the tumors were approached through the cerebello medullary (telo velo tonsilar) fissure technique. Following the excision of the posterior fossa tumor, a sizable stent was placed across the aqueduct from the third ventricle to the cervical subarachnoid space. There were nine male and six female patients with an average age of 23 years. Complete tumor excision could be achieved in 12 patients and subtotal excision with clearance of aqueduct in remaining three patients. Hydrocephalus was controlled effectively in all the patients. There were no stent-related complications. This study showed the reliability of single-stage tumor excision followed by placement of aqueductal stent. The success rate of this technique is comparable to those of conventional CSF diversion procedures. This is a simple, safe, and effective procedure for the management of persistent and or progressive hydrocephalus. This technique may be very useful in situations where the patient's follow-up is compromised and the patients who are from a poor economic background. Long-term results need further evaluation to assess the overall functioning of this stent technique.

  11. RADIATION THERAPY QUALITY IN CCG/POG INTERGROUP 9961: IMPLICATIONS FOR CRANIOSPINAL IRRADIATION AND THE POSTERIOR FOSSA BOOST IN FUTURE MEDULLOBLASTOMA TRIALS

    Directory of Open Access Journals (Sweden)

    Bernadine eDonahue

    2012-12-01

    Full Text Available Purpose: Associations of RT deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose CSI and chemotherapy. The aim of this study is to evaluate the quality of RT on CCG/POG 9961 and analyze associations of RT deviations with outcome.Methods and Materials: Major volume deviations were assessed based on the distance from specified anatomical region to field edge. We investigated associations of RT deviations with progression-free survival (PFS, overall survival (OS, and explored associations with demographics and clinical variables.Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33% did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa; posterior fossa deviations resulted from treating less than whole posterior fossa. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of radiation therapy delivered in COG institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of posterior fossa volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome.

  12. Reconstruction of Temporal Hollowing Defect With Anterior-Lateral Thigh Free Flap Following Resection of Recurrent Ameloblastoma of the Infratemporal Fossa and Right Mandible (a Case Report).

    Science.gov (United States)

    Melville, James C; Hornberger, John C; Young, Simon; Shum, Jonathan W

    2016-09-01

    Recurrent invasive ameloblastoma of the infratemporal fossa is an uncommonly encountered phenomenon in the practice of oral and maxillofacial surgery and presents many surgical challenges for the practitioner. This case report describes a patient who underwent previous resection of a mandibular ameloblastoma with multiple recurrences. The patient was diagnosed with a recurrent ameloblastoma of the infratemporal fossa that was subsequently resected and reconstructed using an anterolateral thigh (ALT) free tissue transfer. There are few reported cases of recurrent ameloblastomas in the infratemporal fossa and none that describe surgical resection and reconstruction of such a lesion. Owing to the uniqueness of the surgical defect, an ALT flap was used to correct the temporal hollowing. There have been multiple reported cases of reconstruction of temporal hollowing defects using autogenous fat or allograft; however, none have described the use of a de-epithelialized ALT microvascular reconstruction of a temporal hollowing defect. This case report describes a unique clinical situation of surgical resection and reconstruction that resulted in a satisfactory outcome for the patient. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Delayed cerebrospinal fluid leak after watertight dural closure with a polyethylene glycol hydrogel dural sealant in posterior fossa surgery: case report.

    Science.gov (United States)

    Jito, Junya; Nitta, Naoki; Nozaki, Kazuhiko

    2014-01-01

    A polyethylene glycol (PEG) hydrogel sealant recently has been approved as an adjunct to sutured dural closure in Japan. We treated consecutive six patients with PEG hydrogel sealant in posterior fossa operation. Three of six cases suffered delayed cerebrospinal fluid (CSF) leak after watertight dural closure with the PEG hydrogel sealant, although there was no leak case which was treated with fibrin glue, before 2 years until the adoption of the new material. These patients underwent posterior fossa craniotomy and discharged without remarkable CSF leak. The pseudomeningocele under the occipital wound caused the CSF leak occurr from 5th to 7th week postoperatively. All CSF leak cases needed surgical repair. At the repair, the PEG hydrogel was liquefied and almost absorbed. A fistula on the closure line and a dead space after the absorption of the PEG hydrogel was observed. When the absorbable PEG hydrogel sealant plugs in small gaps of sutured dura, its properties to prevent adhesion might suppress healing process of dural closure, so that CSF could leak through the gaps and collect as a pseudomeningocele in the dead space after absorption of the PEG hydrogel. In posterior fossa surgery a PEG hydrogel sealant should be applied when dural edges are closed tightly without any gaps.

  14. Posterior fossa dural arteriovenous fistulas: diagnosis and follow-up with time-resolved imaging of contrast kinetics (TRICKS) at 1.5T

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    Pekkola, Johanna; Kangasniemi, Marko (Helsinki Medical Imaging Center, Helsinki Univ. Central Hospital, Helsinki (Finland)), email: johanna.pekkola@hus.fi

    2011-05-15

    Background Time-of-flight MR angiography (TOF MRA) is currently the most widely used non-invasive imaging tool to diagnose dural arteriovenous fistula (DAVF). It is, however, not as sensitive as invasive digital subtraction angiography (DSA) for detecting the arteriovenous shunting inherent in DAVF. Dynamic contrast-enhanced MR angiography allows separation of arterial and venous phases of contrast passage though the brain and can thus demonstrate early venous filling through the arteriovenous shunt. Purpose To compare the diagnostic value of TOF MRA and a commercially available dynamic contrast-enhanced MR angiography sequence (TRICKS) at 1.5T in detecting posterior fossa DAVF. Material and Methods We retrospectively collected image data for 19 patients who underwent TOF MRA, TRICKS, and DSA either for primary diagnosis or for follow-up of posterior fossa DAVF and assessed the performance of TOF MRA and TRICKS in demonstrating the arteriovenous shunt, with DSA as the reference standard. Results TRICKS detected early arterial filling at 94.4% sensitivity and 83.3% specificity. TOF MRA detected high flow-related signal within venous structures at 64.7% sensitivity and 80% specificity. Conclusion The commercially available dynamic MR angiography sequence TRICKS with fully automatic vendor postprocessing at 1.5T is more sensitive than TOF MRA in detecting the arteriovenous shunt in posterior fossa DAVF

  15. Synovial cyst of the antecubital fossa mimicking a brachial artery pseudoaneurysm: report of a case.

    Science.gov (United States)

    Filis, Konstantinos; Galyfos, George; Larentzakis, Andreas; Karanikola, Evridiki; Zarmakoupis, Constantinos

    2014-07-01

    Pseudoaneurysms of the brachial artery are common following a percutaneous cardiac catheterization. Synovial cysts are a commonly identified entity in patients with rheumatic diseases as well. We present a rare case of a synovial cyst in the elbow masquerading as an iatrogenic pseudoaneurysm of the brachial artery. A 51-year-old female patient presented with a pulsatile and painful mass in the right antecubital fossa. The medical history revealed a recent diagnostic cardiac catheterization at the same site and rheumatoid arthritis under oral treatment. Imaging investigations were not fully diagnostic. Because of the clinical suspicion of a thrombosed pseudoaneurysm, exploratory surgery was indicated. The pathologic examination of the specimen confirmed the diagnosis of a synovial cyst. Ultrasonography and computed tomography imaging are valuable in the everyday clinical practice but they do not always exclude an iatrogenic pseudoaneurysm, especially when the medical history is suspicious. Surgical removal is the proper treatment and pathologic examination sets the final diagnosis in such cases of diagnostic difficulty. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Surgical Microanatomy of the Posterior Condylar Emissary Vein and its Anatomical Variations for the Transcondylar Fossa Approach.

    Science.gov (United States)

    Ota, Nakao; Tanikawa, Rokuya; Yoshikane, Tsutomu; Miyama, Masataka; Miyazaki, Takanori; Kinoshita, Yu; Matsukawa, Hidetoshi; Yanagisawa, Takeshi; Sakakibara, Fumihiro; Suzuki, Go; Saito, Norihiro; Miyata, Shiro; Noda, Kosumo; Tsuboi, Toshiyuki; Takeda, Rihei; Kamiyama, Hiroyasu; Tokuda, Sadahisa; Kamada, Kyousuke

    2017-06-01

    It is essential to identify and be aware of the anatomy of the posterior condylar emissary vein (PCEV) for achieving an adequate operative field for the transcondylar fossa approach (TCFA). To describe the variations in the drainage patterns of PCEVs and the technical issues encountered in such cases. This was a retrospective analysis of the anatomy of PCEVs in 104 sides in 52 cases treated by the TCFA. Preoperative findings of multidetector-row computed tomography (CT) and CT venography (CTV) were compared with the intraoperative findings. The drainage patterns were classified as 5 types: the sigmoid sinus (SS), jugular bulb (JB), occipital sinus (OS), anterior condylar emissary vein (ACEV), and marginal sinus (MS). The SS, JB, ACEV, and OS types were observed in 33 (31.7%), 42 (40.3%), 8 (7.7%), and 1 (1.0%) side(s), respectively. One side (1.0%) each had combined drainage from MS and JB, and ACEV and JB, respectively. In 17 sides (16.3%), the PCEVs and posterior condylar canals could not be identified on CT and CTV. Preoperative CT and CTV findings correlated well with the intraoperative findings. To make a sufficient operative field for TCFA, PCEVs should be appropriately dealt with based on the preoperative knowledge of their running course, pattern, and origin.

  17. Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma.

    Science.gov (United States)

    Chua, Felicia H Z; Thien, Ady; Ng, Lee Ping; Seow, Wan Tew; Low, David C Y; Chang, Kenneth T E; Lian, Derrick W Q; Loh, Eva; Low, Sharon Y Y

    2017-03-01

    Posterior fossa syndrome (PFS) is a serious complication faced by neurosurgeons and their patients, especially in paediatric medulloblastoma patients. The uncertain aetiology of PFS, myriad of cited risk factors and therapeutic challenges make this phenomenon an elusive entity. The primary objective of this study was to identify associative factors related to the development of PFS in medulloblastoma patient post-tumour resection. This is a retrospective study based at a single institution. Patient data and all related information were collected from the hospital records, in accordance to a list of possible risk factors associated with PFS. These included pre-operative tumour volume, hydrocephalus, age, gender, extent of resection, metastasis, ventriculoperitoneal shunt insertion, post-operative meningitis and radiological changes in MRI. Additional variables included molecular and histological subtypes of each patient's medulloblastoma tumour. Statistical analysis was employed to determine evidence of each variable's significance in PFS permanence. A total of 19 patients with appropriately complete data was identified. Initial univariate analysis did not show any statistical significance. However, multivariate analysis for MRI-specific changes reported bilateral DWI restricted diffusion changes involving both right and left sides of the surgical cavity was of statistical significance for PFS permanence. The authors performed a clinical study that evaluated possible risk factors for permanent PFS in paediatric medulloblastoma patients. Analysis of collated results found that post-operative DWI restriction in bilateral regions within the surgical cavity demonstrated statistical significance as a predictor of PFS permanence-a novel finding in the current literature.

  18. A safe and effective technique for harvesting the occipital artery for posterior fossa bypass surgery: a cadaveric study.

    Science.gov (United States)

    Fukuda, Hitoshi; Evins, Alexander I; Burrell, Justin C; Stieg, Philip E; Bernardo, Antonio

    2014-01-01

    The occipital artery (OA) is an important donor artery for posterior fossa revascularization. Harvesting the OA is believed to be difficult and time consuming due to its 3-dimensional course through different suboccipital tissue layers. We propose a safe and effective means of dissecting the OA. The course of the OA was explored in 5 cadaveric heads (10 sides). The OA was divided into 3 segments based on the vertical muscle layer it ran through; subcutaneous, transitional, and intramuscular. Three different approaches were attempted, and their respective advantages and disadvantages were assessed. The subcutaneous segment of the OA was found to run above the galea without traversing any vertical layers, and was thus easily dissected down to the superior nuchal line (SNL). The segment between the SNL and the digastric groove, traditionally the suboccipital segment, was divided into transitional and intramuscular segments. After detaching and retracting the suboccipital muscles, the OA was found to run in a single vertical layer of connective tissue. Dissection of the transitional segment was more involved as it ran between the SNL and the superior edge of the splenius capitis muscle, and vertically through the galea aponeurotica and the tendon of the sternocleidomastoid muscle. This segmentation provided a safe and effective procedure for harvesting the OA, in which dissection of the transitional segment is a critical step. Although the course of the OA is complex, precise anatomical knowledge of the suboccipital muscles and a stepwise dissection make harvesting the OA relatively simple. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. 股骨髁间窝的应用解剖及其临床研究%The applied anatomy and clinical study of femoral intercondylar fossa

    Institute of Scientific and Technical Information of China (English)

    李健; 余世勇; 桂俊; 徐敏; 张加创; 董大翠; 吴昌清

    2001-01-01

    目的 探讨如何完善髌韧带中1/3重建前交叉韧带术式,防止重建韧带撞击现象的发生。方法 测量42侧和73侧正常干、湿性股骨髁间窝标本的横径、纵径及其相关值;通过对湿性膝关节标本股骨髁间窝与前交叉韧带和重建韧带解剖关系的观测,确定膝关节伸展时髁间窝与韧带发生撞击的部位。在髌韧带中1/3重建前交叉韧带的模拟和临床手术中,切除股骨髁间窝前外侧壁及顶部部分骨质,加宽加深髁间窝,保持重建韧带与其有5 mm间距。结果 临床应用19例中随访1年以上者11例,无1例出现重建韧带撞击现象,膝关节稳定性恢复良好。结论 股骨髁间窝扩大成形能有效地防止髁间窝对髌韧带的撞击,保证其顺利地替代前交叉韧带的功能。%Objective To improve reconstructive metho d of damaged anterior cruciate ligament and prevent the reconstructed ligament from being damaged. Methods Femoral intercondylar fossae were anatomized and measured in 42 dry samples and 73 undried ones for breadth, h eight and relative other values of it. Meanwhile the place of collision between femoral intercondylar fossa and ligament was found in straight knee joint positi on. After anatomical relations among femoral intercondylar fossa, anterior cruci ate ligament and reconstructed ligament were observed in undried knee joint samp les. Anterolateral and cupular part of intercondylar fossa was removed in the ex perimental and clinical application of middle bundle of patellar ligament recons tructing anterior cruciate ligament, which resulted in broadening and deepening intercondylar fossa in order to keep 5 mm interval between reconstructed ligamen t and femoral intercondylar fossa. Results Nineteen cases of damaged anterior cruciate ligament underwent the operation. Over one year fo llow-up amounted to 11 cases. There was no damage of reconstructed ligament and unstableness of knee

  20. Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil = Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil

    Directory of Open Access Journals (Sweden)

    Ana Carolina Figueiredo Lacerda

    2007-10-01

    Full Text Available The present work had the objective to study parasitic copepods in thenasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae, Schizodon borellii (Anostomidae, Prochilodus lineatus (Prochilodontidae, Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae. Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984; and Rhinergasilus piranhus Boeger & Thatcher, 1988. There were differences in parasite corporal measurements and in the quantity of parasites per host in relation to copepod parasites from the Amazon region. The present study constitutes one of the few studies of identification of copepod parasites in the nasal fossae of fish from the Southern region of Brazil.O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatrofamílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais,variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher

  1. Telomerase activation in posterior fossa group A ependymomas is associated with dismal prognosis and chromosome 1q gain.

    Science.gov (United States)

    Gojo, Johannes; Lötsch, Daniela; Spiegl-Kreinecker, Sabine; Pajtler, Kristian W; Neumayer, Katharina; Korbel, Pia; Araki, Asuka; Brandstetter, Anita; Mohr, Thomas; Hovestadt, Volker; Chavez, Lukas; Kirchhofer, Dominik; Ricken, Gerda; Stefanits, Harald; Korshunov, Andrey; Pfister, Stefan M; Dieckmann, Karin; Azizi, Amedeo A; Czech, Thomas; Filipits, Martin; Kool, Marcel; Peyrl, Andreas; Slavc, Irene; Berger, Walter; Haberler, Christine

    2017-09-01

    Ependymomas account for up to 10% of childhood CNS tumors and have a high rate of tumor recurrence despite gross total resection. Recently, classification into molecular ependymoma subgroups has been established, but the mechanisms underlying the aggressiveness of certain subtypes remain widely enigmatic. The aim of this study was to dissect the clinical and biological role of telomerase reactivation, a frequent mechanism of cancer cells to evade cellular senescence, in pediatric ependymoma. We determined telomerase enzymatic activity, hTERT mRNA expression, promoter methylation, and the rs2853669 single nucleotide polymorphism located in the hTERT promoter in a well-characterized cohort of pediatric intracranial ependymomas. In posterior fossa ependymoma group A (PF-EPN-A) tumors, telomerase activity varied and was significantly associated with dismal overall survival, whereas telomerase reactivation was present in all supratentorial RelA fusion-positive (ST-EPN-RELA) ependymomas. In silico analysis of methylation patterns showed that only these two subgroups harbor hypermethylated hTERT promoters suggesting telomerase reactivation via epigenetic mechanisms. Furthermore, chromosome 1q gain, a well-known negative prognostic factor, was strongly associated with telomerase reactivation in PF-EPN-A. Additional in silico analyses of gene expression data confirmed this finding and further showed enrichment of the E-twenty-six factor, Myc, and E2F target genes in 1q gained ependymomas. Additionally, 1q gained tumors showed elevated expression of ETV3, an E-twenty-six factor gene located on chromosome 1q. Taken together we describe a subgroup-specific impact of telomerase reactivation on disease progression in pediatric ependymoma and provide preliminary evidence for the involved molecular mechanisms.

  2. Outcome on hearing and facial nerve function in microsurgical treatment of small vestibular schwannoma via the middle cranial fossa approach.

    Science.gov (United States)

    Ginzkey, Christian; Scheich, Matthias; Harnisch, Wilma; Bonn, Verena; Ehrmann-Müller, Desiree; Shehata-Dieler, Wafaa; Mlynski, Robert; Hagen, Rudolf

    2013-03-01

    Encouraging results regarding hearing preservation and facial nerve function as well as increasing understanding of the natural behaviour of vestibular schwannomas have led to the recommendation of an early treatment in small VS. The aim of the present study was to evaluate current data on functional outcome of patients with small VS treated by middle cranial fossa (MCF) approach. A retrospective chart study of all cases treated by MCF approach between October 2007 and September 2011 was performed. Records were analyzed regarding demographical data, tumor size, hearing status, vestibular function and facial nerve function. Facial nerve function was classified according to the House-Brackmann scale (HB). Hearing status was classified according to the American Association of Otolaryngology-Head and Neck Surgery (AAO-HNS) and a modified classification of Gardner and Robertson (GR). Eighty-nine patients were included in the study; 41 % of VS was classified as intracanalicular (stage 1) and 59 % as stage 2. From 65 patients with a preoperative hearing status according to AAO-HNS A or B, 74 % still presented with A or B after surgery. Using a modified GR classification, from 70 patients categorized as class I or II prior to surgery, 70 % were still class I or II. Looking to the facial nerve function 1 week after surgery, 82 % of patients presented with HB 1 or 2. Three to twelve months later, 96 % demonstrated HB 1 or 2. A persisting facial palsy was recorded in four patients. Preoperative hearing status was evaluated as a prognostic factor for postoperative hearing, whereas no influence was detected in ABR, vestibular function and tumor length. Early diagnosis of small VS due to high-sensitive MRI requires the management of this tumor entity. Natural behaviour of VS in many cases demonstrates an increase of tumor size over time with deterioration of hearing status. The presented data underline the recommendation of an early surgical treatment in small VS as a valuable

  3. MR-based morphometry of the posterior fossa in fetuses with neural tube defects of the spine.

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    Ramona Woitek

    Full Text Available OBJECTIVES: In cases of "spina bifida," a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA and the maximum transverse diameter of the posterior fossa (TDPF as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs. METHODS: The TDPF and the CSA of 238 fetuses (20-37 GW, mean: 28.36 GW with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18-37 GW, mean: 24.3 GW were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences. RESULTS: Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001 and CSA (r = .714; p<.001 with gestational age. In ONTDs the CSA was significantly smaller (p<.001 than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160. In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001. CONCLUSIONS: The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect.

  4. MR-based morphometry of the posterior fossa in fetuses with neural tube defects of the spine.

    Science.gov (United States)

    Woitek, Ramona; Dvorak, Anton; Weber, Michael; Seidl, Rainer; Bettelheim, Dieter; Schöpf, Veronika; Amann, Gabriele; Brugger, Peter C; Furtner, Julia; Asenbaum, Ulrika; Prayer, Daniela; Kasprian, Gregor

    2014-01-01

    In cases of "spina bifida," a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD) is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs) are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA) and the maximum transverse diameter of the posterior fossa (TDPF) as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs. The TDPF and the CSA of 238 fetuses (20-37 GW, mean: 28.36 GW) with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18-37 GW, mean: 24.3 GW) were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences. Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age. In ONTDs the CSA was significantly smaller (p<.001) than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160). In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001). The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect.

  5. MR-Based Morphometry of the Posterior Fossa in Fetuses with Neural Tube Defects of the Spine

    Science.gov (United States)

    Woitek, Ramona; Dvorak, Anton; Weber, Michael; Seidl, Rainer; Bettelheim, Dieter; Schöpf, Veronika; Amann, Gabriele; Brugger, Peter C.; Furtner, Julia; Asenbaum, Ulrika; Prayer, Daniela; Kasprian, Gregor

    2014-01-01

    Objectives In cases of “spina bifida,” a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD) is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs) are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA) and the maximum transverse diameter of the posterior fossa (TDPF) as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs. Methods The TDPF and the CSA of 238 fetuses (20–37 GW, mean: 28.36 GW) with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18–37 GW, mean: 24.3 GW) were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences. Results Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age. In ONTDs the CSA was significantly smaller (p<.001) than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160). In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001). Conclusions The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect. PMID:25393279

  6. DTI fiber tractography of cerebro-cerebellar pathways and clinical evaluation of ataxia in childhood posterior fossa tumor survivors.

    Science.gov (United States)

    Oh, Myung Eun; Driever, Pablo Hernáiz; Khajuria, Rajiv K; Rueckriegel, Stefan Mark; Koustenis, Elisabeth; Bruhn, Harald; Thomale, Ulrich-Wilhelm

    2017-01-01

    Pediatric posterior fossa (PF) tumor survivors experience long-term motor deficits. Specific cerebrocerebellar connections may be involved in incidence and severity of motor dysfunction. We examined the relationship between long-term ataxia as well as fine motor function and alteration of differential cerebellar efferent and afferent pathways using diffusion tensor imaging (DTI) and tractography. DTI-based tractography was performed in 19 patients (10 pilocytic astrocytoma (PA) and 9 medulloblastoma patients (MB)) and 20 healthy peers. Efferent Cerebello-Thalamo-Cerebral (CTC) and afferent Cerebro-Ponto-Cerebellar (CPC) tracts were reconstructed and analyzed concerning fractional anisotropy (FA) and volumetric measurements. Clinical outcome was assessed with the International Cooperative Ataxia Rating Scale (ICARS). Kinematic parameters of fine motor function (speed, automation, variability, and pressure) were obtained by employing a digitizing graphic tablet. ICARS scores were significantly higher in MB patients than in PA patients. Poorer ICARS scores and impaired fine motor function correlated significantly with volume loss of CTC pathway in MB patients, but not in PA patients. Patients with pediatric post-operative cerebellar mutism syndrome showed higher loss of CTC pathway volume and were more atactic. CPC pathway volume was significantly reduced in PA patients, but not in MB patients. Neither relationship was observed between the CPC pathway and ICARS or fine motor function. There was no group difference of FA values between the patients and healthy peers. Reduced CTC pathway volumes in our cohorts were associated with severity of long-term ataxia and impaired fine motor function in survivors of MBs. We suggest that the CTC pathway seems to play a role in extent of ataxia and fine motor dysfunction after childhood cerebellar tumor treatment. DTI may be a useful tool to identify relevant structures of the CTC pathway and possibly avoid surgically induced long

  7. Evaluation of temporomandibular fossa and mandibular condyle in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography.

    Science.gov (United States)

    Uçar, Faruk Izzet; Buyuk, Suleyman Kutalmış; Şekerci, Ahmet Ercan; Celikoglu, Mevlut

    2016-11-01

    The purposes of this study were to investigate the position of the mandibular condyle and temporomandibular fossa between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls without any cleft by using cone-beam computed tomography (CBCT). The study sample consisted of 17 patients (7 females and 10 males; mean age, 14.27 ± 2.83 years) affected by BCLP and 17 patients (6 females and 11 males; mean age, 14.27 ± 2.12 years) as age-and sex-matched control group without any cleft. Using cone-beam computed tomography segmented three-dimensional temporomandibular fossa and mandibular condyle images were reconstructed and angular, linear, and volumetric measurements of the patients in both sides of the groups were examined using Paired and Student's t-tests. Comparison of the sides showed that both sides were found to be similar in BCLP and control groups, except the condylar angulation of the right side was found to be higher compared to that of the left side in both groups (p condylar angulation in the right side (BCLP group had less angulation compared to controls; p condylar volume was found to be slightly less in the BCLP group in both sides compared to the controls (p > 0.05). The positions of the mandibular condyle and temporomandibular fossa were found to be similar in patients affected by BCLP and control group of without any cleft. SCANNING 38:720-726, 2016. © 2016 Wiley Periodicals, Inc.

  8. Computational Investigation of Cerebrospinal Fluid Dynamics in the Posterior Cranial Fossa and Cervical Subarachnoid Space in Patients with Chiari I Malformation

    Science.gov (United States)

    Støverud, Karen-Helene; Langtangen, Hans Petter; Ringstad, Geir Andre; Eide, Per Kristian; Mardal, Kent-Andre

    2016-01-01

    Purpose Previous computational fluid dynamics (CFD) studies have demonstrated that the Chiari malformation is associated with abnormal cerebrospinal fluid (CSF) flow in the cervical part of the subarachnoid space (SAS), but the flow in the SAS of the posterior cranial fossa has received little attention. This study extends previous modelling efforts by including the cerebellomedullary cistern, pontine cistern, and 4th ventricle in addition to the cervical subarachnoid space. Methods The study included one healthy control, Con1, and two patients with Chiari I malformation, P1 and P2. Meshes were constructed by segmenting images obtained from T2-weighted turbo spin-echo sequences. CFD simulations were performed with a previously verified and validated code. Patient-specific flow conditions in the aqueduct and the cervical SAS were used. Two patients with the Chiari malformation and one control were modelled. Results The results demonstrated increased maximal flow velocities in the Chiari patients, ranging from factor 5 in P1 to 14.8 in P2, when compared to Con1 at the level of Foramen Magnum (FM). Maximal velocities in the cervical SAS varied by a factor 2.3, while the maximal flow in the aqueduct varied by a factor 3.5. The pressure drop from the pontine cistern to the cervical SAS was similar in Con1 and P1, but a factor two higher in P2. The pressure drop between the aqueduct and the cervical SAS varied by a factor 9.4 where P1 was the one with the lowest pressure jump and P2 and Con1 differed only by a factor 1.6. Conclusion This pilot study demonstrates that including the posterior cranial fossa is feasible and suggests that previously found flow differences between Chiari I patients and healthy individuals in the cervical SAS may be present also in the SAS of the posterior cranial fossa. PMID:27727298

  9. Cerebral white matter fractional anisotropy and tract volume as measured by MR imaging are associated with impaired cognitive and motor function in pediatric posterior fossa tumor survivors.

    Science.gov (United States)

    Rueckriegel, Stefan M; Bruhn, Harald; Thomale, Ulrich W; Hernáiz Driever, Pablo

    2015-07-01

    Disease and therapy cause brain damage and subsequent functional loss in pediatric patients with posterior fossa tumors. Treatment-related toxicity factors are resection in patients with pilocytic astrocytoma (PA) and, additionally, cranio-spinal irradiation together with chemotherapy in patients with medulloblastoma (MB). We tested whether damage to white matter (WM) as revealed by diffusion tensor MR imaging (DTI) correlated with specific cognitive and motor impairments in survivors of pediatric posterior fossa tumors. Eighteen MB (mean age ± SD, 15.2 ± 4.9 y) and 14 PA (12.6 ± 5.0 y) survivors were investigated with DTI on a 3-Tesla-MR system. We identified fractional anisotropy (FA) of WM, the volume ratio of WM to gray matter and cerebrospinal fluid (WM/GM + CSF), and volume of specific frontocerebellar tracts. Ataxia was assessed using the International Cooperative Ataxia Rating Scale (ICARS), while the Wechsler Intelligence Scale for Children determined full-scale intelligence quotients (FSIQ). Amsterdam Neuropsychological Tasks (ANT) was used to assess processing speed. Handwriting automation was analyzed using a digitizing graphic tablet. The WM/GM + CSF ratio correlated significantly with cognitive measures (IQ, P = 0.002; ANT baseline speed, P = 0.04; ANT shifting attention, P = 0.004). FA of skeletonized tracts correlated significantly with FSIQ (P = 0.008), ANT baseline speed (P = 0.028) and ANT shifting attention (P = 0.045). Moreover, frontocerebellar tract volumes correlated with both the FSIQ (P = 0.011) and ICARS (P = 0.007). DTI provides a method for quantification of WM damage by tumor and by therapy-associated effects in survivors of pediatric posterior fossa tumors. DTI-derived WM integrity may be a representative marker for cognitive and motor deterioration. © 2015 Wiley Periodicals, Inc.

  10. Reversible dyscognition in patients with a unilateral, middle fossa arachnoid cyst revealed by using a laptop based neuropsychological test battery (CANTAB).

    Science.gov (United States)

    Torgersen, Johan; Helland, Christian; Flaatten, Hans; Wester, Knut

    2010-11-01

    The aim of this study was to evaluate and validate the Cambridge Neuropsychological Test Automated Battery (CANTAB) in a Norwegian group of patients undergoing surgery for middle fossa arachnoid cysts (AC). We also wanted to assess health related quality of life (HRQOL) in these patients to see if it could be improved by decompression of the AC. Adult patients (>18 years) with unilateral middle fossa AC and no previous history of neurological disease, head injury, or a psychiatric disorder were eligible for inclusion. We used four tests from CANTAB to assess the level of neuropsychological performance: paired associate learning (PAL) and delayed matching to sample (DMS) assessed temporal lobe functions, while Stockings of Cambridge (SOC) and intra-extra dimensional (IED) shift focused on frontal lobe functions. Patients with postoperative cerebral complications were reported, but excluded from neuropsychological follow-up. In addition to the CANTAB data, pre- and postoperative clinical and radiological data were collected. HRQOL was assessed using Short Form 36 (SF-36) pre- and postoperatively. We found significant improvement in the two temporal tests assessing memory, but no improvement in the two frontal tests assessing executive function. HRQOL was significantly reduced preoperatively in two of eight SF-36 domains and improved significantly in four domains postoperatively. CANTAB facilitates detection of cognitive improvements after decompression of the cyst in patients with AC in the middle fossa. The improvements were detected on the tests sensitive to temporal lobe problems only, not on the tests more sensitive to frontal lobe affection. This establishes construct validity for CANTAB for the first time in this population.

  11. Fast imaging employing steady-state acquisition (FIESTA) MRI to investigate cerebrospinal fluid (CSF) within dural reflections of posterior fossa cranial nerves.

    Science.gov (United States)

    Noble, David J; Scoffings, Daniel; Ajithkumar, Thankamma; Williams, Michael V; Jefferies, Sarah J

    2016-11-01

    There is no consensus approach to covering skull base meningeal reflections-and cerebrospinal fluid (CSF) therein-of the posterior fossa cranial nerves (CNs VII-XII) when planning radiotherapy (RT) for medulloblastoma and ependymoma. We sought to determine whether MRI and specifically fast imaging employing steady-state acquisition (FIESTA) sequences can answer this anatomical question and guide RT planning. 96 posterior fossa FIESTA sequences were reviewed. Following exclusions, measurements were made on the following scans for each foramen respectively (left, right); internal acoustic meatus (IAM) (86, 84), jugular foramen (JF) (83, 85) and hypoglossal canal (HC) (42, 45). A protocol describes measurement procedure. Two observers measured distances for five cases and agreement was assessed. One observer measured all the remaining cases. IAM and JF measurement interobserver variability was compared. Mean measurement difference between observers was -0.275 mm (standard deviation 0.557). IAM and JF measurements were normally distributed. Mean IAM distance was 12.2 mm [95% confidence interval (CI) 8.8-15.6]; JF was 7.3 mm (95% CI 4.0-10.6). The HC was difficult to visualize on many images and data followed a bimodal distribution. Dural reflections of posterior fossa CNs are well demonstrated by FIESTA MRI. Measuring CSF extension into these structures is feasible and robust; mean CSF extension into IAM and JF was measured. We plan further work to assess coverage of these structures with photon and proton RT plans. Advances in knowledge: We have described CSF extension beyond the internal table of the skull into the IAM, JF and HC. Oncologists planning RT for patients with medulloblastoma and ependymoma may use these data to guide contouring.

  12. Growth and erosion: The volcanic geology and morphological evolution of La Fossa (Island of Vulcano, Southern Italy) in the last 1000 years

    Science.gov (United States)

    Di Traglia, F.; Pistolesi, M.; Rosi, M.; Bonadonna, C.; Fusillo, R.; Roverato, M.

    2013-07-01

    The Island of Vulcano (Aeolian Islands, Southern Italy) consists of several volcanic edifices whose formation overlapped in time and space beginning 120 ka ago. The most recent volcano is the La Fossa cone, a 391 m-high active composite cone that began to erupt 5.5 ka ago. Eruptive activity at the La Fossa cone occurred in several cyclic phases separated by prolonged periods of erosion. The last 1000 years of eruptive activity and morphological variations in the cone and its surrounding area were investigated through a stratigraphic reconstruction. This was based on 139 natural cuts, 26 machine-excavated and 5 hand-dug trenches in the volcaniclastic succession. The revised stratigraphy of the volcanic and volcaniclastic sequence was compared with geological maps based on the Unconformity-bounded Stratigraphic Units criteria compiled in 2006-2010. It was found that the last 1000-year period can be divided into (in hierarchical order) Eruptive Clusters and Units. Several unconformities of different hierarchical order were also identified (erosional surfaces and/or palaeosols). Stratigraphic relationships with the Vulcanello products and with rhyolitic tephras related to the eruptions of Mt. Pilato (the last-formed volcanic edifice of the Island of Lipari) were fundamental in assigning a calendar age to most of the tephra units in the studied sequence. The morphological evolution of the upper part of the cone was also reconstructed in order to assess the average cone growth rate. This work suggests a new stratigraphic and chronological interpretation of the evolution and "cyclic" activity of the La Fossa cone in the last 1000 years. Several eruptions occurred in two main clusters. The stratigraphic record and morphological features reveal that the areas around the cone were affected by the deposition of reworked materials, with large amounts of tephra deposited on the steep slopes and within the major streams.

