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1.
World Neurosurg ; 182: 29-34, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37944859

ABSTRACT

OBJECTIVE: The pterional approach is the workhorse of skull-base neurosurgery, which allows virtual access to any intracranial lesion around the circle of Willis. Preserving the frontotemporal branch of the facial nerve and conserving the temporal muscle's symmetry are fundamental objectives besides the access that can be obtained through this versatile neurosurgical technique. This manuscript proposes a subgaleal preinterfascial dissection, a novel hybrid technique that provides advantages of previously described temporal muscle dissection techniques while preserving the integrity of facial nerve branches and the unobstructed broad pterional region. We describe the subgaleal preinterfascial dissection as a safe and simple to technique to achieve preservation of the facial nerve frontal branches during anterolateral approaches. METHODS: Two cadaveric heads were skillfully dissected and studied to perform a proper subgaleal preinterfascial dissection on both sides of each cadaver. Afterward, the same technique was employed in 108 patients during a pterional approach for different neurosurgical diseases, with a postoperative follow-up of 6 months. RESULTS: None of the 108 patients presented postoperative frontotemporal branch palsy during postoperative follow-up. Likewise, no complications related to the proposed technique were present. CONCLUSIONS: The subgaleal preinterfascial dissection is a reliable, safe technique that may be employed during a pterional approach with an unobstructed surgical view and excellent cosmetic and functional results, preserving the frontotemporal branch of the facial nerve.


Subject(s)
Craniotomy , Facial Nerve , Humans , Facial Nerve/surgery , Facial Nerve/anatomy & histology , Craniotomy/methods , Head/surgery , Neurosurgical Procedures , Dissection , Cadaver
2.
Eur J Ophthalmol ; 34(2): NP5-NP7, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37644840

ABSTRACT

AIM: To report the case of a congenital restrictive strabismus with a contralateral enlargement of extraocular muscles. CASE: The clinical presentation, findings, and postoperative outcomes of a 4 years old boy referred to evaluation for presenting a left eye deviation since birth are detailed. CONCLUSION: A unilateral congenital restrictive strabismus (congenital hypotropia and esotropia) can be the cause of contralateral secondary enlarged extraocular muscle and It must be included in the differential diagnosis.


Subject(s)
Esotropia , Strabismus , Male , Humans , Child, Preschool , Strabismus/diagnosis , Strabismus/etiology , Strabismus/surgery , Oculomotor Muscles/diagnostic imaging , Oculomotor Muscles/surgery , Esotropia/diagnosis , Esotropia/etiology , Esotropia/surgery , Eye Movements , Eye
3.
Andes Pediatr ; 94(3): 333-338, 2023 Jun.
Article in English, Spanish | MEDLINE | ID: mdl-37909936

ABSTRACT

Retinopathy of prematurity (ROP) is one of the leading causes of preventable blindness worldwide. In Guatemala, a large number of premature infants are born in hospitals outside the capital city and present for evaluation at advanced stages of the disease. OBJECTIVE: To compare the cost of screening and timely treatment versus the total cost of comprehensive management of patients with visual impairment secondary to ROP. PATIENTS AND METHOD: The cost of the disease was calculated in patients who consulted due to low vision or blindness secondary to ROP. Direct costs were calculated based on those directly related to the management of the disease: medical care, rehabilitation, education, technical support, transportation, personal assistance, adaptations, and home equipment, compared with the costs of screening and timely treatment. RESULTS: The total cost of managing a child with severe visual impairment due to ROP is USD 214,666.37 and the cost of screening and timely treatment is USD 1,223.12, meaning an additional cost of USD 213,443.24 in patients who were not screened and treated on time. CONCLUSION: The cost of screening and timely treatment represents only 0.57% of the total cost of lifelong management of a child with severe visual impairment.


Subject(s)
Retinal Diseases , Child , Infant , Infant, Newborn , Humans , Blindness , Infant, Premature , Educational Status , Referral and Consultation
4.
Andes Pediatr ; 93(4): 488-495, 2022 Aug.
Article in Spanish | MEDLINE | ID: mdl-37906846

ABSTRACT

The functional visual outcome after cataract surgery is influenced by several factors such as the age at diagnosis and surgical treatment, as well as visual rehabilitation. OBJECTIVE: to characterize con genital cataract patients and assess the postoperative visual outcome in an ophthalmological care center in Guatemala. PATIENTS AND METHOD: A cross-sectional retrospective study. Clinical records of all congenital cataract patients who underwent congenital cataract surgery from 2014 and 2015 were reviewed. The following was recorded: postoperative visual acuity, age at diagnosis and surgery, sex, unilateral or bilateral involvement, etiology and morphology of the cataract, preoperative poor visual prognosis factors, and postoperative follow-up. RESULTS: Fifty-nine patients underwent pediatric ca taract surgery in this period, ages ranging from 1 month to 13 years (median 48 months), and 23 were congenital (38.98%). Fourteen were male, 16 bilateral, and the mean age at diagnosis and surgery was 7 and 12 months, respectively. Only 13 patients completed 3 years of follow-up visits. Visual acuity was recorded at 3 years after surgery, observing in 11 patients and 8 patients visual impairment or worse, respectively. Delayed consultations occurred in 82.6% of the patients (older than 3 months of age). CONCLUSION: In this series, the diagnosis of congenital cataract and its surgical treatment were delayed, observing a high rate of patients unable to complete follow-up visits. The visual outcome at 3 years after congenital cataract surgery was mostly visual impairment or worse.


