Unificación Término Fossa y Fovea en Terminologia Anatomica / Unification of the Term Fossa and Fovea in Anatomical Terminology

Los términos fossa y fovea se encuentran en Terminologia Anatomica, sin embargo, no existe una diferencia clara entre ambos términos. Por este motivo, el objetivo de este estudio fue determinar la coherencia entre la relación léxica, morfológica y etimológica de los términos fossa y fovea con su utilización en Terminologia Anatomica. Los términos fossa y fovea fueron consultados en Terminologia Anatomica (Federative International Programme for Anatomical Terminology, 2019) y en Terminologia Anatomica Internacional (Federative Committee on Anatomical Terminology, 2001). Posteriormente se realizó la búsqueda de ambos términos en diccionarios latín-español e inglés-latín. Finalmente fueron consultados los términos fossa y fovea en el Diccionario de la Real Academia Española y en el Diccionario panhispánico de términos médicos de la Real Academia Nacional de Medicina de España para conocer las definiciones en el área médica. La búsqueda reportó que el término "fosa" proviene del latín fossa, que significa "excavación, foso, fosa; hoyo, agujero". Por su parte "fóvea" proviene del latín fovea que significa"hoyo pequeño". Por lo tanto, la diferencia de fossa y fovea está determinada por su tamaño según sus definiciones. Sin embargo, en Terminologia Anatomica se han descrito estructuras con el diminutivo de fossa y fovea lo que complejiza la diferenciación de los términos según su tamaño. Además, la falta de unificación en la nomenclatura entre fossa, fovea y sus diminutivos, genera una gran confusión e incoherencias en las traducciones del latín al inglés y al español en Terminologia Anatomica que merman la precisión de la nomenclatura. Por lo tanto se propone la unificación de los términos fossa y fovea en base al tamaño de la depresión anatómica y clarificar su traducción al inglés y español.

SUMMARY: The terms fossa and fovea are found in Terminologia Anatomica, however, there is no clear difference between both terms. Therefore, the objective of this study was to determine the coherence between the lexical, morphological and etymological relationship of the term's fossa and fovea with their use in Terminologia Anatomica. The terms fossa and fovea were consulted in Terminologia Anatomica (Federative International Programme for Anatomical Terminology, 2019) and in International Anatomical Terminology (Federative Committee on Anatomical Terminology, 2001). Subsequently, a search for both terms was carried out in Latin-Spanish and English-Latin dictionaries. Finally, the terms fossa and fovea were consulted in the Diccionario de la Real Academia Española and in the Diccionario panhispánico de términos médicos de la Real Academia Nacional de Medicina de España to know the definitions in the medical area. The search reported that the term "fossa" comes from the Latin fossa, which means "excavation, ditch, ditch; hole, hole." For its part, "fovea" comes from the Latin fovea, which means "small hole." Therefore, the difference between fossa and fovea is determined by their size according to their definitions. However, in Terminologia Anatomica, structures have been described with the diminutive of fossa and fovea, which makes the differentiation of the terms according to their size more complex. Furthermore, the lack of unification in the nomenclature between fossa, fovea and their diminutives generates great confusion and inconsistencies in the translations from Latin to English and Spanish in Terminologia Anatomica that reduce the precision of the nomenclature. Therefore, we propose the unification of the terms fossa and fovea based on the size of the anatomical depression and clarify their translation into English and Spanish.

Descompresión de fosa posterior sin duroplastia expansiva en adulto con malformación de Chiari tipo 1-siringomielia

Introducción: La malformación de Chiari tipo 1 incluye un grupo heterogéneo de malformaciones congénitas, caracterizadas por el descenso caudal del cerebelo a través del foramen magno. En un 30-70 % de los casos tiene siringomielia asociada. Existen controversias en torno a la técnica quirúrgica ideal. Objetivo: Presentar un caso de MC-1 asociada a siringomielia en el que no se aplica una duroplastia expansiva. Presentación de caso: Paciente femenina de 43 años, con antecedentes de hipertensión arterial. Acudió a consulta neuroquirúrgica por dolor cervical irradiado al miembro superior derecho. Al examen neurológico mostró signos de afectación de primera y segunda motoneurona. La resonancia magnética confirmó el diagnóstico de MC-1. Se intervino quirúrgicamente mediante descompresión de fosa posterior sin duroplastia expansiva. La paciente evolucionó sin complicaciones y egresó a las 48 horas. Durante el seguimiento mejoraron las manifestaciones parestésicas; sin embargo, el examen neurológico se mantuvo igual. A los seis meses, la resonancia magnética indicó una marcada disminución de la siringomielia y la reconformación de la cisterna magna. Hasta los 18 meses del tratamiento, los síntomas no habían empeorado y la capacidad funcional resultaba aceptable (Karnofsky 90/100). Conclusiones: La descompresión de fosa posterior sin duroplastia expansiva, seguida de re-permeabilización microquirúrgica del foramen de Magendie, tuvo resultados favorables en este caso.

