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1.
BMJ ; 369: m718, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32349978

RESUMO

Head and neck structures govern the vital functions of breathing and swallowing. Additionally, these structures facilitate our sense of self through vocal communication, hearing, facial animation, and physical appearance. Loss of these functions can lead to loss of life or greatly affect quality of life. Regenerative medicine is a rapidly developing field that aims to repair or replace damaged cells, tissues, and organs. Although the field is largely in its nascence, regenerative medicine holds promise for improving on conventional treatments for head and neck disorders or providing therapies where no current standard exists. This review presents milestones in the research of regenerative medicine in head and neck surgery.


Assuntos
Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Otolaringologia/tendências , Procedimentos Cirúrgicos Reconstrutivos/tendências , Medicina Regenerativa/tendências , Tecidos Suporte , Bioengenharia , Transplante de Células/métodos , Transplante de Células/tendências , Cóclea , Cartilagem da Orelha , Ossos Faciais , Humanos , Laringe , Cartilagens Nasais , Procedimentos Cirúrgicos Reconstrutivos/métodos , Glândulas Salivares , Crânio , Engenharia Tecidual/métodos , Engenharia Tecidual/tendências , Traqueia , Membrana Timpânica
2.
J Forensic Odontostomatol ; 1(38): 8-17, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32420908

RESUMO

Sex determination, which is based on the existence of dimorphism between specimens of the same species, plays an important role in the process of human identification. In the absence of pelvic elements, the skull appears to be the best sex indicator, and can also be submitted to quantitative or metric assessments. Eleven measurements were taken for this study, four in the sagittal plane and seven in the horizontal, in two groups of 186 skulls each, with 101 from males and 85 from females for those of the sagittal plane, and 100 and 86, respectively, for those concerning the horizontal, of subjects aged between 18 and 94 years at the time of death. The sample belongs to the Osteological and Tomographic Biobank Professor Doctor Eduardo Daruge of the Piracicaba Dental School of the University of Campinas. The aim of this research was to establish a reliable method to determine sex and elaborate mathematical prototypes capable of assisting in investigation or identification activities, in a preliminary study. Of the measures implemented (Lambda-Nasion, Lambda-Rhinion, Lambda-Nasospinale, Rhinion-Nasospinale, Zygomaxillare-Zygomaxillare, Lambda-Incisive Foramen, Lambda-Right Zygomaxillare, Lambda-Left Zygomaxillare, Basion-Incisive Foramen, Basion-Right Zygomaxillare and Basion-Left Zygomaxillare), only the Lambda-Nasospinale and Rhinion-Nasospinale in the sagittal plane, and the Zygomaxillare-Zygomaxillare and Lambda-Incisive Foramen in the horizontal plane, were significantly dimorphic. Two predictive mathematical models of sex were conceived for each pair of them: one of logistic regression and another of conditional inference trees, displaying accuracy rates of 78.5% and 77.42%, and of 68.28% and 72.04%, respectively. The authors concluded that there is the possibility to apply the aforementioned data in forensic anthropology as an auxiliary tool in investigation or identification tasks.


Assuntos
Determinação do Sexo pelo Esqueleto , Crânio , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Cefalometria , Feminino , Antropologia Forense , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
3.
Nature ; 581(7809): 421-427, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32461642

RESUMO

The fossil record of mammaliaforms (mammals and their closest relatives) of the Mesozoic era from the southern supercontinent Gondwana is far less extensive than that from its northern counterpart, Laurasia1,2. Among Mesozoic mammaliaforms, Gondwanatheria is one of the most poorly known clades, previously represented by only a single cranium and isolated jaws and teeth1-5. As a result, the anatomy, palaeobiology and phylogenetic relationships of gondwanatherians remain unclear. Here we report the discovery of an articulated and very well-preserved skeleton of a gondwanatherian of the latest age (72.1-66 million years ago) of the Cretaceous period from Madagascar that we assign to a new genus and species, Adalatherium hui. To our knowledge, the specimen is the most complete skeleton of a Gondwanan Mesozoic mammaliaform that has been found, and includes the only postcranial material and ascending ramus of the dentary known for any gondwanatherian. A phylogenetic analysis including the new taxon recovers Gondwanatheria as the sister group to Multituberculata. The skeleton, which represents one of the largest of the Gondwanan Mesozoic mammaliaforms, is particularly notable for exhibiting many unique features in combination with features that are convergent on those of therian mammals. This uniqueness is consistent with a lineage history for A. hui of isolation on Madagascar for more than 20 million years.