  13. Surface characteristics and degradational history of debris aprons in the Tempe Terra/Mareotis fossae region of Mars

    Science.gov (United States)

    Chuang, Frank C.; Crown, David A.

    2005-12-01

    We have documented the surface characteristics and degradational history of a population of 65 lobate debris aprons in the Tempe Terra/Mareotis fossae region of Mars. These aprons were compared to other martian debris aprons to evaluate similarities and differences among different populations, which can provide insight into the dominant controls on apron development. Tempe/Mareotis debris aprons, found at the bases of isolated or clustered massifs, escarpments, and crater interior walls, were studied using Viking Orbiter, Mars Global Surveyor, and Mars Odyssey datasets in a GIS database. Six textures related to degradation of apron surfaces are identified in MOC images, and they are divided into two groups: an upper-surface group and a lower-surface group. Degradation occurs within an inferred smooth, upper surface mantle of ice and debris, producing a sequence of pitted, ridge and valley, and knobby textures of the upper-surface group. Where upper-surface materials have been removed, smooth and ridged textures of the lower-surface group are exposed. Degradation to various depths may expose lower-surface materials, which may consist of the main apron mass, remnants of mantling deposits, or both. A combination of geologic processes may have caused the degradation, including ice sublimation, ice melt, and eolian activity. Apron surfaces have lower maximum thermal inertias and mean surface temperatures than adjacent plains surfaces, which may be explained by the trapping of unconsolidated materials in low-lying pits and valleys formed by surface degradation or from the disruption of crusts on degraded portions of apron surfaces. One feature observed only on Tempe/Mareotis debris aprons are broad ridges, which mimic the shape of massif bases for tens of kilometers. We propose these to be constructional features that could have formed during cycles of increased debris production. Apron morphometric parameters including area, volume, slope, thickness, relief, and H

  14. Recurrent inverted papilloma with intracranial and temporal fossa involvement: A case report and review of the literature;Papillome inverse recidivant avec extension temporale et intracranienne: cas clinique et revue de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Acevedo-Henao, C.M.; Pradier, O. [Department of Radiotherapy, Morvan Hospital, CHU de Brest, Brest University, 29 - Brest (France); Talagas, M. [Department of Pathology, Morvan Hospital, CHU de Brest, 29 - Brest (France); Marianowski, R. [Department of Head and Neck Surgery, Morvan Hospital, CHU de Brest, 29 - Brest (France)

    2010-06-15

    Inverted papilloma (I.P.) is a rare naso-sinusal benign tumour, with epithelium surface inversion to inside the stroma. Extension to intracranial temporal fossa and middle ear has been reported in few cases in the literature. This involvement may be derived from either direct extension from sino-nasal cavity via the Eustachian tube or primary middle ear involvement secondary to meta-plastic changes of the middle ear mucosa. Here, we report a case of inverted papilloma in a male patient, with multiple recurrences, middle ear and intracranial involvement into the temporal fossa with posterior development of malignancy. This patient had received multiple surgeries and radiotherapy but despite of that, his disease recurred several times. As a conclusion, inverted papilloma is a benign tumour with an aggressive course, tendency to recurrence and progression to malignancy. Intracranial and temporal fossa involvements are rare and the treatment depends of the symptoms and the severity of the disease. (authors)

  15. Impacted cisterna magna without syringomyelia associated with lancinating headache, throbbed nuchal pain and paraparesis treated byposterior fossa decompression Cisterna magna impactada sem siringomielia associada a cefaléia lancinante, dor na nuca terebrante e paraparesia tratadas com descompressão da fossa posterior

    Directory of Open Access Journals (Sweden)

    José Alberto Gonçalves da Silva

    2007-12-01

    Full Text Available A 29-year-old woman with acute lancinating headache, throbbed nuchal pain and subacute paraparesis underwent brain MRI in supine position that depicted: the absence of the cisterna magna, filled by non herniated cerebellar tonsils and compression of the brain stem and cisternae of the posterior fossa, which are aspects of the impacted cisterna magna without syringomyelia and without hydrocephalus. During eight days, pain was constant and resistant to drug treatment. Osteodural-neural decompression of the posterior fossa, performed with the patient in sitting position, revealed: compression of the brainstem, fourth ventricle and foramen of Magendie by herniated cerebellar tonsils, which were aspirated. Immediately after surgery, the headache and nuchal pain remmited. MRI depicted the large created cisterna magna and also that the cerebellar tonsils did not compress the fourth ventricle, the foramen of Magendie and the brainstem, besides the enlargement of posterior fossa cisternae. Four months after surgery, headache, nuchal pain and paraparesis had disappeared but hyperactive patellar and Achilles reflexes remained.Uma paciente de 29 anos de idade com quadro agudo de cefaléia lancinante, dor terebrante na nuca e paraparesia subaguda foi submetida a RM do encéfalo, em posição supina, que revelou: ausência da cisterna magna, preenchida por tonsilas cerebelares não herniadas e compressão do tronco encefálico e das cisternas da fossa posterior, compatíveis com o diagnóstico de cisterna magna impactada sem siringomielia e sem hidrocefalia. Por oito dias a dor foi constante e resistente aos analgésicos. Com a paciente em posição sentada, foi realizada descompressão osteodural-neural da fossa posterior associada a aspiração das tonsilas cerebelares. Os achados perioperatórios foram caracterizados por herniação das tonsilas cerebelares que comprimiam o tronco cerebral, o quarto ventrículo e o forame de Magendie. No p

  16. Great Balls of Fire: A probabilistic approach to quantify the hazard related to ballistics - A case study at La Fossa volcano, Vulcano Island, Italy

    Science.gov (United States)

    Biass, Sébastien; Falcone, Jean-Luc; Bonadonna, Costanza; Di Traglia, Federico; Pistolesi, Marco; Rosi, Mauro; Lestuzzi, Pierino

    2016-10-01

    We present a probabilistic approach to quantify the hazard posed by volcanic ballistic projectiles (VBP) and their potential impact on the built environment. A model named Great Balls of Fire (GBF) is introduced to describe ballistic trajectories of VBPs accounting for a variable drag coefficient and topography. It relies on input parameters easily identifiable in the field and is designed to model large numbers of VBPs stochastically. Associated functions come with the GBF code to post-process model outputs into a comprehensive probabilistic hazard assessment for VBP impacts. Outcomes include probability maps to exceed given thresholds of kinetic energies at impact, hazard curves and probabilistic isoenergy maps. Probabilities are calculated either on equally-sized pixels or zones of interest. The approach is calibrated, validated and applied to La Fossa volcano, Vulcano Island (Italy). We constructed a generic eruption scenario based on stratigraphic studies and numerical inversions of the 1888-1890 long-lasting Vulcanian cycle of La Fossa. Results suggest a ~ 10- 2% probability of occurrence of VBP impacts with kinetic energies ≤ 104 J at the touristic locality of Porto. In parallel, the vulnerability to roof perforation was estimated by combining field observations and published literature, allowing for a first estimate of the potential impact of VBPs during future Vulcanian eruptions. Results indicate a high physical vulnerability to the VBP hazard, and, consequently, half of the building stock having a ≥ 2.5 × 10- 3% probability of roof perforation.

  17. 后颅窝扩大重建术治疗Chiari畸形%Posterior fossa reconstruction for the teratment of chiari malformation

    Institute of Scientific and Technical Information of China (English)

    许小兵; 师蔚

    2000-01-01

    为评价后颅窝扩大重建术(Posterior fossa reconstruction, PFR)治疗Chiari畸形的效果,对7例有手术适应证的Chiari畸形病人施行后颅窝减压-硬脑膜扩大修补术(即后颅窝扩大重建术).定期随访,并与本院以往施行的传统后颅窝减压术(Posterior fossa decompression,PFD)作对比分析.结果表明:经过6个月~3年(平均1年2个月)随访,PFR组有效率为85.7%,PFD组有效率为60.0%.PFR组各种并发症发生率均明显低于PFD组.提示:PFR是治疗Chiari畸形的有效方法,且术后并发症少,可作为外科治疗Chiari畸形的首选术式.

  18. Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

    Directory of Open Access Journals (Sweden)

    Kalifa Chantal

    2008-01-01

    Full Text Available Abstract Background To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. Methods 23 patients (age 0.3 – 14 years at diagnosis who were treated with local posterior fossa irradiation (54 Gy underwent one (4 patients or sequential (19 patients neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5 years after RT. Results Mean last full scale IQ (FSIQ, verbal IQ (VIQ and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores ≤ 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p Conclusion Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

  19. MORPHOMETRIC PARAMETERS OF THE GLENOID FOSSA WITH THE LABRUM ATTACHED. Parámetros morfométricos de la fosa glenoidea con el labrum incluido

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    Abduelmenem Alashkham

    2016-07-01

    Full Text Available Background: The height and width of the glenoid fossa is important in total shoulder replacement. Previous studies, using different methods, have reported differences in glenoid fossa height and width. The current study aims to provide the morphometric parameters of the glenoid fossa with the labrum attached. Material and Methods: One hundred and forty shoulders from 30 males and 40 females were dissected and measurements taken. Exposure of the glenoid fossa with the labrum attached was undertaken, followed by direct measurement of glenoid height, width and level of maximum width using digital calipers. Data were double-entered into the Statistical Package for Social Sciences (SPSS, version 21. Kruskal-Wallis and One Way Analysis of Variance on Ranks tests were used. Statistical significance was defined as p<0.05. Results: The overall mean height, width and the level of maximum width for both genders were 38.94 mm, 30.50 mm and 17.14 mm respectively. However, the mean height, width and level of maximum width were significantly greater in males than females (P<0.001 for each. Conclusion: The mean height, width and the level of maximum width with the glenoid labrum attached were significantly greater in males than females. It suggests that the increase in height and width is due to the glenoid labrum is proportionate to the height and width of the glenoid fossa thus accounting for the difference between males and females remaining significant with or without the glenoid labrum.  Introducción: La altura y la anchura de la cavidad glenoidea es importante en el reemplazo total de hombro. Estudios previos, utilizando diferentes métodos, han presentado diferencias respecto a la altura y a la anchura de la cavidad glenoidea. El presente estudio tiene como objetivo proporcionar los parámetros morfométricos de la fosa glenoidea con el labrum incluido. Materiales y métodos: Se disecaron y tomaron medidas de ciento cuarenta hombros pertenecientes a

  20. Reconstrução tridimensional da face nos tumores avançados com invasão da fossa craniana anterior Tridimensional facial reconstruction following major resection of tumors involving the anterior cranial fossa

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    Mario Sergio Lomba Galvão

    2004-04-01

    Full Text Available OBJETIVO: Analisar as indicações cirúrgicas e o seguimento pós operatório, ressaltando as complicações e efetividade da abordagem multidisciplinar, para os tumores avançados da base do crânio. MÉTODO: Análise retrospectiva de 46 prontuários de pacientes submetidos à ressecção de tumores invadindo a fossa craniana anterior e reconstruídos com retalhos microcirúrgicos, operados entre março de 1990 e julho de 2002. Todos os pacientes foram operados pelo núcleo de cirurgia de base do crânio do INCA. RESULTADOS: As estruturas mais envolvidas na ressecção foram por ordem: a órbita (76,5%, seio maxilar (76,5%, seio esfenoidal (63,8%, paredes da cavidade nasal (59,5% e palato (42,5%. A dura-máter estava acometida em 32,6% dos casos. A reconstrução microcirúrgica utilizando os retalhos do músculo reto abdominal foi empregada em 93,5 % dos casos. A taxa de sucesso dos transplantes livres foi de 97,8%. As complicações ocorreram em 58,6% dos pacientes e as mais freqüentes foram: infecções locais (21,7%, fístulas liquóricas (15,2%, meningite (6,5% e hematoma (6,5%. CONCLUSÕES: A reconstrução com técnica microcirúrgica permite que se realizem ressecções alargadas destes tumores com limites seguros e índices de complicações aceitáveis, permitindo a estes pacientes uma melhoria da qualidade de vida e da sobrevida, com baixo índice de recidiva.BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were

  1. Determination of the Whiteside line on femur surface models by fitting high-order polynomial functions to cross-section profiles of the intercondylar fossa.

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    Cerveri, Pietro; Marchente, Mario; Manzotti, Alfonso; Confalonieri, Norberto

    2011-01-01

    Innovative methods for morphological and functional analysis of bones have become a primary objective in the development of planning systems for total knee replacement (TKR). These methods involve the interactive identification of clinical landmarks (reference points, distances, angles, and functional axes of movement) and the determination of the optimal implant size and positioning. Among the functional axes used to estimate the correct alignment of the femoral component, the Whiteside line, namely, the anterior-posterior (AP) direction, is one of the most common. In this paper, we present a computational framework that allows automatic identification of the Whiteside line. The approach is based on geometric analysis of the saddle shape of the intercondylar fossa to extract the principal line in the AP direction. A plane parallel to the frontal plane is moved in the AP direction to obtain the 2D profiles of the intercondylar fossa. Each profile is fitted to a fifth-order polynomial curve and its maximum curvature point computed. The point set collected across all the profiles is then processed to compute the principal direction. The 2D profile-fitting and 3D line-fitting residual errors were analyzed to study the relationship between the intercondylar fossa aspect and the nominal saddle surface. The method was validated using femur specimens from elderly subjects reconstructed from CT scans. The repeatability of the method was evaluated across five different femur surface resolutions. For comparison, three expert orthopaedic surgeons identified, by virtual palpation, the Whiteside line on the same 3D femur models. The repeatability (median angular error) of the Whiteside lines computed by the automated method and by manual virtual palpation, was approximately 1.0° and 3.5°, respectively. The angular skew error between the two axes, measured on the axial plane, averaged approximately 4.00° (SD: 2.64°) with no statistical difference. The automated method

  2. Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea

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    Aline Gomes Bittencourt

    2013-04-01

    Full Text Available A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nova abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada através de uma abordagem via fossa craniana média, na parte mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como pontos de reparo. A parede lateral do meato acústico interno foi dissecada após o broqueamento e esqueletização do ápice petroso. A parede dissecada do meato acústico interno foi acompanhada longitudinalmente até a cocleostomia. Design: Estudo anatômico de osso temporal. RESULTADOS: Em todos os ossos temporais, apenas a parte superficial do giro basal da cóclea foi aberta. A exposição do giro basal da cóclea permitiu que as escalas timpânica e vestibular fossem visualizadas. Assim, não houve dificuldade na inserção do feixe de eletrodos através da escala timpânica. CONCLUSÃO: A técnica proposta é simples e permite exposição suficiente do giro basal da cóclea.The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. OBJECTIVE: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa. METHOD: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and

  3. Relationship between posterior fossa space and hemifacial spasm%后颅窝空间大小与面肌痉挛发生的相关性

    Institute of Scientific and Technical Information of China (English)

    梁韡斌; 毛珂; 韦可聪; 张高炼

    2015-01-01

    Objective To quantitatively study the posterior fossa effective space and its relationship with hemifacial spasm (HFS).Methods We conducted a case-control study of patients diagnosed with HFS and sex-and age-matched healthy controls.All subjects underwent high-resolution three-dimensional MRI.The software of 3D-Slicer was used to measure the posterior fossa space and hindbrain tissue volume between the two groups.Results Sixty patients and 60 controls were enrolled in this study.Compared to controls,patients with HFS had a higher posterior fossa crowdedness index (PFCI;83.7% ± 0.6% vs 79.2% ± 0.4%;t =2.58, P =0.01).The multivariate linear regression analysis revealed that a higher PFCI was associated with younger age (r =-0.61, P =0.02), female gender (r =0.76, P =0.003) and HFS (r =-0.43, P =0.01).Conclusions Patients with HFS have a more crowded posterior fossa space than healthy controls, potentially leading to cranial nerve and vascular structure crowding, thus increasing HFS risk.Women have a higher PFCI, which may explain the strong female preponderance in epidemiologic studies.%目的 定量研究面肌痉挛患者及健康人后颅窝有效空间大小,探索后颅窝容积缩小与面肌痉挛发生之间的相关性.方法 共纳入2013年5月至2014年6月就诊于四川大学华西医院神经外科的60例诊断明确的面肌痉挛患者,60名对照为性别、年龄配对的健康人.两组均行头部三维薄层磁共振检查,利用容积测量软件3 D-slicer分别测量两组后颅窝脑组织和骨性空间大小.结果 面肌痉挛患者组后颅窝拥挤指数为83.7%±0.6%;健康对照组后颅窝拥挤指数为79.2%±0.4%,两组差异有统计学意义(t=2.58,P=0.01).多元线性回归分析提示较高的后颅窝拥挤指数与较小的年龄(r=-0.61,P=0.02)、女性(r=0.76,P=0.003)及面肌痉挛患者(r=-0.43,P=0.01)相关.结论 面肌痉挛患者后颅窝较健康对照组更加拥挤,后颅窝空间狭小可能与"

  4. Ameloblastoma de fossa nasal: revisão bibliográfica e relato de dois casos Nasal ameloblastoma: literature review and report of two cases

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    Washington L. C. Almeida

    2001-09-01

    Full Text Available O ameloblastoma é um tumor bastante incomum na cavidade nasal. Surge a partir do epitélio odontogênico, podendo estender-se ao seio maxilar, órbitas e base de crânio. Apresentamos dois casos de ameloblastoma em fossa nasal direita, associados a sintomas nasossinusais e seus principais achados, clínicos e cirúrgicos.Ameloblastoma is a very unusual tumor in the nasal cavity. It arises from the odontogenic epithelium and extends up to the maxillary sinus, orbits and skull base. We have presented two cases of ameloblastoma, both in the right nasal cavity, associated with nasal and sinusal symptoms, and reported the main surgical and clinical findings.

  5. Posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia

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    HU Peng

    2012-08-01

    Full Text Available Background Chiari malformation type Ⅰ(CM-Ⅰ is one of the soft tissue anomalies in craniovertebral junction (CVJ. This kind of soft tissue anomaly usually develops with bone anomaly, such as atlantoaxial subluxation, basilar invagination, platybasia, C1 assimilation, etc. For these complex combined anomalies, the treatment remains unaddressed. This study was performed to evaluate the effect of posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia. Methods Patients with basilar invagination and atlantoaxial subluxation treated from July 2004 to September 2011 were reviewed. Including criterions were made to screen matching patients. Including patients were retrospectively analyzed on both clinical outcomes and radiographical results. Japanese Orthopaedic Association (JOA score was used to evaluate the clinical outcomes, while the syrinx maximum size was measured on transverse view of MRI T2 image. The results were analyzed by SPSS 17.0 using t -text. Significant difference was considered when P ≤ 0.05. Results Fourteen patients met the including criterions, including 4 male patients and 10 female patients, with a mean age of 31.86 ± 11.36 (standard deviation, range: 17-51 years. Mean JOA score preoperatively of 14 patients was 13.07 ± 1.59 (standard deviation, while that was 15.57 ± 1.02 (standard deviation postoperatively (t = 9.946, P = 0.000. The mean syrinx size was (7.05 ± 1.98 mm (standard deviation, while that was (2.21 ± 1.91 mm (standard deviation postoperatively (t = 7.271, P = 0.000. There were no procedure-related morbidity or mortality happened. Conclusion Direct posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression can obviously improve the clinical outcomes and shrink syrinx for patients suffered from Chiari malformation typeⅠ with

  6. Hydrocephaly management in patients with tumors in the posterior fossa. Manejo de la hidrocefalia en pacientes con tumores de fosa posterior.

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    Omar López Arbolay.

    2005-11-01

    Full Text Available Introduction: Preoperative hydrocephalus is reported in about 80 % of posterior fossa tumor patients and in 15-40% of cases postoperative treatment for persistent or progressive hydrocephalus is required. There is no consensus on the way hydrocephalus should be managed before, during, and after PF surgery. Objective: To determine the presence of hidrocephalia in the tumors of the PF and the therapeutic focus in our means. Methods: We report a descriptive, retrospective study of 10 adult patients with posterior fossa mass lesions and obstructive hydrocephalus who were managed medically for compensate intracranial hypertension plus observation and were operated through posterior fossa craniectomy and tumor excision as unique method of surgical treatment. Results: In all 10 cases clinical improvement was obtained immediately after medical treatment. Circulation of cerebrospinal fluid (CSF was totally restored only by tumor excision in 9 patients. The other case had progression of hydrocephalus after surgery and a ventriculoperitoneal shunt was inserted. Radiological normal sized ventricles was obtained between one and two months of surgery Conclusions: Surgical elimination of CFS circulation obstacle helped by medical treatment for lower intracranial pressure should be considered as a safe option in adult patients, reserving endoscopic ventriculostomy and shunt insertion for cases with persistent or progressive hydrocephalus after treatment. Prospective multicenters randomized trials are needed to obtain stronger evidences. Fundamento: La hidrocefalia preoperatoria se reporta en el 80 % de los pacientes con tumores de fosa posterior y en 15-40 % de los casos se necesita tratamiento postoperatorio para hidrocefalia persistente o progresiva. No existe consenso en cuanto a la forma en que la hidrocefalia debe ser tratada antes, durante, o después de

  7. Endoscopic vidian neurectomy assisted by power instrumentation and coblation.

    Science.gov (United States)

    Hsu, Chao-Yuan; Shen, Ping-Hung; Weitzel, Erik Kent

    2013-09-01

    Vidian neurectomy has been used to manage intractable vasomotor rhinitis for decades. After the introduction of endoscopic sinus surgery in the 1980s, transnasal endoscopic vidian neurectomy (EVN) was subsequently reported. The most common problem in performing EVN was excessive bleeding from the pterygopalatine fossa. The complexity and vascularity of the pterygopalatine fossa can cause bloody surgical fields and prevent complete neurectomy. In response to this surgical problem, a procedure was developed to use powered instrumentation and coblation during EVN. There were eight cases of EVNs (16 neurectomies) assisted by power instrumentation and coblation from December 2011 to May 2012. The average blood loss of these cases was 37.5 mL (range, 25-50 mL). The average surgical time of each neurectomy was 27.4 minutes (range, 20-35 minutes). No complications occurred in any of the eight cases. Very limited bleeding and less thermal damage were noted while achieving a complete neurectomy.

  8. Synovial chondromatosis of the right side temporomandibular joint extending to the middle cranial fossa: A case report with 7-year postoperative follow up and expression of a biomarker of cell proliferative activity

    Science.gov (United States)

    Yoshitake, Hiroyuki; Kayamori, Kou; Wake, So; Sato, Fumiaki; Kino, Koji; Harada, Kiyoshi

    2016-01-01

    Introduction Synovial chondromatosis of the temporomandibular joint (TMJ) with cranial extension is rare. Here, we report 7-year follow-up of a case with immunohistochemical examination of cell proliferative activity. Presentation of case The patient was a 72-year-old man. Severe bone resorption of the glenoid fossa was apparent on CT images. Pathological findings by biopsy led to diagnosis of synovial chondromatosis of the right side TMJ. Extirpation of the tumor was performed via temporopreauricular incision under general anesthesia. PCNA expression was examined by immunohistochemical analysis. The lesion had penetrated into the middle cranial fossa, but the cranial dura mater was intact. Expression of PCNA was confirmed. Discussion The PCNA expression suggested that growth activity caused expansion of the lesion to the skull base. Conclusion We were able to follow up this case for a long period without recurrence postoperatively. PMID:26855075

  9. Chondromyxoid fibroma of retromandibular fossa space: report of one case and review of the literatures%下颌后窝区软骨黏液纤维瘤:1例报告及文献复习

    Institute of Scientific and Technical Information of China (English)

    陈井鑫; 廖天安

    2012-01-01

    软骨黏液纤维瘤是一种少见的软骨来源的良性肿瘤,绝大部分发生在儿童和青年人的长骨干骺端,很少发生于颌面部,发生于下颌后窝区者国内未见报道.本文报告1例,并结合相关文献,对其临床表现、诊断及鉴别诊断、治疗进行讨论.%Chondromyxoid fibroma is a rare benign tumor originated from cartilage. It mainly occurs in the metaphysis of long bones in children and young people. And it rarely occurs in the retromandibular fossa. This paper reported a case with chondromyxoid fibroma in the mandibular fossa. The potential histopathologic source,clinical manifestations, diagnosis, several differential diagnosis and treatment were discussed.

  10. Posterior fossa reconstruction in the treatment of Chiari I malformation associated with syringomyelia%颅后窝重建术治疗Chiari I畸形合并脊髓空洞症

    Institute of Scientific and Technical Information of China (English)

    沈建; 方黎明; 濮宏健; 朱岁军; 唐超; 周永庆; 黄红光

    2011-01-01

    Objective To evaluate posterior fossa reconstruction (posterior cranial fossa decompression,duraplasty, resection of the cerebellar tonsil and separation of the arachnoid membrane from the dura) in the treatment of Chiari Ⅰ malformation.Methods A total of 46 patients suffered from Chiari Ⅰ malformation associated with syringomyelia received posterior fossa reconstruction in our department from November 2002 to January 2008.Results The rate of symptom improvement post - operation was 84.8%.The length of syringomyelia was decreased significantly and KPS got remarkable improvement.Conclusion Posterior fossa reconstruction is a rational option for the treatment of Chiari Ⅰ malformation associated with syringomyelia.%目的 探讨后颅窝重建术(后颅窝减压+硬脑膜成形+小脑扁桃体切除+蛛网膜粘连分解)治疗Chiari I畸形合并脊髓空洞症的方法及疗效.方法 2002年11月至2008年1月对收治的46例Chiari I畸形合并脊髓空洞症患者行后颅窝重建术.结果 后颅窝重建术症状改善率84.8%,脊髓空洞长度明显减小,KPS评分显著改善.结论后颅窝重建术是治疗Chiari I畸形合并脊髓空洞症较为合理的术式.

  11. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem Formaciones venosas superficiales de la fosa cubital: aspectos de interés para la práctica de Enfermería Superficial venous formation of the cubital fossa: aspects of interest for nursing practice

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    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí reportado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA.The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we found that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV

  12. Comparison of FSE T2W and 3D FIESTA sequences in the evaluation of posterior fossa cranial nerves with MR cisternography.

    Science.gov (United States)

    Hatipoğlu, Hatice Gül; Durakoğlugil, Tuğba; Ciliz, Deniz; Yüksel, Enis

    2007-06-01

    The aim of this study was to compare 3D fast imaging with steady state acquisition (3D FIESTA) to fast spin echo T2-weighted (FSE T2W) MRI sequences in the imaging of cisternal parts of cranial nerves V-XII. We retrospectively evaluated the temporal MRI sequences of 50 patients (F:M ratio, 27:23; mean age, 44.5 +/- 15.9 years) who were admitted to our hospital with vertigo, tinnitus, and hearing loss. In all, we evaluated 800 nerves. Two radiologists, working independently, divided the imaging findings into 3 groups: 0 (not visualized), 1 (partially visualized), and 2 (completely visualized). The rate of visualization of these cranial nerves with FSE T2W and 3D FIESTA sequences, respectively, (partially and completely visualized) were as follows: nerve V (100% and 100%); nerve VI (43% and 98%); nerve VII (100% and 100%); nerve VIII (100% and 100%); nerve IX-XI complex (67% and 100%); nerve XII (2% and 91%). 3D FIESTA sequences are superior to FSE T2W sequences in the imaging of cisternal parts of the posterior fossa nerves. 3D FIESTA sequences may be used for obtaining high-resolution MR cisternography images.

  13. Combined irradiation and chemotherapy using ifosfamide, cisplatin, and etoposide for children with medulloblastoma/posterior fossa primitive neuroectodermal tumor. Results of a pilot study

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    Sawamura, Yutaka; Ikeda, Jun; Ishii, Nobuaki; Kato, Tsutomu; Tada, Mitsuhiro; Abe, Hiroshi; Shirato, Hiroki [Hokkaido Univ., Sapporo (Japan). School of Medicine

    1996-09-01

    Ten children with newly diagnosed medulloblastoma/primitive neuroectodermal tumor of the posterior fossa were treated with total surgical resection, radiation therapy, and ICE chemotherapy regimen with ifosfamide (900 mg/m{sup 2}, days 1-5), cisplatin (20 mg/m{sup 2}, days 1-5), and etoposide (60 mg/m{sup 2}, days 1-5) every 4 weeks for eight cycles. Four children under 2 years old were at first treated with eight cycles of ICE chemotherapy, and then irradiated. The ICE regimen was well tolerated by all children, with no irreversible adverse effects. However, dose reductions during the eight cycles were inevitable mainly due to myelosuppression. Complete remissions were achieved in eight of 10 patients at 1 month after completion of the treatment. One child showed recurrence 21 months after complete remission. The disease-free survival rate was 70% with a mean observation period of 24 months after surgery. The ICE regimen is a useful treatment modality for children with medulloblastoma. Further study is warranted to clarify long-term outcome in a number of patients. (author)

  14. Facial herpes zoster infection precipitated by surgical manipulation of the trigeminal nerve during exploration of the posterior fossa: a case report

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    Mansour Nassir

    2009-09-01

    Full Text Available Abstract Introduction We present a case of herpes zoster infection (shingles precipitated by surgical manipulation of the trigeminal nerve root during an attempted microvascular decompression procedure. The pathogenesis of this phenomenon, as well as the importance and role of prophylactic acyclovir in its management, are discussed. Case presentation A 54-year-old Caucasian man with a classical long-standing left-sided V2 and V3 division primary trigeminal neuralgia refractory to medical management, underwent posterior fossa exploration for microvascular decompression via a standard retromastoid craniectomy. The patient had immediate and complete relief from pain. Three days after the operation, he developed severely painful vesicles with V2 and V3 dermatomal distribution. Rather than the classical paroxysmal, lancinating type of trigeminal neuralgia, the pain experienced by the patient was of a constant burning nature. A clinical diagnosis of herpes zoster (shingles was made after smear confirmation from microbiological testing. The patient was commenced on antiviral treatment with acyclovir. His vesicular rash and pain gradually subsided over the next two weeks. He remains asymptomatic one year later. Conclusions Postoperative shingles precipitated by trigeminal nerve manipulation during surgery for trigeminal neuralgia can be a distressing and demoralizing experience for the patient. A careful preoperative history, early recognition, and prompt antiviral therapy is necessary.

  15. 后颅窝手术后颅内感染的防治分析%Risk factors relate to intracranial infection and its treatment after selective posterior fossa surgery

    Institute of Scientific and Technical Information of China (English)

    王荆夫; 庄顺福; 蔡维平; 易海波; 张小锋; 林瑞生; 李榕

    2014-01-01

    Objective To explore the factors relate to intracranial infection after the posterior fossa surgery and its treatment. Methods The clinical data of 356 patients undergoing the selective posterior fossa surgery from June, 2005 to June, 2013, of whom, 28 had intracranial infection and 328 not, were analyzed retrospectively. All the patients with intracranial infection were treated by the intravenous infusion of the antibiotics, drainage of cerebrospinal fluid and intrathecal injection of the antibiotics. Results The intracranial infection occurred from 3 to 14 days after the posterior fossa surgery in 28 patients. Of 28 patients with intracranial infection, 27 were cured within 6 weeks after the infection and 1 gave up treatment voluntarily. Conclusions The intracranial infection easily occurs in the patients undergoing the posterior fossa surgery. The curative effect of intravenous infusion and intrathecal injection of antibiotics and drainage of cerebrospinal fluid on the intracranial infection after the posterior fossa surgery is good.%目的:探讨后颅窝手术后颅内感染的易感因素及防治措施。方法回顾性分析对我科2005年6月至2013年6月后颅窝手术后继发生颅内感染的28例患者的临床资料。皮肤切开前应用抗生素,手术时间>4 h者加用1次,术毕用生理盐水250 ml+注射液万古霉素500 mg反复冲洗;全部患者采用全身用抗生素+脑脊液引流+鞘内应用抗生素治疗。结果28例患者颅内感染时间发生在开颅术后3~14 d。27例颅内感染在6周内得到有效控制,1例自动出院。结论后颅窝手术术后容易并发颅内感染,采用全身用抗生素+脑脊液引流+鞘内应用抗生素是一种治疗后颅窝手术术后并发颅内感染的有效方法。

  16. Primary extraparenchymal hemorrhage of the posterior cranal fossa as a premonitory symptom of atlanto-axial instability; Traumatische extraparenchymale Blutung der hinteren Schaedelgrube als Warnsymptom einer atlantoaxialen Instabilitaet

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    Holl, K.; Rolli, K.; Olschowski, A.; Wurm, G. [Neurochirurgische Abt., Landesnervenklinik Linz (Austria); Nussbaumer, K. [Neuroradiologische Abt., Landesnervenklinik Linz (Austria)

    2001-07-01

    The contribution discusses the cases of five patients with cranio-cerebral trauma, (four children and one adult patient), where CT examination revealed extraparenchymal hemorrhage of the posterior cranal fossa, which did not fit into their pattern of intracranial trauma and therefore gave reason to suspect a lesion of the upper cervical spine. The various types of hemorrhage found are explained, as well as the underlying cervical spine lesions, and the choice of respective therapies which proved to be successful. (orig./CB) [German] Wir berichten ueber fuenf Patienten nach Schaedel-Hirn-Trauma, deren gemeinsamer Befund in der kraniellen Computertomographie eine extraparenchymale Blutung der hinteren Schaedelgrube (HSG) ohne Zusammenhang mit dem uebrigen intrakraniellen Verletzungsmuster bzw. ohne sonstige intrakranielle Verletzung war. Es handelte sich um vier Kinder und einen Erwachsenen mit einem Durchschnittsalter von 8,8 (4-22) Jahren. Drei dieser Patienten wiesen eine epidurale Blutung am Clivus bzw. am Foramen magnum auf, bei einem Patienten handelte es sich um eine Subarachnoidalblutung um das Cerebellum, bei einem weiteren Patienten lag eine Blutung im IV. Ventrikel vor. Diese infratentoriellen Blutungen waren der erste Hinweis, dass eine Verletzung in der oberen Halswirbelsaeule (HWS) vorliegen koennte. Es wurde bei den vier Kindern als zugrundeliegende Ursache der Blutung eine ligamentaere Verletzung C1/C2 diagnostiziert, nur bei dem erwachsenen Patienten lag eine knoecherne Verletzung C1/C2 vor. Die Therapie erfolgte in den vier Faellen mit Instabilitaet chirurgisch, bei dem Patienten ohne Instabilitaet konservativ. Nach einem mittleren Nachbeobachtungszeitraum von 5,2 Jahren waren alle operierten Patienten klinisch gebessert bzw. weiterhin neurologisch unauffaellig. Es konnte bei allen Patienten eine stabile Situation C1/C2 bei guter Funktionalitaet der HWS nachgewiesen werden. (orig.)

