Transoral robotic surgery of the central skull base: preclinical investigations.

In this study we explored possible applications of the da Vinci system in approaching the skull base at optic chiasm level on two cryopreserved cadavers, using an entirely transoral robotic technique (TORS). We used a standard 12 mm endoscopy and 8 mm terminals. Bone drilling was performed manually. The da Vinci system is equipped with very good illumination and 3D viewing, thus providing excellent vision and great maneuverability even in the less accessible areas of the skull. Our experience demonstrates that an entirely transoral skull base robotic approach to this complex anatomical region has many advantages as compared to traditional techniques.

[Osseous hemangioma of the upper jaw]. / Hemangioma óseo de maxilar superior.

Osseous hemangioma is a rare tumour of head and neck localisation. In this work the AA. present a case of the tumour located in the upper maxilla, considering the actual concept and the possibilities of differential diagnosis in relation with both radiologic and anatomopathological characteristics.

[Otoneurological evaluation in patients with Arnold-Chiari malformation and various ossicular changes in cranial vertebral unity]. / Evaluación otoneurológica en pacientes con malformación de Arnold-Chiari y diversas alteraciones óseas de la unión craneovertebral.

The union between the inferior portion of the occipital bone and the first two cervical vertebrae is the site of osseous and neurological abnormalities responsible for a wide spectrum of signs and symptoms of otoneurological interest. Often symptoms are vague with an evolution marked by temporary exacerbation or remission. The diagnosis can be difficult, and in our experience is best achieved by combining neurotologic and neurologic evaluation. We discuss the diagnosis of 6 patients with lesions at the craneovertebral junction. Arnold-Chiari malformation was diagnosed most frequently.

[Interactive morphometry and densitometry for the study of epidermoid carcinoma of the larynx. Preliminary results]. / Aplicación de la morfometría y densitometría interactivas al estudio del carcinoma epidermoide laríngeo. Resultado preliminar.

At present the utilization of quantitative techniques in anatomopathological studies is becoming more and more frequent, so adding the possibility of gaining measures and numerical assessments in front of conventional quantitative evaluations. In the paper the AA. report their first attempt with conventional slides of epidermoid carcinomas of the larynx, taken from the files. The aim has been to check out the contribution of this procedure compared with other traditional pathological techniques.

[The Stewart-Morel syndrome in the differential diagnosis of patients with frontal headache]. / Síndrome de Stewart-Morel en el diagnóstico diferencial del paciente con dolor de localización frontal.

Hyperostosis frontalis interna is the name generally applied to skull thickening more or less restricted to the squamous portion of the frontal bone and involving, in particular, its subdural or inner surface. The association of this calvarial thickening with virilism and obesity is a clinic-anatomic complex often know as the Morgagni's syndrome and is also referred to as the Stewart-Morel syndrome or metabolic craniopathy, when accompanied by mental disorders. Hyperostosis frontalis interna is being discussed here mainly in connection with the Stewart-Morel's syndrome of which it is the pivotal feature. Frontal headache is a common complaint and is severe in some cases. In addition various neuropsychiatric disturbances may be manifested.

[Histotopographic study of the pharyngoesophageal junction in newborns]. / Estudio histotopográfico de la unión faringoesofágica en recién nacidos.

In the present work the importance of the cricopharyngeal muscle as the main constituent of the pharyngoesophageal sphincter is showed. Some aspects traditionally admitted by the classic anatomic descriptions and some hypothesis about the function of this part of the aerodigestive pathway are discussed.

[Vascular microinvasion in laryngeal epidermoid carcinoma]. / Microinvasión vascular en el carcinoma epidermoide laríngeo.

Microvascular invasion by carcinoma cells is one of the first steps for the potential development of metástasis. The presence of squamous cell carcinoma within capillaries and/or venules in the immediate vicinity of primary lesions of the oral cavity and oropharynx may be related to regional lymph node metastasis. To evaluate this possibility in laryngeal carcinomas we have reviewed the histopathologic features of 48 cases of this type of tumor with simultaneous surgical treatment of the primary neoplasms and the neck. In our opinion the histologic finding of such invasion is not pathognomonic for establishment of regional metástasis in epidermoid carcinoma of the larynx.

[The importance of laryngeal compartmentation in the limitation of tumor extension]. / Importancia de la compartimentación laríngea en la limitación de la extensión tumoral.

Histologic specimens from 75 patients with squamous cell carcinoma of the larynx treated exclusively by surgery were studied with special attention paid to the growth of the tumor in relation with the different laryngeal compartments. Some aspects traditionally admitted are discussed. The result show a not very close relation between the classic anatomic descriptions and the tumoral growing.

[Prognostic value of lymph node histologic pattern in epidermoid carcinoma of the larynx]. / Interés pronóstico del patrón histológico ganglionar en el carcinoma epidermoide de laringe.

Histologic specimens from 48 patients with squamous cell carcinoma of the larynx treated exclusively by surgery were studied with special attention paid to the reactivity of regional lymph nodes. The lymph nodes were classified into four microscopic patterns of immune response: lymphocytic predominance, sinus histiocytosis, germinal center predominance and unstimulated or lymphocytic depletion. As a result no correlation were then made between the patterns and survival rate at 5 year follow-up.

[Study of histological preparations of laryngeal epidermoid carcinoma using image analysis]. / Estudio de preparaciones histológicas de carcinoma epidermoide laríngeo mediante análisis de imagen.

At the present application of quantitative techniques in anatomopathologic studies is becoming more and more frequent, adding the possibility of numeric and quantitative evaluation. In this study the authors make a first attempt with one of these methods, the image analysis using conventional slides of epidermoid carcinomas from larynx.

[Prognostic value of the grade of malignancy in epidermoid carcinoma of the larynx]. / Valor pronóstico del grado de malignidad en el carcinoma epidermoide de la laringe.

At the moment the use of quantitative techniques in anatomopathology are becoming more and more frequent. In this study, with the mathematical transformation of morphometric data obtained from cell populations of epidermoid carcinoma of the larynx, the authors arrive at the "grade of malignancy" for every patient which has in itself prognostic value without taking into account the other anatomopathologic or clinical parameters.

[Use of morphophotometry in the study of the kinetics of cell populations in laryngeal epidermoid carcinoma]. / Aplicación de la morfofotometría al estudio de la cinética de poblaciones celulares en el carcinoma epidermoide laríngeo.

The use of morpho-photometric techniques in anatomopathology is, on the whole, not very frequent at the moment. In this study the authors show the possible applications of these quantitative methods for the evaluation of kinetics characteristics of cell population in epidermoid carcinomas of the larynx.

[The preservation of hearing in surgery for acoustic neurinoma]. / Conservación de la audición en la cirugía del neurinoma del acústico.

The surgical result in one patient with unilateral tumor of the cerebellopontine angle and internal auditory canal is presented. Total tumor removal and preservation of hearing was possible in spite of the size of the tumor. The authors make some considerations about the possibility to preserve a useful hearing in patients with this type of tumors.

[Granulomatous lymphadenitis in cancer of the larynx]. / Linfadenitis granulomatosa en el cáncer de laringe.

Epithelioid granuloma is not the typical antitumors reaction of the lymph nodes in head and neck area. In this study the authors look at and consider this subject in relation with tumors in the larynx.