RESUMO
The mastoid emissary vein (MEV) is an anatomical structure with limited description in the literature and its importance is even less recognized in the plastic surgical field. Investigations in its anatomy and physiology have described its anthropological significance in transition to bipedalism and preferential intracranial venous flow into the vertebral plexus in the upright man. Inadvertant injury of vessels of this size pose a significant problem due not only to difficulty with haemostasis but also from their bidirectional flow and close proximity to the sigmoid sinus where cases of thromboembolism have been described. Recognition of this common anatomical structure and how to manage bleeding from the vessel it is important for the surgeon operating in this area and even more so for the craniofacial surgeon who operates on complex craniosynostotic patients where the MEV may be the sole dominant drainage pathway of the brain. We conducted a study on 106 cadaveric dry skull specimens looking at the incidence, position and caliber of mastoid emissary foramina. 83.7% of skulls were found to have at least one foramen with a mean diameter of 1.64 mm and the largest specimen measuring 7 mm.
Assuntos
Processo Mastoide/anatomia & histologia , Processo Mastoide/irrigação sanguínea , Veias/anatomia & histologia , Cadáver , Feminino , Humanos , Veias Jugulares/anatomia & histologia , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/cirurgia , Masculino , Processo Mastoide/diagnóstico por imagem , Procedimentos de Cirurgia Plástica/métodos , Sensibilidade e Especificidade , Crânio/anatomia & histologia , Crânio/irrigação sanguínea , Crânio/diagnóstico por imagem , Cirurgia Plástica/métodos , Tomografia Computadorizada por Raios X/métodos , Veias/cirurgiaRESUMO
Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.