  17. Clinical significance of changes in pB-C2 distance in patients with Chiari Type I malformations following posterior fossa decompression: a single-institution experience.

    Science.gov (United States)

    Bonney, Phillip A; Maurer, Adrian J; Cheema, Ahmed A; Duong, Quyen; Glenn, Chad A; Safavi-Abbasi, Sam; Stoner, Julie A; Mapstone, Timothy B

    2016-03-01

    OBJECT The coexistence of Chiari malformation Type I (CM-I) and ventral brainstem compression (VBSC) has been well documented, but the change in VBSC after posterior fossa decompression (PFD) has undergone little investigation. In this study the authors evaluated VBSC in patients with CM-I and determined the change in VBSC after PFD, correlating changes in VBSC with clinical status and the need for further intervention. METHODS Patients who underwent PFD for CM-I by the senior author from November 2005 to January 2013 with complete radiological records were included in the analysis. The following data were obtained: objective measure of VBSC (pB-C2 distance); relationship of odontoid to Chamberlain's, McGregor's, McRae's, and Wackenheim's lines; clival length; foramen magnum diameter; and basal angle. Statistical analyses were performed using paired t-tests and a mixed-effects ANOVA model. RESULTS Thirty-one patients were included in the analysis. The mean age of the cohort was 10.0 years. There was a small but statistically significant increase in pB-C2 postoperatively (0.5 mm, p < 0.0001, mixed-effects ANOVA). Eleven patients had postoperative pB-C2 values greater than 9 mm. The mean distance from the odontoid tip to Wackenheim's line did not change after PFD, signifying postoperative occipitocervical stability. No patients underwent transoral odontoidectomy or occipitocervical fusion. No patients experienced clinical deterioration after PFD. CONCLUSIONS The increase in pB-C2 in patients undergoing PFD may occur as a result of releasing the posterior vector on the ventral dura, allowing it to relax posteriorly. This increase appears to be well-tolerated, and a postoperative pB-C2 measurement of more than 9 mm in light of stable craniocervical metrics and a nonworsened clinical examination does not warrant further intervention.

  18. Magnetic resonance imaging-based diagnosis of middle cranial fossa tumors%中颅窝区脑外肿瘤的MRI表现

    Institute of Scientific and Technical Information of China (English)

    段刚; 彭旭红

    2009-01-01

    Objective To analyze the magnetic resonance imaging (MRI) features of middle cranial fossa tumors. Methods Thirty-one patients with surgically and pathologically confirmed middle cranial fussa tumors were enrolled in this study, including 13 with trigeminal neurinornas, 6 with meningiomas, 3 with arachnoid cysts, 3 with dermoid cysts, 2 with osteoblastomas, 2 with chordomas, and 2 with epidermoid cysts. All the patients underwent plain and enhanced MR scanning and the imaging data were retrospectively analyzed. Results Different types of middle cranial fossa tumors had distinctly different MRI appearances. Trigeminal neuromas displayed hypo- and iso-intense signals on T1-weighted images (T1WI) and hyperintense signals on T2-weighted images (T2WI), and 9 of the 13 patients presented with shell-shaped enhancement after Gd-DTPA injection. Meningioma showed hypo-and iso-intense signals on T1WI and hypo-, iso- and hyper-intense signals on T2WI, with relatively homogeneous enhancement after Gd-DTPA injection. Osteoblastoma exhibited shell-shaped bony encapsulation of the tumor, and chordomas grew along the middle and posterior cranial fussae with close lateral association with the clivus. Arachnoid cysts and epidermoid cysts showed hypointense signals on TIWI and hyperintense signals on T2WI with slight enhancement of the cyst wall after Gd-DTPA injection. The arachnoid cysts grew expansively, and epidermoid cysts were characterized by high invasiveness in any possible directions. Dermoid cysts presented with hyperintense signals on T1WI and T2WI with popcorn-like appearance in some cases. Conclusion The middle fossa tumors present characteristic MRI features, which, in combination with clinical examinations, help derive an accurate diagnosis.%目的 探讨中颅窝区脑外肿瘤的MRI特点,提高其诊断准确率. 方法 经手术病理证实的31例中颅窝区脑外肿瘤(包括三叉神经鞘瘤13例,脑膜瘤6例,蛛网膜囊肿3例,皮样囊肿3

  19. Study of applied anatomy through the operative route of nasal cavity-nasal sinus-pterygomaxillary fossa-infratemporal fossa%经鼻内镜鼻腔-鼻窦-翼腭窝-颞下窝手术入路的应用解剖学研究

    Institute of Scientific and Technical Information of China (English)

    艾文彬; 邱元正; 肖健云; 赵素萍

    2007-01-01

    目的 通过对鼻腔-鼻窦-翼腭窝(pterygomaxillary fossa,PMF)-颞下窝(infratemporal fossa,ITF)手术入路的相关结构进行解剖,为手术入路提供解剖学基础.方法 对6例12侧成人尸头标本按中线锯开后进行解剖,并完全模拟该手术入路,对相关解剖标志进行了观察、拍摄和测量.结果 翼腭窝-颞下窝区结构复杂,有重要的神经和血管经过.圆孔外口距正中矢状面距离为(19.18±1.48)mm,与后鼻孔上缘的距离为(19.81±1.52)mm,距鼻小柱根部为(77.31±5.13)mm.卵圆孔到鼻小柱根部为(86.40±3.76)mm.结论 经鼻内镜鼻腔-鼻窦-翼腭窝-颞下窝手术入路能够简单和迅速地到达翼腭窝和颞下窝,可较好地显露翼腭窝及部分颞下窝区的结构.经鼻内镜入路进入PMF时术野的深度限制为70mm左右,注意保护位于蝶窦外侧壁的翼管神经、上颌神经及颈内动脉(internal carotid artery,ICA),进入ITF时,术野的深度限制为80mm左右.

  20. Orofacial pain

    Directory of Open Access Journals (Sweden)

    Marjolijn Oomens

    2016-06-01

    Full Text Available In the primary care sector, diagnosis and initial management of orofacial pain are often performed by familydoctors and dentists. Knowledge of the different types of orofacial pain and headache disorders is therefor of great importance. The International Classification of Headache Disorders (ICHD-3 provides an overview of the different types of orofacial pain and will be discussed in this lecture. The main focus will be on trigeminal neuralgia and cluster headache and the current research in this field. Trigeminal Neuralgia (TN is defined as a disorder characterized by recurrent, unilateral, brief, electricshock-like pains, abrupt in onset and termination, limited to the distribution of one or more divisions of thetrigeminal nerve and triggered by innocuous stimuli. Unfortunately, most TN is idiopathic, and the aetiology isnot clear. The guidelines on pharmaceutical TN management published by the American Academy of Neurology (AAN and the European Federation of Neurological Societies (EFNS recommend carbamazepine (CBZ; 200–1200 mg/day or oxcarbazepine (OXC; 600–1800 mg/day as first-line therapy. Both are antiepileptics with well known interactions with other drugs and safety problems. An overview of the currently available literature on the pharmaceutical management of TN patients is discussed. Cluster headache (CH is one of the most painful primary headache disorders. It is characterized by daily or almost daily attacks of unilateral excruciating periorbital pain associated with ipsilateral cranial autonomic symptoms, typically lasting between 15 and 180 minutes if untreated. Cluster headache is caused by the relaesement of neurotransmitters and vasodilators from the sphenopalatine ganglion (SPH. The SPG is a large extracranial parasympathetic ganglion located in the pterygopalatine fossa (PPF. The current treatments for CH attacks are injectable sumatriptan and oxygen inhalation. Both treatments have well known side effects and

  1. Resolution of syringomyelia in ten cases of "up-and-down Chiari malformation" after posterior fossa decompression Resolução de siringomielia em dez casos de malformação de Chiari observada apenas com o paciente em posição sentada durante a descompressão da fossa posterior

    Directory of Open Access Journals (Sweden)

    José Alberto Gonçalves da Silva

    2010-10-01

    Full Text Available The authors describe ten cases of syringomyelia without hindbrain herniation depicted by preoperative magnetic resonance imaging (MRI in supine position. However, the herniation was observed in all cases during the operation with the patient in sitting position. The postoperative MRI revealed an intense reduction of the syrinx in all patients, as well as it was also observed a clinical amelioration in all cases. The surgical treatment was based on a large craniectomy with the patient in sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large cisterna magna.Os autores descrevem 10 casos de siringomielia sem herniação do rombencéfalo, observada na ressonância magnética realizada em decúbito dorsal. Por outro lado, a herniação foi observada em todos os pacientes durante a operação com o paciente em posição sentada. A ressonância magnética pós-operatória evidenciou redução da cavidade siringomiélica nos dez pacientes, bem como foi observada melhora clínica em todos os casos. O tratamento cirúrgico consistiu de craniectomia ampla da fossa posterior, tonsilectomia, abertura ampla do quarto ventrículo e duroplastia com a criação de ampla cisterna magna.

  2. Study of the Dextran-DTPA-Gd at rabbit popliteal fossa lymph node metastasis from thigh transplanted tumor with interstitial magnetic resonance lymphography

    Institute of Scientific and Technical Information of China (English)

    Zhenpeng Zhao; Yuanyong Feng; Wei Li; Shengbiao Wan; Tao Jiang; Wei Shang

    2014-01-01

    Objective:The aim of the study was to investigate the developing situation of the interstitial magnetic resonance (MR) lymphoid contrast agent Dextran-DTPA-Gd through the rabbit popliteal fossa lymph node metastasis from thigh VX2 transplanted tumor injection to show targeting enhanced metastatic lymph nodes and lymphatics. Methods:VX2 tumor was transplanted to the right hind limb quadriceps of 12 healthy New Zealand rabbits and the left side as a contrast. Eight rabbits had homonymy popliteal lymph node metastasis after 1 month through 3.0 GE MRI and they were later injected with lym-phatic targeting contrast agent Dextran-DTPA-Gd 0.4 mL (3.96 × 10-3 mol/L) through bilateral hindlimb toe web respectively. Enhanced MR images were obtained with interval 10 min, 15 min, 20 min, 25 min, 30 min, 35 min, 40 min, 45 min, 50 min, 55 min, 60 min, 2 h, 4 h, and 24 h. The signal intensities before and after enhancing were measured to calculate the enhanc-ing rates (E%) of popliteal lymph node and the popliteal lymph node signal intensity-time curves were drawn to observe the development of cancer metastasis lymph nodes and lymphatics and to compare the dif erences of interval sides. Results:Ten minutes after injected into the rabbit’s bilateral hindlimb toe web, we could see hind lymphatic and popliteal lymph nodes were strengthened significantly and evenly without blood vessels developing. The signal reached a peak after 35 min with E%to 315%, which decreased to 205%after 4 h and would be undif erentiated with the surrounding tissues after 24 h. Sta-tistical analysis was made to popliteal lymph node enhancement rate. It was considered statistical y significant as long as P<0.05. The tumor-side popliteal lymph node manifested as coarse and irregular shape, lymphatic vessels tortuous dilated and lymphatic chain incomplete as a result of tumor infection. Conclusion:Dextran-DTPA-Gd is specific to lymphoid tissue development. It can targeting display regional lymphatic

  3. Proton Treatment Techniques for Posterior Fossa Tumors: Consequences for Linear Energy Transfer and Dose-Volume Parameters for the Brainstem and Organs at Risk.

    Science.gov (United States)

    Giantsoudi, Drosoula; Adams, Judith; MacDonald, Shannon M; Paganetti, Harald

    2017-02-01

    In proton therapy of posterior fossa tumors, at least partial inclusion of the brainstem in the target is necessary because of its proximity to the tumor and required margins. Additionally, the preferred beam geometry results in directing the field distal edge toward this critical structure, raising concerns for brainstem toxicity. Some treatment techniques place the beam's distal edge within the brainstem (dose-sparing techniques), and others avoid elevated linear energy transfer (LET) of the proton field by placing the distal edge beyond it (LET-sparing techniques). Hybrid approaches are also being used. We examine the dosimetric efficacy of these techniques, accounting for LET-dependent and dose-dependent variable relative biologic effectiveness (RBE) distributions. Six techniques were applied in ependymoma cases: (a) 3-field dose-sparing; (b) 3-field LET-sparing; (c) 2-field dose-sparing, wide angles; (d) 2-field LET-sparing, wide angles; (e) 2-field LET-sparing, steep angles; and (f) 2-field LET-sparing with feathered distal end. Monte Carlo calculated dose, LET, and RBE-weighted dose distributions were compared. Decreased LET values in the brainstem by LET-sparing techniques were accompanied by higher, not statistically significant, median dose: 53.6 Gy(RBE), 53.4 Gy(RBE), and 54.3 Gy(RBE) for techniques (b), (d), and (e) versus 52.1 Gy(RBE) for technique (a). Accounting for variable RBE distributions, the brainstem volume receiving at least 55 Gy(RBE) increased from 72.5% for technique (a) to 80.3% for (b) (Ptechnique (c) to 77.6% for (d) (Ptechniques compared with the corresponding dose-sparing (P=.03 and .004). Extending the proton range beyond the brainstem to reduce LET results in clinically comparable maximum radiobiologic effective dose to this sensitive structure. However this method significantly increasing the brainstem volume receiving RBE-weighted dose higher than 55 Gy(RBE) with possible consequences based on known dose-volume parameters

  4. Flow patterns of lobate debris aprons and lineated valley fill north of Ismeniae Fossae, Mars: Evidence for extensive mid-latitude glaciation in the Late Amazonian

    Science.gov (United States)

    Baker, David M. H.; Head, James W.; Marchant, David R.

    2010-05-01

    A variety of Late Amazonian landforms on Mars have been attributed to the dynamics of ice-related processes. Evidence for large-scale, mid-latitude glacial episodes existing within the last 100 million to 1 billion years on Mars has been presented from analyses of lobate debris aprons (LDA) and lineated valley fill (LVF) in the northern and southern mid-latitudes. We test the glacial hypothesis for LDA and LVF along the dichotomy boundary in the northern mid-latitudes by examining the morphological characteristics of LDA and LVF surrounding two large plateaus, proximal massifs, and the dichotomy boundary escarpment north of Ismeniae Fossae (centered at 45.3°N and 39.2°E). Lineations and flow directions within LDA and LVF were mapped using images from the Context (CTX) camera, the Thermal Emission Imaging Spectrometer (THEMIS), and the High Resolution Stereo Camera (HRSC). Flow directions were then compared to topographic contours derived from the Mars Orbiter Laser Altimeter (MOLA) to determine the down-gradient components of LDA and LVF flow. Observations indicate that flow patterns emerge from numerous alcoves within the plateau walls, are integrated over distances of up to tens of kilometers, and have down-gradient flow directions. Smaller lobes confined within alcoves and superposed on the main LDA and LVF represent a later, less extensive glacial phase. Crater size-frequency distributions of LDA and LVF suggest a minimum (youngest) age of 100 Ma. The presence of ring-mold crater morphologies is suggestive that LDA and LVF are formed of near-surface ice-rich bodies. From these observations, we interpret LDA and LVF within our study region to result from formerly active debris-covered glacial flow, consistent with similar observations in the northern mid-latitudes of Mars. Glacial flow was likely initiated from the accumulation and compaction of snow and ice on plateaus and in alcoves within the plateau walls as volatiles were mobilized to the mid

  5. A new species of Dermopristis Kearn, Whittington & Evans-Gowing, 2010 (Monogenea: Microbothriidae), with observations on associations between the gut diverticula and reproductive system and on the presence of denticles in the nasal fossae of the host Glaucostegus typus (Bennett) (Elasmobranchii: Rhinobatidae).

    Science.gov (United States)

    Whittington, Ian D; Kearn, Graham C

    2011-09-01

    Dermopristis cairae n. sp. (Monogenea: Microbothriidae) is described from the skin and possibly from the nasal fossae of the giant shovel-nosed ray Glaucostegus typus (Bennett). The new species is distinguished from D. paradoxus Kearn, Whittington & Evans-Gowing, 2010 by its larger size, body shape, lack of transverse ridges on the ventral surface and absence of a seminal receptacle. Extensive short gut branches lie dorsal to the testes and adjacent to the coiled region of the vas deferens and the oötype, possibly reflecting high metabolic demand in these areas. Denticles are present in the lining of the nasal fossae of G. typus, providing a firm substrate for the cement-based attachment of a microbothriid. However, confirmation that D. cairae inhabits the nasal fossae of G. typus is required.

  6. Posterior fossa meningioma (surgical experiences)

    African Journals Online (AJOL)

    Wael M. Moussa

    2012-08-27

    Aug 27, 2012 ... Morbidity included decreased level of consciousness, cranial nerve palsy and wound infection. ..... (10 cases), trigeminal nerve compression (6 cases), facial nerve .... and magnetic resonance imaging for surgical planning for menin- ... anatomy scanning in the operation of intracranial parasagittal.

  7. [Arachnoid cysts of the middle cranial fossa in children. A review of 75 cases, 47 of which have been operated in a comparative study between membranectomy with opening of cisterns and cystoperitoneal shunt].

    Science.gov (United States)

    Lena, G; Erdincler, P; Van Calenberg, F; Genitori, L; Choux, M

    1996-01-01

    The authors report their experience concerning 75 cases of middle fossa arachnoid cysts observed in children during the period 1975-1993, 47 of which (62.6%) were operated upon. The aim of this study was to study the clinical presentation of these cysts, to discuss the surgical indications and to compare the results of the various techniques used to treat these malformations. Head injury was revealing in 17 cases (22.6%) and among these, 12 patients presented intracranial complications (subdural effusions; 6 cases, subdural hematomas: 4 cases and intracystic hematomas: 2 cases). The most usual signs and symptoms were: intracranial hypertension (25.3%), epilepsy (16%) and temporal bulging (24%). Twenty-one patients (44.7%) underwent a cystoperitoneal shunt; 20 patients (42.5%) were treated by membranectomy with opening of the basal cisterns and removal of intracystic (2 cases) or subdural hematoma (4 cases); 2 patients (4.3%) were treated using membranectomy, opening of the cisterns and cystoperitoneal shunt and 4 patients (8.4%) underwent a subduroperitoneal shunt. The long-term results were good regardless of the surgical procedure; nevertheless, only one patient among 20 cases treated by membranectomy and opening of the cisterns developped complications (5%), while multiple shunt revisions were necessary in 11 children (40.7%) out of 27 where a shunt was inserted. The authors conclude that membranectomy and opening of the basal cisterns is the procedure of choice to treat middle fossa arachnoid cysts in children.

  8. A dosimetric comparison between 3D-Conformal radiation therapy and intensity modulated radiation therapy plans in the treatment of posterior fossa boost in children with high risk medulloblastom

    Institute of Scientific and Technical Information of China (English)

    Saad El Din I; Abd El AAl H; Makaar W; Mashhour K; El Beih D; Hashem W

    2013-01-01

    Objective:The work is a comparative study between two modalities of radiation therapy, the aim of which is to compare 3D conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) in treating posterior fossa boost in children with high risk medul oblastoma;dosimetrical y evaluating and comparing both techniques as regard target coverage and doses to organs at risk (OAR). Methods:Twenty patients with high risk medul oblastoma were treated by 3D-CRT technique. A dosimetric comparison was done by performing two plans for the posterior fossa boost, 3D-CRT and IMRT plans, for the same patient using Eclipse planning system (version 8.6). Results:IMRT had a better conformity index compared to 3D-CRT plans (P value of 0.000). As for the dose homogeneity it was also better in the IMRT plans, yet it hasn’t reached the statistical significant value. Also, doses received by the cochleae, brainstem and spinal cord were significantly less in the IMRT plans than those of 3D-CRT (P value<0.05). Conclusion:IMRT technique was clearly able to improve conformity and homogeneity index, spare the cochleae, reduce dose to the brainstem and spinal cord in comparison to 3D-CRT technique.

  9. Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report

    Directory of Open Access Journals (Sweden)

    Yvens B. Fernandes

    1995-09-01

    Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17, estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning

  10. 儿童创伤性颅后窝硬脑膜外血肿的治疗%Treatment of traumatic posterior cranial fossa epidural hematoma in children

    Institute of Scientific and Technical Information of China (English)

    孙育海; 吴海渡; 陈磊; 丁圣豪; 高国一; 包映晖; 潘耀华; 梁玉敏; 江基尧

    2011-01-01

    Objective To summarize the clinical features and treatment experience of traumatic posterior cranial fossa epidural hematomas (PFEDH) in child.Methods Clinical data of 30 patients with PFEDH diagnosed by surgery or imaging were analyzed retrospectively, including traffic accident injury in 18 cases, crash injury in 9, falling injury in 3, and all patients accompanied with occipital impact.The GCS scores were as follows: 8 to 10 scores in 3 cases, 11 to 12 in 9, 13 to 14 in 18.Surgical or conservative treatment was adopted according to the volume of hematoma and conditions of patients.Results Conservative treatment was performed in 6 patients, and the hematoma was completely absorbed according to CT 3 months after operation, and the neurological examination revealed no obvious abnormality.Surgical treatment was performed in 24 patients, whose state was stably improved,headache disappeared gradually, and the hematoma was basically absorbed according to CT postoperatively.No complications related to operation occurred.Good recovery was achieved in all patients according to GOS scores.Conclusions The patients with occipital impact and skull fracture have a higher risk of developing into PFEDH, and early diagnosis and prompt treatment of traumatic PFEDH can achieve satisfactory outcomes in children.%目的:总结儿童创伤性颅后窝硬脑膜外血肿(PFEDH)的临床特点和诊治经验.方法:回顾性分析30例经手术和(或)影像学检查确诊的儿童创伤性PFEDH的临床资料,其中车祸伤18例,坠落伤9例,跌伤3例;均有枕部着力伤.GCS评分:8~10分3例,11~12分9例,13~14分18例.根据血肿量和病人情况,采用非手术治疗或手术治疗.结果:非手术治疗6例,伤后3个月复查CT血肿均完全吸收,神经系统检查未见明显异常;手术治疗24例,术后所有病儿病情平稳好转,头痛症状逐渐消失,术后CT显示血肿基本清除.本组无手术相关并发症.出院时病儿按COS预后分级均恢复

  11. Nursing Experience of Intractable Subcutaneous Effusion after Posterior Fossa Tumor Operation in 15 cases%15例后颅窝肿瘤术后顽固性皮下积液的护理体会

    Institute of Scientific and Technical Information of China (English)

    银秀春; 银秀君; 王参智

    2016-01-01

    目的:探讨腰大池置管+积液腔留置套管针同时持续外引流治疗后颅窝肿瘤术后顽固性皮下积液的护理要点。方法回顾性分析15例腰大池置管+积液腔留置套管针同时外引流治疗后颅窝肿瘤术后顽固性皮下积液患者的临床护理资料。结果本组病例经腰大池置管+积液腔留置套管针同时持续外引流治疗,皮下积液均治愈。结论腰大池置管+积液腔留置套管针同时持续外引流是治疗后颅窝肿瘤术后顽固性皮下积液的有效措施。保持外引流管通畅,是治愈后颅窝肿瘤术后顽固性皮下积液的关键。%Objective To investigate the key points of treating and caring for intractable subcutaneous effusion of postoperative patients with posterior fossa tumors by use of lumbar cistern tube and indwelling needle plus effusion cavity continuous external drain-age. Methods Clinical nursing data of 15 cases were retrospectively analyzed. All the cases of postoperative patients with posterior fossa tumors adopted lumbar cistern tube and indwelling needle plus effusion cavity continuous external drainage to treat intractable sub-cutaneous effusion. Results All the cases with subcutaneous effusion treated by lumbar cistern tube and indwelling needle plus effu-sion cavity continuous external drainage were cured. Conclusion Lumbar cistern tube and indwelling needle plus effusion cavity con-tinuous external drainage is an effective method to treat intractable subcutaneous effusion of postoperative patients with posterior fossa tumors, and the important thing is to keep the external drainage tube unclogged.

  12. Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil - DOI: 10.4025/actascibiolsci.v29i4.887 Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil - DOI: 10.4025/actascibiolsci.v29i4.887

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    Maria de los Angeles Perez Lizama

    2008-02-01

    Full Text Available O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatro famílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais, variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher, 1988. Diferenças foram observadas nas medidas corporais dos parasitos e na quantidade de espécies de parasitos por espécie de peixe em relação aos copépodes encontrados em estudos anteriores na região amazônica. O presente estudo constitui um dos poucos trabalhos de identificação de copépodes parasitos de fossas nasais de peixes da região Sul do Brazil.The present work had the objective to study parasitic copepods in the nasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae, Schizodon borellii (Anostomidae, Prochilodus lineatus (Prochilodontidae, Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae. Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger

  13. Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos Nasal foreign bodies: description of types and complications in 420 cases

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    Ricardo Rodrigues Figueiredo

    2006-02-01

    Full Text Available Corpos estranhos de fossas nasais são acidentes comuns em crianças, podendo, de acordo com a literatura, levar a complicações supurativas e bronco-aspiração do corpo estranho. O diagnóstico é feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiológicos podem ser úteis. OBJETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no serviço de ORL-EPO do Hospital Municipal Souza Aguiar quanto a vários parâmetros como sexo, idade, tipo e complicações. MATERIAL E MÉTODO: 420 casos de corpos estranhos de fossas nasais removidos no serviço de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO do Hospital Municipal Souza Aguiar, no período de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidência na faixa etária de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plástico, grãos de feijão e fragmentos de papel. As complicações ocorreram em 9,05% dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSÃO: Os corpos estranhos de fossas nasais são acidentes encontrados principalmente na faixa etária de 0 a 4 anos, sendo os mais comuns, em nossa casuística, os fragmentos de espuma e pequenos artefatos de plástico. Complicações não são freqüentes, sendo as mais encontradas a epistaxe e vestibulite nasal.Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To evaluate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of

  14. MRI imaging features of common tumors in posterior cranial fossa of children%儿童后颅窝常见肿瘤的MRI影像学特征分析

    Institute of Scientific and Technical Information of China (English)

    贾维; 刘亚龙; 彭礼清

    2013-01-01

    Objective To investigate the MRI imaging features of common tumors in posterior cranial fossa of children.Methods MRI imaging data of 20 children with tumors in posterior cranial fossa that had been clinico-pathologically demonstrated were retrospectively analyzed.Results Six cases with astrocytoma mainly showed iso-and hypo-density on T1WI and mixed signal intensity on T2WI sequences.Of the astrocytoma cases,four had cystic changes,and one case presented completely cystic.Ten cases with medulloblastoma showed slightly hypo-dense signal intensity and iso-or slightly hyper-intense signal intensity on T1WI and T2WI sequences,respectively.Very little cystic changes were found in the type of tumors.Four cases with ependymoma were located at the fourth ventricle,and mainly showed iso-and hypo-signal intensity on T1 WI and high or slightly higher signal intensity on T2WI.All the medulloblastomas were heterogeneously enhanced with obstructive hydrocephalus.Conclusions There are certain MRI imaging features of tumors in posterior cranial fossa of children.MRI has clinically significant in the locating and characterizing tumors in posterior cranial fossa of children.%目的 探讨儿童后颅窝肿瘤的磁共振(MRI)影像学特征.方法 回顾性分析20例经手术病理证实的儿童后颅窝肿瘤的MRI和临床资料.结果 6例星形细胞瘤MRI平扫以T1WI等低信号,T2WI混杂信号为主,其中4例部分囊性变,增强后明显不均匀强化,1例完全囊性变.10例髓母细胞瘤以T1WI稍低信号、T2WI等或稍高信号为主,其中5例病灶信号欠均匀,伴有多个小囊边区.4例室管膜瘤,均位于四脑室区,以T1WI等、低信号,T2WI高或稍高信号为主,呈明显不均匀强化,伴梗阻性脑积水.结论 儿童后颅窝肿瘤的MRI表现具有一定的特征性,MRI对儿童后颅窝肿瘤的定位和定性诊断具有重要的临床价值.

  15. 儿童后颅窝硬膜外血肿35例临床分析%Posterior fossa epidural hematomas in children: a clinical analysis of 35 cases

    Institute of Scientific and Technical Information of China (English)

    王子德; 于如同; 祁正磊; 沈志刚; 苗发安; 谢满意; 纪培志; 王强

    2016-01-01

    Objective To investigate the clinical features,imaging findings,treatment and prognosis of posterior fossa epidural hematomas in children.Methods From August 2010 to April 2015,the clinical data of 35 children with traumatic posterior fossa epidural hematoma admitted to the Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical College were analyzed retrospectively.Eighteen of them were treated conservatively 8 were treated with skull drilling and drainage.Three of which received urokinase therapy because part of residual hematoma after procedure,and 9 were treated by craniotomy.Results In 18 children treated with the conservative treatment,CT revealed that their hematomas were absorbed about 1 month or so after symptom onset.The residual hematomas < 5 ml after procedure in 8 children were treated with skull drilling and drainage,and 9 were treated with craniotomy,their hematomas were removed completely after procedure.They were followed up for 4 months to 5 years.All children recovered well,without operation death and disability.Conclusions The occurrence of posterior fossa epidural hematomas in children are relatively more common.Most of them are falling and slipping injuries.The lambdoid suture separation fracture and occipital fracture are the main causes of bleeding.Headache,vomiting and disturbance of consciousness are more important for identifying the disease.Hemotomas in acute phase are easy to be liquefied.Drilling skull and drainage are safe and effective for the treatment of liquefied hematomas.The early diagnosis and appropriate treatment of posterior fossa epidural hematomas in children have good prognosis.%目的 探讨儿童后颅窝硬膜外血肿的临床特点、影像学表现、治疗方法及预后.方法 回顾性分析2010年8月至2015年4月徐州医学院附属医院神经外科收治的35例儿童外伤性后颅窝硬膜外血肿患儿的临床资料.采用保守治疗18例;钻孔引流治疗8例,其中3例因术后血

  16. 先天性肛门闭锁合并直肠阴道舟状窝瘘的护理%Nursing of congenital anal atresia patients complicated with rectovaginal scaphoid fossa fistula

    Institute of Scientific and Technical Information of China (English)

    朱正云

    2012-01-01

    目的 探讨先天性肛门闭锁合并直肠阴道舟状窝瘘的护理.方法 总结14例先天性肛门闭锁合并直肠阴道道舟状窝瘘围术期护理.护理要点包括:术前心里护理及充分做好肠道准备,术后做好肛周、肛管护理,定期扩肛,观察排便情况,给予健康指导及出院指导.结果 患者中2例术后肛门红肿明显伴有糜烂、流脓.经积极治疗和护理,所有患儿均痊愈出院.结论 充分的术前准备和细致的术后护理及正确扩肛能避免术后并发症的发生,提高患儿生活质量.%Objective To explore the nursing of congenital anal atresia patients complicated with rectovaginal scaphoid fossa fistula. Methods The perioperative nursing of 14 congenital anal atresia patients complicated with rectovaginal scaphoid fossa fistula was summarized. The nursing included preoperative psychological care and adequate bowel preparation and postoperative nursing (perianal and anal canal nursing,regular anal expansion,defecation,health guidance and discharge guidance). Results Two patients had anal swelling accompanied by erosion and pus. After active treatment and nursing,all children were cured and discharged. Conclusion Adequate preoperative preparation,careful postoperative nursing,right anal expansion can avoid complications and improve quality of life of those patients.

  17. Merging field mapping and numerical simulation to interpret the lithofacies variations from unsteady pyroclastic density currents on uneven terrain: The case of La Fossa di Vulcano (Aeolian Islands, Italy)

    Science.gov (United States)

    Doronzo, Domenico M.; Dellino, Pierfrancesco; Sulpizio, Roberto; Lucchi, Federico

    2017-01-01

    In order to obtain results from computer simulations of explosive volcanic eruptions, one either needs a statistical approach to test a wide range of initial and boundary conditions, or needs using a well-constrained field case study via stratigraphy. Here we followed the second approach, using data obtained from field mapping of the Grotta dei Palizzi 2 pyroclastic deposits (Vulcano Island, Italy) as input for numerical modeling. This case study deals with impulsive phreatomagmatic explosions of La Fossa Cone that generated ash-rich pyroclastic density currents, interacting with the topographic high of the La Fossa Caldera rim. One of the simplifications in dealing with well-sorted ash (one particle size in the model) is to highlight the topographic effects on the same pyroclastic material in an unsteady current. We demonstrate that by merging field data with 3D numerical simulation results it is possible to see key details of the dynamical current-terrain interaction, and to interpret the lithofacies variations of the associated deposits as a function of topography-induced sedimentation (settling) rate. Results suggest that a value of the sedimentation rate lower than 5 kg/m2 s at the bed load can still be sheared by the overlying current, producing tractional structures (laminae) in the deposits. Instead, a sedimentation rate higher than that threshold can preclude the formation of tractional structures, producing thicker massive deposits. We think that the approach used in this study could be applied to other case studies (both for active and ancient volcanoes) to confirm or refine such threshold value of the sedimentation rate, which is to be considered as an upper value as for the limitations of the numerical model.