Subject(s)
Cataract , Ophthalmology , Child , Humans , Male , Female , Lens Implantation, Intraocular/adverse effects , Retrospective Studies , Cross-Sectional Studies , Treatment Outcome , Cataract/complications , Cataract/diagnosis , Cataract/congenital , Vision Disorders/diagnosis , Vision Disorders/etiology
7.
Arq. bras. oftalmol ; 84(4): 339-344, July-Aug. 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1285288

ABSTRACT

ABSTRACT Purpose: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. Methods: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. Results: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. Conclusion: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.


RESUMO Objetivos: Avaliar a percepção do risco de exposição da Doença de Coronavírus 2019 (COVID-19), conhecimento sobre medidas de proteção pessoal entre os profissionais de oftalmologia latino-americanos e priorização de pacientes com Covid-19. Métodos: Pesquisa anônima voluntária autoadministrada (formulários do Google Drive) distribuída por mensagem de texto para profissionais de oftalmologia em 1º a 5 de maio de 2020. Resultados: Trezentos e setenta e um profissionais completaram a pesquisa (taxa de resposta de 45%), composta por 118 residentes (27,6%), 111 oftalmologistas (40,5%) e 142 subespecialistas (32,8%). 106 profissionais (32,6%) sentiram-se em alto risco de adquirir o COVID-19 no trabalho. 273 (69,1%) acreditavam que as diretrizes atuais não são suficientes para identificar os pacientes com COVID-19. 265 (59,5%) não tinham treinamento para usar os equipamentos de proteção individual (EPI) e, mesmo com seu uso correto, 341 (91,5%) ainda se sentiram em risco de adquirir COVID-19. 80% consideraram que a equipe de trabalho não tem conhecimento de protocolos nacionais para o atendimento aos pacientes com COVID-19. Apenas 9 dos profissionais (2%) consideraram mudar a profissão para minimizar o risco de contágio por COVID-19. Conclusão: Esta pesquisa mostra a escassez de pessoal e treinamento específico que os praticantes de oftalmologia na América Latina enfrentam em sua prática diária. Essas preocupações e ansiedade parecem ser as mesmas em todo o mundo com a pandemia de COVID- 19. É importante reforçar a confiança dos profissionais de oftalmologia nas diretrizes atuais de atendimento ao paciente com COVID-19 e também disponibilizar programas de treinamento sobre o uso de EPI e também itens de EPI disponíveis em todos os momentos para garantir a qualidade do atendimento e a disseminação mínima da doença.

8.
World Neurosurg ; 154: 91-92, 2021 10.
Article in English | MEDLINE | ID: mdl-34303002

ABSTRACT

Among the posterolateral corridors to the ventral foramen magnum (FM), the transcondylar fossa (supracondylar transjugular tubercle) approach (TCFA) is indicated for lesions lying anteriorly to the dentate ligament and above the jugular foramen and hypoglossal canal.1-13 It involves the drilling of the condylar fossa, namely the exocranial surface of the jugular tubercle. Despite the anatomic variability of the condyle and posterior condylar emissary vein,14,15 they are important landmarks for the TCFA. The extradural jugular tuberculectomy has no risk of iatrogenic mechanical instability compared with the transcondylar approach. This 2-dimensional operative video (Video 1) aims to show the key technical aspects of the TCFA through the case description of an anterolateral FM meningioma. A 35-year-old male patient with a left anterolateral FM meningioma underwent TCFA in a semisitting position. Drilling of the condylar fossa led to an extradural resection of the jugular tubercle. Posterior condylar emissary veins connecting the sigmoid sinus/jugular bulb with the vertebral venous plexus marked the lateral limit of the approach. Through a suprahypoglossal working corridor, the meningioma was debulked and dissected. Postoperative magnetic resonance imaging confirmed complete resection of the tumor, and the patient was discharged neurologically intact on the third postoperative day. TCFA is a valuable technical option for selected anterolateral FM meningiomas. The perfect knowledge and intraoperative use of specific anatomic landmarks are critical to safely perform the TCFA while maximizing the exposure of the surgical target and decreasing the risk of postoperative mechanical instability of the craniovertebral junction.