Introduction: Chiari malformation type 1 includes a heterogeneous group of congenital malformations, characterized by caudal descent of the cerebellum through the foramen magnum. It has associated syringomyelia in 30-70% of cases. Controversies exist regarding the ideal surgical technique. Objective: To present a case of MC-1 associated with syringomyelia in which an expansive duroplasty is not applied. Case report: Female patient, 43 years old, with history of arterial hypertension. She went to the neurosurgical consultation for cervical pain radiating to the right upper limb. On neurological examination, she showed signs of first and second motor neuron involvement. MRI confirmed the diagnosis of MC-1. She underwent surgery by decompression of the posterior fossa without expansive duroplasty. The patient evolved without complications and she was discharged after 48 hours. During the follow-up, the paresthetic manifestations improved; however, the neurological examination remained the same. At six months, MRI indicated a marked decrease in syringomyelia and reshaping of the cisterna magna. Until 18 months after treatment, symptoms had not worsened and functional capacity was acceptable (Karnofsky 90/100). Conclusions: Posterior fossa decompression without expansive duroplasty, followed by microsurgical re-permeabilization of Magendie's foramen, had favorable results in our case.

Analysis of the Asterion Morphology in Relation to Its Clinical Significance / Análisis de la Morfología del Asterion en Relación con su Importancia Clínica

SUMMARY: The asterion presents a significant anthropological marking and meeting point between three sutures. It is a surface landmark for the transverse-sigmoid venous sinus complex and is also a surgical landmark for access to the posterior cranial fossa, giving it clinical importance. The aim of this research was to analyze the shape of the asterion and to set the measurement methods that will determine distance between the asterion and surrounding features. The study sample, as a part of the Osteological collection of the Department of Anatomy, Faculty of Medicine Novi Sad, consisted of 43 skulls. Morphometric analysis was related to the measurement of the defined parameters and descriptive analysis presented the classification of asterion in relation to the presence of sutural bones, as well as the determination of the position of the asterion according to the transverse-sigmoid venous complex. There was a statistically significant difference between male and female skulls for all the measured parameters. The results show that 34.88 % were type 1 (one or more sutural bones are present) and 65.12 % were type 2 asteria (no sutural bones are present). More frequent occurrence of asteria type 2 was seen on both, male and female skulls. The most frequent position of the asteria on both sides of the skull was in the transverse- sigmoid venous complex (76.92 % on the right side vs. 72.22 % on the left cranial side). Clinical significance of knowing the area of asterion is reflected in order to make the surgical, as well as diagnostic procedures, as successful as possible.

El asterion presenta una importante marca antropológica y punto de encuentro entre tres suturas. Es un punto de referencia de superficie para el complejo del seno venoso sigmoideo transverso y también es un punto de referencia quirúrgico para el acceso a la fosa craneal posterior, lo que le confiere importancia clínica. El objetivo de esta investigación fue analizar la forma del asterión y establecer los métodos de medición que determinarán la distancia entre el asterión y las características circundantes. La muestra del estudio, que forma parte de la colección osteológica del Departamento de Anatomía de la Facultad de Medicina de Novi Sad, estuvo compuesta por 43 cráneos. El análisis morfométrico se relacionó con la medición de los parámetros definidos y el análisis descriptivo presentó la clasificación del asterion en relación a la presencia de huesos suturales, así como la determinación de la posición del asterion según el complejo venoso transverso-sigmoideo. Hubo una diferencia estadísticamente significativa entre los cráneos masculinos y femeninos para todos los parámetros medidos. Los resultados muestran que el 34,88 % eran tipo 1 (hay uno o más huesos suturales presentes) y el 65,12 % eran asteria tipo 2 (no hay huesos suturales presentes). Se observó una aparición más frecuente de asteria tipo 2 en cráneos tanto masculinos como femeninos. La posición más frecuente de la asteria en ambos lados del cráneo fue en el complejo venoso sigmoideo transverso (76,92 % en el lado derecho vs. 72,22 % en el lado craneal izquierdo). La importancia clínica de conocer el área de asterion se refleja en que los procedimientos quirúrgicos y de diagnóstico tengan el mejor resultado posible.

Posterior fossa choroidplexus papilloma in the pediatric population: case series and literature review / Papiloma de plexo coroide na fossa posterior na população pediátrica: série de casos e revisão da literatura

Abstract Choroid plexus papillomas (CPPs) are rare benign neoplasms which are particularly uncommon in the posterior fossa in children. We herein present a case series of five patients treated at a tertiary care hospital. A comprehensive literature review was also carried out. The patients treated at the tertiary care hospital were aged between 4 and 16 years. Gross total resection (GTR) was initially achieved in two patients. All patients showed clinical improvement. Moreover, 27 articles published between 1975 and 2021 were selected for the literature review, totaling 46 patients; with the 5 patients previously described, the total sample was composed of 51 cases, With a mean age was 8.2 years. The lesions were located either in the fourth ventricle (65.3%) or the cerebellopontine angle (34.7%). Hydrocephalus was present preoperatively in 66.7% of the patients, and a permanent shunt was required in 31.6% of the cases. The GTR procedure was feasible in 64.5%, and 93.8% showed clinical improvement. For CPPs, GTR is the gold standard treatment and should be attempted whenever feasible, especially because the role of the adjuvant treatment remains controversial. Neuromonitoring is a valuable tool to achieve maximal safe resection. Hydrocephalus is common and must be recognized and promptly treated. Most patients will need a permanent shunt. Though there is still controversy on its efficacy, endoscopic third ventriculostomy is a safe procedure, and was the authors' first choice to treat hydrocephalus.