Assuntos
Fósseis , Ilhas , Mamíferos/anatomia & histologia , Mamíferos/classificação , Filogenia , Esqueleto/anatomia & histologia , Animais , Dentição , Madagáscar , Crânio/anatomia & histologia
4.
Zootaxa ; 4742(1): zootaxa.4742.1.6, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32230393

RESUMO

Bunocephalus hertzi, new species, is described from two tributaries of the upper Rio Paraná basin. Because the type series of B. larai (the only other species of Bunocephalus in the basin) is lost, a redescription of B. larai is also provided herein. Bunocephalus larai and B. hertzi can be distinguished from all its congeners, except B. minerim, by the absence of an epiphyseal bar (vs. present). From B. minerim, both species can be distinguished by the presence of 10 principal caudal-fin rays (vs. 9). Bunocephalus hertzi can be differentiated from B. larai by the longer coracoid process size (11.9-16.2% vs. 6.7-9.8% SL), shorter maxillary barbel (just reaching the pectoral fin origin; 54.6-67.4% vs. 73.7-84.6% HL) and skull ornamentation represented by five bony protuberances between the posterior end of the occipital and the origin of the dorsal fin (vs. four bony protuberances).


Assuntos
Peixes-Gato , Rajidae , Animais , Brasil , Rios , Crânio
5.
Science ; 368(6486)2020 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-32241925

RESUMO

Understanding the extinction of Australopithecus and origins of Paranthropus and Homo in South Africa has been hampered by the perceived complex geological context of hominin fossils, poor chronological resolution, and a lack of well-preserved early Homo specimens. We describe, date, and contextualize the discovery of two hominin crania from Drimolen Main Quarry in South Africa. At ~2.04 million to 1.95 million years old, DNH 152 represents the earliest definitive occurrence of Paranthropus robustus, and DNH 134 represents the earliest occurrence of a cranium with clear affinities to Homo erectus These crania also show that Homo, Paranthropus, and Australopithecus were contemporaneous at ~2 million years ago. This high taxonomic diversity is also reflected in non-hominin species and provides evidence of endemic evolution and dispersal during a period of climatic variability.


Assuntos
Evolução Biológica , Extinção Biológica , Hominidae/anatomia & histologia , Hominidae/classificação , Animais , Cavernas , Classificação , Humanos , Crânio , África do Sul
6.
Adv Exp Med Biol ; 1236: 137-155, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32304072

RESUMO

The formation of the head and face is a complex process which involves many different signaling cues regulating the migration, differentiation, and proliferation of the neural crest. This highly complex process is very error-prone, resulting in craniofacial defects in nearly 10,000 births in the United States annually. Due to the highly conserved mechanisms of craniofacial development, animal models are widely used to understand the pathogenesis of various human diseases and assist in the diagnosis and generation of preventative therapies and treatments. Here, we provide a brief background of craniofacial development and discuss several rare diseases affecting craniofacial bone development. We focus on rare congenital diseases of the cranial bone, facial jaw bones, and two classes of diseases, ciliopathies and RASopathies. Studying the animal models of these rare diseases sheds light not only on the etiology and pathology of each disease, but also provides meaningful insights towards the mechanisms which regulate normal development of the head and face.


