RESUMO
Historical studies of the anatomy of the spinal accessory nerve (SAN) have reported conflicting results regarding its relationship with the internal jugular vein (IJV). A literature review was undertaken to establish the prevalence of anatomical variations of the SAN encountered during routine neck dissection surgery, in order to increase awareness and reduce morbidity associated with iatrogenic SAN injury. The published literature was analysed by qualitative synthesis and nine articles were yielded following application of the inclusion and exclusion criteria. Incidences of the SAN lateral to the IJV and medial to the IJV ranged from 39.8% to 96.6%, and 2.6% to 57.4%, respectively. Five of the studies reported incidences of the SAN traversing the IJV, which occurred in 0.9% to 2.8% of cases. One study reported an isolated variant of the SAN dividing around the IJV, with a prevalence of 0.5%. We present a case report demonstrating the rare variant of the SAN traversing the IJV. Preoperative identification of rare anatomical association of the SAN and IJV may reduce perioperative injury to vital structures during neck dissection.
Assuntos
Nervo Acessório , Esvaziamento Cervical , Nervo Acessório/anatomia & histologia , Nervo Acessório/cirurgia , Humanos , Veias Jugulares , Esvaziamento Cervical/métodosRESUMO
Pilomatrixomas are benign, calcified epitheliomas of the hair follicle, predominately affecting children and commonly presenting in the head and neck region. The current literature is almost unanimous in recommending surgical excision. Reconstruction of these defects may require the need for a skin graft, resulting in poor cosmetic outcome and donor site morbidity. We present two cases demonstrating the benefits of minimal access incisions for pilomatrixomas in children. We recommend that multiple or recurrent lesions should prompt referral to a specialist for management and long-term follow-up.
Assuntos
Tecido Adiposo/transplante , Amputação Cirúrgica/métodos , Traumatismos do Pé/cirurgia , Fraturas Expostas/cirurgia , Calcanhar/lesões , Calcanhar/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Acidentes de Trânsito , Calcâneo/lesões , Calcâneo/cirurgia , Terapia Combinada/métodos , Seguimentos , Traumatismos do Pé/diagnóstico , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/transplante , Resultado do Tratamento , Cicatrização/fisiologiaAssuntos
Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Artérias Temporais/diagnóstico por imagem , Artérias Temporais/cirurgia , Adulto , Procedimentos Cirúrgicos Ambulatórios , Anestesia Local , Erros de Diagnóstico , Cisto Epidérmico/diagnóstico , Traumatismos Cranianos Fechados/complicações , Humanos , Ultrassonografia Doppler em Cores , Ultrassonografia Doppler DuplaAssuntos
Carcinoma de Células Escamosas/secundário , Linfonodos/cirurgia , Retalho Miocutâneo , Terapia de Salvação , Úlcera Cutânea/cirurgia , Neoplasias do Colo do Útero/patologia , Infecções por Escherichia coli/complicações , Feminino , Humanos , Canal Inguinal , Linfonodos/patologia , Metástase Linfática , Reto do Abdome , Úlcera Cutânea/etiologia , Deiscência da Ferida Operatória/complicações , Infecção da Ferida Cirúrgica/complicaçõesRESUMO
This species study was to investigate the differentiation level among 26 populations in which 12 are locals originating from the Tunisian South and 14 introduced from Italy, Austerely, France and Morocco with two SSR markers. These highly polymorphic and co dominant markers, together with recent population genetic statistic extended to autotetraploids, offer tools to analyse genetic diversity in alfalfa. The number of alleles per locus varied between 8 and 9. The genetic similarity between these various populations is estimated by the index of Rogers and Tanimoto. Genetic diversity is analysed by two statistical procedures: Hierarchical classification and Correspondence Factorial Analysis (CFA). Four large groups were obtained.