Resumo Os papilomas do plexo coroide (PPCs) são neoplasias benignas raras e, na população pediátrica, são particularmente incomuns na fossa posterior. Apresentamos uma série de casos de cinco pacientes atendidos em um hospital terciário. Além disso, foi realizada uma ampla revisão da literatura. Os pacientes atendidos no hospital terciário tinham entre 4 e 16 anos. Ressecção macroscópica total (RMT) foi inicialmente realizada em dois pacientes. Todos os pacientes apresentaram melhora clínica. Além disso, 27 artigos publicados entre 1975 e 2021 foram selecionados para a revisão da literatura, totalizando 46 pacientes. Somados à série de casos atuais, encontramos 51 pacientes, com média de idade de 8,2 anos. As lesões localizavam-se no quarto ventrículo (65,3%) ou no ângulo pontocerebelar (34,7%). Hidrocefalia estava presente no pré-operatório em 66,7% dos pacientes, e derivação ventricular permanente foi necessária em 31,6% dos casos. A RMT foi possível em 64,5%, e 93,8% tiveram melhora clínica. Para os CPPs, a RMT é o tratamento padrão-ouro e deve ser tentado sempre que possível, especialmente porque ainda existem controvérsias quanto ao papel do tratamento adjuvante. A neuromonitorização é uma ferramenta importante para se atingir a máxima ressecção segura. A hidrocefalia é comumente vista nesses pacientes e deve ser identificada e tratada. A maioria dos pacientes irá precisar de uma derivação permanente. Apesar de persistirem controvérsias sobre sua eficácia, a terceiro-ventriculostomia endoscópica foi a primeira escolha para tratar a hidrocefalia na experiência dos autores e é uma opção segura.

Endometriosis de la pared abdominal en una paciente con antecedente de histerectomía. Reporte de caso / Abdominal wall endometriosis in a patient with a history of hysterectomy. Case report

Resumen ANTECEDENTES: La endometriosis de la pared abdominal implica la coexistencia de tejido endometrial en la superficie peritoneal parietal; la incidencia reportada es de 0.03 a 3.5%. Su causa aún no está debidamente esclarecida. CASO CLÍNICO: Paciente de 35 años, con antecedentes ginecoobstétricos de: tres embarazos, tres cesáreas, última cinco años previos a la intervención, en la que se practicó una histerectomía obstétrica indicada por sangrado transoperatorio. El padecimiento actual se inició 24 horas previas a su ingreso a Urgencias, con dolor espontáneo en la fosa iliaca derecha, de difícil relación con los ciclos menstruales debido al antecedente quirúrgico, acompañado de aumento de volumen y náuseas. En la exploración inicial se identificaron dos masas intraabdominales que se confirmaron en la tomografía computada, situadas por encima de la aponeurosis. Se procedió a la intervención quirúrgica para extirpación de ambas masas. El estudio histopatológico reportó: tumores compatibles con endometriosis. CONCLUSIÓN: La endometriosis es un padecimiento con alta prevalencia en el mundo, no así en su ubicación en la pared abdominal. A pesar de que aún no se conoce con certeza su causa, se sabe que la inoculación directa (muchas veces debida a un procedimiento ginecológico quirúrgico) y la proliferación celular tienen participación relevante en su origen.

Abstract BACKGROUND: Abdominal wall endometriosis is the coexistence of endometrial tissue on the parietal peritoneal surface with a reported incidence of 0.03 to 3.5%. Its cause is not well understood. CLINICAL CASE: 35-year-old female patient with a gyneco-obstetric history of: three pregnancies, three cesarean sections, last five years prior to surgery, in which an obstetric hysterectomy was performed, indicated by transoperative bleeding. The current presentation began 24 hours before her admission to the emergency department with spontaneous pain in the right iliac fossa, difficult to relate to menstrual cycles due to her surgical history, accompanied by increased volume and nausea. Initial examination revealed two intra-abdominal masses, confirmed by computed tomography, located above the aponeurosis. Surgery was performed to remove both masses. Histopathologic examination revealed tumors compatible with endometriosis. CONCLUSION: Endometriosis is a very common disease in the world, but not in the abdominal wall. Although its cause is still not known with certainty, it is known that direct inoculation (often due to gynecologic surgery) and cell proliferation play a relevant role in its origin.

Cerebral oxygenation assessed by near-infrared spectroscopy in the sitting and prone positions during posterior fossa surgery: a prospective, randomized clinical study

Abstract Objectives: Sitting position (SP) or prone position (PP) are used for posterior fossa surgery. The SP induced reduction in cerebral blood flow and cerebral oxygen saturation (rSO2) has been shown in shoulder surgeries, but there is not enough data in intracranial tumor surgery. Studies showed that PP is safe in terms of cerebral oxygen saturation in patients undergoing spinal surgery. Our hypothesis is that the SP may improve cerebral oxygenation in the patients with intracranial pathologies due to reduction in intracranial pressure. Therefore, we compared the effects of the SP and PP on rSO2 in patients undergoing posterior fossa tumor surgery. Methods: Data were collected patients undergoing posterior fossa surgery, 20 patients in SP compared to 21 patients in PP. The rSO2 was assessed using INVOS monitor. Heart rate (HR), mean arterial pressure (MAP), EtCO2, BIS, and bilateral rSO2 were recorded preoperatively, and at 5, 8, and 11 minutes after the intubation and every 3 minutes after patient positioning until the initial surgical incision. Results: Cerebral oxygenation slowly reduced in both the sitting and prone position patients following the positioning (p < 0.002), without any difference between the groups. The HR and MAP were lower in the sitting SP after positioning compared to the PP. Conclusion: Neurosurgery in the SP and PP is associated with slight reduction in cerebral oxygenation. We speculate that if we rise the lower limit of MAP, we might have showed the beneficial effect of the SP on rSO2.