Assuntos
Anormalidades Craniofaciais , Modelos Animais de Doenças , Cabeça/embriologia , Animais , Anormalidades Craniofaciais/diagnóstico , Anormalidades Craniofaciais/prevenção & controle , Anormalidades Craniofaciais/terapia , Face/embriologia , Humanos , Crista Neural/embriologia , Crânio/embriologia
7.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(3. Vyp. 2): 13-15, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32307424

RESUMO

The aspects of disruption of venous blood outflow from face region into skull are well-known; they can occur at any age - from neonatal to old age, however, the possible compensation mechanisms for such disorders are usually difficult to identify. A description is given of a unique case of unilateral epistaxis and a homolateral (right-sided) headache that developed much later. Examination revealed hypoplasia of the left sigmoid sinus and blood overflow of the right sigmoid sinus. After prescription of betahistine in a dose of 24 mg before bedtime and after awakening the headache and nosebleeds disappeared on the second day. The effect was persistent. The case demonstrates previously unknown compensation mechanisms for venous outflow - a retrograde outflow from the skull to the face region.


Assuntos
Face/irrigação sanguínea , Crânio/irrigação sanguínea , Veias/fisiologia , beta-Histina/uso terapêutico , Cavidades Cranianas/patologia , Cavidades Cranianas/fisiopatologia , Epistaxe/tratamento farmacológico , Epistaxe/fisiopatologia , Face/patologia , Cefaleia/tratamento farmacológico , Cefaleia/patologia , Cefaleia/fisiopatologia , Humanos , Crânio/patologia
8.
Adv Exp Med Biol ; 1236: 157-188, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32304073

RESUMO

Skeletal defects, such as cleft palate, scoliosis, and shortening of the limb bones are common in the human population. Animal models have been essential for characterizing the molecular and cellular mechanisms that underlie these and other skeletal disorders. This chapter will explore the cellular origins of the vertebrate skeleton and introduce a selection of animal models for human disorders of the skull and facial bones, spinal column, and limbs. The common genetic pathways that build the skeleton of various vertebrate species and how these similarities facilitate the study of human developmental processes in laboratory animals will be a focus of discussion. This chapter will also highlight how current genome editing technologies can be applied to model various perturbations of human chromatin structure in laboratory animals.


Assuntos
Osso e Ossos/anormalidades , Modelos Animais de Doenças , Animais , Fissura Palatina , Ossos Faciais/anormalidades , Humanos , Crânio/anormalidades , Coluna Vertebral/anormalidades
9.
PLoS One ; 15(4): e0228402, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271782

RESUMO

BACKGROUND: The application of three-dimensional scan models offers a useful resource for studying craniofacial variation. The complex mathematical analysis for facial point acquisition in three-dimensional models has made many craniofacial assessments laborious. METHOD: This study investigates three-dimensional (3D) soft-tissue craniofacial variation, with relation to ethnicity, sex and age variables in British and Irish white Europeans. This utilizes a geometric morphometric approach on a subsampled dataset comprising 292 scans, taken from a Liverpool-York Head Model database. Shape variation and analysis of each variable are tested using 20 anchor anatomical landmarks and 480 sliding semi-landmarks. RESULTS: Significant ethnicity, sex, and age differences are observed for measurement covering major aspects of the craniofacial shape. The ethnicity shows subtle significant differences compared to sex and age; even though it presents the lowest classification accuracy. The magnitude of dimorphism in sex is revealed in the facial, nasal and crania measurement. Significant shape differences are also seen at each age group, with some distinct dimorphic features present in the age groups. CONCLUSIONS: The patterns of shape variation show that white British individuals have a more rounded head shape, whereas white Irish individuals have a narrower head shape. White British persons also demonstrate higher classification accuracy. Regarding sex patterns, males are relatively larger than females, especially in the mouth and nasal regions. Females presented with higher classification accuracy than males. The differences in the chin, mouth, nose, crania, and forehead emerge from different growth rates between the groups. Classification accuracy is best for children and senior adult age groups.


Assuntos
Cefalometria , Face/anatomia & histologia , Imageamento Tridimensional , Caracteres Sexuais , Crânio/anatomia & histologia , Adolescente , Adulto , Fatores Etários , Análise de Variância , Pontos de Referência Anatômicos , Análise Discriminante , Feminino , Humanos , Pessoa de Meia-Idade , Análise de Componente Principal , Adulto Jovem
10.
Nature ; 580(7803): 372-375, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32296179