  18. 特发性青少年脊髓空洞症患儿后颅窝线性容积的改变及临床意义%Morphometric analysis of the posterior fossa in adolescents with idiopathic syringomyelia

    Institute of Scientific and Technical Information of China (English)

    闫煌; 朱泽章; 邱勇; 沙士甫; 江龙; 伍伟飞; 杨宗

    2013-01-01

    目的 评估青少年特发性脊髓空洞(idiopathic syringomyelia,IS)患儿后颅窝线性容积,并探讨其临床意义.方法 从2008年1月至2011年10月我院诊断为IS的病例中选择影像学资料完整的青少年患儿25例(IS组).同时选取性别、年龄匹配的继发于Chiari畸形Ⅰ型的脊髓空洞(Chiari malformation type Ⅰ& syringomyelia,CMI-S)患儿(CMI-S组)及正常青少年作为对照组.在正中矢状面MR影像上分别测量三组患儿后颅窝线性容积的距离指标(后颅窝斜坡长度、枕骨大孔径、枕上长度、后颅窝矢状径、后颅窝高径)和角度指标(后颅窝斜坡倾斜角),并运用单向方差分析统计三组患儿后颅窝各测量指标间的差异.结果 IS组后颅窝斜坡长度25.4~48.7 mm(平均38.3 mm);枕骨大孔前后径27.2~44.2 mm(平均33.6 mm);枕骨鳞部长度23.6~48.2 mm(平均36.7 mm);后颅窝矢状62.9~88.4 mm(平均74.3 mm);后颅窝高径18.5~43.9 mm(平均31.3 mm)及斜坡倾斜角30.0°~77.0°(平均56.7°).IS组与CMI-S组患儿的后颅窝线性容积各测量指标均显著小于正常青少年,差异有统计学意义(P<0.05).IS组患儿后颅窝斜坡倾斜角为56.7°±10.6°,显著大于CMI-S组患儿50.8°±11.7°,差异有统计学意义(P<0.05),其余指标差异没有统计学意义(P>0.05).结论 IS患儿与CMI-S患儿均存在后颅窝骨性结构的发育异常.与CMI-S患儿相比,IS患儿具有较为陡直的斜坡结构.%Objective To investigate the morphometric characteristics of the posterior fossa in adolescents with idiopathic syringomyelia (IS) and to elucidate the clinical significances.Methods A retrospective radiographic review was performed on 25 adolescents who were diagnosed as IS and treated at our clinic between January 2008 and October 2011.Another cohort of normal adolescents and chiari malformation type Ⅰ & syringomyelia(CMI-S) patients,matched with the IS patients in age and gender,were recruited as the control

  19. Osteoplastic maxillotomy approach for infraorbital nerve schwannoma, a case report.

    Science.gov (United States)

    Karkas, Alexandre A; Schmerber, Sébastien A; Bettega, Georges V; Reyt, Emile P; Righini, Christian A

    2008-03-01

    Extracranial schwannomas can readily occur in the head and neck region and rarely involve the trigeminal nerve. As a rule, their treatment is surgical and dictated by the location of the tumor and nerve of origin. We describe a case of a 14-year-old boy with a mass invading right nasal fossa, maxillary sinus, orbital floor, pterygopalatine fossa, and infratemporal fossa. The diagnosis of a nerve sheath tumor was evoked after angiography showed no vascular blush. The tumor was removed through a Weber-Fergusson incision with subciliary extension followed by maxillozygomatic osteotomy. This approach showed the tumor to be coming from the infraorbital nerve and allowed complete tumor exposure and removal. Pathology confirmed the diagnosis of a schwannoma. We describe the osteoplastic maxillotomy approach which we felt most appropriate for removal of the infraorbital schwannoma and discuss other possible surgical options for this type of tumor. (c) 2007 Wiley Periodicals, Inc. Head Neck 2008.

  20. Strategy of endoscopic surgery for posterior cranial fossa cysts with hydrocephalus in children%儿童颅后窝囊肿合并脑积水的内镜治疗

    Institute of Scientific and Technical Information of China (English)

    朱广通; 胡志强; 黄辉; 戴缤; 关峰; 王劭恒; 毛贝贝; 任乐宁; 康庄

    2011-01-01

    Objective To explore the surgical approach, techniques and efficacy for different types of posterior cranial fossa cysts treated by endoscopic surgery. Methods Clinical data of 26 patients with posterior cranial fossa cysts complicated by hydrocephalus were analyzed retrospectively. Cerebrospinal fluid (CSF) Cine MRI and radionuclide cisternography were performed in all the patients preoperatively. The endoscope-assisted microsurgery through infratentorial posterior median approach was performed in 3 cases, and endoscopic surgery alone via supratentorial transfrontal cortical approach in 23. Results High intracranial pressure improved to different degrees in all the patients postoperatively, limb dyskinesia improved in 1 case and was not obviously changed in 2.Postoperatively intracranial pressure declined to normal level after releasing CSF by lumbar puncture. CSF leaked into the hypoderma in 1 case and no other serious complications occurred postoperatively. Cine MRI 1 week after operation showed CSF flowed through the ostomy of third ventricle floor in all patients undergoing surgery via supratentorial approach. MRI reexamination was performed in all the patients 6 months after operation, the cysts shrank in 18 cases and was not obviously changed in 8, and the size of ventricles diminished in 11 cases and was not obviously changed in 15. Conclusions Endoscopic surgery through supratentorial transfrontal cortical approach has obvious therapeutic efficacy for huge posterior cranial fossa cysts encroached on the tentorium cerebelli and Dandy-Walker malformation with expanded midbrain aqueduct, which can solve the mass effect caused by hydrocephalus and cysts at the same time.%目的 探讨神经内镜手术治疗不同类型颅后窝囊肿的手术入路、技巧及疗效.方法 回顾性分析26例颅后窝囊肿合并脑积水病人的临床资料.术前均行脑脊液磁共振电影成像(Cine MRI)和同位素脑池显像检查.采用幕下后正中

  1. Tortícolis recurrente como forma de presentación de un tumor de la fosa posterior del cerebro Recurrent torticollis as a form of presenting a tumor in the posterior fossa brain

    Directory of Open Access Journals (Sweden)

    Isael Olazábal Armas

    2012-09-01

    Full Text Available La tortícolis se presenta como una manifestación focal del sistema nervioso central, y es una afección poco frecuente, aunque puede ser el síntoma inicial en patologías de la fosa posterior del cerebro. Se presenta el caso de un paciente masculino de cuatro años de edad, con antecedentes de dolor, lateralización y torsión del cuello con nueve meses de evolución, cuyos síntomas se mantuvieron progresando. Gradualmente se asocian cefalea, náuseas e inestabilidad a la marcha. Al realizar el examen físico se encontraron elementos clínicos de una tortícolis y un síndrome cerebeloso de hemicuerpo derecho. Se realizó una resonancia magnética nuclear de cráneo, la cual evidenció una lesión sólida que ocupaba todo el piso del IV ventrículo, y se extendía hasta el segundo segmento medular cervical. Se efectuó abordaje quirúrgico de la fosa posterior del cerebro y exeresis de la lesión. El diagnóstico histológico fue el de un ependimoma. Aunque la tortícolis la mayoría de las ocasiones es una condición benigna, cuando se presenta secundariamente en los niños, uno de los diagnósticos diferenciales que deben tenerse en cuenta, son los tumores de la fosa posterior del cerebro, como ocurrió en este caso.Torticollis is presented as a focal demonstration of the central nervous system, and it is a rare condition, but it may be the initial symptom in diseases of the posterior fossa brain. We report the case of a male patient aged four, with a history of pain, lateralization and twisted neck with nine months of evolution, whose symptoms were progressing. Gradually, headache, nausea and gait instability are associated. When performing the physical examination, we found clinical elements of a stiff neck and a right hemisphere cerebellar syndrome. We performed a cranial MRI, which showed a solid lesion occupying the entire floor of the fourth ventricle, and it extended to the second cervical spinal segment. Surgical approach was

  2. Inner structure of La Fossa di Vulcano (Vulcano Island, southern Tyrrhenian Sea, Italy) revealed by high-resolution electric resistivity tomography coupled with self-potential, temperature, and CO2 diffuse degassing measurements

    Science.gov (United States)

    Revil, A.; Finizola, A.; Piscitelli, S.; Rizzo, E.; Ricci, T.; Crespy, A.; Angeletti, B.; Balasco, M.; Barde Cabusson, S.; Bennati, L.; BolèVe, A.; Byrdina, S.; Carzaniga, N.; di Gangi, F.; Morin, J.; Perrone, A.; Rossi, M.; Roulleau, E.; Suski, B.

    2008-07-01

    La Fossa cone is an active stratovolcano located on Vulcano Island in the Aeolian Archipelago (southern Italy). Its activity is characterized by explosive phreatic and phreatomagmatic eruptions producing wet and dry pyroclastic surges, pumice fall deposits, and highly viscous lava flows. Nine 2-D electrical resistivity tomograms (ERTs; electrode spacing 20 m, with a depth of investigation >200 m) were obtained to image the edifice. In addition, we also measured the self-potential, the CO2 flux from the soil, and the temperature along these profiles at the same locations. These data provide complementary information to interpret the ERT profiles. The ERT profiles allow us to identify the main structural boundaries (and their associated fluid circulations) defining the shallow architecture of the Fossa cone. The hydrothermal system is identified by very low values of the electrical resistivity (400 Ω m). Inside the crater it is possible to follow the plumbing system of the main fumarolic areas. On the flank of the edifice a thick layer of tuff is also marked by very low resistivity values (in the range 1-20 Ω m) because of its composition in clays and zeolites. The ashes and pyroclastic materials ejected during the nineteenth-century eruptions and partially covering the flank of the volcano correspond to relatively resistive materials (several hundreds to several thousands Ω m). We carried out laboratory measurements of the electrical resistivity and the streaming potential coupling coefficient of the main materials forming the volcanic edifice. A 2-D simulation of the groundwater flow is performed over the edifice using a commercial finite element code. Input parameters are the topography, the ERT cross section, and the value of the measured streaming current coupling coefficient. From this simulation we computed the self-potential field, and we found good agreement with the measured self-potential data by adjusting the boundary conditions for the flux of water

  3. A new species of Dermopristis Kearn, Whittington & Evans-Gowing, 2010 (Monogenea: Microbothriidae), with observations on associations between the gut diverticula and reproductive system and on the presence of denticles in the nasal fossae of the host Glaucostegus typus (Bennett) (Elasmobranchii: Rhinobatidae)

    OpenAIRE

    Whittington, ID; Kearn, GC

    2011-01-01

    Dermopristis cairae n. sp. (Microbothriidae) is described from the skin and possibly from the nasal fossae of the giant shovelnosed ray Glaucostegus typus (Bennett). The new species is distinguished from D. paradoxus Kearn, Whittington & Evans-Gowing, 2010 by its larger size, body shape, lack of transverse ridges on the ventral surface and absence of a seminal receptacle. Extensive short gut branches lie dorsal to the testes and adjacent to the coiled region of the vas deferens and the oo¨typ...

  4. Topography of the third portion of the maxillary artery via the transantral approach in Asians.

    Science.gov (United States)

    Kwak, Hyun-Ho; Jo, Jae-Beom; Hu, Kyung-Seok; Oh, Chang-Seok; Koh, Ki-Seok; Chung, In-Hyuk; Kim, Hee-Jin

    2010-07-01

    The maxillary artery (MA) passes over the lateral pterygoid muscle in the infratemporal fossa and enters the pterygopalatine fossa through the pterygomaxillary fissure. Refractory epistaxis is managed by ligation of the sphenopalatine artery via a transmaxillary-transantral approach; there is considerable risk of complications associated with such invasive surgical approaches. The aim of this study was to describe the gross anatomy and variations therein of the MA and its branches at the pterygopalatine fossa. One hundred hemifaces of embalmed Korean adult cadavers were dissected to establish the precise course of the MA and its branching patterns. The average thickness of the posterior wall of the maxillary sinus was 0.8 mm, but varied over a wide range from 0.2 to 3.6 mm. We classified the third part of the MA into 3 morphological categories: looped (61%), bifurcated (19%), and straight (18%). Two cases could not be classified into any of these 3 categories. The pattern of the bifurcation between the sphenopalatine and descending palatine arteries was classified into 4 types: Y (19%), intermediate (36%), M (17%), and T (28%). The posterior wall of the maxillary sinus was divided into 9 sections. The branching areas of the sphenopalatine and descending palatine arteries were most frequently (62% of cases) located at the top of the medial partition and at the middle of the medial partition (30% of cases).

  5. 关节镜清理成形术治疗肘骨关节炎伴肘后撞击症%Efficacies of arthroscopic debridement and olecranon fossa plasty in the treatment of osteoarthtis and posterior elbow impingement

    Institute of Scientific and Technical Information of China (English)

    刘玉杰; 王俊良; 李海峰; 齐玮; 王宁

    2012-01-01

    Objective To evaluate the efficacies of arthroscopic debridement and removal of osteophyma for olecroanon and olecranon fossa plasty for posterior impingement of elbow joint.Methods Between 1999 and 2008,a total of 21 cases were diagnosed with osteoarthritis and posterior elbow impingement.There were 15 males and 6 females.And there were 16 right and 15 left cases.They included volleyball players (n =7),tennis players ( n =7 ),golf enthusiasts ( n =4) and fencers ( n =3 ).The average duration of onset-operation was 3.5 years ( range:2.5 - 8 ).Arthroscopic exploration revealed synovial hyperplasia hypertrophy,cartilage degeneration and olecranon fossa hyperplasia with deformed olecranon fossa.Debridement and plasty were performed.Loose bodies were removed from elbow joint in 6 patients.Partial resection of posterior olecranon tip was performed and osteophytes or fibrous tissue removed in this area.Dynamic observation showed no posterior elbow impingement.Results Postoperative follow-up was conducted in 19 cases and 2 cases became lost to follow-up.The average follow-up period was 25.3 months (range:18 -42).All patients were evaluated preoperatively and postoperatively with the Hospital for Special Surgery Elbow Assessment Scale.The outcomes were excellent ( n =12 ),good ( n =7 ) and fair ( n =2).Postoperative patients elbow swelling and pain relieve,sports and life function returns to normal,elbow flexion and rotating mobility obviously improved.With the elbow radiological films to measure the range of motion,the average range of motion was 90.5° preoperatively and improved to 130° postoperatively.There was significant improvement in all cases.Conclusion Posterior elbow impingement is caused by hyperextension trauma and elbow overuse during specific sporting activities.Arthroscopic debridement and olecroanon or olecranon fossa plasty demonstrates excellent results for posterior impingement of elbow joint.%目的 探讨肘关节镜清理成形术治疗尺骨

  6. 11~13+6周胎儿颅后窝结构的产前超声检测%Ultrasound measurement of fetal posterior fossa at 11 to 13 + 6 gestational weeks for screening open spina bifida

    Institute of Scientific and Technical Information of China (English)

    秦凤真; 李胜利; 华轩; 欧阳玉容; 郑琼; 毕静茹

    2014-01-01

    Objective To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13+6 gestational weeks and explore their clinical value in screening open spina bifida (OSB). Methods Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13+6 weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges. Results In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL;the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1. Conclusion The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to

  7. Neuroendoscopic therapy for hydrocephalus caused by cysts of the posterior fossa%神经内镜治疗后颅窝囊肿合并脑积水31例分析

    Institute of Scientific and Technical Information of China (English)

    刘华; 彭玉平; 漆松涛; 韦拳堂; 宋烨

    2011-01-01

    Objective To explore the process and technique ofneuroendoscopic operation in obstructive hydrocephalus caused by cysts of the posterior fossa. Methods An analysis of 31 patients with obstractive hydrocephalus caused by cysts of the posterior fossa, admitted to our hospital from April 2004 to August 2010, was performed; CT and MRI were performed on these patients. Among all the 31patients, 19 had arachnoid cyst of the posterior fossa, 5 Dandy-Walker malformations, 2 Blake' s pouch cyst, and 5 cysts after resection of the tumor. Treatment efficacy was determined according to the improvement of clinical symptoms, imaging manifestations and appearing of relative complications.Results Endoscopic management (n=14), microsurgery (n=9) and ventriculoperitoneal shunt (n=8) were performed. All the patients' postoperative hydrocephalus was alleviated in early stage of treatnent.Subsequent follow-up, ranged from 0.6 to 6 years, revealed a sharp reduction of sizes of the cyst and ventricle system under MRI in 28 patients, with a total effective rate of 87.1%. The effective rate and incidence of complications were 92.9% and 14.3% in patients performed endoscopic management, 88.9%and 33.3% in patients performed microsurgery, and 75% and 50% in patients performed ventriculoperitoneal shunt, respectively.Conclusion Neuroendoscopic procedure is a safe and effective technique for hydrocephalus caused by cysts of the posterior fossa; as compared with those with microsurgery and ventriculoperitoneal shunt, higher success rate and less operative complications are achieved in patients with endoscopic management.%目的 探讨神经内镜治疗后颅窝囊肿合并脑积水的诊治方法。 方法 回顾性分析南方医院神经外科自2004年4月至2010年8月收治的31例后颅窝扩大囊室合并脑积水患者资料,所有患者均经头颅CT和MRI证实。其中后颅窝真性蛛网膜囊肿19例,Dandy walker畸形5例,布莱克囊肿2

  8. 垂体窝上口形态学特点与垂体腺瘤生长关系的影像学研究%Imaging study of the relationship between morphological features of pituitary fossa superior orifice and growth pattern of pituitary adenomas

    Institute of Scientific and Technical Information of China (English)

    韦拳堂; 漆松涛; 彭玉平; 陆云涛; 龙浩; 王剑新

    2012-01-01

    Objective To explore the relationship between morphological features of pituitary fossa superior orifice and growth pattern of pituitary adenomas. Methods One hundred patients with pituitary adenomas were selected as pituitary adenoma. One hundred healthy people were set as normal control group. Head CT scan was used to observe the anatomical features of the pituitary fossa superior orifice in healthy people and the sella turcica in patients with pituitary adenoma. The effect of morphological features of pituitary fossa superior orifice on the growth pattern of pituitary adenoma was analyzed. Results The slant angle of pituitary fossa superior orifice was 0.79°±l 1.69° in healthy people and -1.73°±12.42° in pituitary adenoma group. The angle in normal control group can be classified into three types, namely anteverted type, horizontal type and retroverted type. The angle between the longest diameter of tumor and pituitary fossa superior orifice was 91.18°±10.24° in pituitary adenoma patients. According to morphology of the sella turcica, the tumor was of sac type in 41 patients, wok type in 24, cylinder type in 13 and cribriform type in 22. Conclusions Pituitary adenoma grows upward basically perpendicularly to pituitary fossa superior orifice. The slant angle of pituitary fossa superior orifice determines the growth direction of pituitary adenoma toward suprasella.%目的 探讨垂体窝上口形态学特点与垂体腺瘤生长方式的关系.方法 收集100例垂体腺瘤病人作为垂体腺瘤组,正常对照组为100例健康人.运用CT扫描观察正常人垂体窝上口与垂体腺瘤病人蝶鞍的解剖特点,并分析垂体窝上口形态学特点对垂体腺瘤生长方式的影响.结果 正常对照组垂体窝上口倾斜角为(0.79°±11.69°),垂体腺瘤组为(-1.73°±12.42°).该夹角在正常人可分为前倾型、水平型、后仰型.肿瘤最长径与垂体窝上口之间的夹角为(91.18°±10.24°).垂体腺瘤根据蝶鞍

  9. Meckel腔及毗邻结构显微解剖在中颅底入路中的应用研究%Study of microsurgical anatomy of Meckel's cave and adjacent structure in operation of middle cranial fossa

    Institute of Scientific and Technical Information of China (English)

    刘晓东; 徐启武

    2013-01-01

    Objective To obtain more detailed information about Meckel's cave and adjacent structures in order to offer anatomical base for clinical application. Methods Twenty sides of 10 adult cadaver heads fixed in formalin were used. The relationship of the main structures adjacent to Meckel's cave was observed. Result Meckel's cave is a cleft-like dural pocket that protruding from the posterior cranial fossa into the middle cranial fossa. The contents of the Meckel's cave are the sensory and motor roots of the trigeminal nerve, gasserian ganglion (GG), and the trigeminal cistern. The lengh, width, thickness of Meckel's cave is (14.53± 0.98 )mm, (15.24±1.29 )mm and (4.95±0.54)mm, respectively. The average distance between porus trigeminus and Dorello's canal and IAC is (9.25±1.14)mm, (15.30±1.14)mm, respectively. The posterior part of the medial wall of Meckel's cave is separated from Dorell's canal by the petrosphenoidal ligament, and the inferior wall is separated from the ICA lacerum segment (C3) by the petrolingual ligament. Conclusion The medial wall of Meckel's cave, which directly contacts the venous channel of the cavernous sinus, is very thin, and maybe a weak point for tumor invasion to the cavernous sinus. The petrosphenoidal ligament and the petrolingual ligament can be regarded as anatomical landmarks to identify CN VI and ICA lacerum segment.%目的 研究Meckel腔及毗邻结构的显微外科解剖关系,为临床手术治疗相关疾病提供解剖学依据.方法 成人尸头标本10例(20侧),采用手术显微镜观察Meckel腔及毗邻结构.结果 Meckel腔是颅后窝向颅中窝后内侧突入的硬脑膜凹陷,内有三叉神经运动根和感觉根、三叉神经节及三叉神经池,腔前后长( 14.53 ±0.98 )mm,内外宽(15.24±1.29)mm,上下厚(4.95±0.54)mm.三叉神经孔至Dorello管开口(9.25±1.14)mm,至内耳道开口(15.30±1.14)mm.Meckel腔内侧壁为各壁中比较薄的,内侧壁后部与颞骨岩尖部岩蝶

  10. Analysis of the position of the glenoid fossa in Angle class Ⅱ malocclusion with mandibular retrusion%安氏Ⅱ类下颌后缩畸形患者颞颌关节窝位置变化的研究

    Institute of Scientific and Technical Information of China (English)

    刘金波; 方飞; 雷敬; 易娟

    2011-01-01

    Objective: To assess the position of the glenoid fossa in subjects with Class Ⅱ malocclusion associated with mandibular retrusion and normal mandibular size in the mixed dentition.Materials and Method: A sample of 31 subjects (16 male, 14 female), age (12.3±0.5)years, with skeletal and dental Class Ⅱ malocclusion associated with mandibular retrusion, normal skeletal vertical relationships, and normal mandibular dimensions,was compared with a matched group of 38 subjects (17 male, 21 female),age (11.7±0.7)years with skeletal and dental Class Ⅰ relationships.The comparisons between the Class Ⅱ group and the control group on the cephalometric measures for the assessment of g]enoid fossa position were performed by means of a nonparametric test for independent samples (Mann-Whitney U-test,P <0.05).Result: Subjects with Class Ⅱ malocclusion presented with a significantly more distal position of the glenoid fossa,when compared with the control group as measured by means of three parameters (GF-S on FH, GF-Ptm on FH, and GF-FMN).Conclusion: A posteriorly displaced glenoid fossa is a possible diagnostic feature of Class Ⅱ malocclusion associated with mandibular retrusion.An effective cephalometric measurement to evaluate glenoid fossa position is the distance from the glenoid fossa to the frontomaxillonasal suture (GF-FMN).%目的:研究恒牙初期安氏Ⅱ类下颌后缩畸形患者颞颌关节窝位置的变化.方法:实验组为31例安氏Ⅱ类下颌后缩畸形恒牙列初期病例,男13例,女18例,年龄12.3±0.5岁,对照组为38例安氏Ⅰ类错(牙合)恒牙列初期病例,男17例,女21例,年龄11.7±0.7岁.在X线头颅定位侧位片上进行头影测量,比较关节窝的位置变化.结果用独立样本t检验.结果:同对照组安氏Ⅰ类错(牙合)相比.安氏Ⅱ类错(牙合)患者的关节窝位置更偏远中(GF-S on FH,GF-Ptm on FH,GF-FMN)(P<0.05).结论:下颌后缩时,关节窝可能后移,评估关节窝位置的最佳测量

  11. 后颅窝扩大重建术促进Chiari畸形合并脊髓空洞症患者上下肢运动及感觉功能恢复%Restoration of motor and sensory functions of upper and lower extremities by posterior fossa reconstruction in patients with Chiari malformation combined with syringomyelia

    Institute of Scientific and Technical Information of China (English)

    赵丽萍; 王丹玲; 石英

    2003-01-01

    目的观察后颅窝扩大重建术后 Chiari畸形合并脊髓空洞症患者上下肢运动及感觉功能的恢复情况,探讨此术式对 Chiari畸形合并脊髓空洞症脊髓功能恢复的作用.方法所有患者被分为两组:后颅窝扩大重建术组 (posterior fossa reconstruction,PFR组 )共 56例患者;后颅窝减压术组 (posterior fossa decompression,PFD组 )共 62例患者.定期随访.按 NCSS (Neurosurgical Cervical Spine Scale)定量分析上下肢运动及感觉障碍恢复情况,其结果作统计学分析.结果 PFR组的上、下肢和感觉功能的有效率分别为 76% ,71% ,70%; PFD组的上、下肢和感觉功能的有效率分别为 58% ,60% ,66%.两组上下肢及感觉障碍的有效率经χ 2检验差异无统计学意义.结论 PFR 能明显促进 Chiari畸形合并脊髓空洞症患者上下肢运动及感觉障碍的功能恢复.%Aim To explore effect of posterior fossa reconstruction on restoration of spinal cord function by observing the effect of posterior fossa reconstruction(PFR) on functional restoration of spine in patients with Chiari malformation and syringomyelia.Methods 118 patients with Chiari malformation and syringomyelia were divided into 2 groups: Posterior fossa reconstruction(PFR)group(56 patients) and Posterior fossa decompression(PFD)group(62 patients).All the patients were followed up at regular time.Quantitative analysis of the recovery of motor and sensory function in upper and lower extremities according to NCSS (Neurosurgical Cervical Spine Scale) in the two groups had been done. The results were statistically analysed.Results The efficiency rates of the motor function recovery in the upper and lower extremities and the recovery of the sensory disturbance were 76% ,71% ,70% respectively in PFR group and 58% ,60% ,66% in PFD group.The difference of the results in the two groups was not significant according to χ 2 test.Conclusion PFR can promote the recovery of motor and sensory functions of upper

  12. Electrical Cauterization of Hernia Below Cerebellar Tonsil Combined with the Decompression of Posterior Cranial Fossa for the Treatment of Chiari Ⅰ Malformation Complicated with Syringomyelia%小脑扁桃体热灼加后颅窝减压治疗ChiariⅠ型畸形合并脊髓空洞症

    Institute of Scientific and Technical Information of China (English)

    邹叔骋; 黄红星; 刘博; 张卫民

    2013-01-01

    [目的]探讨小脑扁桃体热灼加后颅窝减压治疗ChiariⅠ型畸形合并脊髓空洞症的手术方式及疗效.[方法]对18岁以上成年患者及健康对照者行MRI检测后颅窝容积相关骨性标志间线性距离并进行比较,对72例MRI证实的Chiari Ⅰ型畸形合并脊髓空洞症患者采用后颅窝正中入路,显微镜下行小脑扁桃体熟灼,松解粘连,使之回缩到枕骨大孔水平以上;后颅窝减压,硬膜扩大缝合.[结果]成年患者后颅窝容积相关骨性标志间线性距离均显著小于健康对照组(P<0.05).72例患者手术顺利,65例术后获得6个月至5年随访,按Tator标准,有效58例,有效率89.2%,无严重并发症.65例患者均复查MRI,63例示下疝之扁桃体均回缩到枕骨大孔水平以上,19例脊髓空洞消失,脊髓形态接近正常,38例脊髓空洞缩小.[结论]采用小脑扁桃体热灼加后颅窝减压是治疗Chiari Ⅰ型畸形合并脊髓空洞症的有效方法.%[Objective]To explore the method and efficacy of electrical cauterization of hernia below cerebellar tonsil combined with the decompression of posterior cranial fossa for the treatment of Chiari Ⅰ malformation complicated with syringomyelia. [Methods]After MRI was performed in patients over 18 yeas old and healthy controls, the linearity distance among boney landmarks related to posterior cranial fossa volume was measured and compared. Totally 72 patients with Chiari Ⅰ malformation complicated with syringomyelia confirmed by MRI underwent electrical cauterization of hernia below cerebellar tonsil, separation of the adhesions retracted above foramen magnum, decompression of posterior cranial fossa and extensive suture of dura under microscope through middle posterior cranial fossa approach. [Results]The linearity distance among boney landmarks related to posterior cranial fossa volume of adult patients was significantly shorter than that in control group( P<0. 05). The 72 patients were operated

  13. Expansive posterior fossa eranioplnsty with occipital flip for arnold-chiari Ⅰ malforma-tion%自体骨瓣后颅窝扩大成形治疗Chiari Ⅰ型畸形(附9例临床分析)

    Institute of Scientific and Technical Information of China (English)

    张亚召; 蔡恩源; 李盛善; 唐兆伟; 李海校

    2013-01-01

    Objective To explore the treatment of expansive posterior fossa cranioplasty with occipital flips for Arnold-chiari I malformation. Methods Methods 9 cases of the patients with Arnold-chiari I malformation all use surgical treatment, do the decompression of posterior cranial fossa,duraplastic repair, resection of hernia below cerebellar tonsil and separation of adherence of arachnoid membrane. Results Postoperative MRI studies revealed that cerebellar ton-sillar lower edge of the cases are rising to the foramen magnum level above, the posterior fossa volume increase,8 cases symptoms improved significantly, 1 cases no improvement. Follow-up of 3-18 months, all patients got good clinical outcomes with symptoms relief. MRI showed sy-ringomyelia disappeared in 2cases, significantly thinned in 5 cases, no improvem. Conclusion Conclusion Expansive posterior fossa cranioplasty using occipital flip is effective for arnold-chiari I malformation.%目的 探讨利用自体骨瓣进行后颅窝扩大成形术治疗Chiari Ⅰ型畸形的临床效果.方法 本组9例Chiari Ⅰ型患者均采用手术治疗,行后颅窝自体骨骨瓣扩大成形、硬脑膜成形、小脑扁桃体切除及粘连蛛网膜分解术.结果 9例患者术后均复查MRI示小脑扁桃体下缘均上升到枕骨大孔水平以上,后颅窝容积增大.8例症状改善明显,1例改善不明显.随访3~18个月,所有病例症状体征较术前改善.MRI示7例合并脊髓空洞患者中,2例空洞消失,5例脊髓空洞明显缩小.结论 自体骨瓣后颅窝扩大成形治疗Chiari Ⅰ畸形患者,临床症状改善,效果满意.

  14. Posterion fossa decompression for Chiari I malformation with hydrocephalus:a meta-analysis%后颅窝减压术治疗Chiari畸形Ⅰ型合并脑积水疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    张家康; 彭飞; 陈鑫; 侯旭; 张大明; 刘震东; 赵世光

    2016-01-01

    Objective To evaluate the effect of posterior fossa decompression (PFD) on ChiariⅠmalformation associated with hydrocephalus. Methods The data which accorded with the demands of the present study were individually extracted the Chinese and English literature obtained by searching electronic database including EBSCO, PUBMED, EMBASE, CNKI, VIP, Wanfang and OVID from the day when the library was built to 31 May 2015. All the statistical analyses were performed by the STATA software version 13. Results The rate of improvement of Chiari I malformation associated with hydrocephalus was 82.3% (95% CI 74.2%~90.4%). The female patients account for 62.9%(95%CI 52.6%~73.1%)of all the patients with Chiari I malformation associated with hydrocephalus. Conclusion The female patients account for the majority of all the patients with Chiari malformation associated with hydrocephalus, and PFD is an effective method to treat this disease.%目的:评价后颅窝减压术(PFD)治疗合并脑积水的Chiari畸形Ⅰ型的有效性。方法计算机检索EBSCO、PubMed、EmBase、OVID等英文数据库以及中国知网、维普、万方等中文数据库,检索从建库到2015年5月31日发表的文献。采用STATA 13.0软件进行Meta分析。结果共纳入3篇文献,86例,PFD治疗83例;PFD术后好转率为82.3%(95%CI 74.2%~90.4%);合并脑积水的Chiari畸形Ⅰ型中,女性占62.9%(95%CI 52.6%~73.1%)。结论合并脑积水的Chiari畸形Ⅰ型中,女性占大多数;PFD治疗合并脑积水的Chiari畸形Ⅰ型具有较高的有效率。

  15. Marie-François Xavier Bichat (1771-1802) and his contributions to the foundations of pathological anatomy and modern medicine.

    Science.gov (United States)

    Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios; Shokouhi, Ghaffar; Ardalan, Mohammad R

    2008-11-20

    Marie-François Xavier Bichat (1771-1802) was a prominent French anatomist during a time of revolution and one of the founders of French scientific medicine. He conducted several experimental studies, which laid the foundation for modern physiology. Based on autopsy findings, Bichat introduced 21 tissues as the basic elements of organs. His name is carried on by several eponyms in anatomy and histology; Bichat's fossa (pterygopalatine fossa), Bichat's protuberance (buccal fat pad), Bichat's foramen (cistern of the vena magna of Galen), Bichat's ligament (lower fasciculus of the posterior sacroiliac ligament), Bichat's fissure (transverse fissure of the brain) and Bichat's tunic (tunica intima vasorum). This paper deals with the life and works of this early pioneer in anatomy and physiology.

  16. Oblique rifting at Tempe Fossae, Mars

    Science.gov (United States)

    Fernández, Carlos; Anguita, Francisco

    2007-09-01

    This work shows the results of a structural study of the faults observed at the Tempe Rift (northeastern Tharsis region), Mars. A new, detailed map of faults and fault systems was used to geometrically characterize the fracture architecture of the Tempe Rift and to measure fault length, displacement, and spacing data, to analyze the spatial distribution of fault centroids, and to investigate the fractal nature of fault trace maps. A comparison with analog models and the use of conventional techniques of fault population analysis show that the Tempe Rift was most probably generated under sinistral oblique-rifting processes, which highlights the importance of the presence of inherited fractures in the tectonic evolution of the Noachian crust. The angle between the extension direction and the rift axis varies along the Tempe Rift, ranging from 50°-60° at its central southern part to 66°-88° to the southwest. Fault scaling relationships are similar to those found at mid-ocean ridges on Earth with exponential fault length-frequency distributions. Localized, inhomogeneous deformation generated weakly interacting faults, spanning the entire thickness of the mechanical layer. This thickness decreased from southwest to northeast along the rift, along with distance from the central part of the Tharsis dome.