Ultrasound fusion navigation-guided core needle biopsy for lesions involved the parapharyngeal space, infratemporal fossa, and skull base: a pilot study / 中华超声影像学杂志

Objective:To explore the value of ultrasound fusion navigation technology in the biopsy of parapharyngeal-infratemporal fossa-skull base (PIS) lesions.Methods:This study was conducted at the First Affiliated Hospital of Sun Yat-Sen University from March 2021 to March 2022 and included 8 patients [3 females and 5 males; age, (50±20) years; range, 16-76 years] with PIS lesions who needed to clarify the pathological diagnosis. The ultrasound fusion navigation with CT or MRI was used to guide lesion biopsy, and the technical feasibility, pathological diagnostic results and complications were evaluated.Results:The biopsy procedures were successful in all 8 patients, and the lesion size ranged from 2.2 to 6.5 cm. The exact pathological diagnosis was obtained in 7 patients, and the diagnostic rate was 87.5% (7/8). No major complication was observed after the biopsy. Mild complications occurred in 1 case, with a incidence of 12.5% (1/8).Conclusions:Ultrasound fusion navigation-guided biopsy is feasible, effective, and safe in the biopsy of deep head and neck lesions.

Surgical management of Dandy-Walker syndrome in infants and the literature review / 中国综合临床

Dandy-Walker syndrome is one of the posterior fossa malformations, which is easily confused with arachnoid cyst or cerebellar dysplasia in clinical practice, leading to misdiagnosis. Dandy-Walker syndrome is easy to be combined with hydrocephalus, resulting in increased intracranial pressure, increased head circumference, growth retardation, spastic hemiplegia and other manifestations, and can also be accompanied by other nervous system malformations. On February 27, 2021, a child with Dandy-Walker syndrome with growth retardation as the primary manifestation was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine. After multiple surgical treatment, the child's hydrocephalus was significantly improved. Through the analysis of the clinical data of the child's operation and the treatment of complications, it is helpful to improve the clinicians' understanding of the surgical treatment of the disease.

Research Progress on the Application of Goel Technique in Craniovertebral Junction Anomalies / 中国医学科学院学报

Craniovertebral junction anomalies are a group of diseases characterized by the pathological changes of occipital bone,atlantoaxial bone,cerebellar tonsil,surrounding soft tissue,and nervous system,which are caused by a variety of factors.Chiari malformation is a common type of craniovertebral junction anomalies,the conventional surgical therapy of which is posterior fossa decompression.Currently,scholars represented by Goel have proposed a new theory on the classification,pathogenesis,and treatment of Chiari malformation based on posterior atlantoaxial fixation (Goel technique).This article introduces the progress in Goel technique,aiming to provide reference for the clinical work.

Measurement of the magnetic resonance imaging of the area supratentorial and infratentorial mid-sagittal plane of the normal Tibetan adults / 解剖学报

[Abstract] Objective To explore the relationship between supratentorial area (STA), posterior fossa area (PFA) and intracranial area (ICA) of normal adult Tibetans with age and gender. Methods The subjects of this study were native Tibetan adults living in Lhasa. Totally 158 sample populations were between the ages of 20 and 59 years, with an average age (36. 60 ± 10. 75) years, including 64 males and 94 females. Siemens MAGNETOM ESSENZA 1. 5T magnetic resonance scanner was used to scan with 3D-fSPGR sequence, and the images obtained by scanning were stored in DICOM format and imported into 3D Medical medical image processing software, and region of interest was delineated by using the software’s own toolkit. STA, PFA and ICA were measured on T1WI mid-sagittal imaging, and the ratios of PFA / STA, STA / ICA and PFA / ICA were calculated. In order to eliminate the influence of individual differences in skull size on brain structure, this paper corrected the STA and PFA with the same level of ICA, and obtained the relativity of supratentorial area (RSTA) and relativity of posterior fossa area (RPFA). Results The STA was (127. 91 ± 9. 84) cm

Clinical study of intercondylar fossa formation to prevent intercondylar fossa impingement after high tibia osteotomy / 中国骨伤

OBJECTIVE@#To observe the clinical efficacy of intercondylar fossa plasty in preventing intercondylar fossa impingement syndrome after high tibial osteotomy.@*METHODS@#From August 2018 to August 2020, 84 patients with inverted knee osteoarthritis were treated by arthroscopy combined with high tibial osteotomy, and were divided into two groups with 42 cases in each group according to different surgical methods. In the intercondylar fossa plasty group, there were 13 males and 29 females, age ranged from 52 to 67 years old with an average of(58.27±4.32) years old, and arthroscopic intercondylar fossa plasty was performed first, and then high tibial osteotomy. In the arthroscopic cleansing group, 16 males and 26 females, age ranged from 50 to 71 years old with an average of (59.02±5.14) years old, underwent arthroscopic cleansing and then high tibial osteotomy. Postoperative treatment was evaluated using visual analogue scale(VAS), hospital for special surgery (HSS) score for the knee, and the occurrence of intercondylar percussa impingement.@*RESULTS@#All 84 patients were followed up, the duration ranged from 12 to 18 months with an average of (14.1±1.6) months. The VAS and HSS score of knee joint at 6, 12 and 18 months after surgery were significantly improved compared with preoperative period, and there was no significant difference between the two groups (P>0.05), but the incidence of intercondylar fossa index and intercondylar fossa impact between the two groups was significantly compared 18 months after surgery (P<0.05).@*CONCLUSION@#Intercondylar fossa plasty can effectively prevent the incidence of intercondylar fossa impact after high tibial osteotomy, and has a more significant effect on postoperative knee pain and function improvement.

Dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius / 中国骨伤

OBJECTIVE@#To explore clinical efficacy of dorsal plate assisted fixation of dorsal lunate fossa fracture block of distal radius.@*METHODS@#From January 2019 to January 2022, 30 patients were treated with dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius, including 13 males and 17 females, aged from 42 to 68 years old with an average of (48.7±5.6) years old;According to Doi fracture classification, 24 patients were type 3 blocks and 6 patients were type 4 blocks. The degree of palmar angle of anterior and posterior distal radius was fixed by dorsal steel plate during operation. Fracture healing and functional recovery of wrist were observed after operation. Functional evaluation was performed by Gartland and Werley scoring system at 12 months after operation.@*RESULTS@#All patients were followed up from 12 to 13 months with an average of (11.3±0.9) months. All fractures healed for 4 to 5 months with an average of(4.7±0.8) months. Median palpal inclination of anterior and posterior distal radius fixed by dorsal plate was 5.30°(4.85°, 6.03°), 12.45°(11.98°, 13.43°) respectively, and had statistical difference( P<0.01). Gartland and Werley scores was (1.1±0.4) at 12 months afteropertaion, and 27 patients got excellent result and 3 good.@*CONCLUSION@#Dorsal plate assisted fixation of dorsal lunate fossa fractures is beneficial to reduction and stabilization of displaced dorsal fractures and restoration of palmar inclination.

A morphometric study on skulls of Hasmer and Hasak sheep breeds / Un estudio morfométrico de cráneos de razas de ovejas Hasmer y Hasak

SUMMARY: The aim of the study was to investigate the head structures of two domestic sheep breeds (Hasak and Hasmer) in Turkey. Gender neutral eight adult Hasmer sheep of 45-66 kg and eight Hasak sheep breeds of 43-66 kg obtained from Bahri Dag˘das¸ International Agricultural Research Institute were used in this study. Measurements were made using digital caliper from 40 points on the skulls of both species. The skull of Hasmer sheep (265.56 ± 14.08) was longer than the skull of Hasak sheep (262.86 ± 9.65). However, the length of the arcus alveolaris maxillaris (77.01 ± 5.08), the length of the molar teeth (50.81 ± 1.22) and the length of the premolar teeth (26.16 ± 4.62) of Hasak sheep were compared to the Hasmer sheep (71.59, ± 5.25; 47.99 ± 3.64; 24.03 ± 3.76, respectively) was observed to be greater. According to these findings, although the skull length of Hasak sheep was shorter than that of Hasmer sheep and arcus alveolaris maxillaris in which molar and premolar teeth were placed was longer. In Hasmer sheep the values of greatest breadth of the foramen magnum, height of the foramen magnum (basion - opisthion), greatest neurocranium breadth-greatest breadth of the braincase (euryon - euryon) were higher than those of Hasak sheep. The difference between these values was also statistically significant (p <0.05). The lateral length of the premaxilla (nasointermaxillare- prosthion) parameter measured between these two species was statistically very important (p <0.01). In conclusion, in this study craniometric values depending on skull morphology of Hasmer and Hasak sheep which accepted as native breeds of Turkey were tried, to reveal similarities and differences with other sheep breeds in both amongst themselves.

El objetivo del estudio fue investigar las estructuras de la cabeza de dos razas de ovejas domésticas (Hasak y Hasmer) de Turquía. En este estudio se utilizaron ocho ovejas Hasmer adultas de género neutral de 45-66 kg y ocho ovejas de raza Hasak de 43-66 kg, obtenidas del Instituto Internacional de Investigación Agrícola Bahri Dagdas. Las mediciones en los cráneos de ambas especies se realiza-ron con caliper digital de 40 puntos. El cráneo de la oveja Hasmer (265,56 ± 14,08 mm) era más largo que el cráneo que el de la oveja Hasak (262,86 ± 9,65 mm). En las ovejas Hasak la longitud del arcus alveolaris maxillaris fue 77,01 ± 5,08 mm, la longitud de los dientes molares fue 50,81 ± 1,22 mm y la longitud de los dientes premolares fue de 26,16 ± 4,62 mm, en cambio en las ovejas Hasmer fue de 71,59 ± 5,25 mm; 47,99 ± 3,64 mm; 24,03 ± 3,76 mm, respectivamente. Según estos hallazgos, la longitud del cráneo de la oveja Hasak era más corta que la de la oveja Hasmer y el arcus alveolaris maxillaris en el que se colocaron los dientes molares y premolares era más largo. En ovinos Hasmer los valores de mayor amplitud del foramen magnum, altura del foramen magnum (basion - opisthion), mayor amplitud del neurocráneo-mayor amplitud de la caja craneana (euryon - euryon) fueron superiores a los de las ovejas Hasak. La diferencia entre estos valores también fue estadísticamente significativa (p <0,05). El parámetro de longitud lateral del premaxilar (nasointermaxillare-prosthion) medido entre estas dos especies fu estadísticamente significativo (p <0.01). En conclusión, los valores craneométricos en relación a la morfología del cráneo de las ovejas Hasmer y Hasak que se definieron como razas autóctonas de Turquía revelaron similitudes y diferencias con otras razas de ovejas.

