RESUMO
Los tumores del cuerpo carotideo (paragangliomas, quimiodectomas), se originan en el tejido paraganglionico de la bifurcaci6n carotidea; son lesiones de lenta evolución que aumentan gradualmente en el curso de los años y pueden comprimir las estructuras neurovasculares del cuello; su transformación maligna es rara. La lesión, a menudo asintomatica, puede aparecer en la tercera o cuarta decadas de la vida y es mas frecuente en personas que viven a grandes alturas, y en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El propósito de este estudio es enfatizar los beneficios de nuestra tecnica quirurgica, ya que con ella hemos obtenido excelentes resultados. Vale destacar la utilidad de la angiografia carotidea bilateral en el estudio y tratamiento de esta patologia. En nuestros pacientes tratados quirurgicamente no se presentó ninguna complicacion definitiva, y la unica morbilidad fue una paresia de la rama mandibular del nervio facial y otra del hipogloso; tampoco hubo mortalidad.
Assuntos
Tumor do Corpo Carotídeo/cirurgia , Tumor do Corpo Carotídeo/patologiaRESUMO
Variations in anatomy were found quite frequently during bilateral gonadal vein dissection and resection for pelvic varices in the past 5 years (120 cases). In about one fourth of the cases, routine gonadal phlebography was not technically feasible or did not correlate exactly with the operative findings. Some cases of male varicocele showed recurrence after surgery. These facts, in addition to the scarce information provided by anatomy textbooks, induced us to study thoroughly the gonadal veins. One hundred cadaver dissections (200 veins) were done for length, diameter, number, and location of valves and collaterals, number of trunks in each side, and mode of termination in the renal vein and vena cava. Topographic division of the veins by thirds facilitated the information. Variations from the classic anatomic description were encountered frequently. As to the number of trunks, at the middle third, where the vein is usually divided, only 60% have one trunk on the left and only 75% have one on the right side. The rest are multiple; as many as four and six trunks in the lower third were found. The knowledge of these anatomic variations, not clearly described before, is of great importance to both surgeons and invasive radiologists and conducive to successful results.