  17. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2011-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  18. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2012-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  19. Dural cavernous haemangioma of posterior cranial fossa.

    Directory of Open Access Journals (Sweden)

    Goel A

    1993-10-01

    Full Text Available A rare case of extracerebral dural cavernous angioma sited near the sigmoid sinus is reported. This 60 yr old male patient gave history of episodic ataxia of left sided limbs experienced twice on same day and occasional giddiness. Examination did not reveal any findings. A mass was diagnosed on CT Scan following which angiography was carried out. The features matched with those of a meningioma. Retro-sigmoid craniectomy was performed. Occipital artery was coagulated. Tumor was dissected out. Post-operative course of the patient was uneventful. Histopathology revealed that the mass was a cavernous haemangioma.

  20. The study of proper depth of muscle relaxant in posterior fossa surgery under total intravenous anesthesia%全凭静脉麻醉下后颅凹术中合理肌松深度的研究

    Institute of Scientific and Technical Information of China (English)

    郭少川; 韩一仙; 王国林

    2014-01-01

    Objective To investigate the proper depth of muscle relaxant without affecting elec-trophysiological monitoring in patients undergoing posterior fossa surgery under total intravenous an-esthesia (TIVA).Methods Forty patients selected for posterior fossa surgery were randomly divided into two groups A and B.Group A:no muscle relaxants were administered after anesthesia induction until the EMG was completed.Group B:muscle relaxants maintained in range of TOF 2%-25% dur-ing electrophysiological monitor.TIVA were used to all patients and BIS was maintained in range of 40-60.Two electrophysiological data were applied during the electrophysiological monitoring:sponta-neity EMG and evoked EMG.EMG amplitude was recorded at different TOF value.Operation time and the dosages of propofol,sufentanil,rocuronium bromide were recorded.Also,the SBP,DBP,HR at perioperational period and facial nerve function before surgery,one week and six months after sur-gery were recorded.Results The electrophysiological monitoring completed successfully in all pa-tients.The total amount of propofol in group A significantly increased than those in group B(P <0.05).Three patients in group A had body movement during the operation.Four cases in group B couldnt perform electrophysiological monitor when the TOF had three signals.There were no differ-ence between the two groups in SBP,DBP,HR and facial nerve function.Conclusion Maintaining TOF value in range of 2%-25% under non-depolarizing muscle relaxant during CPA surgery doesnt affect intraoperative nerve electrophysiological monitor and prevent body movement,total dose of sed-ative anesthetics is also decresed.%目的:探讨在后颅凹占位手术中采用全凭静脉麻醉方式,寻找不影响神经传导功能监测的合理肌松深度。方法选择后颅凹桥小脑角区(CPA)占位手术患者40例,随机分为两组:A 组不用肌松药,即采用常规麻醉方法,全麻诱导插管后到电生理监测结束前不用肌松药;B

  1. 囊肿脑池造瘘治疗儿童中颅窝蛛网膜囊肿%Cystocistern fenestration for the treatment of middle cranial fossa cyst in children

    Institute of Scientific and Technical Information of China (English)

    李禄生; 张雨婷; 梁平; 李映良; 翟瑄; 周渝冬

    2012-01-01

    Objective To evaluate the curative effect of cystocistern fenestration for the treatment of middle cranial fossa cyst in children and the value of post-operative evaluation using phase-contrast MRI.(PC-MRI).Methods 28 patients with intracranial arachnoid cysts (IAC) underwent PC-MRI assessment.Cystocistern fenestration was decided in those who were found to have NCIAC.A retrospective study was carried out analysing the clinical manifestations before and after surgery,postoperative decrease of the cyst size using phase-contrast cine MRI scan in these cases.The fistula flow of cerebrospinal fluid,the cerebrospinal fluid dynamics index (peak velocity,flow and flow wave) were obtained.Results Phase-contrast cine MR imaging showed no communication between IAC and the adjacent subarachnoid space in 20 of 28 patients pre-operation and they underwent cystocistern fenes tration.In these patients,arachnoid cysts reduced in size post-operatively.Furthermore,the clinical symptoms were improved or cured.CSF flow direction in the fistula of the basal cistern were bi-directional,which was similar to normal aqueduct flow waveform,suggesting patent fistula.In the 8 patients who were diagnosed to have communicating arachnoid cyst (CIAC),there was no clinical manifestation and no progressive increase in cyst size.Conclusions 1.Cystocistern fenestration could be an effective treatment of children with middle cranial fossa cysts; 2.PC cine MRI can be used to diagnose and assess post-operative progress of non-communicating IAC.%目的 探讨囊肿脑池造瘘术治疗儿童中颅窝蛛网膜囊肿(intracranial arachnoid cyst,IAC)的效果及MRI相位对比电影(phase-contrast cine,PC cine)用于囊肿分型诊断及术后疗效评估的价值.方法 对28例中颅窝IAC患儿行PC cine检查,选择非交通性蛛网膜囊肿(non-communicating intracranial arachnoid cysts,NCIAC)的患儿,行显微镜下囊肿脑池造瘘术.回顾分析术前术后临床表现、术后随

  2. Endophthalmitis due to an intra-ocular linear foreign body in a cat

    Directory of Open Access Journals (Sweden)

    Esmeralda Delgado

    2015-05-01

    Full Text Available Case summary An unusual case of an intraocular linear foreign body that migrated from the oral cavity, causing a severe endophthalmitis, in a cat is described. A 2-year-old female domestic shorthair cat presented with signs of infection from the left eye that had begun 2 weeks previously. Despite having been prescribed oral and topical antibiotics, there was a progressive worsening of the clinical signs. On ophthalmic examination the cat presented with severe endophthalmitis, secondary glaucoma and exposure keratitis of the left eye. Radiography demonstrated the presence of an intraocular linear metallic foreign body compatible with a sewing needle. During enucleation, when the globe was extracted, the sewing needle stayed in the orbit. When the needle was pulled away, a piece of thread was also retrieved, which demonstrated that the linear foreign body had migrated retrogradely from the oral cavity to the orbit through the pterygopalatine fossa. Surgical recovery was uneventful. Relevance and novel information Intraocular foreign bodies may present in a variety of ways, which may hinder their clinical detection. The management and prognosis depend on the composition and location of the foreign body, as well as the possible presence of secondary infection. To the author’s knowledge, this is the first time that a case of severe endophthalmitis following retrograde intraocular migration of a linear foreign body from the oral cavity to the orbit through the pterygopalatine fossa in a cat has been reported.

  3. Anatomical study of the roots of cranial parasympathetic ganglia: a contribution to medical education.

    Science.gov (United States)

    Lovasova, Kvetuse; Sulla, Igor J; Bolekova, Adriana; Sulla, Igor; Kluchova, Darina

    2013-05-01

    A major key to increasing the safety of cranial surgery is a thorough understanding of anatomy. The anatomy of the head is of fundamental interest to dental and medical students early in their studies. Clinically, it is mostly relevant to surgeons who are performing interventions and reconstruction in the maxillofacial region, skull base, and the orbit. However, the level of appropriate anatomical knowledge necessary for general and special medical and surgical practice is still under discussion. This study maps the significant areas and structures of the head that are not normally accessible during dissection courses because of time and difficulties involved in the preparation. The detailed photodocumentation enriched by diagrams provides a view of structures until now only partially documented. Three parasympathetic ganglia are located in hardly accessible areas of the head - inside the orbit, infratemporal fossa, and in the pterygopalatine fossa. No detailed photographs have been found in current anatomical textbooks and atlases in relation to the morphology of fibers (roots) connected to the ciliary, otic, and pterygopalatine ganglia. Therefore, this study focused on the detailed display of sensory, sympathetic, and parasympathetic roots of ganglia to provide relevant photodocumentation and an improvement in human anatomy teaching. This study also confirms that cadaver dissection provides an excellent opportunity for the integration of anatomy and clinical medicine into the early clinical training of undergraduate dental and medical students. We believe this article, because of the details mentioned above, will be beneficial not only for the future anatomical undergraduate but also for postgraduate education.

  4. A morphometric analysis on the correlation between position of cerebellar tonsil and posterior fossa volume in the patients with idiopathic scoliosis%特发性脊柱侧凸患者小脑扁桃体位置与后颅窝容积关系的影像学观察

    Institute of Scientific and Technical Information of China (English)

    吴涛; 刘臻; 朱泽章; 孙旭; 朱锋; 钱邦平; 邱勇

    2012-01-01

    目的:比较特发性脊柱侧凸(idiopathic scoliosis,IS)患者与年龄匹配的非脊柱畸形患者后颅窝容积的差异,探讨IS患者后颅窝发育异常与小脑扁桃体生理性下疝的关系.方法:从2009年1月至2011年6月我科收治的500例IS患者中选取70例年龄16~20岁、Risser征5级、术前行站立位全脊柱正侧位X线片及颈枕部MRI检查的患者为研究对象(A组),男48例,女22例,侧凸平均Cobb角51.2°±14.1°.选取年龄匹配的58例非脊柱畸形患者作为对照组(B组),男27例,女31例.测量两组研究对象头颈正中矢状位MRI中小脑扁桃体下缘超出枕骨大孔连线(AB线)的距离(d值)、枕骨大孔前后径(AB)、斜坡长度(AD)、枕上长度(BC)以及后颅窝矢状径(CD),比较两组小脑扁桃体位置及后颅窝容积差异.根据MRI表现,将IS组患者分为伴生理性小脑扁桃体下疝组(A1组)和不伴生理性小脑扁桃体下疝组(A2组),分析后颅窝容积与小脑扁桃体生理性下疝间关系及主弯Cobb角与小脑扁桃体生理性下疝程度的相关性.结果:A组d值和枕骨大孔前后径明显大于B组(P<0.05),而AD、BC以及CD均明显小于B组(P<0.05).A组患者d值与主弯Cobb角无显著相关性(P>0.05),其生理性小脑扁桃体下疝发生率为22.9%,A1组患者BC显著小于A2组患者(P<0.05),AB、AD、CD两组间均无显著性差异(P>0.05).结论:IS患者小脑扁桃体位置低可能与其后颅窝枕骨大孔增大而斜坡、枕骨发育受限有关,IS患者成骨异常可能也影响到了其后颅窝发育.%Objectives: To compare the posterior fossa volume of idiopathic scoliosis(IS) patients with that of age-matched healthy adolescents and to determine the correlation between position of cerebellar tonsil and posterior fossa volume in IS patients. Methods: A retrospective radiographic study was performed on 500 patients with IS who received surgical treatment at our center between January 2009 and June 2011. 70

  5. 神经内镜辅助显微手术切除后颅窝表皮样囊肿的临床对照研究%Clinical controlled study of neuroendoscope assisted microneurosurgery for epidermoid cysts of the posterior cranial fossa

    Institute of Scientific and Technical Information of China (English)

    李运军; 樊娟; 赵浩; 李文德; 魏群; 陈立华; 徐如祥

    2014-01-01

    目的 探讨神经内镜辅助显微手术治疗后颅窝表皮样囊肿的疗效. 方法 回顾性分析北京军区总医院附属八一脑科医院自2008年1月至2013年1月49例后颅窝表皮样囊肿患者的临床资料,将单独采用显微神经外科手术进行治疗的20例患者作为对照组;显微镜下大部切除肿瘤后,再用神经内镜进行探查,切除残余肿瘤的29例患者作为观察组;比较2组的手术时间、术后并发症发生率、肿瘤残存率. 结果 对照组20例术后复查MR发现有6例残存,并有4例出现了脑脊液漏、无菌性脑膜炎等并发症.观察组29例患者9例有肿瘤残余,予内镜下进一步切除,术后复查MR未发现残存,仅有1例术后出现三叉神经不全损伤症状的并发症.2组间并发症发生率与残存率的比较差异具有统计学意义(P<0.05). 结论 神经内镜辅助显微手术切除后颅窝表皮样囊肿可以明显提高全切率,降低手术并发症.%Objective To summarize the experience of microsurgical treatment of posterior fossa epidermoid cyst in nearly five years,and to explore the effect of endoscopic assisted microsurgical treatment on posterior fossa epidermoid cysts.Methods A retrospective analysis of 49 patients with posterior fossa epidermoid cysts,admitted to our hospital from January 2008 to January 2013,was conducted.The controls were 20 patients treated only by micro-neurosurgery,and the other 29 were as observation subjects:the tumors were,first,mostly removed under micro-neurosurgery,and then,residual tumors were resected under neuroendoscopy.The operation time,complications and tumor residual rate were compared between the two groups.Results According to the different tumor location in posterior fossa,three surgical approaches were adopted:suboccipital posterior midline approach,suboccipital posterior sigmoid sinus approach and supratentorial infratentorial combined approach.Postoperative complications were aseptic meningitis

  6. Swallowing therapy--a prospective study on patients with neurogenic dysphagia due to unilateral paresis of the vagal nerve, Avellis' syndrome, Wallenberg's syndrome, posterior fossa tumours and cerebellar hemorrhage.

    Science.gov (United States)

    Prosiegel, M; Höling, R; Heintze, M; Wagner-Sonntag, E; Wiseman, K

    2005-01-01

    No studies exist dealing with the outcome of dysphagic patients with posterior fossa (IV. ventricle) tumours (PFT) or cerebellar hemorrhage (CH), and the outcome of patients with Wallenberg's syndrome (WS) after functional swallowing therapy (FST) has so far not been studied in detail. Patients and methods. 208 patients with neurogenic dysphagia (ND) who were consecutively admitted for functional swallowing therapy (FST) over a 3 year period to our hospital were examined clinically, by use of a videofluoroscopic swallowing study (VFSS) and/or fibreoptic evaluation of swallowing (FEES). The most frequent etiology was stroke (48%), followed by CNS tumours (13%). In the present study we defined three groups. Group 1 comprised 8 patients with PFT or CH. Group 2 consisted of 27 patients with WS, which was the leading cause among patients with non-hemispheric stroke. Since in WS a vagal nerve paresis due to affection of the Nucleus ambiguus occurs, 8 patients with Avellis' syndrome or unilateral paresis of the vagal nerve served as controls and were defined as group 3. Findings. In the three groups, functional feeding status showed significant improvement after FST comprising methods of restitution, compensation and adaptation, each of which were applied in more than 80% of patients. Outcome was, however, significantly worse in group 1 as compared to group 2 and in group 2 as compared to group 3. Dysfunction of the upper esophageal sphincter and reflex triggering were significantly more severely disturbed in groups 1 and 2 as compared to group 3. Group 1 showed significantly more severe disturbances of the oral phase as compared to groups 2 and 3. After FST, more than 50% (5/8) of group 1 and 30% (8/27) of WS patients (group 2) were dependent on tube feeding, whereas all patients of group 3 were full-oral feeders. Interpretation. This is the first study dealing with the outcome of dysphagic patients with PFT or CH. Based on our results it can be assumed that in these

  7. 后颅窝小骨窗减压及硬脑膜成形术治疗Chiari畸形Ⅰ型45例疗效分析%Therapeutic effect analysis of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty for 45 patients with Chiari malformation type Ⅰ

    Institute of Scientific and Technical Information of China (English)

    凌国源; 玉石; 黄锦丰; 陈文斗

    2014-01-01

    目的 探讨采用后颅窝小骨窗减压及硬脑膜成形术治疗Chiari畸形Ⅰ型的疗效.方法 回顾性分析45例Chiari畸形Ⅰ型患者行后颅窝小骨窗减压及硬脑膜成形术临床资料,其中合并脊髓空洞症31例.结果 按Tator等标准,术后1个月优30例,良15例.随访6个月至6年,其中优37例,良8例.31例合并脊髓空洞症患者中有26例脊髓空洞消退,5例脊髓空洞无明显变化.结论 后颅窝小骨窗减压及硬脑膜成形术可使颅颈交界区充分减压,并对脊髓空洞症有明显的治疗作用,是治疗Chiari畸形Ⅰ型安全有效的治疗方法.%Objective To evaluate the therapeutic effect of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty in the treatment of Chiari malformation type Ⅰ.Methods The clinical data of 45 Chiari malformation type Ⅰ patients who were treated with small bone flap craniotomy decompression of posterior cranial fossa and duraplasty were retrospectively analyzed,31 cases among them with syringomyelia.Results According to Tator etc.standard,1 month after surgery,the excellent in 30 cases,good in 15 cases.Follow up from 6 months to 6 years,the excellent in 37 cases,good in 8 cases.Among 31 patients with syringomyelia,26 cases were syringomyelia subsided,5 cases were not obvious change.Conclusion The small bone flap craniotomy decompression of posterior cranial fossa and duraplasty can make the craniocervical decompression,and has obvious effect of treating syringomyelia,is safe and effective in treatment of Chiari malformation type Ⅰ.

  8. Estudo morfométrico da fossa intercondilar femoral em joelhos com e sem lesão do ligamento cruzado anterior (L.C.A., através da aplicação de um software sobre imagens radiográficas digitalizadas Morphometric study of the femoral intercondylar notch of knees with and without injuries of anterior cruciate ligament (A.C.L., by the use of software in digitalized radiographic images

    Directory of Open Access Journals (Sweden)

    Rita di Cássia de Oliveira Angelo

    2004-09-01

    Full Text Available Os autores sugerem a aplicação de um software sobre imagens radiográficas digitalizadas para análise morfométrica da fossa intercondilar e dos côndilos femorais. O programa permite o tracejamento de linhas guias que facilitam a mensuração da extremidade distal do fêmur. Foram analisadas 39 radiografias simples da fossa intercondilar femoral dos joelhos direito e esquerdo, obtidas de indivíduos do sexo masculino reunidos em grupo normal (n=23 e grupo lesionado (n=16. A média de idade da amostra foi de 26,56 anos. As variáveis analisadas foram largura bicondilar femoral, larguras da fossa intercondilar ao nível do sulco poplíteo e da base da fossa, a altura da fossa intercondilar e a largura do côndilo femoral lateral. A fossa intercondilar foi classificada quanto ao formato em cônica, circular e retangular. Os resultados encontrados sugerem que a largura da base da fossa e a largura do côndilo femoral lateral seriam fatores de risco importantes na lesão do L.C.A. Os valores médios das variáveis analisadas aproximam-se dos descritos na literatura especializada em mensurações diretas em peças cadavéricas e ressonância nuclear magnética e demonstram que a aplicação de um software sobre as imagens radiográficas digitalizadas proporciona uma mensuração confiável, mesmo utilizando-se de imagens radiográficas simples e de baixo custo.The authors suggest the use of software in digitalized radiographic images to morphometric analysis of the intercondylar notch and the femoral condyles. The software allows the draw of guide lines which facilitate the measurement of the distal extremity of femur. Thirty-nine radiographic simple has been analyzed of femoral intercondylar notch of right and left knees, of male sex individuals collected into normal (n=23 and injured (n=16 groups. The age average was 26-56 years old.The analyzed variable had been femoral bicondylar width, widths of intercondylar notch to the level of the

  9. Imaging features of trigeminal schwannoma and the relationship between its classification and surgical approaches%三叉神经鞘瘤影像学特点和分型与手术入路的关系

    Institute of Scientific and Technical Information of China (English)

    胡可明; 罗秋红; 苏凯; 李春宏; 李家志

    2012-01-01

    Objective To explore the imaging features of trigeminal schwannoma and the relationship between its classification and surgical approaches. Methods The imaging features and the classification and the surgical approaches of trigeminal schwannoma confirmed by pathology in 15 cases were analyzed retrospectively. Results In 15 cases, the tumors located in middle cranial fossa in 3 cases, in posterior cranial fossa in 2 cases, in middle and posterior cranial fossa in 7 cases, in infratemporal fossa in 1 case, in pterygopalatine fossa in 1 case and in orbita in 1 case. The imaging features were as following: ① The tumors located in petrous apex, Meckel's cave enlarged and petrous bone absorbed; ②The tumors located in the cistern of pontocerebellar trigone and connected with the root of trigeminal nerve; ③The tumors grew along trigeminal nerve and acrossed middle and posterior cranial fossa with dumbbell appearance; ④ The tumors of infratemporal fossa and pterygopalatine fossa grew up to middle cranial fossa, foramen ovale and foramen rotundum enlarged; ⑤ The tumor was between rectus superior and orbita, superior orbital fissure expended; ⑥ The tumors showed inhomogeneous e-qual and low density on CT, inhomogeneous hypo-intense and iso-intense signal on T1WI , inhomogeneous iso-intense and hyper-intense signal on T2WI and inhomogeneous enhancement with clear edge. These cases were divided into six types: type of middle cranial fossa in 3 cases, type of posterior cranial fossa in 2 cases, type of middle and posterior cranial fossa in 7 cases, type of infratemporal fossa in 1 case, type of pterygopalatine fossa in 1 case, and type of orbita in 1 case. The different approaches were used to remove the tumors according to the type of tumor. 3 cases were through frontotemporal with zygomatic osteomy approach, 2 cases through sigmoid sinus approach, 4 cases through extended middle cranial fossa approach, 2 cases through temproromandibular cerebelli tentorium approach

  10. 腋窝顶泌汗腺的应用解剖与组织病理学观察%Anatomy and histopathology of apocrine sweat glands in axillary fossa

    Institute of Scientific and Technical Information of China (English)

    王擎; 柳大烈; 王晋煌; 陈兵; 陈伯华

    2011-01-01

    目的 研究腋臭顶泌汗腺的分布范围与层次,为治疗腋臭提供应用解剖与病理学依据.方法 对2具腋臭,8具非腋臭10%甲醛固定成人尸体,进行腋窝应用解剖;对25例重度腋臭患者予以顶泌汗腺去除手术的组织病理学观察.结果 顶泌汗腺分泌部肉眼清晰可见,呈粟粒样颗粒;尸体上呈黑褐色,活体上为粉红色;主要分布在腋毛区域内,可超过腋毛区域外,但未超过1.0 cm;以腋窝中央横皱襞处最为密集,外围呈散在分布.顶泌汗腺分泌部位于真皮网状层与腋浅筋膜之间的浅层脂肪组织内,在真皮网状层下方已移行为导管部.在靠近真皮网状层处,其被结缔组织缠绕,形成完整、坚韧、不易刮除的膜状结构;在下方与腋浅筋膜连接紧密,不易分离.真皮面上白色突起颗粒为皮脂腺毛囊复合体.结论 直视下去除真皮下粉红色粟粒样组织和腋浅筋膜,干净去除顶泌汗腺分泌部;结合紧贴真皮面剪除毛囊处理导管部,可根治腋臭.手术范围不可过宽,以腋毛区域外1.0 cm为宜.%Objective To investigate the distribution range and depth of the apocrine sweat glands of the axillary fossa,in order to supply with anatomic and histopathologic basis in the treatment on axillarv osmidrosis.Methods From December 2008 to ()ctober 2010,2 biopsy samples(with axillary osmidrosis),8 biopsy samples(normal,without axillary osmidrosis),were employed into the axillarv anatomy study. 25 patients with severe axillary osmidrosis were observed both maerographicallv and microscopically by using of operation and histopathological methods.Results Secretory portion of apocrine sweat glands was seen clearly,it was pitchy millet-like granules on axillary osmidrosis corpse,and pink millet-like granules in vivo.Secretory portions distributed most within the armpit hair area,exceeded the edge of armpit hair line,but not surpassed the edge of armpit hair line 1.0 cm.The depth of the apocrine

  11. 32例后颅窝血管母细胞瘤的临床特征分析%Clinical Characteristics of Posterior Fossa Hemangioblastoma:a Report of 32 Cases

    Institute of Scientific and Technical Information of China (English)

    李鸣; 梁冲; 丁一; 张洁

    2015-01-01

    [Objective]To explore the diagnosis and treatment of posterior fossa hemangioblastoma (HB) .[Methods]The clinical data were retrospectively analyzed for 32 HB cases between January 2008 and January 2014 at our hospital .All cases were examined with magnetic resonance imaging (MRI) .Both solid ( n =4) and cystic ( n =28) masses were visualized .And there were 3 cases of von Hippel‐Lindau'(VHL) disease . All cystic tumors were completely resected .And 4 solid masses were completely ( n=3) and subtotally ( n=2) resected while residual tumor was treated by gamma knife .[Results]Nervous system symptoms of all cystic tumors significantly improved postoperatively .Among 4 solid masses ,the symptom of 3 cases with complete resection achieved partial remission postoperatively .Ventriculo‐peritoneal shunt was performed in one case with subtotal resection due to unresolved hydrocephalus .[Conclusion]The diagnosis of HB is dependent mostly upon M RI examination . Operation remains a first choice and a fair prognosis may be achieved for cystic tumors .The treatment of solid mass especially in brain stem is still challenging .Comprehensive therapy en‐hances the efficacies .The prognosis of VHL disease is still poor due to multi‐organ involvement and frequent recurrence .%【目的】探讨后颅窝血管母细胞瘤(HB)的诊断和治疗方法。【方法】回顾性分析自2008年1月至2014年1月本院收治的32例后颅窝 HB患者的临床资料。全部患者行M RI检查,实质性肿瘤4例,囊性肿瘤28例,其中包括3例VHL病( von Hippel‐Lindau's disease)。28例囊性肿瘤行囊结节切除术;4例实质性肿瘤,3例行肿瘤全切除术,1例行次全切除术,残留肿瘤行伽玛刀治疗。【结果】28例囊性肿瘤术后神经系统症状明显改善,4例实质性肿瘤中,3例全切除患者术后症状部分缓解,1例次全切除患者术后因脑积水未解除而行侧脑室-腹腔分流术,术后颅高压

  12. 多层螺旋CT三维重建在Chiari I型畸形骨性后颅窝测量中的应用%Multislice spiral CT three-dimensional reconstruction of the posterior cranial fossa in Chiari I malformation

    Institute of Scientific and Technical Information of China (English)

    田超; 阎世鑫; 靳松; 谢中福

    2011-01-01

    目的 评价多层螺旋CT(MSCT)三维重建诊断Chiari I型畸形患者骨性后颅窝发育不全的临床意义.方法 以52例Chiari I型畸形患者骨性后颅窝为研究对象并以100例正常成人后颅窝为参照.测量项目包括:后颅窝前后径(TL)、后颅窝高度(PCFH)、枕大孔前后径(FMD)、斜坡长度(CL)、后枕长度(SL)、小脑幕倾斜角(ACTS)和后颅窝容积(PCFV).采用独立样本资料t检验比较Chiari I型畸形组及对照组后颅窝形态测量结果的差异,计算Pearson相关系数(r)评价TL、PCFH、FMD、CL、SL和ACTS与PCFV间的相关性.结果 与对照组比较,Chiari I型畸形组的TL、CL、PCFH和PCFV减小而FMD和ACTS增加,差异有统计学意义,SL虽然减小但差异无统计学意义.PCFH、CL和SL与PCFV呈正性相关,FMD和ACTS与PCFV呈负性相关,其中PCFH(r=0.813,P<0.001)和CL(r=0.752,P<0.001)与PCFV的相关性较高.Chiari I型畸形组与对照组各测量结果间的95%置信区间均无重叠.结论 MSCT三维重建技术能够对骨性后颅窝形态进行准确测量,可以作为评价骨性后颅窝发育不全的影像学方法之一.MSCT的测量结果可以进一步完善对Chiari I型畸形患者后颅窝狭窄的诊断.%Objective To assess the clinical usefulness of MSCT three-dimensional reconstruction in diagnosis of osseous posterior cranial fossa(PCF)hypoplasia in patients with Chiari I malformation. Methods Osseous PCF of 52 adult patients with Chiari I malformation and 100 healthy adults control subjects involved in this study. Variable measurements includeing Twining's line (TL) , foramen magnum diameter (FMD) , posterior cranial fossa height (PCFH) , clivus length (CL) , supraocciput length (SL) , angle of cerebellar tentorium steepness (ACTS) and posterior cranial fossa volume (PFCV). Independent-sample Student's t test was used as a statistical method. Pearson correlation coefficient (r) was calculated to summarize the relationship between parameters and volume

  13. The lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contraction of popliteal fossa%膝上外侧动脉穿支髂胫束皮瓣修复腘窝部瘢痕挛缩

    Institute of Scientific and Technical Information of China (English)

    郑鑫; 安洪宾; 陈滔; 王海宝

    2013-01-01

    Objective:To discuss clinical results of the lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contracture of popliteal fossa. Methods: Form January 1999 to December 2011,11 patients with scar contraction of popliteal fossa were treated with the lateral superior genicular artery perforator iliotibial band flap. Among the patients , 7 patients were male and 4 patients were female, ranging in age from 24 to 58 years old, with an average of 33 years old. The operation time ranged from 3 months to 1 year after trauma. Eight patients had injuries in the right side and 3 patients had the injuries in the left. Five patients had the injuries caused by traffic, 3 patients had the injuries caused by hot compression and other 3 patients suffered from burns. The flap area ranged from 7.0 cm×4.0 cm to 20.0 cm×8.0 cm. Results:AH the flaps survived. Three patients had epidermis necrosis. After 5 months to 2 years follow-up period,the knee function recovered,the flap shape was favorable and the skin firmness was moderated. Conclusion: The lateral superior genicular artery perforator iliotibial band flap is a practical, simple and an ideal donor in the reconstruction of popliteal fossa scar contracture.%目的:探讨膝上外侧动脉穿支髂胫束皮瓣治疗腘窝部瘢痕挛缩的临床疗效,为腘窝区瘢痕挛缩寻找最佳的手术方式.方法:自2009年1月至2011年12月,应用膝上外侧动脉穿支髂胫束动脉皮瓣修复腘窝瘢痕挛缩11例,男7例,女4例;年龄24~58岁,平均33岁;病程3个月~1年,平均6.5个月;右膝关节8例,左膝关节3例;交通伤5例,热压伤3例,烧伤3例.采用膝上外侧动脉穿支髂胫束皮瓣局部转移修复创面,切取皮瓣面积最大20.0 cm×8.0 cm,最小7.0 cm×4.0 cm.结果:术后皮瓣全部成活,3例远端血运差,局部色素沉着,表皮坏死脱痂.术后随访5个月~2年,膝关节活动均恢复正常,皮瓣外形良好,皮肤松紧度适中.

  14. 后颅窝内减压治疗Chiari 畸形Ⅰ型并脊髓空洞中期疗效评价%Mid-term outcomes of posterior fossa decompression and cranioplasty for Chiari malformation and syringomyelia type Ⅰ

    Institute of Scientific and Technical Information of China (English)

    吕学明; 袁绍纪; 张荣伟; 卢培刚; 孙希炎; 朱伟杰; 刘子生; 陈援朝; 吕福林

    2011-01-01

    Objective To evaluate the mid-term outcomes of posterior fossa decompression and cranioplasty for Chiari malformation and syringomyelia type Ⅰ. Methods Posterior fossa decompression and cranioplasty were performed in a consecutive series of 40 patients. Clinical outcomes were assessed by Karnofsky Performance Scale (KPS) scores and activies of daily living (ADL) questionnaires before and after operation. Operation time, intraoperative blood loss, incision status and complications were recorded. Radiological examination was obtained for each patient to assess the situation of changes in syringomyelia, postoperative cerebrospinal fluid flow rates and the stability of the craniocervical junction. Results The KPS scores increased significantly from (70 ± 10) preoperatively to (80 ± 10) postoperatively(P < 0.01 ). The ADL scores were decreased remarkably from (20.6 ±2.2) preoperatively to (15.8 ±0.5) postoperatively (P <0.01 ) and the proportion with optimal effect was 86%. Syringomyelia narrowing and disappearance rate was 90.5% (19/21). Cerebrospinal fluid flow speed improved compared with that before operation.Conclusion Posterior fossa decompression and cranioplasty is an effective and convenient method for Chiari malformation and syringomyelia type Ⅰ .%目的 评价后颅窝内减压(后颅窝减压+后颅窝颅骨成形术)治疗Chiari 畸形Ⅰ型并脊髓空洞疾病的中期临床疗效.方法 采用后颅窝内减压术治疗40 例符合标准的Chiari 畸形Ⅰ型并脊髓空洞.观察手术时间、切口愈合情况,分析相关并发症.采用远期生活质量评估(KPS)和美国Lawton 和Brody1996 年制定的日常生活能力量表评分(ADL)评价疗效,并且通过影像学检查对脊髓空洞的变化、脑脊液流速情况以及颅颈交界区稳定性情况进行评价.结果 随访KPS 分值由术前的(70 ±10)分提高到到末次随访时(80 ± 10)分(P <0.01),ADL 分值由术前的(20.6 ±2.2)分降至末次随访时(15

  15. Effect of decompression window area of posterior fossa on short-term surgical outcomes in Chiari malformation patients with syringomyelia%Chiari畸形合并脊髓空洞症术中不同大小后颅窝减压窗近期疗效的比较

    Institute of Scientific and Technical Information of China (English)

    刘彬; 王振宇; 谢京诚; 李振东; 马长城; 陈晓东

    2016-01-01

    Objective To explore the effect of decompression skull window area on short-term surgical outcomes in the Chiari malformation (CM) patients with syringomyelia (SM). Methods The clinical data of 117 patients with CM and SM treated in our hospital from 2007 to 2010 were analyzed retrospectively. The decompression of posterior cranial fossa and duraplasty was performed in all the patients. The decompression of syringomyelias with puncture was performed in the patients in whom the horizontal diameters of the syringomyelias were more than 50%of the horizontal diameters of the spinal cords. The patients were divided into 2 groups according to the decompressed area of the posterior cranial fossa, i.e. group A (n=87) where the decompression skull window area was about 12 cm2 and group B (n=30) where the skull window area was less than 6 cm2. The therapeutic effects were evaluated with Tater scale 2 weeks after the operation in all the patients. Results Of 117 patients, 97 were improved in the postoperative symptoms and 20 not. The rate (87.4%, 76/87) of improved symptoms was significantly higher in group A than that (70.0%, 21/30) in group B (P脊髓50%者行空洞穿刺减压术.根据后颅窝减压窗面积分为2组:Ⅰ组,87例,减压面积为12 cm2(3 cm×4 cm);Ⅱ组,30例,减压面积<6 cm2.术后2周采用Tater评分评定疗效.结果 117例患者手术后症状均无加重,症状改善97例(82.9%),无变化20例.Ⅰ组症状改善76例(87.4%),Ⅱ组为21例(70%);两组症状改善率差异显著(P<0.05).结论 Chiari畸形合并脊髓空洞症患者的后颅窝减压面积以不小于12 cm2的近期疗效较好.