Fossa navicularis magna: detección por tomografía computarizada de haz cónico / Fossa navicularis magna: detection by cone-beam computed tomography

Introducción: La identificación, interpretación y manejo de hallazgos incidentales en imagenología dental es imprescindible. Algunos de ellos requieren técnicas de imagen adicionales y remisión a profesionales de experiencia, otros únicamente su descripción. Una de estas variantes anatómicas se halla en el clivus, la fossa navicularis magna, asociada en pocos casos a repercusiones sistémicas. Objetivo: Describir las características de la fossa navicularis magna para su identificación mediante tomografía computarizada de haz cónico. Presentación de los casos: Tres pacientes de sexo femenino, con un rango de edad entre 35-71 años que acuden al Centro Odontológico de la Universidad San Martín de Porres para tratamientos de ortodoncia y rehabilitación oral. En estas áreas, como parte del protocolo se solicita tomografía computarizada de haz cónico por pieza retenida y elaboración de guías quirúrgicas respectivamente. El escaneo permite la identificación de un defecto tipo muesca en el clivus, de límites bien definidos y bordes corticalizados, lo que sugiere fossa navicularis magna. La historia clínica de los pacientes no sugirió implicaciones clínicas. Principales comentarios: Se informa y discute esta variante anatómica cuya presencia no requiere tratamiento y generalmente no tiene repercusiones sistémicas. En contados casos ha estado asociado con cuadros clínicos que amenazan la vida del paciente, precisamente porque puede servir como un trayecto para infecciones intracraneales. De ahí la necesidad de conocer y describir esta variante anatómica(AU)

Introduction: The identification, interpretation and management of incidental findings in dental imaging is essential. Some of them require additional imaging techniques and referral to experienced professionals, others only their description. One of these anatomical variants is found in the clivus, fossa navicularis magna, associated in few cases with systemic repercussions. Objective: Describe the characteristics of fossa navicularismagna for its identification by cone-beam computed tomography. Presentation of cases: Three female patients, with an age range between 35-71 years who come to the Dental Center of San Martín de Porres University for orthodontic treatments and oral rehabilitation. In these areas, as part of the protocol, cone-beam computed tomography per retained piece and development of surgical guides are requested, respectively. The scan allows the identification of a notch-like defect in the clivus, of well-defined boundaries and corticalized edges, suggesting fossa navicularis magna. The patients' medical history did not suggest clinical implications. Main comments: This anatomical variant is reported and discussed and its presence does not require treatment and generally has no systemic repercussions. In rare cases it has been associated with clinical pictures that threaten the patient's life, precisely because it can serve as a path for intracranial infections. Hence the need to know and describe this anatomical variant(AU)

Aneurisma poplíteo izquierdo / Left popliteal aneurysm

El aneurisma de la arteria poplítea es el principal aneurisma periférico y el segundo en frecuencia después del aneurisma de la aorta abdominal. Su incidencia se desconoce. Posee un patrón característico de presentación que corresponde a personas del sexo masculinos, mayores de 65 años, con múltiples comorbilidades, donde la hipertensión arterial representa la más frecuente. La definición de aneurisma corresponde a una dilatación del 50 por ciento del diámetro del vaso, en el caso de la arteria poplítea, mayor de 1,5 cm. El 50 por ciento de los aneurismas poplíteos resulta asintomático, el resto presenta síntomas isquémicos (trombosis, embolismos periféricos), compresivos y la ruptura. El tratamiento es quirúrgico: convencional (vías medial-posterior) y endovascular. El objetivo del artículo fue presentar este caso por la infrecuencia del aneurisma de la arteria poplítea unilateral. Se trata de un paciente masculino de 62 años, con aumento de volumen localizado a nivel de la fosa poplítea izquierda con latido y expansión a la palpación, diámetro transversal aproximado de 3 cm y longitudinal de 4 cm, presencia de soplo sistólico a la auscultación con diagnóstico ecográfico y arteriográfico de aneurisma de la arteria poplítea izquierda. La evolución del paciente fue satisfactoria y se mantiene bajo seguimiento médico para evaluar la permeabilidad del injerto sintético(AU)

Popliteal artery aneurysm is the main peripheral aneurysm and the second in frequency after abdominal aortic aneurysm. Its incidence is unknown. It has a characteristic presentation pattern that corresponds to male people, over 65 years of age, with multiple comorbidities, where arterial hypertension represents the most frequent. The definition of aneurysm corresponds to a dilation of 50 percent of the diameter of the vessel, in the case of the popliteal artery, greater than 1.5 cm. 50 percent of popliteal aneurysms are asymptomatic, the rest have ischemic symptoms (thrombosis, peripheral embolisms), compression and rupture. Treatment is surgical: conventional (medial-posterior pathways) and endovascular. The objective of the article was to present this case due to the infrequency of the unilateral popliteal artery aneurysm. This is a 62-year-old male patient, with localized volume increase at the level of the left popliteal fossa with heartbeat and expansion on palpation, approximate transverse diameter of 3 cm and longitudinal diameter of 4 cm, presence of systolic murmur at auscultation with ultrasound and arteriographic diagnosis of aneurysm of the left popliteal artery. The patient's evolution was satisfactory and he remains under medical follow-up to evaluate the permeability of the synthetic graft(AU)

