Anatomical and Clinical Evaluation of Tympanic Tegmen and Mastoid Bone with Multidetector Computed Tomography / Evaluación Anatómica y Clínica del Tegmen Timpánico y Hueso Mastoideo con Tomografía Computarizada Multidetector

SUMMARY: Tegmen level and mastoid bone thickness are important parameters of surgical risk in middle ear and mastoid region surgeries. This retrospective cohort study was conducted to provide a risk classification for the mastoid and middle ear regions. The study population comprised of 300 patients who underwent multidetector computed tomography (MDCT) for various indications. Patients with no pathology that disrupted the structure of the temporal region were included in the study. A risk classification was generated by analyzing the data obtained from mastoid and tympanic tegmen depths and the mastoid bone thickness by MDCT. The mastoid and tympanic tegmen were lower on the right side than on the left. In women, the right-sided mastoid bone thickness and mastoid tegmen were lower, and low-level tympanic and mastoid tegmen on the left and thin right mastoid bones were more common. According to the risk classifications for mastoid and middle ear region surgeries, women demonstrated a higher risk than men. In addition, as the thickness of the mastoid bone increased, the levels of the mastoid and tympanic tegmen increased. The present study provides a proper risk classification that may be helpful for preoperative risk assessment prior to middle ear and mastoid region surgery.

El nivel del tegmen y el grosor del hueso mastoideo son parámetros importantes del riesgo quirúrgico en las cirugías del oído medio y la región mastoidea. Este estudio de cohorte retrospectivo se llevó a cabo para proporcionar una clasificación del riesgo en las regiones mastoidea y del oído medio. La población de estudio estuvo compuesta por 300 pacientes que se sometieron a una tomografía computarizada multidetector (MDCT) por diversas indicaciones. Se incluyeron en el estudio pacientes sin patología que alterase la estructura de la región temporal. Se generó una clasificación de riesgo analizando los datos obtenidos de las profundidades del tegmen mastoideo y timpánico y el grosor del hueso mastoideo por TCMD. El tegmen mastoideo y timpánico estaban más bajos en el lado derecho que en el izquierdo. En las mujeres, el grosor del hueso mastoideo del lado derecho y el tegmen mastoideo eran más bajos, y eran más frecuente la presencia de tegmen timpánico y mastoideo de bajo nivel en los huesos mastoideos izquierdo y delgados en el lado derecho. Según las clasificaciones de riesgo de las cirugías de la región mastoidea y del oído medio, las mujeres presentaban un mayor riesgo que los hombres. Además, a medida que aumentaba el grosor del hueso mastoides, aumentaban los niveles del tegmen mastoideo y timpánico. El presente estudio proporciona una clasificación de adecuada de riesgo que puede ser útil para la evaluación preoperatoria del riesgo antes de la cirugía del oído medio y la región mastoidea.

Extended reality veterinary medicine case studies for diagnostic veterinary imaging instruction: Assessing student perceptions and examination performance.

Educational technologies in veterinary medicine aim to train veterinarians faster and improve clinical outcomes. COVID-19 pandemic, shifted face-to-face teaching to online, thus, the need to provide effective education remotely was exacerbated. Among recent technology advances for veterinary medical education, extended reality (XR) is a promising teaching tool. This study aimed to develop a case resolution approach for radiographic anatomy studies using XR technology and assess students' achievement of differential diagnostic skills. Learning objectives based on Bloom's taxonomy keywords were used to develop four clinical cases (3 dogs/1 cat) of spinal injuries utilizing CT scans and XR models and presented to 22 third-year veterinary medicine students. Quantitative assessment (ASMT) of 7 questions probing 'memorization', 'understanding and application', 'analysis' and 'evaluation' was given before and after contact with XR technology as well as qualitative feedback via a survey. Mean ASMT scores increased during case resolution (pre 51.6% (±37%)/post 60.1% (± 34%); p < 0.01), but without significant difference between cases (Kruskal-Wallis H = 2.18, NS). Learning objectives were examined for six questions (Q1-Q6) across cases (C1-4): Memorization improved sequentially (Q1, 2 8/8), while Understanding and Application (Q3,4) showed the greatest improvement (26.7%-76.9%). Evaluation and Analysis (Q5,6) was somewhat mixed, improving (5/8), no change (3/8) and declining (1/8).Positive student perceptions suggest that case studies' online delivery was well received stimulating learning in diagnostic imaging and anatomy while developing visual-spatial skills that aid understanding cross-sectional images. Therefore, XR technology could be a useful approach to complement radiological instruction in veterinary medicine.

