[Surgical anatomy of the petrous canal and posterior cranial fossa in relation to hearing preservation in surgery of acoustic neuroma]. / Chirurgische Anatomie der Pars petrosa und der Fossa cranii posterior unter dem Aspekt der Hörerhaltung bei der Operation von Akustikusneurinomen.

The suboccipital (retrosigmoid) and the middle fossa routes are recommended for preservation of hearing in surgery for acoustic neuroma. We carried out a comparative study of the critical distances and bony landmarks on 520 petrous bones. Unlike the transtemporal route, the suboccipital approach offers no landmarks for identification of the common crus, the vestibule or the facial nerve; the lateral portion of the internal auditory canal is not always seen. The fundus can be seen in only 50% of bones without opening the labyrinth.

Hypertension and social factors in a developing country.

A coronary heart disease prevention study, implemented in and near Havana (Cuba), evaluated the correlation of social factors with major cardiovascular risk factors, including elevations in blood pressure, in order to improve treatment strategies and compliance. The protocol consisted of questionnaires, standardized measurements of blood pressure and cholesterol determination at a central laboratory. The assessment of social aspects was carried out as previously described in comparable preventive studies in the German Democratic Republic. Around 1200 people aged 30-50 years had been screened by home visits. Correlations were found between blood pressure elevation (as well as smoking and hypercholesterolaemia, at least in part) and education, but in the opposite direction compared with experience in the United States and Europe. The prevalence of hypertension (and mean blood pressure) was higher in qualified than unqualified people (especially in younger males). Sex was a more important factor than age. No conclusion can be drawn from the variations between urban and rural subjects because the observations were not complete.

Comparative studies in hypertension under different continental conditions.

Preventive studies were undertaken according to the same protocol (questionnaire, blood pressure and cholesterol assay standardized) integrated in the Public Health Services of the GDR and Cuba. In a German community (Cottbus-Land) 5,377 people (2,340 males/3,037 females) and in the Havana region 1,179 people (437 males/742 females), all aged 30-50 years, were followed up. The Germans revealed higher proportions of hypertension and hypercholesterolemia, the Cubans those of (heavy) smoking. Conditioning factors, such as overweight, physical inactivity and psychic stress, were found to be quite differently distributed, explaining however only in part prevalence differences between the continental regions even when both sex and localization of living were considered separately.