RESUMO

The cranium from Broken Hill (Kabwe) was recovered from cave deposits in 1921, during metal ore mining in what is now Zambia1. It is one of the best-preserved skulls of a fossil hominin, and was initially designated as the type specimen of Homo rhodesiensis, but recently it has often been included in the taxon Homo heidelbergensis2-4. However, the original site has since been completely quarried away, and-although the cranium is often estimated to be around 500 thousand years old5-7-its unsystematic recovery impedes its accurate dating and placement in human evolution. Here we carried out analyses directly on the skull and found a best age estimate of 299 ± 25 thousand years (mean ± 2σ). The result suggests that later Middle Pleistocene Africa contained multiple contemporaneous hominin lineages (that is, Homo sapiens8,9, H. heidelbergensis/H. rhodesiensis and Homo naledi10,11), similar to Eurasia, where Homo neanderthalensis, the Denisovans, Homo floresiensis, Homo luzonensis and perhaps also Homo heidelbergensis and Homo erectus12 were found contemporaneously. The age estimate also raises further questions about the mode of evolution of H. sapiens in Africa and whether H. heidelbergensis/H. rhodesiensis was a direct ancestor of our species13,14.


Assuntos
Evolução Biológica , Hominidae , Crânio , Animais , Fósseis , Fatores de Tempo
11.
Medicine (Baltimore) ; 99(16): e19786, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311988

RESUMO

The posterior fossa is an important brain structure containing the cerebellum, cerebral ventricle, and cistern. Early evaluation of the cerebellar structure and function may be valuable for early detection of fetal deformities. At present, no normal value for the fetal posterior fossa has been established yet. This study is aimed to investigate the development of the posterior fossa in normal Chinese fetuses by using magnetic resonance imaging (MRI).Pregnant women who need MRI scan were enrolled in our Hospital between January 2012 and December 2014. The fetal supero-inferior diameter (SID), anterio-posterior diameter (APD), cerebellar vermis area, cerebellar width (CW), cerebellar volume (CV), superior cerebellar cistern width, and cerebellomedullary cistern width were measured using MRI. Pearson's correlation analysis was used to detect the relationship between those parameters and gestational age. A regression analysis was performed for all parameters.A total of 92 participants were retrospectively enrolled finally. The results indicated SID, APD, cerebellar vermis area, CW, and CV were positively associated with gestational age, while no significant correlation was found between the superior cerebellar cistern width and cerebellomedullary cistern width and gestational age. Each equation was established.Our study demonstrated that MRI has the advantages over ultrasound imaging for prenatal evaluation of the fetal posterior fossa with multiple views. Normal value of the posterior fossa of Chinese fetuses was established in this study.


Assuntos
Cerebelo/diagnóstico por imagem , Feto/diagnóstico por imagem , Crânio/embriologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Gravidez , Valores de Referência , Estudos Retrospectivos , Crânio/diagnóstico por imagem
15.
Head Face Med ; 16(1): 3, 2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32127030

RESUMO

BACKGROUND: The reconstruction of large head and face missing structures in the craniofacial region in children is very challenging for plastic surgeons. Expanded local and expanded axial-pattern flaps are widely used for the reconstruction of large-area scars. Free flaps are used very cautiously in children. 3D printing technology is a new technology with great development potential. 3D printing technology is used to assist in individualizing titanium alloy restorations for prefabricated skull defect repair. This application has great advantages in the repair of large skull loss. However, it is crucial to choose appropriate techniques and treat deformities of the head and face with integrated approaches and collaboration among multiple departments. CASE PRESENTATION: This study proposes a method to combine the expanded flap method and 3D printing technology to achieve natural remodeling of the craniofacial region in a child. CONCLUSION: Large area of head and face missing structures can be reconstructed by using expanded skin flaps combined with 3D printing, and patients can get better new faces.