Golden ratio for the foramen magnum on CT images: a morphological and morphometrical study / Proporción áurea para el foramen magnum en imágenes de TC: un estudio morfológico y morfométrico

SUMMARY: The foramen magnum (FM) is a transition zone between the spine and skull. There is a study in the literature showing the golden ratio (4.62) and harmony between both FM and the anteroposterior and transverse diameters of the skull. The aim of this study is to examine the existence of this ratio on CT images and to investigate whether this ratio changes according to the FM shape types. In this study, 402 adult CT images belonging to the Turkish population were examined. Maximum cranial length (MCL), maximum cranial width (MCW) and the FM length (FML) and FM width (FMW) were measured. The different shapes of the FM were macroscopically classified. The number and incidence of each type in the studied skull was registered. In the 402 CT images used in the study, 12 FM shapes were detected. Three of the shape types observed in our study have not been reported in the literature until now, and were found in our study for the first time. In addition, our data supported that by using the ratio of 4.62, there was a great harmony between the skull and FM. The results obtained from the research show that there is a ratio of 4.62 between the basic cranial measurements and FM dimensions in all shapes except triangular shape. It is thought that repeating the calculated coefficients over more different FM shapes will contribute to the effectiveness of the proposed golden ratio.

RESUMEN: El foramen magno (FM) es una zona de transición entre la columna y el cráneo. Existe un estudio en la literatura que muestra la proporción áurea (4,62) y la armonía entre el FM y los diámetros anteroposterior y transversal del cráneo. El objetivo de este estudio fue examinar la existencia de esta relación en las imágenes de TC e investigar si esta relación cambia según los tipos de forma del FM. Se examinaron 402 imágenes de TC de adultos pertenecientes a la población turca. Se midieron la longitud craneal máxima, el ancho craneal máximo y la longitud del FM y la anchura del FM. Las diferentes formas del FM se clasificaron macroscópicamente. Se registró el número e incidencia de cada tipo en el cráneo estudiado. En las 402 imágenes de TC utilizadas en el estudio, se detectaron 12 formas de FM. Tres de los tipos de formas observados en nuestro estudio no se han reportado en la literatura consultada describiéndose por primera vez. Además, nuestros datos respaldaron que al usar la proporción de 4,62, había una armonía importante entre el cráneo y el FM. Los resultados obtenidos de la investigación muestran que existe una relación de 4,62 entre las medidas craneales básicas y las dimensiones de la FM en todas las formas excepto en la triangular. Se cree que la repetición de los coeficientes calculados en más formas de FM diferentes contribuirá a la eficacia de la proporción áurea propuesta.

Diseño y aplicación piloto de un atlas imagenológico de pelvis femenina utilizando dispositivos móviles como apoyo al aprendizaje de la anatomía humana / Design and pilot application of an image atlas of female pelvis using mobile devices to support the learning of human anatomy

Resumen: Introducción: Las imágenes médicas constituyen un recurso de enseñanza-aprendizaje que complementa las metodologías tradicionales en el estudio de la Anatomía Humana para las profesiones de la salud. La pelvis femenina es una entidad anatómica compleja que contiene estructuras de varios sistemas, cuyas relaciones anatómicas son susceptibles de estudiar con detalle utilizando imágenes de resonancia magnética. Propósito: Diseñar una aplicación móvil como complemento al aprendizaje de la anatomía radiológica de la pelvis femenina y realizar una aplicación piloto a baja escala. Metodología: Se diseñó una aplicación móvil de anatomía normal de la pelvis femenina utilizando recursos gratuitos disponibles en línea, a partir de imágenes anonimizadas de resonancia magnética del archivo digital local. A partir de literatura anatómica relevante se seleccionaron las estructuras a rotular. Para evaluar la percepción de los usuarios, se diseñó y aplicó una encuesta por vía digital. Resultados: La aplicación móvil interactiva fue diseñada para dispositivos Android, con 7 secciones y 107 imágenes. Existió una adecuada recepción de la herramienta por parte de los seis estudiantes que participaron en la implementación piloto, destacando la accesibilidad como el principal aspecto a mejorar. Conclusión: Este atlas imagenológico a través de dispositivos móviles es un complemento del aprendizaje de la anatomía humana utilizando imágenes médicas.

