ABSTRACT
PURPOSE: To describe topographic and endoscopic anatomy of guinea pig ear for development of surgical approaches in experimental studies. METHODS: Experimental study. Eight adult guinea pigs (Cavia porcellus) were used in this study. Four animals were described through endoscopic view and four animals were used to describe topographic anatomy. RESULTS: The main structures of middle ear were well identified through endoscopy view: oval and round window, ossicles and vascular structures. Temporal bone position, landmarks and its relations to skull are perceived with topographic description. CONCLUSION: Topographic anatomic description allowed exposition of temporal bone relations for external surgical approaches. Alternatively, grooves and middle ear structures were identified and may be used to transcanal accesses. .
Subject(s)
Animals , Guinea Pigs , Ear/anatomy & histology , Ear/surgery , Natural Orifice Endoscopic Surgery/methods , Anatomic Landmarks/anatomy & histology , Cochlea/anatomy & histology , Ear, Inner/anatomy & histology , Ear, Inner/surgery , Ear, Middle/anatomy & histology , Ear, Middle/surgery , Models, Animal , Reproducibility of Results , Temporal Bone/anatomy & histologyABSTRACT
Introdução: Tonsilectomia associada ou não a adenoidectomia é um dos procedimentos cirúrgicos mais antigos e mais praticados pela medicina. Desde a sua primeira descrição, vem sofrendo diversas modificações, com intuito de diminuir suas complicações, sendo o sangramento a mais temida delas. Objetivo: O objetivo deste estudo é analisar a incidência de sangramento no intra-operatório e no pós-operatório imediato, analisando a frequência de episódios hemorrágicos, a necessidade de procedimentos hemostáticos, reintervenção cirúrgica e hemotransfusão. Método: Foram analisados prospectivamente os pacientes submetidos à adenoidectomia e/ou tonsilectomia no Hospital Paulista de Otorrinolaringologia - São Paulo no período de fevereiro de 2005 a fevereiro de 2007. Todas as cirurgias foram realizadas sob anestesia geral com entubação orotraqueal, sendo a técnica empregada à dissecção mecânica do tecido amigdaliano e curetagem do tecido adenoideano com cureta de Beckman. Resultados: Foram estudados 832 pacientes submetidos à adenoidectomia e/ou tonsilectomia, 431 (52,3%) do sexo masculino e 401 (47,7%) do sexo feminino. Dentre os 832 procedimentos, 195 foram adenoidectomia, 254 tonsilectomia e 383 adenotonsilectomias. Observou-se hemorragia nas primeiras 24 horas após o procedimento em apenas 11 pacientes (1,32%) sendo que 5 deles foram após adenoidectomia e os outros 6 pacientes foram após tonsilectomia. Apenas 1 caso necessitou de uma unidade de concentrado de hemácias para adequado equilíbrio hemodinâmico. Conclusão: A adenotonsilectomia e/ou tonsilectomia é um procedimento seguro com indicações precisas, porém não isento de complicações, sendo a hemorragia pós-operatória a mais frequente. Na nossa casuística, a incidência deste evento foi de 1,32%.
Introduction: Tonsillectomy associated or not to adenoidectomy is one of the oldest and mostly practiced surgical procedures by the medicine. Since its first description, it has been undergoing several modifications, aiming at diminishing its complications and bleeding is the most feared of them. Objective: The objective of this study is to analyze the incidence of bleeding in the immediate intraoperative and postoperative period, by analyzing the frequency of hemorrhage cases, the need for hemostatic procedures, surgical reintervention and hemotransfusion. Method: We analyzed prospectively the patients submitted to adenoidectomy and/or tonsillectomy at the Hospital Paulista de Otorrinolaryngologia - São Paulo, in the period from February 2005 through February 2007. All surgeries were carried out under general anesthesia with orotracheal intubation, and the technique employed was the mechanical dissection of the tonsillar tissue and removal of the adenoid tissue with Beckman's curette. Results: We studied 832 patients submitted to adenoidectomy and/or tonsillectomy, 431 (52.3%) of the male sex and 401 (47.7%) of the female sex. Among the 832 procedures, 195 were of adenoidectomy, 254 tonsillectomy and 383 adenotonsillectomy. We observed hemorrhage in the first 24 hours after the procedure in only 11 patients (1.32%) and 5 of whom had it after adenoidectomy and the other 6 patients had it after tonsillectomy. Only 1 case needed a unit of red blood cells concentrate for the suitable hemodynamic balance. Conclusion: The adenotonsillectomy and/or tonsillectomy is a safe procedure with precise indications, but it's not exempted from complications, and postoperative hemorrhage is the most frequent one. In our work, this event incidence was of 1.32%.