Study of Variations in the Course of Brachial Artery: A Cadaveric Study

Background: Brachial artery begins as a continuation of axillary artery at the distal border of teres major, runs downward at first medial to the humerus and then inclines to lie in front of the bone until it appears in the cubital fossa, where it ends at the level of the neck of radius by dividing into radial and ulnar arteries. Objectives: To know the variations in the course of brachial artery. Methods: Dissection was done on 40 upper limbs from embalmed adult human cadavers in the Department of Anatomy, Kamineni Institute of Medical Sciences, Narketpally. Dissection of Brachial artery was carried out according to Cunningham’s manual of practical anatomy. Results: In all 40 specimens (100%), the brachial artery begins at the inferior border of the teres major muscle as the continuation of the axillary artery. In 37 specimens (92.5%), single brachial artery (BA) was present in the arm. It runs inferiorly on the medial side of the biceps brachii muscle to the cubital fossa. It divides into the radial artery (RA) and ulnar artery (UA) opposite the neck of radius at elbow. In 3 specimens (7.5%), doubling of the brachial artery in its course was observed. In these specimens, the brachial artery was divided into two divisions in the arm. Both divisions runs inferiorly on the medial side of the biceps brachii muscle to the cubital fossa. In these two divisions, one lies superficial to the median nerve and was called the superficial brachial artery (SBA) and other division continues as the brachial artery proper (BAP). In all these 3 specimens (7.5%), the superficial brachial artery (SBA) continued as the radial artery (RA) and brachial artery proper (BAP) continued as the ulnar artery (UA) in the cubital fossa. Interpretation and Conclusion: The present study is important for Surgeons, Orthopedicians, Vascular surgeons, Clinicians and Anatomists as it provides the knowledge of variations in the course of brachial artery in the arm and cubital fossa.

Pleomorpic Adenoma of Infratemporal Fossa Co- Existing with Actinomycosis: A Rare Case Report with Review of Literature

Introduction: Salivary gland tumors account for about 3% of head and neck tumors and the majority are benign in nature. Among these, the most common pathological type is pleomorphic adenoma also called the mixed tumor. It is a kind of tumor containing glandular tissue, myxoid and cartilage-like tissue. As the structure of the tissue is diverse, it is called a “mixed tumor.” Actinomycosis is a chronic suppurative bacterial infection caused by Actinomyces israelii. In this case report, we are presenting a rare co-existence of pleomorphic adenoma and Actinomycosis in the infratemporal fossa. Case description: A 40-year-old female patient complains of pain over the upper left back tooth region for the past 6months. The patient had a past history of a small lesion in 28 region which resulted in constant irritation. The patient had consulted the dentist for the same and underwent extraction of 28 and 38 three years back, which was thought to be the cause of the swell- ing. Conclusion: The case highlights the importance of proper history taking, clinical examination, and histopathological examina- tion in arriving at a precise diagnosis of a lesion irrespective of size and clinical presentation.

Meningioma de la fosa posterior con hidrocefalia secundaria a resección quirúrgica / Posterior fossa meningioma with hydrocephalus after surgical resection

RESUMEN Los meningiomas de la fosa posterior representan el 10 % en relación con los otros sitios en los que pueden estar localizados. Estas lesiones pueden provocar compromiso de la circulación de líquido cerebroespinal. Se presentó el caso de una paciente de 67 años de edad con antecedentes previos de trastornos en la deambulación, se observó dificultad para caminar, en 15 días de evolución. Se realizó diagnóstico por tomografía de lesión ocupante de espacio localizada en fosa posterior. La paciente fue operada y secundariamente presentó hidrocefalia aguda, no comunicante, se le realizó derivación ventrículo-peritoneal. No existieron otras complicaciones asociadas a la intervención quirúrgica.

ABSTRACT Posterior fossa meningiomas represent 10% in relation to the other sites where they may be located. These lesions can compromise cerebrospinal fluid circulation. We present a 67-year-old female patient with a previous history of walking disorders, observing walking difficulty with 15 days of evolution. Diagnosis was made by a tomography of the space-occupying lesion located in the posterior fossa. The patient underwent surgery and subsequently developed acute non-communicating hydrocephalus, for which a ventricle-peritoneal shunt was performed. No other complications were associated with surgical intervention.