  16. Detection of tumoral lesions in the posterior fossa, in brain computerized tomography scans for various conditions of acquiring a preliminary approach; Deteccion de lesiones tumorales en fosa posterior en imagenes de Tomografia Computarizada cerebral para diversas condiciones de adquisicion: un enfoque preliminar

    Energy Technology Data Exchange (ETDEWEB)

    Perez, M.; Carvalho-Filho, A. E.; Khoury, H. J.; Casas, M. C.; Andrade, M. E.; Paz, J. E.

    2010-07-01

    The present work performs a study over 13 tomographic images, using an anthropomorphic head phantom. It contains small lesions in the posterior fossa. Tube current (I [mA]), slice thickness (E [mm]), were the parameters changed among studies, looking for the best acquisition conditions, which permit good lesion detectability, and applying the lowest dose. Air Kerma in air [mGy] was calculated. Image quality was analyzed by both expert criterion and some merit figures. Two of them were global: contrasts to noise ratio (RCR [dB]) and signal to noise ratio (RSR). The rest of the measures used were relatives to the maximum dose condition: The gain in signal to noise ratio (SNR [dB]) and the maximum signal to noise ratio (PSNR [dB]), the normalized mean squared error (NMSE) and the structural similarity index (SSIM). Objective and subjective results were correlated. It is shown that it is possible to reduce the dose using lower values of mAs without affecting lesion detectability and keeping good image quality for the scanner used. An optimized protocol is also proposed for the technology used. (Author) 27 refs.

  17. Surgical anatomy of the maxillary nerve in the zygomatic region Anatomia cirúrgica do nervo maxilar na região zigomática

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    Elizandra Paccola Moretto

    2005-06-01

    Full Text Available Anatomic knowledge on the zygomatic fossa is of primary importance to improve the regional anesthetic technique of the maxillary nerve. Few reports in the literature have addressed the trajectory of the maxillary nerve and its branches in this region; thus, this study aimed at presenting information about the trajectory of these nerves. Thirty human half-heads of both genders were fixed in 10% formalin and demineralized in 5% nitric acid, and the maxillary nerve was dissected since its origin on the pterygopalatine fossa until penetration into the inferior orbital fissure. It was observed that the maxillary nerve sends one to three posterior superior alveolar branches and tuberal descendent branches, which supply the soft tissue structures of the region. The posterior superior alveolar nerves are inferiorly oriented near the maxillary tuberosity, where they penetrate the alveolar canals with the posterior superior alveolar artery and send small nerve branches that continue in an extraosseous trajectory. This study found that nearly 2/3 of the trajectory of the maxillary nerve is located in the zygomatic region, with a short segment (1/3 in the pterygopalatine fossa.O conhecimento anátomo-cirúrgico da região zigomática é fundamental para o aprimoramento de técnicas anestésicas tronculares do nervo maxilar. A literatura pouco se refere à trajetória do nervo maxilar e seus ramos nessa região, portanto, o presente estudo tem como objetivo esclarecer o percurso desses nervos. Foram dissecadas ao microscópio cirúrgico MC900 (D.F.Vasconcelos, 30 hemicabeças humanas, de ambos os sexos, que foram previamente formolizadas a 10% e desmineralizadas em ácido nítrico a 5%. Observou-se que o nervo maxilar, desde sua origem na fossa pterigopalatina até penetrar na fissura orbital inferior, emite de um a três ramos alveolares superiores posteriores e ramos tuberais descendentes que vão para estruturas moles da região. Os nervos alveolares

  18. [Four cases of extracranial trigeminal benign neurogenic tumors].

    Science.gov (United States)

    Mada, Yusuke; Ueki, Yuji; Konno, Akiyoshi

    2014-11-01

    Extracranial trigeminal schwannomas are rare tumors accounting for about 10% of all trigeminal schwannomas. We report herein on four cases of extracranial trigeminal benign neurogenic tumors. The patients were aged between 39 and 75 years; they consisted of one male and three females. The origins of the schwannomas consisted of the maxillary nerve in two cases and the mandibular nerve in two cases. All cases were surgically treated using a transmaxillary approach in three cases, and a combination of the transcervical-parotid approach with a midline mandibulotomy in one case. In two cases, the schwannomas located in the pterygopalatine fossa were removed using a transmaxillary approach with the endoscope and the surgical microscope. Two patients underwent selective intravascular embolization of the feeding artery to reduce intraoperative bleeding, and they were less invasively treated via the transmaxillary approach.

  19. Malignant tumors of the nasal cavity: computed tomography and magnetic resonance imaging; Tumores malignos da cavidade nasal: tomografia computadorizada e ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Paes Junior, Ademar Jose de Oliveira; Gonzalez, Fabio Mota; Cordeiro, Flamarion de Barros; Yamashiro, Ilka [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Programa de Residencia Medica em Radiologia e Diagnostico por Imagem]. E-mail: ricapires@ig.com.br; Lenh, Carlos Neutzling [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Servico de Cirurgia de Cabeca e Pescoco; Rapoport, Abrao [Complexo Hospitalar Heliopolis, Sao Paulo, SP (Brazil). Curso de Pos-graduacao em Ciencias da Saude

    2004-10-01

    The aim of this study is to evaluate the role of computed tomography and magnetic resonance imaging in the characterization of deep tissue extension of malignant tumors of the nasal cavity. Twelve patients diagnosed with malignant tumors of the nasal cavity were retrospectively evaluated at the Departments of Diagnostic Imaging and Head and Neck Surgery of the 'Complexo Hospitalar Heliopolis', Sao Paulo, Brazil, between 1990 and 2000. All cases were confirmed by histopathologic examination. The results were: extension to the maxillary and ethmoid sinuses was identified in six patients, extension to contralateral nasal cavity, orbit and lamina cribosa in five patients, extension to nasal pharynx and masticator space in two patients, extension to cavernous sinus, anterior/middle cranial fossa, pterygomaxillary fossa, inferior/superior orbital fissure, frontal sinus, contralateral ethmoid sinus, contralateral lamina cribosa, hard palate and pterygopalatine fossa in one patient. Conclusion: It is important to precisely assess the local extension and spread of tumor by computed tomography and magnetic resonance imaging in order to plan the approach to treatment, which will influence the prognosis. (author)

  20. 后颅凹减压加脑室外引流治疗大面积小脑梗死78例分析%Analysis of posterior fossa decompression and brain outdoor drainage in the treatment of 78 cases of large area of cerebellar infarction

    Institute of Scientific and Technical Information of China (English)

    马清涛

    2014-01-01

    Objective:To explore the effect of posterior fossa decompression and brain outdoor drainage in the treatment of large area of cerebellar infarction.Methods:78 patients with large area of cerebellar infarction were selected from March 2009 to June 2014.Patients were prone position with general anesthesia.6.0 cm×7.0 cm window was opened along the suboccipital midline.The right occipital horn of lateral ventricle drainage was given.Part of the softening of necrotic brain tissue was removed.The incision was sutured.After operation,patients were given intensive care.After 1 week,external ventricular drainage tube was pulled out. Results:On the second day after operation,78 patients with consciousness were restored,and there was no death.After 3 months to 5 years follow-up,according to the physiscal self-maintenance scale,the patients were assessed:46 cases(59%) were gradeⅠ;14 cases(17.9%) were grade Ⅱ;8 patients(10.3%) were grade Ⅲ;6 patients were grade Ⅳ;4 cases(5.1%) were grade Ⅴ.The complications after operation:11 cases(14.1%) had vertigo;11 cases(14.1%) had dysphagia;5 cases(6.4%) had hearing loss;16 cases(20.5%) had ataxia;5 cases(6.4%) had hoarseness.Conclusion:The effect of posterior fossa decompression and brain outdoor drainage in the treatment of large area of cerebellar infarction is significant.The operation is simple and easy to operate.It is worthy of popularization.%目的:探讨后颅凹减压加脑室外引流治疗大面积小脑梗死的临床效果。方法:2009年3月-2014年6月收治大面积小脑梗死患者78例,患者取俯卧位,采取全身麻醉,沿枕下正中开6.0 cm×7.0 cm窗口,行右侧枕角脑室外引流术,切除部分软化坏死的脑组织,缝合切口。术后进行重症监护,1周后拔出脑室外引流管。结果:78例患者术后第2天均恢复意识,无死亡病例发生,经过3个月~5年的随访,根据日常生活能力量表(physiscal self-maintenance scale

  1. 后颅窝减压及硬膜成形术与单纯后颅窝减压术比较治疗Ⅰ型Chiari畸形效果的Meta分析%Comparison of Posterior Fossa Decompression with and without Duraplasty for Surgical Treatment of Chiari Malformation Type Ⅰ: A Meta-Analysis

    Institute of Scientific and Technical Information of China (English)

    张豆豆; 陈海锋; 黄思庆; 郝德; 任海波; 汤俊佳

    2012-01-01

    Objective To systematically evaluate posterior fossa decompression with duraplasty (PFDD) and posterior fossa decompression without duraplasty (PFD) for Chiari malformation type I (CM-I). Methods A meta-analysis was performed according to the guideline of the MOOSE statement. Relevant literature and references were electronically searched in CENTRAL, Science Citation Index Expanded, MEDLINE (Ovid), PubMed, CBM, CNKI and WanFang Data from 1993 to September 2011. Two reviewers independently identified literature according to inclusion and exclusion criteria. The included studies were evaluated using the Newcastle-Ottawa Scale. Original data were extracted and analyzed using RevMan 5.1 software. Besides, the level of evidence was assessed using the GRADE system. Results Ten studies involving 829 patients were included. The results of meta-analyses showed that: a) compared with patients undergoing PFD, patients undergoing PFDD had a significantly lower reoperation rate (RR=0.41, 95%CI 0.23 to 0.74, P=0.003), and a higher rate of syringomyelia decrease (RR=1.27, 95%CI 1.03 to 1.56, P=0.02). But there was no significant difference in clinical improvement (RR=1.11, 95%CI 0.95 to 1.28, P=0.18). b) compared with PFD, patients undergoing PFDD had a higher rate of cerebrospinal fluid-related complications (RR=6.3, 95%CI 2.71 to 14.67, P0.05). Based on GRADE system, the evidence was at Level C and we made a weak recommendation. Conclusion Posterior fossa decompression with duraplasty is associated with a lower risk of reoperation, a better effect of syringomyelia decrease and a greater risk for cerebrospinal fluid-related complications, compared with PFD. Due to the influencing factors of lower-quality included studies, a prudent choice is suggested, and also more high-quality, large-sample studies are need.%目的 系统评价后颅窝减压及硬膜成形术(PFDD)与单纯后颅窝减压(PFD)两种术式比较治疗Ⅰ型Chiari畸形的有效性和安全性.方法

  2. Producción y calidad sanitaria de la lechuga fertilizada con efluente de fosa séptica biodigestora Produção e qualidade sanitária de alface adubada com efluente de fossa séptica biodigestora

    Directory of Open Access Journals (Sweden)

    Miréia Aparecida Bezerra Pereira

    2012-04-01

    Full Text Available

    Se evaluó la producción y los aspectos sanitarios de la lechuga fertilizada con aguas residuales de efluente humano derivada de fosa séptica biodigestora en Assentamento Rural Vale Verde, Gurupi, Estado de Tocantins, Brasil. Fueron realizadas evaluaciones morfofisiológicas y microbiológicas en plantas y microbiológicas en muestras de agua del suelo, de la lechuga y del efluente de la fosa séptica biodigestora. Por el número de hojas, altura de planta y peso fresco se observó que las plantas que recibieron la dosis de 60 L de efluente tuvieron valores más altos que los demás. Hubo un aumento del área foliar de las plantas con el aumento de la dosis de efluente. Las plantas que recibieron 60 L de efluentes fueron las que produjeron más clorofila total, y las que recibieron 20 L presentaran valores cerca de éstos. El rendimiento de la producción fue significativamente mayor en las plantas que recibieron 20, 40 y 60 L de efluente, y menor para los demás (0 y 80 L. En este estudio, no hubo contaminación por coliformes fecales a 45 º C en las muestras 1, 3, 4, 5 y 7. De las plantas de las parcelas fertilizadas con efluente del tanque séptico, sólo una muestra presentó contaminación, sin embargo, el valor se ha considerado como adecuado por estar dentro de los límites de 95% de la prueba. Se trata de una alternativa sostenible que contribuye a maximizar los recursos disponibles dentro de la agricultura familiar, sin comprometer el nivel de calidad sanitaria de consumo humano de la lechuga en las condiciones estudiadas y con incremento de la productividad.

    Avaliou-se a produção e os aspectos sanitários de alface adubada com efluente humano de fossa séptica biodigestora no Assentamento Rural Vale Verde, Gurupi-TO. Foram realizadas avaliações morfofisiológicas e análises microbiológicas de amostras de água do solo, alface e do efluente de fossa séptica biodigestora. Para número de

  3. Ewing Sarcoma of the Posterior Fossa in an Adolescent Girl

    Directory of Open Access Journals (Sweden)

    Andreas M. Stark

    2014-01-01

    Full Text Available Medulloblastoma, astrocytoma, and ependymoma represent the most common infratentorial tumors in childhood, while Ewing sarcomas in that localization are extremely rare. A large left infratentorial space-occupying lesion was diagnosed in a 12-year-old girl with signs of increased intracranial pressure. Following total tumor resection, histological and molecular examination revealed Ewing sarcoma with rearranged EWSR-1 gene. The patient achieved complete remission following adjuvant chemotherapy and radiotherapy according to Euro-EWING 2008 treatment protocol. Intracranial Ewing sarcoma, although rare, should be an important differential diagnosis of intracranial tumors in childhood which requires aggressive multimodal treatment.

  4. A rare case of racemose neurocysticercosis of the posterior fossa.

    Science.gov (United States)

    Karegowda, Lakshmikanth Halegubbi; Shenoy, Poonam Mohan; Prakashini, Koteshwara; Karur, Gauri

    2014-05-26

    A 43-year-old man presented with a 3 month history of headache, vertigo and swaying while walking. MRI of the brain showed cystic lesions involving the cerebellopontine angle cisterns, the right perimedullary cistern, the fourth ventricle and bilateral foramen of Luschka with resultant obstruction to cerebrospinal fluid outflow and hydrocephalus. The patient underwent right retromastoid craniotomy with endoscopic third ventriculostomy for cyst excision. The postoperative period was uneventful and he was able to carry out routine activities within a month. This case report stresses on the clinical importance, unique characteristics and imaging features of racemose neurocysticercosis.

  5. Lupus vulgaris of the popliteal fossa: a delayed diagnosis.

    Science.gov (United States)

    Altunay, Ilknur Kivanc; Kayaoglu, Semra; Ekmekci, Tugba Rezan; Kutlu, Safiye; Arpag, Esra Saygin

    2007-07-13

    Lupus vulgaris (LV) is the most common form of cutaneous tuberculosis. It commonly presents on the head and neck regions. The diagnosis may be difficult when LV occurs at unexpected regions or in unusual clinical forms. Sometimes special stains for the organism and mycobacterial cultures may be negative. Nevertheless, it is usually possible to reach the correct diagnosis of LV using clinical and histopathological findings. But at times, a therapeutic trial with antitubercular agents may be required.

  6. Surveillance imaging in children with medulloblastoma (posterior fossa PNET)

    Energy Technology Data Exchange (ETDEWEB)

    Roebuck, D.J. [Department of Radiology, Children' s Hospital Los Angeles, Los Angeles (United States); Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH (United Kingdom); Villablanca, J.G. [Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles (United States); Maher, K.; Nelson, M.D. Jr. [Department of Radiology, Children' s Hospital Los Angeles, Los Angeles (United States)

    2000-07-01

    Background. The use of surveillance imaging in children with medulloblastoma has been criticised. The aim of this study was to determine what proportion of relapses are detected by surveillance and whether these are found at a relatively favourable stage. Methods. This study was a retrospective review of the medical charts and imaging studies of 89 patients treated at a single children's cancer centre. Relapse was defined as evidence of an increase in volume of residual tumour of greater than 25% or the presence of metastases, or new onset of positive CSF cytology. Relapse was termed symptomatic if it was diagnosed by tests performed because of new symptoms that occurred in the interval between surveillance examinations. Asymptomatic relapse was diagnosed solely on the basis of surveillance imaging. Survival time to relapse was calculated from the date of the first surgical procedure. Results. Surveillance imaging detected 17 (71%) of the 24 relapses that occurred later than 6 months after diagnosis. All seven patients who presented with symptoms between scans have died, with a median survival from relapse of 5 months. Median survival from relapse in the patients detected by surveillance was 44 months, and four remain alive at 44-75 months. The patients detected by surveillance tended to have less advanced disease, which was more amenable to salvage therapy. Conclusion. This type of study cannot prove that surveillance imaging improves survival in children with medulloblastoma because of the effects of lead time and length biases. Despite this, surveillance does appear to be effective in detecting potentially curable medulloblastoma relapses and should be offered to all patients. (orig.)

  7. Longstanding suppurative granulomatous inflammation of the infratemporal fossa

    Directory of Open Access Journals (Sweden)

    Brian E. Kinard, DMD, MD

    2016-03-01

    This case serves as a briefing for this form of uncommon inflammation and additionally serves to prime the reader on the distinction between actinomycosis, the clinical syndrome, and Actinomycosis, the bacteria. We present this case, perhaps from more of a philosophical standpoint, to illustrate the manner in which a longstanding, clinically significant, destructive process in an unusual anatomic location was successfully resolved via collaborative interdisciplinary management and months of effort.

  8. 儿童后颅窝肿瘤合并脑积水的治疗及预后影响因素分析%Treatment and prognosis of posterior fossa tumor combined with hydrocephalus in children: an analysis of influencing factors

    Institute of Scientific and Technical Information of China (English)

    林佳平; 单臻; 黄毓婵; 陈昆; 黄正松

    2011-01-01

    Objective To explore whether preoperative treatment of hydrocephalus could change the occurrence of postoperative hydrocephalus after tumor resection in children with posterior fossa tumor, and analyze the risk factors of postoperative hydrocephalus. Methods Sixty-three children with posterior fossa tumors accompanied with hydrocephalus, admitted to our hospital from January 2003 to December 2009, were chosen; conservative treatment of preoperative hydrocephalus was performed in 43 patients and surgery was performed in the other 20 patients. The clinical data of these patients were retrospectively analyzed and the occurrence of postoperative hydrocephalus in patients performed conservative treatment and tumor resection was compared. Gender, age, Evans index, location of the tumor, extent of the tumor resection, pathology of the tumor were analyzed as risk factors using logistic regression. Results Occurrence of hydrocephalus after tumor resection showed no statistical differences between patients accepted conservative treatment (14/43, 32.6%) and patients received surgical treatment ([8/20, 40.0%], P=0.564). Evans index, location of the tumor and extent of resection were related to hydrocephalus relapse after tumor resection(P=0.029, P=0.036, P=0.038). Conclusion Preoperative treatment of hydrocephalus could not change the occurrence of hydrocephalus after tumor resection. Evans index, location of the tumor and extent of tumor resection are all risk factors of postoperative hydrocephalus.%目的 探讨儿童后颅窝肿瘤合并脑积水患者行肿瘤切除术前对于脑积水的治疗是否影响术后脑积水的发生率,并分析术后脑积水发生的相关危险因素.方法 中山大学附属第一医院神经外科自2003年1月至2009年12月行肿瘤切除术治疗后颅窝肿瘤合并脑积水儿童患者63例,其中对术前脑积水行保守治疗43例,手术治疗20例.回顾性分析患者的临床资料并比较术前脑积水保守治疗组和

  9. Posterior cranial fossa dimensions in Chiari Ⅰ malformation relates to the degree of cerebellar tonsillar descent and syringomyelia%Chiari Ⅰ畸形后颅窝线性容积与小脑扁桃体下疝及脊髓空洞的相关性研究

    Institute of Scientific and Technical Information of China (English)

    金铂; 苏亦兵; 王汉斌; 王科大

    2013-01-01

    目的 对Chiari Ⅰ畸形患者后颅窝的各线性结构进行测量,探讨不同下疝程度以及是否并发脊髓空洞的Chiari Ⅰ畸形患者的发病机制以及利用MRI在后颅窝结构上的测量意义.方法 回顾分析2004年8月至2012年6月北京积水潭医院神经外科住院治疗的Chiari Ⅰ畸形患者97例,在MRI上测量其斜坡的长度、枕骨基底部的长度、蝶骨底长度、枕骨鳞部、脑干的长度、小脑半球的长度、枕骨大孔径、Twining's线、小脑幕与Twining's线的角度.结果 根据MRI影像学的表现,将Chiari Ⅰ畸形患者小脑扁桃体下缘尾向移位程度分为3度,其中Ⅰ度48例(49.5%),Ⅱ度36例(37.1%),Ⅲ度13例(13.4%);合并脊髓空洞69例(71.1%),无脊髓空洞28例(28.9%).Chiari Ⅰ畸形小脑扁桃体下疝Ⅰ度的患者斜坡的长度(d+e)、枕骨基底部的长度(e)、脑干长度(b)和小脑半球的长度(c)显著大于Ⅱ度和Ⅲ度的患者(P<0.05).合并脊髓空洞患者枕骨大孔径(B to OP)显著小于无脊髓空洞患者(P<0.05),脑干的长度(b)显著长于无脊髓空洞组患者(P<0.05).结论 在Chiari Ⅰ畸形患者中,后颅窝骨性结构及内在神经结构的发育异常,是引起小脑扁桃体下疝及脊髓空洞等病理生理改变的重要原因,在手术治疗中要对此区域的病理改变进行有针对性的治疗,为患者制定合适的手术策略.%Objective To measure the linear structures of posterior cranial fossa in Chiari Ⅰ malformation (CMI) patients base on fMRI techniques and to investigate the causes associated with different degrees of cerebellar tonsillar descent and syringomyelia. Methods A retrospective radiographic study was performed for 97 CMI patients who were treated in Jishuitan hospital during 2004-2012. According to the degree of cerebellar tonsillar descent, CMI patients were divided into three categories: CMI Ⅰ in 48 cases (49.5%), CMI Ⅱ in 36 cases (37.1%), and CMI Ⅲ in 13

  10. CT findings of malignant tumors of maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Ae; Byun, Hong Sik; Kim, Kie Hwan; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1987-12-15

    CT findings of histologically proven malignant tumors of maxillary sinus in 36 patients were retrospectively analyzed. A variety of malignant tumors were included; 27 cases of squamous cell carcinoma, 3 malignant lymphomas, 2 malignant melanomas, 2 rhabdomyosarcomas, and chondrosarcoma, adenoid cystic carcinoma, and malignant ameloblastoma. CT staging was T4 in 19 cases, T3 in 16 cases and T2 in 1 case. The most common involved area beyond maxillary antrum was nasal cavity (25 cases), followed by ethmoid sinus (20 cases), orbit (19 cases), infratemporal fossa (17 cases), check skin (13 cases), pterygopalatine fossa (10 cases), and nasopharynx (6 cases). Skeletal destruction was seen in medial wall of antrum (31 cases), posterior wall of antrum (25 cases), anterior wall of antrum (23 cases), roof of antrum (19 cases), lamina papyracea (6 cases), and lateral wall of orbit (5 cases) in that order of frequency. Lymph node metastases were found in 2 cases of malignant melanoma, 2 cases of malignant lymphoma, and chondrosarcoma, squamous cell carcinoma, and malignant ameloblastoma. Predilection site of lymph node involvement was submandibular (3 cases), internal jugular (2 cases), parotid (2 cases), and retropharyngeal node (1 case)

  11. Natural history of scoliosis after posterior fossa decompression in patients with Chiari malformation/syringomyelia%Chiari畸形合并脊髓空洞患者后颅窝减压术后脊柱侧凸的自然转归分析

    Institute of Scientific and Technical Information of China (English)

    沙士甫; 朱泽章; 邱勇; 孙旭; 钱邦平; 刘臻; 闫煌; 江龙

    2014-01-01

    目的 评估Chiari畸形/脊髓空洞患者后颅窝减压术(PFD)后脊柱侧凸的自然进展并分析影响侧凸转归的相关因素.方法 对2002年1月至2007年12月期间南京大学医学院附属鼓楼医院脊柱外科PFD治疗的26例Chiari畸形/脊髓空洞伴脊柱侧凸患者的影像学资料进行回顾性分析,记录PFD术前及末次随访时主弯Cobb角、弯型、矢状面参数(胸椎后凸、胸腰段交界后凸、腰椎前凸)、小脑扁桃体下疝程度、空洞大小及长度.定义末次随访Cobb角小于或等于行后颅窝减压术时5°为侧凸未进展(未进展组),大于行后颅窝减压术时5°以上为侧凸进展(进展组).运用成组设计资料t检验和Fisher精确检验比较两组PFD术前各项参数间的差异.结果 26例患者接受PFD手术时平均年龄6.5 ~14.7(10.3±2.4)岁,主弯Cobb角20 ~45(33.5±7.7)°.术后24~118(57.5±26.9)个月随访时,11例(42%)患者脊柱侧凸获得稳定或改善.进展组平均初始年龄显著大于非进展组(11.1±2.2)比(9.2±2.2)岁,P=0.041,此外进展组中胸腰双弯比例显著高于非进展组(26.7%比9.1%,P=0.037).而Cobb角、Risser征、矢状面参数、小脑扁桃体下疝程度、空洞大小及长度、术前伴神经症状/体征比例在两组间差异均无统计学意义(均P >0.05).结论 后颅窝减压术后42%的Chiari畸形/脊髓空洞患者可获得脊柱侧凸的稳定或改善.PFD手术时年龄较大、胸腰双弯弯型可能是术后脊柱侧凸进展的危险因素.%Objective To explore the natural history of scoliosis after posterior fossa decompression (PFD) in patients with Chiari malformation/syringomyelia and examine the risk factors associated with curve progression.Methods A retrospective radiographic study was performed at our scoliosis center for 26patients undergoing PFD for Chiari malformation between January 2002 and December 2007.Their clinical and radiological parameters,including age

  12. Tumores malignos da cavidade nasal: tomografia computadorizada e ressonância magnética Malignant tumors of the nasal cavity: computed tomography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Ricardo Pires de Souza

    2004-10-01

    nasal pharynx and masticator space in two patients, extension to cavernous sinus, anterior/middle cranial fossa, pterygomaxillary fossa, inferior/superior orbital fissure, frontal sinus, contralateral ethmoid sinus, contralateral lamina cribosa, hard palate and pterygopalatine fossa in one patient. CONCLUSION: It is important to precisely assess the local extension and spread of tumor by computed tomography and magnetic resonance imaging in order to plan the approach to treatment, which will influence the prognosis.

  13. Radiological challenges in distinguishing keratocystic odontogenic tumor from ameloblastoma: an extraordinary occurrence in the same patient.

    Science.gov (United States)

    Moubayed, Sami P; Khorsandi, Azita; Urken, Mark L

    2016-01-01

    The aims of this study are to describe the radiological appearance of two common odontogenic lesions (keratocystic odontogenic tumor and ameloblastoma) arising in the same patient simultaneously with their radiological differences and histological correlates, and to describe challenges in radiological diagnosis. Single case report. Tertiary referral center. Forty-one year-old African-American male patient. Lesion appearance on computed tomography (CT) scan and pathological correlates. A 41year-old African-American male presented with asymptomatic right maxillary swelling. A CT scan of the maxillofacial skeleton showed and expansile and cystic lesion of the right hemimaxilla with trabecular osseous expansion, and a left cystic lesion in the left hemimaxilla expanding into the pterygopalatine fossa. Biopsy confirmed the suspected diagnoses of right ameloblastoma and left keratocystic odontogenic tumor. Although they are among the most common odontogenic tumors, the presence of concurrent ameloblastoma and KOT is an exceedingly rare occurrence in the same patient. The appearance on CT scan may help in distinguishing ameloblastoma from KOT by looking at bone expansion and high density areas, although the gold standard diagnostic test remains open biopsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Perineural spread of adenoid cystic carcinoma in the oral and maxillofacial regions: evaluation with contrast-enhanced CT and MRI

    Science.gov (United States)

    Shimamoto, H; Chindasombatjaroen, J; Kakimoto, N; Kishino, M; Murakami, S; Furukawa, S

    2012-01-01

    Objectives The objective of this study was to compare the accuracy of contrast-enhanced CT (CECT) and contrast-enhanced MRI (CEMRI) in the detection of perineural spread (PNS) of adenoid cystic carcinoma (ACC) in the oral and maxillofacial regions. Methods This study consisted of 13 ACCs from 13 patients, all of which were histopathologically diagnosed. Both CECT and CEMRI were performed in all patients before the treatment. The images of each patient were retrospectively evaluated for the detection of PNS. The definitions of PNS included abnormal density/signal intensity, contrast enhancement or widening of the pterygopalatine fossa, palatine foramen, incisive canal, mandibular foramen and mandibular canal, and enlargement or excessive contrast enhancement of a nerve. Results 11 out of 13 cases were proven to exhibit PNS histopathologically. 8 of the 11 cases for which PNS was histopathologically proven exhibited PNS on MR images. Six of the eight cases for which PNS was exhibited on MR images also exhibited PNS on CT images. The sensitivity, specificity and accuracy for the detection of PNS were 55%, 100% and 62% on CT images and 73%, 100% and 77% on MR images, respectively. Although the accuracy of PNS on MR images was slightly superior to that on CT images, there were no statistically significant differences between the detection of PNS on CT images and on MR images. Conclusions CT and MR images are equally useful for the detection of PNS of ACC in the oral and maxillofacial regions. PMID:22301639

  15. An exquisitely preserved troodontid theropod with new information on the palatal structure from the Upper Cretaceous of Mongolia

    Science.gov (United States)

    Tsuihiji, Takanobu; Barsbold, Rinchen; Watabe, Mahito; Tsogtbaatar, Khishigjav; Chinzorig, Tsogtbaatar; Fujiyama, Yoshito; Suzuki, Shigeru

    2014-02-01

    Troodontidae is a clade of small-bodied theropod dinosaurs. A new troodontid, Gobivenator mongoliensis gen. et sp. nov., is described based on the most complete skeleton of a Late Cretaceous member of this clade presently known, from the Campanian Djadokhta Formation in the central Gobi Desert. G. mongoliensis is different from other troodontids in possessing a pointed anterior end of the fused parietal and a fossa on the surangular in front of the posterior surangular foramen. The skull was superbly preserved in the specimen and provides detailed information of the entire configuration of the palate in Troodontidae. Overall morphology of the palate in Gobivenator resembles those of dromaeosaurids and Archaeopteryx, showing an apparent trend of elongation of the pterygoid process of the palatine and reduction of the pterygopalatine suture toward the basal Avialae. The palatal configuration suggests that the skull of Gobivenator would have been akinetic but had already acquired prerequisites for later evolution of cranial kinesis in birds, such as the loss of the epipterygoid and reduction in contact areas among bones.

  16. Deep fat of the face revisited.

    Science.gov (United States)

    Cho, Kwang Ho; Lee, Hak Seung; Katori, Yukio; Rodríguez-Vázquez, Jose Francisco; Murakami, Gen; Abe, Shin-Ichi

    2013-04-01

    The midfacial deep fatty tissue has been divided into the buccal and parapharyngeal fat pads although the former carries several extensions in adults. Using histological sections of 15 large human fetuses, we demonstrated that the parapharyngeal fat pad corresponds to the major content of the prestyloid compartment of the parapharyngeal space or, simply, the prestyloid fat. The buccal and prestyloid fatty tissues were separated by the medial and lateral pterygoid muscles. In these tissues, superficial parts, corresponding to the lower body and the masseteric extension of the adult buccal fat pad, were well encapsulated and showed the most advanced stage of histogenesis. As the sphenoid bone was not fully developed even in the largest specimens, the temporal, infratemporal, and pterygopalatine fossae joined to provide a large space for a single, large upper extension of the buccal fat pad. In the intermediate part of the extension course, the larger specimens carried a narrower part between the maxilla and the temporalis muscle. The single, upper extension appeared to divide into several extensions, as seen in adults. The periocular fat was clearly separated from the upper extension of the buccal fat pad by the sheet-like orbitalis muscle. A communication between the prestyloid fat and the buccal fat pad likely occurred through a potential space along the lingual nerve immediately superior to the deep part of the submandibular gland. At this site, therefore, the prestyloid fat may be injured or infected when the buccal fat pad is treated surgically.

  17. Maxillary reconstruction using a multi-element free fibula flap based on a three-dimensional polyacrylic resin model.

    Science.gov (United States)

    Jędrzejewski, Piotr; Maciejewski, Adam; Szymczyk, Cezary; Wierzgoń, Janusz

    2012-01-01

    Preoperative preparation of working models of the skull and free bone flaps using the digital print technology and photocured polyacrylic resins may be of a great benefit to the patient, for whom a virtual resection and reconstruction procedure may be planned in detail and performed. The purpose of mid-facial reconstruction using 3D models is to plan a functional mid-facial reconstruction procedure in order to restore supportive function of intraorbital structures and to make placement of dental implants and further prosthetic rehabilitation possible.Maxillary and mid-facial reconstruction using a free fibula flap based on a three-dimensional working model was performed in a patient diagnosed with a squamous cell carcinoma of the left maxillary sinus penetrating to the orbit, the ethmoid complex, and the pterygopalatine fossa. The use of three-dimensional polyacrylic models allowed for detailed preoperative planning and a virtual resection and reconstruction procedure with a highly satisfying functional and cosmetic effect.A procedure based on methods discussed here may be significantly shorter and more precise.

