Classification, neurovascularrelations and ostia of the sphenoid air sinus: a cadaveric study

The sphenoid air sinus is located deep at the base of the skull and is intimately related to delicate neurovascular structures. The purpose of this study was to describe the variations of the sphenoid sinus in relation to pneumatisation within the sphenoid bone, its ostium and the structures related to the walls of the sinus. Twenty-five cadaveric specimens were cut midsagittally and studied bilaterally (n = 50). The presellar, sellar and post-sellar sphenoid sinus types were observed in 16%, 36% and 48% cases, respectively. The protrusion of the internal carotid artery (ICA) in relation to the sinus walls was observed in 70% cases, while bulges of the optic (ON), maxillary (MN) and Vidian (VN) nerves were observed in 56%, 32% and 22% cases, respectively. Protrusions of ICA, ON and VN were prevalent in post-sellar sinuses and the bulge of MN was prevalent in the sellar sinuses. The ICA had a longer course in sellar and post-sellar sphenoid sinuses. The sphenoid sinus ostium shape was oval in 72.55% cases and round in 27.45% cases. The ostia were located superiorly on the anterior wall of the sinus in 34.69% cases and in the middle in 65.31% cases. Knowledge on the level of complexity and variability of the sphenoid sinus plays a pivotal role in preparing for saferendoscopic trans-sphenoid surgical approaches

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A case of cervical rib andneurovascular compression inRoman period

The possibility to study axial anomalies directly on a skeletal individual is not very frequent. One well preserved skeletal individual from an Italian site dating to the late antique period (5th -4th centuries CE) was studied. This individual shows some interesting skeletal changes in the vertebrae and ribs. A supernumerary rib was found. It is a cervical rib connected to the 1st thoracic rib, presumably with a fibrous bundle. The presence of cervical ribs can produce neurovascular compression of the brachial plexus and subclavian vessels. Because of this, it is often a cause of thoracic out-let syndrome (TOS). In our case the presence of a cervical rib articulated with the first thoracic rib through a probable fibrous band could have re-stricted the space where the brachial plexus and subclavian vessels pass through, creating a state of neurovascular compression, similar

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Estudio estadístico de la acción terapéutica del ácido retinoico tópico en los trastornos de queratinización / A statistical study of the topical retinoid´s therapeutic action in keratin disorders

Los retinoides han adquirido con el paso del tiempo la condición de fármaco indispensable en la práctica clínica diaria tras la observación de un gran número de resultados efectivos en un amplio abanico de procesos cutáneos. De hecho, los retinoides son los fármacos de elección en el tratamiento de los trastornos importantes de la queratinización. Ello se debe al amplio espectro de acción que poseen, el cual a su vez se explica por la gran diversidad de actividades farmacológicas que tienen los retinoides debido a los efectos que se derivan de la acción que ejercen sobre receptores celulares. Estas acciones incluyen, entre otras, la normalización de los desórdenes de queratinización al inducir el crecimiento de una nueva población de queratinocitos de apariencia normal. El presente estudio tiene como objetivo principal demostrar la efectividad que tiene la aplicación de ácido retinoico al 0,1% para el tratamiento del heloma neurovascular, una lesión dérmica que si bien su primera opción terapéutica es actualmente la extirpación quirúrgica, en ciertas ocasiones nos veremos obligados a recurrir a otra estrategia terapéutica. Será en estos casos en los que los retinoides tópicos constituirán un fármaco de elección para el tratamiento del trastorno de queratinización que se desarrolla durante la formación del heloma neuro vascular. Asimismo, otro objetivo de este estudio es valorar la efectividad de la aplicación de retinoides por via tópica como elemento coadyuvante al tratamiento ortopodológico (AU)

The success of retinoids in dermatology and skin care has made these chemical compounds to be a potential treatment for skin and dermatological diseases, being a key compound in the treatment of keratin disorders. Retinoids work by triggering molecular switches in skin cells called retinoid receptors. These switches affect many intracellular processes including the control of cell proliferation and cell differentiation. All these functions determine their usefulness in clinical dermatology being effective in the treatment of a number of dermatological conditions. The principal objective of the following article is to show retinoid acid cream 0,1% effect in the treatment of a specific keratin disorder, the neurovascular corn. The neurovascular corn is a dermatological disease whose principal treatment is the surgical excision. However, we should resort to others therapeutic strategies in different cases. Is in these situations when the retinoid acid will be a key compound for the treatment of the keratin disorder that takes place during the neurovascular corn evolution. Another objective of this study is to value the effectiveness of the retinoid acid cream as an adjuvant treatment of foot orthoses. An exploration protocol has been developed to covers from statistical dates to a clinical and dermoscopic exam of each neurovascular corn. Finally, a pain scale has been designed to value the degree of pain before starting the treatment and once topic treatment is completed. Based on the results we can conclude that topical retinoids are a very effective therapeutic tool in the treatment of dermatological conditions that are accompanied by a keratin disorder (AU)