Values of the apparent diffusion coefficient in the differential diagnosis of tumors of the posterior fossa in the pediatric population of Colombia / Valores del coeficiente de difusión aparente en el diagnóstico diferencial de los tumores de la fosa posterior en población pediátrica de Colombia

Abstract Introduction: Posterior fossa tumors are common in the pediatric population and require adequate characterization by means of structural magnetic resonance imaging (MRI) and advanced MRI techniques to achieve an appropriate therapeutic approach. Objectives: To determine the usefulness of apparent diffusion coefficient (ADC) values for the differential diagnosis of posterior fossa tumors in the pediatric population treated at a reference hospital in Bogotá D.C., Colombia. Materials and methods: Diagnostic accuracy study carried out in 28 pediatric patients diagnosed with posterior fossa tumor between 2017 and 2019 at the Fundación Hospital de la Misericordia, a quaternary care institution. ADC values were measured and compared with histopathological diagnosis as gold standard, obtaining sensitivity, specificity, and positive and negative predictive values. Differences between medians were determined using the Kruskall-Wallis test. The p value between the quantitative ADC value and the gold standard was calculated using Pearson's chi-squared test, with a significance level of p<0.05. Results: The mean age of the participants was 83.9 months (SD=57 months), and 64.28% of them were boys. Medulloblastoma was the most frequent tumor (39.29%). For the diagnosis of medulloblastoma, an ADC value of 0.6210x10-3mm2/s was established, obtaining a sensitivity and specificity of 81.82% and 76.47%, respectively. For the diagnosis of pilocytic astrocytoma, an ADC of 1.03x10-3mm2/s was determined, with a sensitivity of 66.67% and a specificity of 89.40%. Conclusions: ADC value is useful to classify and differentiate posterior fossa tumors in the Colombian pediatric population, showing an inversely proportional relationship with the tumor grade.

Resumen Introducción. Los tumores de la fosa posterior son frecuentes en población pediátrica y requieren de una adecuada caracterización mediante resonancia magnética (RM) estructural y técnicas avanzadas de RM para lograr un enfoque terapéutico apropiado. Objetivo. Determinar la utilidad de los valores del coeficiente de difusión aparente (ADC cuantitativo) en el diagnóstico diferencial de los tumores de la fosa posterior en población pediátrica de un hospital de referencia en Bogotá D.C., Colombia. Materiales y métodos. Estudio de validez de prueba diagnóstica realizado en 28 pacientes pediátricos diagnosticados con tumor de fosa posterior entre 2017 y 2019 en la Fundación Hospital Pediátrico de la Misericordia, hospital de IV nivel de complejidad. Se midieron los valores del ADC cuantitativo, los cuales fueron comparados con el diagnóstico histopatológico como estándar de oro, obteniendo datos de sensibilidad, especificidad, valores predictivos positivos y negativos. Las diferencias entre medianas fueron determinadas mediante la prueba de Kruskall-Wallis. El valor p entre el valor del ADC cuantitativo y el estándar de oro se calculó con la prueba X2 de Pearson, con un nivel de significancia de p<0.05. Resultados. La edad media fue 83.9 meses (DE=57 meses) y 64.28% fueron niños. El tumor más frecuente fue el meduloblastoma (39.29%). Para el diagnóstico de meduloblastoma se estableció un valor ADC cuantitativo de 0.6210x10-3mm2/s, obteniéndose una sensibilidad y especificidad de 81.82% y 76.47%, respectivamente, y para el diagnóstico de astrocitoma pilocítico, un ADC cuantitativo de 1.03x10-3mm2/s, con una sensibilidad de 66.67% y una especificidad de 89.40%. Conclusiones. El valor del ADC cuantitativo es útil para clasificar y diferenciar los tumores de la fosa posterior en población pediátrica colombiana, mostrando una relación inversamente proporcional con el grado tumoral.

Remoción diferida de un tercer molar superior impulsado a la región infratemporal / Deferred removal of a third upper molar driven to the infratemporal region

La cirugía de los terceros molares retenidos puede ser considerada una intervención de rutina para el cirujano bucomaxilofacial. Como todo procedimien-to quirúrgico, puede presentar complicaciones intra y postoperatorias. Las más frecuentes son el dolor, edema, trismus, hemorragia y fracturas de las piezas dentarias a extraer, o de las tablas óseas. Pero tam-bién se pueden presentar otras complicaciones ines-peradas, como la impulsión o desplazamiento de la pieza dentaria a espacios anatómicos vecinos, entre los que podemos encontrar al espacio pterigomandi-bular, la celda submaxilar, el seno maxilar, el espacio infratemporal, según se trate de terceros molares retenidos inferiores o superiores. En el presente ar-tículo, se describe una situación clínica de un tercer molar superior, que fue accidentalmente impulsado a la región infratemporal, y removido en una segunda cirugía realizada 3 semanas después del primer in-tento de exodoncia. Se analizan también los estudios preoperatorios para su correcto diagnóstico, y las maniobras clínicas e instrumentales tendientes a po-sibilitar su remoción minimizando las complicaciones intra y postquirúrgicas (AU)

Surgery of retained third molars can be considered a routine intervention for the oral surgeon. Like any surgical procedure, it can present intra and posto-perative complications. The most frequent are pain, edema, trismus, hemorrhage and fractures of the teeth to be extracted or of the bone tables. But other unexpected complications can also occur, such as the impulsion or displacement of the tooth to neighbo-ring anatomical spaces, among which we can find the pterygomandibular space, the submaxillary cell, the maxillary sinus, the buccal space, the infratemporal space and the lateral pharyngeal space, depending on whether they are lower or upper retained third mo-lars. In this article, the clinical case of a third upper molar is described, which was accidentally driven to the infratemporal region, which was removed in a second surgery performed 3 weeks after the first attempt at exodontics. It should be noted the impor-tance of diagnostic imaging as an indispensable com-plement to the correct location of the displaced tooth and its subsequent removal (AU)