ABSTRACT
RESUMO As neoplasias das glândulas salivares são relativamente raras, compreendendo cerca de 1% das neoplasias de todo corpo, com incidência de 1/100.000 habitantes por ano. As neoplasias benignas predominam sobre as malignas. O prognóstico depende muito do tipo histológico, grau de diferenciação, localização, infiltração de tecidos vizinhos e da presença de metástases regionais ou a distância. O principal tratamento ainda é a cirurgia, com os seus desafios e dificuldades, devido aos ramos do nervo facial nas glândulas salivares maiores, seguido de radioterapia e em casos selecionados quimioterapia adjuvante. O objetivo desta revisão é fornecer ao leitor uma abordagem histórica sobre o tratamento das doenças das glândulas salivares, com especial atenção às doenças da glândula parótida assim como peculiaridades associadas aqueles que as estudaram ao longo da história.
ABSTRACT Salivary gland neoplasms are a relatively uncommon disease, with nearly one case per 100.000 adults estimated per year and an overall incidence of 1% of all neoplasms. The benign neoplasms are majority and the prognosis depends on the histologic type, grade, localization, soft tissue infiltration, regional and distant metastasis. The main treatment is surgery with caution to facial nerve in the major salivary glands, followed by radiotherapy and chemotherapy in selected cases. The objective of this review is to provide the lector an historic approach about salivary gland diseases treatment, with special attention to the parotid neoplasms and its peculiarities associated to those who studied these glands in their history course.
Subject(s)
Humans , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , Salivary Gland Neoplasms/surgery , Salivary Gland Neoplasms/history , Oral Surgical Procedures/history , History, Ancient , History, MedievalABSTRACT
PURPOSE The parotidectomy technique still has an elevated paresis and paralysis index, lowering patient life's quality. The correct identification of the facial nerve can prevent nerve damage. Fluorescent dye identifies nerves in experimental studies but only few articles focused its use on facial nerve study in parotidectomies. We aimed to stain the rat facial nerve with fluorescent dye to facilitate visualization and dissection in order to prevent injuries. METHODS Forty adult male Wistar rats were submitted to facial injection of saline solution (Gsf-control group, 10) or fluorescent dye solution (Gdye group, 30) followed by parotidectomy preserving the facial nerve, measuring the time for localization and facility of localization (LocTime and LFN). Nerve function was assessed using the Vibrissae Movements (PMV) and Eyelid Closure Motion (PFP) scores. RESULTS Nerve localization was faster in Gdye group, with 83% Easy LFN rate. The Gdye group presented with low nerve injury degree and better PMV and PFP scores, with high sensitivity and accuracy. CONCLUSIONS This experimental method of facial nerve fluorescence was effective for intraoperative nerve visualization, identification and preservation. The technique may be used in future facial nerve studies, translated to humans, contributing to the optimization of parotid surgery in the near future.
Subject(s)
Animals , Male , Parotid Gland/surgery , Carbocyanines/administration & dosage , Facial Nerve/surgery , Fluorescent Dyes/administration & dosage , Time Factors , Observer Variation , Sensitivity and Specificity , Rats, Wistar , Models, Animal , Dissection/methods , Microinjections/instrumentation , Microscopy, PolarizationABSTRACT
Magnetic resonance images are useful in the study of experimental models of temporal lobe epilepsy. The manganese-enhanced MRI (MEMRI) technique is of interest since it combines the effects caused by manganese on the increased contrast in activated cell populations, when competing with calcium in synaptic transmission. Thus, the purpose of this study was to investigate the temporal evolution of the contrast related to manganese in the acute phase of temporal lobe epilepsy induced by systemic pilocarpine and compare it to the expression of the c-Fos protein. During this phase, the intensity of the MEMRI signal was analyzed at three different time points (5, 15 or 30 minutes) after the onset of status epilepticus (SE). The group that was maintained in status epilepticus for 30 minutes showed a decrease in intensity of the signal in CA1 and the dentate gyrus (DG). There were no differences between the control group and the other groups treated with pilocarpine. The expression of the protein, c-Fos, in the same animals showed that even in the short-duration status epilepticus (5 minutes), there was already maximal cellular activation in subregions of the hippocampus (DG, CA1 and CA3). Under the experimental conditions tested, our data suggest that the MEMRI signal was not sensitive for the identification of detectable variations of cell activation in the acute phase of the pilocarpine model. Our findings are not consistent with the idea that manganese contrast reflects primarily alterations in cellular activity during SE when other signal-modifying elements can act.
As imagens de ressonância magnética são úteis no estudo de modelos experimentais de epilepsia do lobo temporal. A técnica manganese-enhanced MRI (MEMRI) é de interesse por combinar os efeitos provocados pelo manganês no aumento do contraste de populações celulares ativadas, ao competir com o cálcio na transmissão sináptica. Assim, o propósito deste estudo foi investigar a evolução temporal do contraste provocado pelo manganês na fase aguda da epilepsia do lobo temporal induzida por pilocarpina sistêmica e compará-las à expressão da proteína c-Fos. Nessa fase, a intensidade do sinal MEMRI foi analisada em três diferentes pontos temporais (5, 15 ou 30 minutos) após o início do status epilepticus (SE). O grupo que foi mantido em status epilepticus por 30 minutos mostrou diminuição na intensidade de sinal no CA1 e giro denteado (GD). Não houve diferenças entre o Grupo Controle e os outros grupos tratados com pilocarpina. A expressão da proteína c-Fos, nos mesmos animais, mostrou que, mesmo no status epilepticus de curta duração (5 minutos) já há ativação celular máxima nas sub-regiões do hipocampo (GD, CA1 e CA3). Nas condições experimentais testadas, nossos dados sugerem que o sinal MEMRI não foi sensível para identificar variações detectáveis da ativação celular na fase aguda do modelo de pilocarpina. Nossos achados não são consistentes com a ideia que o contraste por manganês reflete primariamente alterações na atividade celular durante o SE quando outros elementos modificadores do sinal podem atuar.
Subject(s)
Epilepsy , Hippocampus , Magnetic Resonance Imaging , ManganeseABSTRACT
A busca por modelos experimentais constitui passo fundamental para o avanço da medicina. OBJETIVO: Demonstrar, através da dissecção com técnicas microcirúrgicas, as estruturas anatômicas do osso temporal do primata Callithrix sp. FORMA DE ESTUDO: Experimental. MÉTODO: Dissecção de ossos temporais de Callithrix sp e documentação fotográfica. RESULTADOS: Identificamos as principais estruturas do osso temporal (orelhas externa, média e interna, e nervo facial). CONCLUSÃO: O primata não-humano Callithrix sp representa aparentemente um modelo viável para o estudo do osso temporal uma vez que apresenta alta similaridade anatômica com humanos.
The search for experimental (animal) models is essential to the development of clinical studies. AIM: To demonstrate, by means of micro dissection techniques, the anatomical structures of temporal bones from the primate Callithrix sp. STUDY DESIGN: Experimental. METHODS: Dissection of temporal bone structures of Callithrix sp and photographic documentation. RESULTS: We identified the main constituents of the temporal bone (external, medium and inner ear and facial nerve). CONCLUSION: The non-human primate Callithrix sp. is an adequate experimental model for the studies of temporal bone structures given its close anatomical similarities to that found in humans.