Assuntos
Anormalidades Craniofaciais , Retalhos de Tecido Biológico , Procedimentos Cirúrgicos Reconstrutivos , Criança , Anormalidades Craniofaciais/cirurgia , Cabeça , Humanos , Impressão Tridimensional , Crânio
16.
World Neurosurg ; 136: 462-469, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32204298

RESUMO

Chiari malformation comprises a spectrum of congenital malformations characterized by a herniation of the cerebellar tonsils below the foramen magnum. Chiari malformation type I (CM-I) is the most prevalent subtype seen in clinical practice. This condition variably compresses the cerebellum and medulla-spinal cord junction secondary to malformation of the posterior fossa. Most neurologists and neurosurgeons recognize the sensorimotor and lower brainstem manifestations that result in the clinical picture of CM-I. The effects of CM-I on cognitive functioning, however, and their impact on neuropsychological performance are poorly understood, despite having long been recognized. This article reviews neuropsychological deficits demonstrated by individuals with CM-I, and explores cerebellocortical neuroanatomic pathways to provide possible rationale for the neurocognitive impairments present in affected individuals.


Assuntos
Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/cirurgia , Parafusos Ósseos , Procedimentos Neurocirúrgicos/métodos , Crânio/diagnóstico por imagem , Crânio/cirurgia , Adolescente , Adulto , Malformação de Arnold-Chiari/psicologia , Cadáver , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Fixação Interna de Fraturas , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuronavegação , Fusão Vertebral , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
17.
Nature ; 579(7799): 397-401, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32188952

RESUMO

Our understanding of the earliest stages of crown bird evolution is hindered by an exceedingly sparse avian fossil record from the Mesozoic era. The most ancient phylogenetic divergences among crown birds are known to have occurred in the Cretaceous period1-3, but stem-lineage representatives of the deepest subclades of crown birds-Palaeognathae (ostriches and kin), Galloanserae (landfowl and waterfowl) and Neoaves (all other extant birds)-are unknown from the Mesozoic era. As a result, key questions related to the ecology4,5, biogeography3,6,7 and divergence times1,8-10 of ancestral crown birds remain unanswered. Here we report a new Mesozoic fossil that occupies a position close to the last common ancestor of Galloanserae and fills a key phylogenetic gap in the early evolutionary history of crown birds10,11. Asteriornis maastrichtensis, gen. et sp. nov., from the Maastrichtian age of Belgium (66.8-66.7 million years ago), is represented by a nearly complete, three-dimensionally preserved skull and associated postcranial elements. The fossil represents one of the only well-supported crown birds from the Mesozoic era12, and is the first Mesozoic crown bird with well-represented cranial remains. Asteriornis maastrichtensis exhibits a previously undocumented combination of galliform (landfowl)-like and anseriform (waterfowl)-like features, and its presence alongside a previously reported Ichthyornis-like taxon from the same locality13 provides direct evidence of the co-occurrence of crown birds and avialan stem birds. Its occurrence in the Northern Hemisphere challenges biogeographical hypotheses of a Gondwanan origin of crown birds3, and its relatively small size and possible littoral ecology may corroborate proposed ecological filters4,5,9 that influenced the persistence of crown birds through the end-Cretaceous mass extinction.


Assuntos
Aves/classificação , Fósseis , Filogenia , Animais , Bélgica , Aves/anatomia & histologia , Feminino , Masculino , Crânio/anatomia & histologia
18.
Cell Prolif ; 53(4): e12796, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32202021

RESUMO

OBJECTIVES: Bone regeneration is a complex process modulated by multiple growth factors and hormones during long regeneration period; thus, designing biomaterials with the capacity to deliver multiple bioactive molecules and obtain sustained release has gained an increasing popularity in recent years. This study is aimed to evaluate the effect of a novel core-shell electrospun fibre loaded with dexamethasone (DEX) and bone morphogenetic protein-2 (BMP-2) on bone regeneration. MATERIALS AND METHODS: The core-shell electrospun fibres were fabricated by coaxial electrospinning technology, which were composed of poly-D, L-lactide (PLA) shell and poly (ethylene glycol) (PEG) core embedded with BMP-2 and DEX-loaded micelles. Morphology, hydrophilicity, gradation, release profile of BMP-2 and DEX, and cytological behaviour on bone marrow mesenchymal stem cells (BMSCs) were characterized. Furthermore, the effect on bone regeneration was evaluated via critical-sized calvarial defect model. RESULTS: The electrospun fibres were featured by the core-shell fibrous architecture and a suitable degradation rate. The sustained release of DEX and BMP-2 was up to 562 hours. The osteogenic gene expression and calcium deposition of BMSCs were significantly enhanced, indicating the osteoinduction capacity of electrospun fibres. This core-shell fibre could accelerate repair of calvarial defects in vivo via synergistic effect. CONCLUSIONS: This core-shell electrospun fibre loaded with DEX and BMP-2 can act synergistically to enhance bone regeneration, which stands as a strong potential candidate for repairing bone defects.