  18. Incidence of abnormal retropharyngeal lymph nodes in sinonasal malignancies among adults

    Energy Technology Data Exchange (ETDEWEB)

    Sai, Asari; Shimono, Taro; Yamamoto, Akira; Takeshita, Toru; Miki, Yukio [Osaka City University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Osaka (Japan); Ohsawa, Masahiko; Wakasa, Kenichi [Osaka City University Graduate School of Medicine, Department of Diagnostic Pathology, Osaka (Japan)

    2014-12-15

    The aim of this study is to investigate the relationship between abnormal retropharyngeal lymph nodes (RPLNs) and sinonasal malignancies among adults. Magnetic resonance and computed tomography images from 89 patients over 20 years old who were all histopathologically confirmed to have sinonasal malignancies from September 2001 to April 2014 were assessed retrospectively. Abnormal RPLNs were determined as those >5 mm in shortest axis or showing heterogeneous enhancement on axial images. Locations of sinonasal malignancies were categorized using the anterior border of the pterygopalatine fossa as a boundary: (a) anterior lesions, only present anterior to the boundary, or (b) posterior lesions, present or extending posterior to the boundary. Fisher's exact test was used for the analysis of the relationship between frequency of abnormal RPLNs and lesion location. Abnormal RPLNs were present in 13 of 89 patients (15 %), including 6 of 41 squamous cell carcinomas (15 %), 4 of 24 malignant lymphomas (17 %), 3 of 5 olfactory neuroblastomas (60 %), and 0 of 19 others (0 %). Four of the 39 patients (10 %) with anterior lesions showed abnormal RPLNs, compared to 9 of 50 patients (18 %) with posterior lesions. No significant difference in frequency of abnormal RPLNs was apparent between anterior and posterior lesions (P = 0.37). In primary sinonasal malignancies among adults, the highest incidence of abnormal RPLNs was seen with olfactory neuroblastoma. The frequency of abnormal RPLNs was unaffected by the location of sinonasal malignancies among adults. (orig.)

  19. The Middle Fossa Approach for the Removal of a Trochlear Schwannoma

    Directory of Open Access Journals (Sweden)

    Andrew B. Boucher

    2014-01-01

    Full Text Available Objectives. Schwannomas originating from the trochlear nerve are extremely rare; only 30 cases have been reported in the literature. Many operative approaches have been utilized for lesion resection, but the advantages of the anterior transpetrosal approach are numerous and include excellent exposure, minimal extradural retraction of the temporal lobe, and minimal cerebrospinal fluid leaks. We report the second case of a trochlear schwannoma resected via the anterior transpetrosal approach. Setting. A 64-year-old male presented with 3-month history of diplopia and headaches. On physical examination, he was found to have a right fourth nerve palsy. Brain magnetic resonance imaging revealed a mass within the right ambient cistern compressing the adjacent midbrain. A right-sided anterior transpetrosal approach was used—which confirmed that the trochlear nerve entered the mass—to achieve gross total resection. Pathological examination confirmed diagnosis of schwannoma. The patient was discharged on postoperative day 3. He experienced a persistent fourth nerve palsy postoperatively with an otherwise normal neurological examination. Follow-up imaging confirmed complete removal of the tumor. Conclusion. The anterior transpetrosal approach is an excellent approach for removal of trochlear schwannomas involving the cisternal course of the trochlear nerve. It affords complete visualization of this anatomical region while introducing minimal morbidity.

  20. Cemento-ossifying fibroma presenting as a posterior fossa mass lesion.

    Science.gov (United States)

    Kansal, Ritesh; Sharma, Arpit; Gaikwad, Ninad; Mahore, Amit; Goel, Atul

    2010-04-01

    Cemento-ossifying fibromas are benign lesions of the jaw, which arise from the periodontal membrane. Histopathologically these are composed of fibrous tissues with calcified structures resembling bone and cementum. Surgical resection is the treatment of choice. They have rarely been reported in the ethmoid sinus, maxillary sinus and sphenoid sinus Mastoid bone is an extremely rare site of such tumors. Only one case of cemento-ossifying fibroma of petromastoid bone has been reported before. We present a case of cementoossifying fibroma involving the petromastoid bone, with the large intracranial component causing compression on the cerebellum. This unique case may provide insight into the etiopathogenesis of these tumors.

  1. Gabapentin for Postoperative Vomiting in Children Requiring Posterior Fossa Tumor Resection

    Directory of Open Access Journals (Sweden)

    Ko-Chun Tsai

    2015-10-01

    Full Text Available Gabapentin is well known for its pain control and antiepileptic effect, but its antiemetic effect is poorly investigated. Here we report on effective gabapentin use for refractory vomiting after craniotomy in two children with medulloblastoma in the fourth ventricle. The two pediatric patients (an 11-year-old girl and a 4-year-old boy underwent near-total excision of the tumor via craniotomy. Both patients suffered from refractory postoperative nausea and vomiting, treated with multiple traditional antiemetic drugs but without relief. After gabapentin intake, their nausea and vomiting improved from one to two episodes per day to complete resolution of symptoms. This report suggests that gabapentin may be a novel antiemetic therapeutic intervention for patients with refractory nausea and vomiting after craniotomy.

  2. Extra-axial ependymoma of posterior fossa extending to the Meckel's cave.

    Science.gov (United States)

    Torun, Fuat; Tuna, Hakan; Bozkurt, Melih; Deda, Haluk

    2005-06-01

    An extra-axial ependymoma extending from the left cerebellopontine corner to the Meckel's cave is reported. This lesion's clinical, radiological, and histological characteristics are presented. This tumor's infrequent extra-axial location, extension to the Meckel's cave and possible origin are discussed.

  3. Primary leptomeningeal malignant melanoma in posterior fossa and upper cervical canal: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kyu Ran; Kim, Jung Hyuk; Shin, Bong Kyung; Lee, Nam Joon [Korea Univ. Hospital, Seoul (Korea, Republic of)

    2001-11-01

    The term 'primary melanocytic neoplasm' covers a wide disease spectrum, from well differentiated meningeal melanocytoma to malignant melanoma, its most aggressive malignant counterpart. Previous reports have shown that due to the paramagnetic effect of melanin, melanocytic neoplasms show high signal intensity on T1-weighted images and very low signal intensity on T2-weighted images, with relatively homogeneous contrast enhancement. The differentiation of leptomeningeal malignant melanoma from benign melanocytoma is important because of their different prognosis but on the basis of imaging findings alone is difficult. Ultrastructural immunohistochemical analysis is a possible alternative. We report the imaging findings of rare primary malignant melanoma, revealed by noncontrast-enhanced CT as a high-density mass, and demonstrating high signal intensity on T1-weighted images, and very low signal intensity on T2WI, with relatively good contrast enhancement.

  4. MODIFIED TRANSCRANIAL APPROACH FOR RESECTION OF TUMORS INVOLVING THE ANTERIOR CRANIAL FOSSA

    Institute of Scientific and Technical Information of China (English)

    赵素萍; 陶正德; 肖健云

    2001-01-01

    Objective: To introduce the method of a modified transcranial approach for resection of paranasal sinuses tumors involving the anterior skull base and to address our experience with the approach. Patients and Methods: Ten cases were operated by the approach. Among them, 4 suffered from benign meningeomas, 6 with malignant tumors included one chondrosarcoma, two malignant meningeomas, two olfactory neuroblastomas, and one squamous sarcoma. Of the patients, 4 cases had primary tumor and 6 cases had recurrent tumors. Result: All of the ten cases underwent operation and no postopertion complication occurred. 7 cases have survived for one to four years without tumor recurrence. 3 cases with malignant tumor died of tumor relapse in one to two years. Conclusion: This method significantly has helped to reduce the persistence and recurrence of the disease.

  5. Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients

    Directory of Open Access Journals (Sweden)

    Han-Song Sheng

    2017-08-01

    Conclusion: Our results suggest that trephination mini-craniectomy is a safe surgical technique for selected PFEDH patients with moderate hematoma volume and stabilized neurological functions. However, standard craniectomy is recommend when there are rapid deteriorations in patients' neurological functions or the hematomas are large and exerted severe mass effects.

  6. Chondromyxoid fibroma invasion of the transverse-sigmoid sinus junction causing posterior fossa hemorrhage.

    Science.gov (United States)

    Hersh, David S; Firempong, Alexander O; Chesler, David; Castellani, Rudolph J; Woodworth, Graeme F

    2016-02-01

    We report a 50-year-old woman with a chondromyxoid fibroma of the occipital bone, who presented with a cerebellar hemorrhage due to invasion of the adjacent sinus. Chondromyxoid fibromas are benign cartilaginous tumors. However, this case represents the first example, to our knowledge, of a chondromyxoid fibroma invading the transverse-sigmoid junction, resulting in intracranial hemorrhage. Our report highlights that the location of an intracranial chondromyxoid fibroma is an important factor in guiding surgical management.

  7. [Case report with multiple variations of blood vessels originating from the fossa axillaris].

    Science.gov (United States)

    Papanchev, V; Krustev, D; Krustev, N

    2003-01-01

    In the course of a dissection of a male's cadaver, fixed in formol carbol solution, we identified the following arterial variations: A) Regio axillaris dextra: a musculi teretis major (9 cm long); a. musculi subscapularis (of insignificant calibre and length); a. thoracica lateralis accessoria prima (10 cm long, with a course along the surface of m. subscapularis); a. thoracica lateralis accessoria secunda (25 cm long, with a course within the conjunctive tissue of the axilla); B) Regio axillaris sinistra: a musculi subcapularis prima et secunda (of insignificant calibre and length); a. musculi teretis major (9 cm long); a. thoracica lateralis accessoria secunda (20 cm long); a. thoracica lateralis accessoria tertia (25 cm long); All three additional arteria had a course along the surface of m. serratis anterior. We called the identified vessels after the name of the muscle blood-supplied by them. Only the vessels ending in m. serratus anterior did we call aa. thoracicae laterales accessoriae.

  8. [A recurrent desmoid tumor of the popliteal fossa with vascular compromise].

    Science.gov (United States)

    Díaz Hernández, M; Febles, G; Domínguez del Toro, M; Reboso Morales, L E; Llopart López, J R; Gambra Michel, L E

    1993-01-01

    We report a case of a 18-year-old male patient with his fourth relapse of a desmoid tumour of the left popliteal hollow after a traumatism in this area. Arterial displacement and extrinsic compression were showed by arteriography. Tumoration was extirpated including popliteal artery, in this way a terminal by-pass from distal femoral to peroneo-tibial trunks with contralateral great saphena was made. Diagnosis of intestinal polyposis and of the little osseous malformations, was discarded these pathologies frequently are related with these tumours. The research for 8 years and 4 months doesn't show any relapse, nor local neither multicentral. Furthermore, some considerations about this theme are reported.

  9. Fractured inlet connecting tube of the flat bottom flushing device of a posterior fossa cystoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Abbas Amirjamshidi

    2015-01-01

    Conclusion: Awareness of the possibility of fracture site in the junction of the inlet connector of flat bottom shunt systems is warranted and can be diagnosed by three-dimensional computed tomography (3D CT imaging without performing shunt series study.

  10. Towards a Proactive Risk Mitigation Strategy at La Fossa Volcano, Vulcano Island

    Science.gov (United States)

    Biass, S.; Gregg, C. E.; Frischknecht, C.; Falcone, J. L.; Lestuzzi, P.; di Traglia, F.; Rosi, M.; Bonadonna, C.

    2014-12-01

    A comprehensive risk assessment framework was built to develop proactive risk reduction measures for Vulcano Island, Italy. This framework includes identification of eruption scenarios; probabilistic hazard assessment, quantification of hazard impacts on the built environment, accessibility assessment on the island and risk perception study. Vulcano, a 21 km2 island with two primary communities host to 900 permanent residents and up to 10,000 visitors during summer, shows a strong dependency on the mainland for basic needs (water, energy) and relies on a ~2 month tourism season for its economy. The recent stratigraphy reveals a dominance of vulcanian and subplinian eruptions, producing a range of hazards acting at different time scales. We developed new methods to probabilistically quantify the hazard related to ballistics, lahars and tephra for all eruption styles. We also elaborated field- and GIS- based methods to assess the physical vulnerability of the built environment and created dynamic models of accessibility. Results outline the difference of hazard between short and long-lasting eruptions. A subplinian eruption has a 50% probability of impacting ~30% of the buildings within days after the eruption, but the year-long damage resulting from a long-lasting vulcanian eruption is similar if tephra is not removed from rooftops. Similarly, a subplinian eruption results in a volume of 7x105 m3 of material potentially remobilized into lahars soon after the eruption. Similar volumes are expected for a vulcanian activity over years, increasing the hazard of small lahars. Preferential lahar paths affect critical infrastructures lacking redundancy, such as the road network, communications systems, the island's only gas station, and access to the island's two evacuation ports. Such results from hazard, physical and systemic vulnerability help establish proactive volcanic risk mitigation strategies and may be applicable in other island settings.

  11. Twelfth nerve paresis induced by an unusual posterior fossa arachnoid cyst: case report and literature review.

    Science.gov (United States)

    Tarantino, Roberto; Marruzzo, Daniele; Colistra, Davide; Mancarella, Cristina; Delfini, Roberto

    2014-08-01

    There are only three cases of arachnoid cysts inducing twelfth nerve paresis described in English medical literature. We herein report one more instance. Six weeks after surgery, the patient has almost fully recovered. This case underlines the importance of considering the arachnoid cyst as a possible cause of twelfth nerve paresis.

  12. Quantifying rotator cuff atrophy and fatty degeneration at the supraspinatus origin in the scapular fossa.

    Science.gov (United States)

    Yoo, Hye Jin; Choi, Ja-Young; Hong, Sung Hwan; Kim, Eo Jin; Kim, Sae Hoon

    2015-02-01

    The aim of this study was to evaluate the location difference (distance) between the conventional Y-view (CYV) and the bony origin of the supraspinatus, and therefore, to suggest hypotrophy measurement in the CYV could be highly influenced by retraction of a torn tendon. Ninety five arthroscopically repaired rotator cuff tears were retrospectively enrolled in this study. The most lateral portion of the osseous origin of the supraspinatus muscle [the Y-view at the level was newly defined as the supraspinatus origin-view (SOV)] and the CYV were determined on the MRI, and location discrepancy between the two levels was measured. Fatty degeneration and cross-sectional areas of rotator cuff muscles were measured on both views. Subgroup analyses were performed in partial-thickness tears and full-thickness tears with tendon retraction. Distance between the SOV and CYV was 11.2 ± 3.7 mm. Discrepancy of the supraspinatus areas at the two views was greater in full-thickness tears than it was in partial-thickness tears without retraction. In the full-thickness tear group, correlation analysis between retraction and cross-sectional areas of the supraspinatus in both views exhibited statistical significance [Pearson's correlation coefficients = 0.500 (P hypotrophy are routinely measured. Case series, Level IV.

  13. Muller's muscle, no longer vestigial in endoscopic surgery.

    Science.gov (United States)

    De Battista, Juan Carlos; Zimmer, Lee A; Rodríguez-Vázquez, Jose Francisco; Froelich, Sebastien C; Theodosopoulos, Philip V; DePowell, John J; Keller, Jeffrey T

    2011-01-01

    As a thin filmy covering overlaying the inferior orbital fissure (IOF), Muller's muscle was considered a vestigial structure in humans, and for this reason, its anatomical significance was neglected. Because of increasing interest in endonasal approaches to the skull base that encompasses this region, we re-examined this structure's role as an anatomical landmark from an endoscopic perspective. In 10 cadaveric specimens, microanatomical dissections were performed (n = 5); endoscopic dissections were performed (n = 5) via approaches of the middle turbinate or inferior turbinate, and via the Caldwell-Luc approach through the maxillary sinus. Histological examinations were performed in 20 human fetuses (Embryology Institute, Universidad Complutense de Madrid, Madrid, Spain). In cadaveric dissections, Muller's muscle was demonstrated in all specimens, serving as a bridge-like structure that spanned the entire IOF and separated the orbit from the temporal, infratemporal, and pterygopalatine fossas. Depending on which endoscopic corridor was used, a different aspect of the IOF and Muller's muscle was identified. In our endoscopic and microscopic observations, Muller's muscle was extensive, not only spanning the IOF but also extending posteriorly to reach the superior orbital fissure (SOF) and anterior confluence of the cavernous sinus. Histological analysis identified many anastomotic connections between the ophthalmic venous system and pterygoid plexus that may explain how infection or tumor spreads between these regions. Muller's muscle serves as an anatomical landmark in the IOF and facilitates anatomical orientation in this region for endoscopic skull base approaches. Its recognition during endoscopic approaches allows for a better three-dimensional understanding of this anterior cranial base region. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. 中颅窝沟通性软骨母细胞瘤1例及文献复习%Chondroblastoma of the temporal bone invading the middle cranial fossa and infratemporal fossa (One case report and literature review

    Institute of Scientific and Technical Information of China (English)

    马杰科; 刘劲松; 吕扬成; 吴宇平; 王光辉; 朱江

    2009-01-01

    目的 报道1例中颅窝沟通性软骨母细胞瘤,结合相关文献对该类肿瘤的诊断和治疗进行复习.方法 分析我科收治1例中颅窝沟通性软骨母细胞瘤的临床特征及治疗方法,并搜索MEDLINE数据库对所有颞骨软骨母细胞瘤相关文献有关治疗方法及术后并发症等进行分析.结果 本例患者肿瘤位于中颅窝,向颅内外沟通性生长,采用颞下颧弓入路手术切除,术后给予残留肿瘤立体定向放疗.随访1年,患者症状改善,无术后并发症.结论 对颅底沟通性软骨母细胞瘤手术为主要治疗方案,对残余肿瘤可采用伽玛刀等综合治疗.

  15. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Science.gov (United States)

    Smith, Keely; Gomez-Rubio, Ana M.; Harris, Tomika S.; Brooks, Lauren E.

    2016-01-01

    We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2) resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV) during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway. PMID:27418995

  16. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Directory of Open Access Journals (Sweden)

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  17. Giant posterior fossa mature teratoma with adjacent subacute haematoma, compressive on the brainstem, with acute hydrocephalus. Case report

    Directory of Open Access Journals (Sweden)

    Balasa D.

    2016-09-01

    Full Text Available Mature teratoma of the vermis is a rare entity in neurosurgical adulthood pathology. We present the case of a 65 years old patient, admited as an emergency for intense headache (VAS 8/10, nausea, vomiting, gait ataxia, orizontal nistagmus, dismetria, disdiadocokinezia, predominant on the left side, long tracts signs, predominant on the left side. Native and contrast CT and MRI scan of the head revealed a tumoral lesion, in the vermian, paravermian and in the fourth ventricle, with the aspect of a teratoma with intratumoral subacute haemorrhage including a giant lesion 5,5/5/4,5 cm, compressive on mesencephalon, and with suprajacent acute internal hidrocephalus. Emergency neurosurgery was performed (occipital infratentorial craniectomy, microneurosurgical total tumoral resection and haematoma evacuation. Postoperative, the patient recovered progressivelly , subtotal neo and arhicerebellar symptoms. The motor long tract signs recovered slower and persisted incomplete.

  18. Evaluation of Right Iliac Fossa Pain with Reference to Alvarado Score – Can We Prevent Unnecessary Appendicectomies?

    Directory of Open Access Journals (Sweden)

    P. D. Gurav

    2013-07-01

    Full Text Available Background: Appendicectomy for acute appen-dicitis is the most common surgical cause ofemergency laparotomy throughout the world.Acute appendicitis is a clinical diagnosis; theaccuracy of clinical examination has been re-ported from 71 to 97% and varies greatly de-pending upon the experience of the examiner.The treatment being surgical, negative appen-dicectomy rates are high. Aim and Objective:Present study was conducted to evaluateAlvarado Scoring system for diagnosis of acuteappendicitis and its co-relation by histopathol-ogy. Material and Methods: Prospective studyof consecutive patients admitted with suspectedacute appendicitis during the period of July2011 to December 2012 was undertaken.Alvarado Score of each patient was calculated.Out of 130, 95 patients had histologicallyproven acute appendicitis. Reliability of scor-ing system was assessed by calculating posi-tive predictive value and negative appendicec-tomy rate. Results and Conclusion: The posi-tive predictive value was 88.37% and negativeappendicectomy rate was 11.63% (with respectto Alvarado score > 7. Alvarado Scoring sys-tem is easy, simple, cheap, useful tool in pre-operative diagnosis of acute appendicitis.

  19. Functional Outcome After Antegrade Femoral Nailing : A Comparison of Trochanteric Fossa Versus Tip of Greater Trochanter Entry Point

    NARCIS (Netherlands)

    Moein, Chloe Ansari; ten Duis, Henk-Jan; Oey, Liam; de Kort, Gerard; van der Meulen, Wout; Vermeulen, Karin; van der Werken, Christiaan

    2011-01-01

    Objectives: This study was performed to explore the relationship between entry point-related soft tissue damage in antegrade femoral nailing and the functional outcome in patients with a proximal third femoral shaft fracture. Design: Retrospective clinical trial. Setting: Level I university trauma c

  20. Nonrandom spatial clustering of spontaneous anterior fossa cerebrospinal fluid fistulas and predilection for the posterior cribriform plate.

    Science.gov (United States)

    Murray, Richard D; Friedlander, Rachel; Hanz, Samuel; Singh, Harminder; Anand, Vijay K; Schwartz, Theodore H

    2017-05-01

    OBJECTIVE The anterior skull base is a common site for the spontaneous development of meningoceles, encephaloceles, and meningoencephaloceles that can lead to cerebrospinal fluid (CSF) fistula formation, particularly in association with idiopathic intracranial hypertension. In some circumstances the lesions are difficult to localize. Whether all sites in the anterior skull base are equally prone to fistula formation or whether they are distributed randomly throughout the anterior skull base is unknown, although the anterior cribriform plate has been proposed as the most frequent location. The purpose of this study was to identify sites of predilection in order to provide assistance for clinicians in finding occult leaks and increase the understanding of the etiology of this pathology. METHODS The authors performed a retrospective review of a prospectively acquired surgical database of all endonasal endoscopic surgeries performed at Weill Cornell Medical College by the senior authors. Spontaneous CSF fistulas of the anterior skull base were identified. The anatomical sites of the defects were located on radiographic images and normalized to a theoretical 4 × 2 grid representing the anterior midline skull base. Data from the left and right skull base were combined to increase statistical power. This grid was then used to analyze the distribution of defects. Frequency analysis was performed by means of a chi-square test, with a subsequent Monte Carlo simulation to further strengthen the statistical support of the conclusions. RESULTS Nineteen cases of spontaneous CSF fistulas were identified. Frequency analysis using chi-square indicated a nonrandom distribution of sites (p = 0.035). Monte Carlo simulation supported this conclusion (p = 0.034). Seventy-four percent of cases occurred in the cribriform plate (p = 0.086). Moreover, 37% of all defects occurred in the posterior third of the cribriform plate. CONCLUSIONS Anterior skull base spontaneous CSF leaks are distributed in a nonrandom fashion. The most likely site of origin of the spontaneous CSF leaks of the anterior midline skull base is the cribriform plate, particularly the posterior third of the plate, likely because of the lack of significant thick bony buttressing. Clinicians searching for occult spontaneous leaks of the anterior skull base should examine the cribriform plate, especially the posterior third with particularly close scrutiny.

  1. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Directory of Open Access Journals (Sweden)

    Keely Smith

    2016-01-01

    Full Text Available We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2 resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway.

  2. Craniectomy for a bilobed dermoid cyst in the temporal fossa and greater wing of the sphenoid bone.

    Science.gov (United States)

    Nevrekar, Dipti; Abdu, Emun; Selden, Nathan R

    2009-01-01

    Dermoid cysts are common periorbital lesions. They usually occur near the superolateral orbital rim, indenting but not extending within the bony outer table. We present an unusual case of a dumbbell-shaped dermoid cyst underlying the temporalis muscle with extension into the lateral wing of the greater sphenoid bone, approaching the optic canal. The cyst was successfully removed en bloc via a small skull base craniectomy without spillage of cyst contents. The patient recovered well without neurological or visual sequelae.

  3. 神经纤维瘤病Ⅰ型累及眶部的MRI表现%Magnetic resonance imaging findings of orbital disease in neurofibromatosis type 1 patients

    Institute of Scientific and Technical Information of China (English)

    付琳; 王振常; 鲜军舫; 李静; 张征宇

    2012-01-01

    目的 探讨神经纤维瘤病Ⅰ型( NF1)累及眶部的MRI特征.方法 回顾性分析2004年1月至2011年5月首都医科大学附属北京同仁医院80例符合国际医疗组织临床诊断标准的NF1型患者眼眶MRI表现,86侧眼眶受累.80例患者均行眼眶和(或)头颅MR成像,其中71例同时行增强扫描.结果 79例85侧眶内从状神经纤维瘤,累及颞窝61侧,海绵窦61侧,翼腭窝51侧,颞下窝31侧,增强后71侧轻度-中等强化;蝶骨大翼发育不良所致眶壁骨质缺损79侧,蝶骨小翼发育不良72侧;眼球增大32侧,视神经胶质瘤5侧;伴发脑实质多发T2WI高信号灶53例.结论 NF1容易累及眼眶,MRI可直接显示眶部受累范围以及伴发的其他异常.%Objective To explore the magnetic resonance imaging (MRI) features of neurofibromatosis type 1 (NF1) with orbital involvement.Methods We retrospectively reviewed the MRI findings of orbital abnormalities in 80 NF1 patients (86 orbits).The diagnosis was confirmed by the updated National Institute of Health (NIH) criteria All of them underwent MRI scans of orbit or brain while 71 patients had contrast enhancement.Results The orbital abnormalities were documented in 80 patients.And 79 cases (85 orbits) had plexiform neurofibroma in orbit and/or adjacent regions.The orbital involvements extended to superficial temporal fossa ( n =61 ),infratemporal fossa ( n =31 ),cavernous sinus ( n =61 )and pterygopalatine fossa (n =51 ).There was mild-to-moderate enhancement in 71 orbits on contrastenhanced MRI examinations.There were localized defects of orbital walls because of sphenoid bone dysplasia of greater wing (n =79),sphenoid bone dysplasia of lesser wing (n =72),augmentation (glaucoma) of eyeballs ( n =32 ) and optic nerve gliomas ( n =5 ).And 53 cases had hyperintense lesions on T2-weighted brain images.Conclusion Orbital involvement is common for NF1.And MRI is a useful tool of evaluating the extent of involvements and other abnormalities in the NF

  4. Recycling of palm oil industrial wastes using vermicomposting technology: its kinetics study and environmental application.

    Science.gov (United States)

    Rupani, Parveen Fatemeh; Embrandiri, Asha; Ibrahim, Mahamad Hakimi; Shahadat, Mohammad; Hansen, Sune Balle; Ismail, Sultan Ahmed; Ab Kadir, Mohd Omar

    2017-05-01

    The present paper reports management of palm oil mill effluent (POME) mixed with palm-pressed fibre (PPF) POME-PPF mixture using eco-friendly, cost-effective vermicomposting technology. Vermicomposting of POME-PPF was performed to examine the optimal POME-PPF ratio with respect to the criteria of earthworm biomass and to evaluate the decomposition of carbon and nitrogen in different percentages of POME-PPF mixtures. Chemical parameters such as TOC, N, P and K contents were determined to achieve optimal decomposition of POME-PPF. On this basis, the obtained data of 50% POME-PPF mixture demonstrated more significant results throughout the experiment after addition of the earthworms. However, 60 and 70% mixtures found significant only in the last stages of the vermicomposting process. The decomposition rate in terms of -ln (CNt/CNo) showed that the 50% mixture has higher decomposition rate as compared to the 60 and 70% (k50% = 0.0498 day(-1)). The vermicomposting extracts (50, 60 and 70%) of POME-PPF mixtures were also tested to examine the growth of mung bean (Vigna radiata). It was found that among different extract dilutions, 50% POME-PPF vermicompost extract provided longer root and shoot length of mung bean. The present study concluded that the 50% mixture of POME-PPF could be chosen as the optimal mixture for vermicomposting in terms of both decomposition rate and fertilizer value of the final compost. Graphical abstract ᅟ.

  5. Novel Sustained-Release of Propafenone through Pellets: Preparation and in Vitro/in Vivo Evaluation

    OpenAIRE

    2014-01-01

    In this study, an extrusion-spheronization method was applied successfully to fabricate propafenone hydrochloride (PPF) sustained-release pellets. Using scanning electron microscopy, it was shown that the PPF pellets had a mean size of approximately 950 µm with a spherical shape. The in vitro release profiles indicated that the release of PPF from the pellets exhibited a sustained release behavior. The relatively high correlation coefficient (r) values obtained from the analysis of the amount...

  6. Fibronectin promotes proplatelet formation in the human megakaryocytic cell line UT-7/TPO.

    Science.gov (United States)

    Kawaguchi, Tatsuya; Hatano, Ryo; Yamaguchi, Kyoji; Nawa, Katsuhiko; Hashimoto, Ryuji; Yokota, Hiroshi

    2012-01-01

    We investigated PPF (proplatelet formation) in the human megakaryocytic cell line UT-7/TPO in vitro and signal transduction pathways responsible for PPF. The megakaryocytic cell lines are useful for studying megakaryocyte biology, although PPF is induced only in the presence of phorbol ester. TPO (thrombopoietin) stimulates megakaryocyte proliferation and differentiation; however, no PPF occurred in the megakaryocytic cell lines, even after the addition of TPO. Therefore, factors other than TPO may play an important role in the process of PPF. As PPF occurs in the bone marrow in vivo, we noted extracellular matrix proteins and found that soluble FN (fibronectin) induced potent PPF in UT-7/TPO without phorbol ester. A Western blot analysis showed that the expression of integrins was not increased by FN treatment. Anti-β1 antibody and the RGD (arginine-glycine-aspartate) peptide inhibited FN-induced PPF. This result indicates that the signal originated from integrin β1, which is essential to inducing PPF in UT-7/TPO. Results of the experiments using several inhibitors suggest that activation of the MEK [MAPK (mitogen-activated protein kinase)/ERK (extracellular-signal-regulated kinase) kinase]-ERK and PI3K (phosphoinositide 3-kinase) pathways are necessary for PPF. The phosphorylation of ERK gradually increased for 2 h after the addition of soluble FN, which suggests that activation of ERK is essential for the initial induction of FN-induced PPF in UT-7/TPO. UT-7/TPO is a useful cell line that enables us to study the signals of PPF without effects of chemical compounds.

  7. Flexural behaviour of reinforced concrete beams with discrete steel – polypropylene fibres

    Directory of Open Access Journals (Sweden)

    Amizah Wan Jusoh Wan

    2017-01-01

    Full Text Available This paper discusses the experimental results on the flexural test of concrete containing different proportions of steel fibre (SF and polypropylene fibre (PPF. The flexural test was carried out under 4-point bending load and followed the relevant standards to FRC. Hooked-end deformed SF fibre with 60 mm length and fibrillated virgin PPF fibre with 19 mm length were used in this study. Meanwhile, the concrete was designed for high strength concrete of C60. The mixture included both single SF and PPF, and also the combination of both fibres; Control beam (PC, beam with 75%SF, beam with 75%SF + 25%PPF and beam with 25%PPF. The total fibre volume fraction (Vf was fixed at 1.5%. The experimental results show that the percentage proportion of combined SF-PPF at 75-25% had the best performance for its flexural capacity. Mixture with single PPF was also found not effective in delaying the onset of tension cracks and to increase the tensile strength of the concrete. Experimental result also shows beam with 75%SF +25%PPF had their structural stiffness improved the most as compared with the others. For the compressive strength, beam with 75%SF + 25%PPF also revealed comparable performance with the control for high strength composite concrete.

  8. Biomimetic synthesis of poly(propylene-fumarate)-calcium phosphate composites for tissue engineering

    Science.gov (United States)

    Hakimi Mehr, Dorna

    A novel in-situ co-precipitation process for the synthesis of poly(propylene-fumarate)-calcium phosphate composites was developed. In this process the calcium phosphate phase nucleates and grows in the presence of poly(propylene-fumarate) (PPF), in a novel two-solvent system including tetrahydrofuran (THF) and water. It was found that the presence of the organic solvent (THF) does not affect the phase evolution of the calcium phosphate. Both in the presence and absence of THF crystalline dicalcium phosphate dihydrate (DCPD, brushite) and poorly crystalline hydroxyapatite (HAp) form, and transform to crystalline HAp after 24 hours of synthesis time. Contrary to the organic solvent, PPF has a significant influence on the calcium phosphate phase that forms in its presence. It is found that PPF provides a template for the formation of the calcium phosphate phase through a coordination bond between the calcium ion and the carbonyl group of the polymer. As a result of this templating, hydroxyapatite can form in a significantly shorter period of time (˜1 hr) compared to the system where PPF is not present (24 hrs). The nature of the calcium phosphate phase that forms in the presence of PPF depends on the molecular weight and concentration of PPF. High concentration of PPF in the composite (e.g. 80%) stabilizes an amorphous calcium phosphate (ACP) phase and hinders its transformation to crystalline apatite, while low concentration of PPF (e.g. 5%) promotes the formation of crystalline apatite. Higher molecular weight PPF (Mw = 4500) is found to be more efficient in stabilizing the amorphous phase compared to lower molecular weight PPF (Mw = 1800). While high molecular weight PPF stabilizes ACP, low molecular weight PPF promotes its conversion to crystalline apatite. TEM observations revealed that flake-like hydroxyapatite crystals form in the absence of PPF while spherical ACP particles form in a composite containing 80% PPF. The ACP nano-particles (50-100 nm in diameter

  9. Propentofylline treatment on open field behavior in rats with focal ethidium bromide-induced demyelination in the ventral surface of the brainstem.

    Science.gov (United States)

    Martins-Júnior, J L; Bernardi, M M; Bondan, E F

    2016-03-01

    Propentofylline (PPF) is a xanthine derivative with pharmacological effects that are distinct from those of classic methylxanthines. It depresses the activation of microglial cells and astrocytes, which is associated with neuronal damage during neural inflammation and hypoxia. Our previous studies showed that PPF improved remyelination following gliotoxic lesions that were induced by ethidium bromide (EB). In the present study, the long-term effects of PPF on open field behavior in rats with EB-induced focal demyelination were examined. The effects of PPF were first evaluated in naive rats that were not subjected to EB lesions. Behavior in the beam walking test was also evaluated during chronic PPF treatment because impairments in motor coordination can interfere with behavior in the open field. The results showed that PPF treatment in unlesioned rats decreased general activity and caused motor impairment in the beam walking test. Gliotoxic EB injections increased general activity in rats that were treated with PPF compared with rats that received saline solution. Motor incoordination was also attenuated in PPF-treated rats. These results indicate that PPF reversed the effects of EB lesions on behavior in the open field and beam walking test.