Abstract: Introduction: Medical imaging is a teaching-learning resource that complements traditional methodologies in the study of Human Anatomy to health professions. The female pelvis is a complex anatomical entity that contains structures of several systems, whose anatomical relationships can be studied in detail using magnetic resonance imaging. Purpose: To design a mobile application as a complement to the learning of the radiological anatomy of the female pelvis and to carry out a pilot application in a small scale. Methodology: A mobile application of normal anatomy of the female pelvis was designed using free resources available online from anonymized magnetic resonance images from the local digital archive. The structures to be labelled were selected from relevant anatomical literature. In order to evaluate user's perception, a digital survey was designed and applied. Results: The interactive mobile application was designed for Android devices, with 7 sections and 107 images. There was an adequate reception of the tool by the six students who participated in the pilot implementation, highlighting accessibility as the main aspect to improve. Conclusion: This atlas imaging through mobile devices is a complement to the learning of human anatomy using medical images.

Presencia y biometría del os peroneum en individuos chilenos: estudio radiológico / Presence and biometry of os peroneum in Chilean individuals: radiological study

RESUMEN: El esqueleto está formado por 206 huesos constantes (200 huesos axiales y apendiculares más los 6 osículos del oído). Sin embargo, aparte de éstos existen otros huesos que pueden ser inconstantes, los que se denominan accesorios y sesamoideos. Basado en lo anterior, el objetivo fue identificar el os peroneum, que es uno de los huesos sesamoideos que podría estar presente en el pie humano, relacionando su presencia con el sexo, grupos etarios y dominancia, registrando también mediciones de cada hueso encontrado. Se realizó un estudio de tipo descriptivo, en donde se utilizaron radiografías de 200 pacientes, de ambos sexos, chilenos, de la IX región de La Araucanía, 50 de sexo masculino y 150 de sexo femenino, con edades entre 15 y 90 años. De los 200 pacientes estudiados, se encontraron 28 (14 %) con presencia de Os peroneum, 23 del sexo femenino y 5 de sexo masculino. En 16 (57,1 %) individuos se determinó que los huesos eran bilaterales. Los registros biométricos del hueso en estudio se muestran en tablas. Los datos obtenidos complementarán el conocimiento morfológico y médico acerca de este hueso en la población chilena, ya que el dolor en la zona lateral del pie puede ser causado por un espectro de etiologías, y con los datos obtenidos, caracterizar a nuestra población, aportando otra posible causa al dolor lateral de pie.

SUMMARY: The skeleton is made up of 206 constant bones (200 bones and the 6 ossicles of the ear). However, apart from these there are other bones that can be inconstant, which are called accessories and sesamoids. Based on the above, the objective was to identify to the Os peroneum, which is one of the sesamoid bones that could be present in the human foot, relating its presence with sex, age groups and dominance, also recording measurements of each bone found. A descriptive study was carried out, in which radiographs of 200 patients of both sexes were used, Chilean, from the IX region of La Araucanía, 50 male and 150 female, aged between 15 and 90 years. Of the 200 patients studied, 28 (14 %) were found with the presence of peroneal bone, 23 of the female sex and 5 of the male sex. In 16 (57.1 %) individuals it was determined that the bones were bilateral. The biometric records of the bone under study are shown in tables. The data obtained will complement the morphological and medical knowledge about this bone in the Chilean population, since the pain in the lateral zone of the foot can be caused by a spectrum of etiologies, and with the data obtained, characterize our population, providing another possible cause to lateral standing pain.

Does an Additional Online Anatomy Course Improve Performance of Medical Students on Gross Anatomy Examinations?

AIM: An online learning course in anatomy was added to the regular academic anatomy course in the 2nd year of medicine at UNAN-Leon in Nicaragua, using the MOODLE platform. This study aims to determine the learning effect of this course. METHOD: Second-year medical students were randomly allocated to an experimental (N = 25) and control group (N = 50). Only the experimental group had access to the online learning module. We compared the performance of the experimental and the control group on both regular anatomy assessment and an objective structured practical exam (OSPE). Additionally, five focus groups were interviewed to learn about their experiences of the expanded course. RESULTS: Of students in the experimental group 94.1% and 81.6% of students in the control group took the OSPE. The experimental group significantly outperformed the control group (41.1 ± 19.3 points vs. 32.1 ± 23.1 points) on the OSPE. No differences between the two groups were found on the regular anatomy examination. Focus group interviews revealed students' opinions about the online course were generally positive. CONCLUSION: In general, the addition of an online course to the regular course was beneficial. The results of the qualitative evaluation of this intervention provides us with input about how to teach and evaluate the anatomy course and how to further improve the online course to enhance anatomy learning.