Assuntos
Anti-Inflamatórios/uso terapêutico , Proteína Morfogenética Óssea 2/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Dexametasona/uso terapêutico , Tecidos Suporte/química , Animais , Anti-Inflamatórios/administração & dosagem , Materiais Biocompatíveis/química , Proteína Morfogenética Óssea 2/administração & dosagem , Células Cultivadas , Dexametasona/administração & dosagem , Sinergismo Farmacológico , Feminino , Humanos , Osteogênese/efeitos dos fármacos , Ratos Sprague-Dawley , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/uso terapêutico , Crânio/efeitos dos fármacos , Crânio/lesões
19.
Acta Cir Bras ; 35(1): e202000102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32215463

RESUMO

PURPOSE: To evaluate the local effect of simvastatin (SVT) combined with deproteinized bovine bone (DBB) with hydroxyapatite/ß-tricalcium phosphate biphasic ceramics (HA/TCP) and with collagen sponge (CS) on bone repair in critical size defects (CSDs) in rat calvaria. METHODS: Forty-two 5-mm diameter CSDs were made bilaterally in the calvaria of 18 rats. The animals were allocated according to the type of biomaterial and associations used to fill the CSD. After 8 weeks, the animals were euthanized, and their calvaria were evaluated for repaired tissue composition using histologic and histometric analyses. RESULTS: In the histometric analysis, the use of SVT showed to increase bone formation in the CSDs when combined with all the bone substitutes tested in this study (p<0.05). Greater bone formation was observed in the groups with SVT compared to the groups without SVT. CONCLUSIONS: The use of SVT without the need for a vehicle and combined with a commercially available biomaterial may be a cheaper way to potentiate the formation of bone tissue without the need to produce new biomaterials. Therefore, SVT combined with DBB induced significantly greater new bone formation than did the other treatments.


Assuntos
Materiais Biocompatíveis/farmacologia , Substitutos Ósseos/farmacologia , Colágeno/farmacologia , Osteogênese/efeitos dos fármacos , Sinvastatina/farmacologia , Crânio/efeitos dos fármacos , Animais , Anticolesterolemiantes/farmacologia , Regeneração Óssea/efeitos dos fármacos , Transplante Ósseo/métodos , Bovinos , Modelos Animais de Doenças , Feminino , Ratos , Ratos Wistar , Crânio/cirurgia
20.
J Laryngol Otol ; 134(3): 272-274, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32079553

RESUMO

BACKGROUND: Implantation of bone-anchored hearing devices is performed to improve hearing in patients with chronic suppurative otitis media who cannot wear a conventional hearing aid. The surgical procedure can be safely performed in children aged over five years. CASE REPORT: A 15-year-old patient with bilateral chronic suppurative otitis media and conductive hearing loss underwent the procedure to implant a bone-anchored hearing device but was found to have skull thickness of less than 2.5 mm and the procedure was abandoned. A computed tomography scan of the skull was undertaken and a three-dimensional template was reconstructed to identify appropriate thickness of the skull to implant the abutment during a second procedure. CONCLUSION: Bone-anchored hearing devices can be implanted by prior imaging and using a template to identify the area of appropriate skull thickness to implant the abutment safely.


Assuntos
Auxiliares de Audição , Perda Auditiva Condutiva/cirurgia , Imageamento Tridimensional/métodos , Otite Média Supurativa/cirurgia , Implantação de Prótese/métodos , Adolescente , Condução Óssea , Perda Auditiva Condutiva/diagnóstico por imagem , Perda Auditiva Condutiva/etiologia , Humanos , Masculino , Otite Média Supurativa/complicações , Otite Média Supurativa/diagnóstico por imagem , Crânio/diagnóstico por imagem
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