  10. 低场MRI在鼻咽癌诊断中的应用%Low field MRI on the diagueqs of nasopharynged carcinoma(NPC)

    Institute of Scientific and Technical Information of China (English)

    刘华敢; 黎燕飞; 陈光新

    2010-01-01

    Objective The MRI manifestdtions of NPC were analysed and low-field MRI on the diagnosis of NPC was disscussed.Methods The MRI manifestations cf 83 casea that were confirmed by biopsy were analysed retrospectively. Results The MRI of NPC manifese mainly as follow:The mucosa thickened or solf tissue mass formed on the top of posterior, left and right nasopharyngeal wall,Pharyngeal recess became supperficial and disappearing, And pharyngeal ostium of eustachian tube became dull or bstructive, The pharyngeal space displaced or narrowed and disappeared. unilteral or bilateral otomastoiditis can be seen and can be accompanied by the destruction of skull base, carernous sinus and orbit can be violated, and temporal fossa or pterygopalatine fossa can be involed .The T1WI signal of tumorous tissue was homogeneous or slightly low, the T2WI signal was slightly high or higher on the enhamced scanning, the amount(or ratio) of serer,moderate and mild enhanced cases were respectively 22(31.0%), 41(57.7%), 8( 11.3% ).Conclusions Low-fild MRI can imdicate muticfaceted clearly and accurately the location,size, shape, violating scope of NPC and the extent of involting adjacent tissue and structure, So the low-fild MRI is the best imaging examination on the diagnosis of NPC.%目的 分析鼻咽癌的MRI表现,探讨低场MRI在鼻咽癌诊断中的应用.方法 回顾性分析我院83例经病理活检证实的鼻咽癌MRI表现.结果 鼻咽癌的主要MRI表现:鼻咽顶后壁及左侧壁、右侧壁粘膜增厚或局部软组织肿块形成,咽隐窝表浅、消失,咽鼓管咽口变钝或闭塞,咽旁间隙移位或变窄、消失,一侧或双侧中耳乳突炎症,可伴颅底骨破坏,并侵犯海绵窦、眼眶、颞下窝或翼腭窝受累及.瘤体组织T1WI呈均匀等信号或稍低信号,T2WI呈均匀稍高信号或较高信号,增强扫描肿瘤呈重度、中等度、轻度强化分别为22(31.0%)例、41(57.7%)例、8(11.3%)例.结论 低场MRI能多方位清楚、准

  11. Ct Anatomy of Buccal Fat Pad and its Role in Volumetric Alterations of Face

    Science.gov (United States)

    Guryanov, R. A.; Guryanov, A. S.

    2015-05-01

    The aim of our study is the revision of the anatomy of buccal fat pad and its role in a volumetric pattern of face. Bichat fat pad is a fatty anatomical structure with body and numerous process enclosed between the bony and muscular structures in temporal, pterygopalatine fossae and extents to the cheek area. Nevertheless, the opinion about its structure and role in forming of volume pattern of face sometimes could be controversial. The Bichat fat pad consists on predominately hormone insensitive fat tissue with underdeveloped stroma, this leads to the stability of the fat pad volume and lesser radiodensity in contrast to the subcutaneous fat. Moreover, the buccal fat pad is delimited from the subcutaneous fat of cheek area by the strong capsule. This feature allows us to use CT to divide the Bichat fat pad from the surrounding tissues. The thorough embryological data provide the distinction of Bichat fat pad from the subcutaneous fat of cheek area even at the stage of development. On the other hand, the border between the masticatory muscles and the processes of the fat pad is not evident and resembles cellular spaces in the other anatomical areas. To elicit the role of the buccal fat pad in volume pattern of face and its function we have performed the several experiments, analyzed the postoperative results after Bichat fat pad resection using surface scanner and CT data. At first, we have performed the gravity test: the patient's face photogrammetry scanning in horizontal and vertical position of head and it revealed the excess of volume in temporal area in horizontal position. To exclude mechanism of overflowing of the skin and subcutaneous fat over the zygomatic arch we have placed the markers on the skin surface at the different areas of face including the projection of ligaments and found out that the migration of soft tissue over the zygomatic arch is about 3-5 mm and almost the same in temporal area. However, the acquired result was unsatisfying because

  12. Usefulness of high-resolution 3D multifusion medical imaging for preoperative planning in patients with posterior fossa hemangioblastoma: technical note.

    Science.gov (United States)

    Yoshino, Masanori; Nakatomi, Hirofumi; Kin, Taichi; Saito, Toki; Shono, Naoyuki; Nomura, Seiji; Nakagawa, Daichi; Takayanagi, Shunsaku; Imai, Hideaki; Oyama, Hiroshi; Saito, Nobuhito

    2017-07-01

    Successful resection of hemangioblastoma depends on preoperative assessment of the precise locations of feeding arteries and draining veins. Simultaneous 3D visualization of feeding arteries, draining veins, and surrounding structures is needed. The present study evaluated the usefulness of high-resolution 3D multifusion medical imaging (hr-3DMMI) for preoperative planning of hemangioblastoma. The hr-3DMMI combined MRI, MR angiography, thin-slice CT, and 3D rotated angiography. Surface rendering was mainly used for the creation of hr-3DMMI using multiple thresholds to create 3D models, and processing took approximately 3-5 hours. This hr-3DMMI technique was used in 5 patients for preoperative planning and the imaging findings were compared with the operative findings. Hr-3DMMI could simulate the whole 3D tumor as a unique sphere and show the precise penetration points of both feeding arteries and draining veins with the same spatial relationships as the original tumor. All feeding arteries and draining veins were found intraoperatively at the same position as estimated preoperatively, and were occluded as planned preoperatively. This hr-3DMMI technique could demonstrate the precise locations of feeding arteries and draining veins preoperatively and estimate the appropriate route for resection of the tumor. Hr-3DMMI is expected to be a very useful support tool for surgery of hemangioblastoma.

  13. Removal of Infected Maxillary Third Molar from the Infra-temporal Fossa by Caldwell Luc Procedure - Rare Case Report with Literature Review

    Science.gov (United States)

    Srivastava, Ram Kumar; Saxena, Anurag; Khanna, Ruchika; Ali, Iqbal

    2016-01-01

    Dentigerous or follicular cysts of odontogenic origin are innocuous benign cysts that are often linked with the crowns of permanent teeth. A dentigerous cyst circumventing permanent teeth fails to erupt and is often displaced into ectopic positions in the upper and lower jaw in the maxillofacial region. In the maxilla or upper jaw region, the impacted teeth are often displaced and/or shift into the maxillary sinus and apart from the nasal septum, mandibular condyle, coronoid process and the palate, to harbour such ectopic eruptions of teeth. We report a rare case of an impacted left third molar of maxilla, associated with dentigerous cyst. The impacted tooth was embedded in the anterosuperior part of the infratemporal space. The cyst along with the tooth was removed using a modified Caldwell Luc incision.

  14. Feasibility and Safety of Right and Left Heart Catheterization Via an Antecubital Fossa Vein and the Radial Artery in Patients With Heart Failure.

    Science.gov (United States)

    D'Amario, Domenico; Burzotta, Francesco; Leone, Antonio M; Porto, Italo; Niccoli, Giampaolo; Aurigemma, Cristina; Ruggio, Aureliano; Borovac, Josip A; Massetti, Massimo; Trani, Carlo; Crea, Filippo

    2017-09-01

    Heart failure is the leading cause of hospitalization among patients older than 65 years of age. A significant proportion of patients require heart catheterization for diagnostic, therapeutic, and prognostic purposes. To determine the feasibility and safety of full arm-arm catheterization access, we aimed to compare this approach with other established catheterization approaches. In this retrospective cohort study, a total of 493 consecutive patients with heart failure requiring right and left heart catheterization were studied and analyzed. Subsequently, all patients were divided into three groups based on the catheterization approach used: arm-arm, hybrid femoral-arm, and femoral-femoral access. The three groups did not significantly differ in their baseline clinical, demographic, or risk factor characteristics. The full arm-arm catheterization procedures were significantly longer when compared with hybrid femoral-arm and femoral-femoral approach (73 min vs 68 min vs 67 min, respectively; P=.04), but remarkably provided significantly less fluoroscopy radiation dose (40,337 ± 64,799 cG/cm² vs 62,270 ± 120,420 cG/cm² vs 156077 ± 566495 cG/cm², respectively; P=.04). Procedural complications were rare and occurred in 0.9% of the arm-arm group, 4.8% of the femoral-arm group, and 3.3% of the femoral-femoral group (P=.45). Finally, in arm-arm patients, a significantly earlier ambulation was achieved compared with the others groups (P=.02). Full arm-arm access for bilateral heart catheterization in patients with heart failure proved to be a safe and feasible approach, and was associated with lower radiation burden and early ambulation time when compared with hybrid arm-leg and full femoral catheterization approaches.

  15. Construction of nanometer cisplatin core-ferritin (NCC-F) and proteomic analysis of gastric cancer cell apoptosis induced with cisplatin released from the NCC-F.

    Science.gov (United States)

    Ji, Xue-Tao; Huang, Lin; Huang, He-Qing

    2012-06-18

    Both transmission electron microscopy (TEM) and fluorescence spectrometry were used to reveal the characteristics of both subunit disassociation and recombination in apo-pig pancreas ferritin (apoPPF) in an alkaline medium ranging reversibly from pH 7.0 to 13.0. The experimental results indicated that apoPPF could be completely disassociated into 24 free subunits at pH 13.0, and then these subunits could be quickly reassembled into the original apoPPF once the pH of the reactive medium was returned to pH7.0. This novel and simple method could be used to effectively construct a novel nanometer cisplatin core-PPF (NCC-PPF). The major characteristics of NCC-PPF were investigated using various analytical methods such as ultraviolet-spectrometry, circular dichroism spectrometry and TEM, which indicated that its molecular structure was still similar to that of the original apoPPF. Results from the inductively coupled plasma mass spectrometer (ICP-MS) method showed that 11.26 cisplatin (CDDP) molecules were successfully packaged within the NCC-PPF shell, indicating that each molecule of apoPPF had the ability to enwrap 11.26 CDDP molecules for constructing the NCC-PPF. Flow cytometry showed that NCC-PPF also had the ability to release CDDP for inducing the apoptosis of gastric cancer cells BGC823 (GCC), but this phenomenon could scarcely be observed using apoPPF. A differential proteomic technique using two-dimensional electrophoresis (2-DE) gels selected and identified the differential proteins from cell apoptosis in order to reveal the molecular pathway of GCC apoptosis by both NCC-PPF and free CDDP, giving 13 differential expression proteins. These differential proteins could be further classified into six groups, which were described as being involved in the regulation of apoptosis, RNA transcription, oxidative stress response, signal transduction, cell metabolism, and cytoskeleton changes. In addition, a real-time PCR method was used to prove the expression level of

  16. Speech Outcomes After Clinically Indicated Posterior Pharyngeal Flap Takedown.

    Science.gov (United States)

    Katzel, Evan B; Shakir, Sameer; Naran, Sanjay; MacIsaac, Zoe; Camison, Liliana; Greives, Matthew; Goldstein, Jesse A; Grunwaldt, Lorelei J; Ford, Matthew D; Losee, Joseph E

    2016-10-01

    Velopharyngeal insufficiency affects as many as one in three patients after cleft palate repair. Correction using a posterior pharyngeal flap (PPF) has been shown to improve clinical speech symptomatology; however, PPFs can be complicated by hyponasality and obstructive sleep apnea. The goal of this study was to assess if speech outcomes revert after clinically indicated PPF takedown. The cleft-craniofacial database of the Children's Hospital of Pittsburgh at the University of Pittsburgh Medical Center was retrospectively queried to identify patients with a diagnosis of velopharyngeal insufficiency treated with PPF who ultimately required takedown. Using the Pittsburgh Weighted Speech Score (PWSS), preoperative scores were compared to those after PPF takedown. Outcomes after 2 different methods of PPF takedown (PPF takedown alone or PPF takedown with conversion to Furlow palatoplasty) were stratified and cross-compared. A total of 64 patients underwent takedown of their PPF. Of these, 18 patients underwent PPF takedown alone, and 46 patients underwent PPF takedown with conversion to Furlow Palatoplasty. Patients averaged 12.43 (range, 3.0-22.0)(SD: 3.93) years of age at the time of PPF takedown, and 58% were men. Demographics between groups were not statistically different. The mean duration of follow-up after surgery was 38.09 (range, 1-104) (SD, 27.81) months. For patients undergoing PPF takedown alone, the mean preoperative and postoperative PWSS was 3.83 (range, 0.0-23.0) (SD, 6.13) and 4.11 (range, 0.0-23.0) (SD, 5.31), respectively (P = 0.89). The mean change in PWSS was 0.28 (range, -9.0 to 7.0) (SD, 4.3). For patients undergoing takedown of PPF with conversion to Furlow palatoplasty, the mean preoperative and postoperative PWSS was 6.37 (range, 0-26) (SD, 6.70) and 3.11 (range, 0.0-27.0) (SD, 4.14), respectively (P speech. Although there is concern that PPF takedown may degrade speech, this study finds that surgical takedown of PPF, when clinically

  17. Water-holding capacity of soluble and insoluble polysaccharides in pressed potato fibre

    NARCIS (Netherlands)

    Ramasamy, U.; Gruppen, H.; Kabel, M.A.

    2015-01-01

    Pressed potato fibres (PPF), a by-product of starch production, has a high water-holding capacity (WHC).In this study, it is shown that the WHC is caused by a network of mainly insoluble, non-cellulosic cellwall polysaccharides (CWPs). Despite the solubilization of one-fourth of the CWPs from PPF, r

  18. In vivo degradation of porous poly(propylene fumarate)/poly(DL-lactic-co-glycolic acid) composite scaffolds.

    NARCIS (Netherlands)

    Hedberg, E.L.; Kroese-Deutman, H.C.; Shih, C.K.; Crowther, R.S.; Carney, D.H.; Mikos, A.G.; Jansen, J.A.

    2005-01-01

    This study investigated the in vivo degradation of poly(propylene fumarate) (PPF)/poly(DL-lactic-co-glycolic acid) (PLGA) composite scaffolds designed for controlled release of osteogenic factors. PPF/PLGA composites were implanted into 15.0mm segmental defects in the rabbit radius, harvested after

  19. Pathologic Malgaigne fracture following pelvic irradiation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jones, A.R.; Lachiewicz, P.F.

    1987-08-01

    A 48-year-old woman developed symptomatic superior and inferior pubic rami fractures with a concomitant subluxation of the ipsilateral sacroiliac joint three years after pelvic irradiation for a gynecologic malignancy. Pathologic pelvic fractures (PPF) caused by irradiation may be difficult to distinguish from those caused by metastatic disease. PPF produce prolonged disability.

  20. In vivo degradation of porous poly(propylene fumarate)/poly(DL-lactic-co-glycolic acid) composite scaffolds.

    NARCIS (Netherlands)

    Hedberg, E.L.; Kroese-Deutman, H.C.; Shih, C.K.; Crowther, R.S.; Carney, D.H.; Mikos, A.G.; Jansen, J.A.

    2005-01-01

    This study investigated the in vivo degradation of poly(propylene fumarate) (PPF)/poly(DL-lactic-co-glycolic acid) (PLGA) composite scaffolds designed for controlled release of osteogenic factors. PPF/PLGA composites were implanted into 15.0mm segmental defects in the rabbit radius, harvested after

  1. Contribution of personal and environmental factors on positive psychological functioning in adolescents.

    Science.gov (United States)

    Fadda, Daniela; Scalas, L Francesca; Meleddu, Mauro

    2015-08-01

    This study examined self-esteem as mediator in the relations of personal (extraversion, neuroticism) and environmental (maternal, paternal, peer-relationships) variables with domains of positive psychological functioning (PPF) in adolescence (Satisfaction with life, Mastery, Vigor, Social Interest, Social Cheerfulness). We compared one-sided and multidimensional models using a sample of 1193 high school students (592 males and 601 females). We examined variations in adolescent PPF as a function of parenting styles via independent examination of maternal and paternal bonding. Results supported the multidimensional models, which indicated direct effects of personality traits, maternal care and peer relationships, as well as indirect effects, mediated by self-esteem, of all predictors on most PPF dimensions. Overall, our study provided a broader picture of personal and environmental predictors on different dimensions of PPF, which supported the mediating role of self-esteem and emphasized the importance of considering multidimensional models to characterize PPF in adolescents.

  2. Effective autodissemination of pyriproxyfen to breeding sites by the exophilic malaria vector Anopheles arabiensis in semi-field settings in Tanzania.

    Science.gov (United States)

    Lwetoijera, Dickson; Harris, Caroline; Kiware, Samson; Dongus, Stefan; Devine, Gregor J; McCall, Philip J; Majambere, Silas

    2014-04-29

    Malaria vector control strategies that target adult female mosquitoes are challenged by the emergence of insecticide resistance and behavioural resilience. Conventional larviciding is restricted by high operational costs and inadequate knowledge of mosquito-breeding habitats in rural settings that might be overcome by the juvenile hormone analogue, Pyriproxyfen (PPF). This study assessed the potential for Anopheles arabiensis to pick up and transfer lethal doses of PPF from contamination sites to their breeding habitats (i.e. autodissemination of PPF). A semi-field system (SFS) with four identical separate chambers was used to evaluate PPF-treated clay pots for delivering PPF to resting adult female mosquitoes for subsequent autodissemination to artificial breeding habitats within the chambers. In each chamber, a tethered cow provided blood meals to laboratory-reared, unfed female An. arabiensis released in the SFS. In PPF-treated chambers, clay pot linings were dusted with 0.2 - 0.3 g AI PPF per pot. Pupae were removed from the artificial habitats daily, and emergence rates calculated. Impact of PPF on emergence was determined by comparing treatment with an appropriate control group. Mean (95% CI) adult emergence rates were (0.21 ± 0.299) and (0.95 ± 0.39) from PPF-treated and controls respectively (p clay pot reduced adult emergence in six habitats to (0.34 ± 0.13) compared to (0.98 ± 0.02) in the controls (p < 0.0001), showing a high level of habitats coverage amplification of the autodissemination event. The study provides proof of principle for the autodissemination of PPF to breeding habitats by malaria vectors. These findings highlight the potential for this technique for outdoor control of malaria vectors and call for the testing of this technique in field trials.

  3. Application of bone grafting in glenoid fossa to improve the stability of Biomet fossa prosthesis in 8 consecutive cases%关节窝植骨增加标准型人工颞下颌关节窝假体稳定性的效果评价

    Institute of Scientific and Technical Information of China (English)

    白果; 杨驰; 何冬梅; 张晓虎; 陈敏洁

    2015-01-01

    目的:为提高标准型人工颞下颌关节窝假体植入的稳定性,进行关节窝植骨并评价其应用效果.方法:2013年11月-2014年2月间收治的经计算机辅助测量设计并进行人工关节置换的8例患者,采用关节窝植骨代替关节窝骨磨削的方法进行手术技术改进,通过计算假体的骨接触面积,评价植骨法对提高关节窝假体植入稳定性的作用.植骨术后CT模拟测量评价假体骨接触面积变化,评价其稳定性,并利用SPSS 19.0软件包中的配对t检验评价是否有统计学差异.结果:采用关节窝植骨法假体术中就位稳定,术后CT测量显示,关节窝假体的骨接触面积比磨骨法增加34.85% (P<0.05).结论:关节窝植骨可以显著提高人工关节窝假体的稳定性.

  4. Pancreaticopleural fistula:etiology, treatment and long-term follow-up

    Institute of Scientific and Technical Information of China (English)

    Keith J Roberts; Maria Sheridan; Gareth Morris-Stiff; Andrew M Smith

    2012-01-01

    BACKGROUND: Pancreaticopleural fistula (PPF) are uncommon. Complex multidisciplinary treatment is required due to nutritional compromise and sepsis. This is the first description of long-term follow-up of patients with PPF. METHODS: Eleven patients with PPF treated at a specialist unit were identified. Causation, investigation, treatment and outcomes were recorded. RESULTS: Pancreatitis was the etiology of the PPF in 9 patients, and in the remaining 2 the PPF developed following distal pancreatectomy. Cross-sectional imaging demonstrated the site of duct disruption in 10 cases, with endoscopic retrograde cholangiopancreatography identifying the final case. Suppression of pancreatic exocrine secretion and percutaneous drainage formed the mainstay of treatment. Five cases resolved following pancreatic duct stent insertion and three patients required surgical treatment for established empyema. There were no complications. In all cases that resolved there has been no recurrence of PPF over a median follow-up of 50 months (range 15-62). CONCLUSIONS: PPF is an uncommon event complicating pancreatitis or pancreatectomy; pancreatic duct disruption is the common link. A step-up approach consisting of minimally invasive techniques treats the majority with surgery needed for refractory sepsis.

  5. Evaluation of the feeding value of palm press fibre using in vitro digestibility techniques.

    Science.gov (United States)

    Obese, F Y; Osafo, E L; Okai, D B

    2001-04-01

    Palm press fibre (PPF) was obtained from two sources, a small-scale oil palm processing unit and a large-scale factory processing unit, and its chemical composition was determined. In vitro digestibility techniques were used to assess the feeding value of untreated, defatted and sodium hydroxide-treated PPF. For the NaOH treatment, 0.5 g oven-dried PPF was treated for 24 h with 5% NaOH in three ways: treated and not washed (NaNW); treated and washed (NaW); and treated after milling (NAD). The results indicate that, on a dry matter basis, PPF is low in nitrogen (12-13 g/kg), moisture (37-90 g/kg) and ash (53-62 g/kg), but high in ether extract (269-355 g/kg), neutral detergent fibre (532-768 g/kg), acid detergent fibre (375-548 g/kg) and lignin (219 g/kg). The in vitro dry matter digestibility values were low for the samples from both sources, but the large-scale factory-processed PPF had higher in vitro dry matter digestibility (0.215 vs 0.166) and in vitro organic matter digestibility (0.196 vs 0.145). Defatting the PPF and treating it with 5% NaOH solution significantly (p defatting and treatment with 5% NaOH would improve the feeding value of PPF.

  6. Chemical and microstructural characterizations of plasma polymer films by time-of-flight secondary ion mass spectrometry and principal component analysis

    Science.gov (United States)

    Cossement, Damien; Renaux, Fabian; Thiry, Damien; Ligot, Sylvie; Francq, Rémy; Snyders, Rony

    2015-11-01

    It is accepted that the macroscopic properties of functional plasma polymer films (PPF) are defined by their functional density and their crosslinking degree (χ) which are quantities that most of the time behave in opposite trends. If the PPF chemistry is relatively easy to evaluate, it is much more challenging for χ. This paper reviews the recent work developed in our group on the application of principal component analysis (PCA) to time-of-flight secondary ion mass spectrometric (ToF-SIMS) positive spectra data in order to extract the relative cross-linking degree (χ) of PPF. NH2-, COOR- and SH-containing PPF synthesized in our group by plasma enhanced chemical vapor deposition (PECVD) varying the applied radiofrequency power (PRF), have been used as model surfaces. For the three plasma polymer families, the scores of the first computed principal component (PC1) highlighted significant differences in the chemical composition supported by X-Ray photoelectron spectroscopy (XPS) data. The most important fragments contributing to PC1 (loadings > 90%) were used to compute an average C/H ratio index for samples synthesized at low and high PRF. This ratio being an evaluation of χ, these data, accordingly to the literature, indicates an increase of χ with PRF excepted for the SH-PPF. These results have been cross-checked by the evaluation of functional properties of the plasma polymers namely a linear correlation with the stability of NH2-PPF in ethanol and a correlation with the mechanical properties of the COOR-PPF. For the SH-PPF family, the peculiar evolution of χ is supported by the understanding of the growth mechanism of the PPF from plasma diagnostic. The whole set of data clearly demonstrates the potential of the PCA method for extracting information on the microstructure of plasma polymers from ToF-SIMS measurements.

  7. Anti-aging effects of Piper cambodianum P. Fourn. extract on normal human dermal fibroblast cells and a wound-healing model in mice

    Directory of Open Access Journals (Sweden)

    Lee H

    2016-07-01

    Full Text Available Hyunji Lee,1 Youngeun Hong,1 So Hee Kwon,2 Jongsun Park,1 Jisoo Park1 1Department of Pharmacology and Medical Science, Metabolic Diseases and Cell Signaling Laboratory, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, 2Department of Pharmacy, College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea Background: Aging of skin is associated with environmental factors such as ultraviolet rays, air pollution, gravity, and genetic factors, all of which can lead to wrinkling of skin. Previous reports suggest that the wound repair is impaired by the aging process and strategies to manipulate the age-related wound healing are necessary in order to stimulate repair.Objective: Several traditional plant extracts are well-known for their properties of skin protection and care. Piper cambodianum P. Fourn. (PPF, a member of Piperacecae, is a plant found in Vietnam that might have therapeutic properties. Therefore, the effects of PPF stem and leaf extract on aging process were investigated in vitro and in vivo.Methods: PPF extract dissolved in methanol was investigated using Western blotting, real-time quantitative reverse transcription-polymerase chain reaction, flow cytometry, and cell wound-healing assays. We assessed the anti-aging effect of PPF in mouse using the wound-healing assay. The results were analyzed by Student’s unpaired t-test; *P<0.05 and **P<0.01 were considered to indicate significant and highly significant values, respectively, compared with corresponding controls.Results: PPF treatment demonstrated in vitro and in vivo anti-aging activity. Western blot analysis of PPF-treated normal human dermal fibroblast cells showed a dose-dependent increase in the expression of extracellular matrix genes such as collagen and elastin, but decreased expression of the aging gene matrix metalloproteinase-3. Quantitative polymerase chain reaction showed

  8. Controlled clinical comparison of plastic versus glass bottles of BacT/ALERT PF medium for culturing blood from children.

    Science.gov (United States)

    Petti, Cathy A; Mirrett, Stanley; Woods, Christopher W; Reller, L Barth

    2005-01-01

    The plastic pediatric BacT/ALERT (bioMérieux, Durham, N.C.) PF (PPF) is a new nonvented aerobic culture medium in a clear plastic bottle designed to prevent breakage. We compared the performance of the new PPF bottle to that of the present glass BacT/ALERT PF bottle for the recovery of microorganisms as well as for the time to detection of growth in samples of blood obtained for culture from children. We found that the PPF and PF bottles were comparable for recovery of microorganisms and that the safety advantage of plastic bottles can be achieved without compromising performance.

  9. The formin DIAPH1 (mDia1) regulates megakaryocyte proplatelet formation by remodeling the actin and microtubule cytoskeletons.

    Science.gov (United States)

    Pan, Jiajia; Lordier, Larissa; Meyran, Deborah; Rameau, Philippe; Lecluse, Yann; Kitchen-Goosen, Susan; Badirou, Idinath; Mokrani, Hayat; Narumiya, Shuh; Alberts, Arthur S; Vainchenker, William; Chang, Yunhua

    2014-12-18

    Megakaryocytes are highly specialized precursor cells that produce platelets via cytoplasmic extensions called proplatelets. Proplatelet formation (PPF) requires profound changes in microtubule and actin organization. In this work, we demonstrated that DIAPH1 (mDia1), a mammalian homolog of Drosophila diaphanous that works as an effector of the small GTPase Rho, negatively regulates PPF by controlling the dynamics of the actin and microtubule cytoskeletons. Moreover, we showed that inhibition of both DIAPH1 and the Rho-associated protein kinase (Rock)/myosin pathway increased PPF via coordination of both cytoskeletons. We provide evidence that 2 major effectors of the Rho GTPase pathway (DIAPH1 and Rock/myosin II) are involved not only in Rho-mediated stress fibers assembly, but also in the regulation of microtubule stability and dynamics during PPF.

  10. Anti-aging effects of Piper cambodianum P. Fourn. extract on normal human dermal fibroblast cells and a wound-healing model in mice.

    Science.gov (United States)

    Lee, Hyunji; Hong, Youngeun; Kwon, So Hee; Park, Jongsun; Park, Jisoo

    2016-01-01

    Aging of skin is associated with environmental factors such as ultraviolet rays, air pollution, gravity, and genetic factors, all of which can lead to wrinkling of skin. Previous reports suggest that the wound repair is impaired by the aging process and strategies to manipulate the age-related wound healing are necessary in order to stimulate repair. Several traditional plant extracts are well-known for their properties of skin protection and care. Piper cambodianum P. Fourn. (PPF), a member of Piperacecae, is a plant found in Vietnam that might have therapeutic properties. Therefore, the effects of PPF stem and leaf extract on aging process were investigated in vitro and in vivo. PPF extract dissolved in methanol was investigated using Western blotting, real-time quantitative reverse transcription-polymerase chain reaction, flow cytometry, and cell wound-healing assays. We assessed the anti-aging effect of PPF in mouse using the wound-healing assay. The results were analyzed by Student's unpaired t-test; *P<0.05 and **P<0.01 were considered to indicate significant and highly significant values, respectively, compared with corresponding controls. PPF treatment demonstrated in vitro and in vivo anti-aging activity. Western blot analysis of PPF-treated normal human dermal fibroblast cells showed a dose-dependent increase in the expression of extracellular matrix genes such as collagen and elastin, but decreased expression of the aging gene matrix metalloproteinase-3. Quantitative polymerase chain reaction showed that PPF-treated cells displayed dose-dependent increase in messenger RNA expression levels of collagen, elastin, and hyaluronan synthase-2 and decreased expression levels of matrix metalloproteinase-1 aging gene. PPF treatment led to decreased production of reactive oxygen species in cells subjected to ultraviolet irradiation. Furthermore, PPF extract showed positive wound-healing effects in mice. This study demonstrated the anti-aging and wound

  11. Influence of MgO and Hybrid Fiber on the Bonding Strength between Reactive Powder Concrete and Old Concrete

    OpenAIRE

    Mo Jinchuan; Ou Zhongwen; Wang Yahui

    2016-01-01

    The reactive powder concrete (RPC) was used as concrete repair material in this paper. The influence of steel fiber, steel fiber + MgO, and steel fiber + MgO + polypropylene fiber (PPF) on the mechanical properties of RPC repair materials and the splitting tensile strength between RPC and old concrete was studied. Influences of steel fiber, MgO, and PPF on the splitting tensile strength were further examined by using scanning electronic microscopy (SEM) and drying shrinkage test. Results indi...

  12. Changes of EEG and CT findings in patients with dementia of Alzheimer type

    Energy Technology Data Exchange (ETDEWEB)

    Shinohara, Masao; Higashidani, Yoshiaki; Kawakatsu, Shinobu; Totsuka, Shirou (Yamagata Univ. (Japan). Faculty of Medicine); Ariumi, Kiyohiko; Kinoshita, Osami

    1992-01-01

    Computed tomography (CT) was performed in 39 patients with dementia of Alzheimer type (DAT) and 16 normal subjects. Three CT parameters, including the Sylvian fissure/brain area (SBR) ratio, the lateral ventricle/brain area (VBR) ratio, and the ratio of the maximum diameter of the third ventricle to the intracranial diameter (III V), were examined in terms of the severity of DAT and electroencephalograms (EEG). All of the CT parameters were significantly increased in the group of patients with severe DAT. They were also correlated with intelligence test scores obtained by the Hasegawa Dementia Scale and the Gottfries-Brane-Steen Scale. The intelligence test scores became worse with increasing cerebral atrophy. There was a strong correlation between the III V ratio and both VBR and SBR ratios; however, there was no correlation between VBR and SBR ratios. SBR ratio was well correlated with {delta}-, {theta}-, and {beta} 1-percentage power fraction (PPF) in the frontal, temporal, parietal, and occipital lobes on the left side, and slightly correlated with {delta}- and {alpha}-PPF in the frontal lobe alone on the right side. For all of the four lobes, VBR was correlated with {delta}-PPF on the left side and {delta}- and {beta} 1-PPF on the right side. III V ratio was correlated with {delta}-PPF in the bilateral four lobes and {alpha} 1-PPF and {alpha} 2-PPF in the four lobes on the left side and in the three lobes on the right side. The aforementioned correlation between CT and PPF suggests the strong involvement of subcortical disturbance in the abnormality on EEG in patients with DAT. (N.K.).

  13. Influence of MgO and Hybrid Fiber on the Bonding Strength between Reactive Powder Concrete and Old Concrete

    OpenAIRE

    Mo Jinchuan; Ou Zhongwen; Wang Yahui

    2016-01-01

    The reactive powder concrete (RPC) was used as concrete repair material in this paper. The influence of steel fiber, steel fiber + MgO, and steel fiber + MgO + polypropylene fiber (PPF) on the mechanical properties of RPC repair materials and the splitting tensile strength between RPC and old concrete was studied. Influences of steel fiber, MgO, and PPF on the splitting tensile strength were further examined by using scanning electronic microscopy (SEM) and drying shrinkage test. Results indi...

  14. Assessment of Palm Press Fibre and Sawdust-Based Substrate Formulas for Efficient Carpophore Production of Lentinus squarrosulus (Mont.) Singer.

    Science.gov (United States)

    Osibe, Dandy Ahamefula; Chiejina, Nneka Virginia

    2015-12-01

    Development of efficient substrate formulas to improve yield and shorten production time is one of the prerequisites for commercial cultivation of edible mushrooms. In this study, fifteen substrate formulas consisting of varying ratios of palm press fibre (PPF), mahogany sawdust (MS), Gmelina sawdust, wheat bran (WB), and fixed proportions of 1% calcium carbonate (CaCO3) and 1% sucrose were assessed for efficient Lentinus squarrosulus production. Proximate compositions of mushrooms produced on the different substrate formulas were also analysed and compared. Substrate formulations containing 85% PPF, 13% WB, 1% CaCO3, and 1% sucrose were found to produce the highest carpophore yield, biological efficiency and size (206.5 g/kg, 61.96%, and 7.26 g, respectively). Days to production (first harvest) tended to increase with an increase in the amount of WB in the substrate formulas, except for PPF based formulas. The addition of WB in amounts equivalent to 8~1