Endoscopic reconstruction of large anterior skull base defects with opening of the sellar diaphragm. Experience at a tertiary level university hospital.

BACKGROUND: The indications for expanded endoscopic transnasal approaches continue to increase, with more complex skull base defects needing to be repaired. This study reviews the management of large anterior skull base defects with opening of the sellar diaphragm. METHOD: A prospective analysis of endonasal endoscopic surgery carried out at Son Espases University Hospital between January 2013 and December 2018 was performed. The analysis included only the cases with a significative intra-operative cerebrospinal fluid leak. In all cases, reconstruction was performed by combining the gasket seal technique with a pedicled mucosal endonasal flap. RESULTS: Twenty-eight patients were included. The mucoperiosteal nasoseptal flap, the lateral wall flap and the middle turbinate flap were used in 13, 8 and 7 patients, respectively, combined with the gasket seal technique. One case of post-operative cerebrospinal fluid leak was observed (3.57 per cent). CONCLUSION: The combination of a gasket seal with an endonasal mucosal flap is an excellent technique for repairing large anterior skull base defects.

[Testicular microlithiasis: is there a relationship with malignant tumour?]. / Microlitiasis testicular: existe relación con patología maligna?

The aim of this revision is to assess the relationship between testicular microlithiasis and malignant tumours. We reviewed 98 charts of patients with pathological diagnosis of testicular malignant tumour. Diagnosis of testicular tumour was made by ultrasound, and 6.02% (6 pts.) presented testicular lithiasis, and this finding makes us conclude that this is not a characteristic feature of this entity. We also reviewed bibliography related to this theme, and conclude that the management of microlithiasis remains being controversial.