Subject(s)
Foramen Magnum/surgery , Meningeal Neoplasms/surgery , Meningioma/surgery , Neurosurgical Procedures/methods , Adult , Humans , Male
9.
Arq Bras Oftalmol ; 84(4): 339-344, 2021.
Article in English | MEDLINE | ID: mdl-34287515

ABSTRACT

PURPOSE: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. METHODS: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. RESULTS: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. CONCLUSION: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.


Subject(s)
COVID-19 , Ophthalmology , Humans , Latin America/epidemiology , Pandemics/prevention & control , Perception , SARS-CoV-2 , Surveys and Questionnaires
12.
Rev. bras. oftalmol ; 78(1): 11-14, jan.-fev. 2019. tab, graf
Article in English | LILACS | ID: biblio-990792

ABSTRACT

Abstract Introduction: Muscular transposition procedures are used when there is no ocular rotation in a particular direction due to alterations of the extraocular muscles such as paralysis, agenesis or congenital anomalies. The objective of this study is to characterize the patients treated with this procedure and determine the percentage of correction of the deviation angle obtained after surgery in the Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology Unit. "Dra. Ana María Illescas Putzeys", Hospital de ojos y oídos "Dr. Rodolfo Robles V. Methods: A retrospective, descriptive, observational study was conducted with review of records of patients operated on muscle transposition during the years 1999 to 2016. Results: Twenty-three rectus muscle transposition procedures were performed. Thirteen were male (56.5%). The mean age was 42 years. In our series, an average correction of 42 PD (82%) was obtained regardless of the type of paralysis or the surgical procedure performed. Conclusion: In selected cases of paralytic strabismus, the main approach may be only muscle transposition with augmentation (posterior intermuscular fixation suture), with good results, similar to those obtained with muscle transposition using adjuvants such as botulinum toxin treatment.


Resumo Introdução: Os procedimentos de transposição muscular são utilizados quando não há rotação ocular em nenhuma direção determinada devido a alterações dos músculos extraoculares, como paralisia, agenesia ou anomalias congênitas. O objetivo deste estudo é caracterizar os pacientes tratados com este procedimento e determinar a porcentagem de correção do ângulo de desvio obtida após a cirurgia na Unidade Pediátrica de Oftalmologia, Estrabismo e Neuro-Oftalmologia. "Dra. Ana María Illescas Putzeys", Hospital de ojos y oídos "Dr. Rodolfo Robles V. Métodos: Foi realizado um estudo retrospectivo, descritivo, observacional, com revisão dos registros de pacientes operados para transposição muscular nos anos de 1999 a 2016. Resultados: Foram realizados vinte e três procedimentos de transposição do músculo reto. Treze pacientes eram homens (56,5%). A idade média foi de 42 anos. Em nossa série, foi obtida uma correção média de 42 PD (82%), independente do tipo de paralisia ou do procedimento cirúrgico realizado. Conclusão: Em casos selecionados de estrabismo paralítico, a principal abordagem pode ser apenas a transposição muscular com aumento (sutura de fixação intermuscular posterior), com bons resultados semelhantes aos obtidos com a transposição muscular com a utilização de adjuvantes como o tratamento com toxina botulínica.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Strabismus/surgery , Oculomotor Muscles/surgery , Epidemiology, Descriptive , Retrospective Studies , Observational Study
13.
Arch. argent. pediatr ; 116(3): 216-219, jun. 2018. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1038423

ABSTRACT

El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.


Ocular trauma is a significant problem worldwide. The obj ective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.


Subject(s)
Child , Pediatrics , Cataract , Amblyopia , Eye Injuries/surgery
14.
Arch. Soc. Esp. Oftalmol ; 93(6): 300-302, jun. 2018. ilus
Article in Spanish | IBECS | ID: ibc-174898

ABSTRACT

CASOS CLÍNICOS: Describimos los casos de dos pacientes de sexo femenino con síndrome de Straatsma y tratamiento satisfactorio de ambliopía. DISCUSIÓN: La anisometropía y la mielinización de fibras nerviosas de la retina (MFNR) fue diferente en cada paciente; pero las dos alcanzaron agudeza visual con corrección de 0,20 (logMAR) en ambos ojos posterior al tratamiento de ambliopía con parche ocular. El pronóstico visual de ambliopía asociada a MFNR y anisometropía es peor que en ambliopía anisometrópica sin MFNR, siendo la primera refractaria a la terapia oclusiva. La rehabilitación visual debe intentarse a pesar de encerrar un mal pronóstico. Nuestros casos fueron tratados exitosamente con parche ocular


CLINICAL CASES: The cases are presented on 2 female patients with Straatsma syndrome, with satisfactory treatment of amblyopia. DISCUSSION: The level of anisometropia and myelination of retinal nerve fibres were different in these two patients. However, both achieved 0.20 (logMAR) visual acuity with correction in both eyes following amblyopia treatment with ocular patching. Visual prognosis of amblyopia associated with myelination of retinal nerve fibres and anisometropia is poorer than anisometropic amblyopia without myelination. It is well known that the former is refractory to occlusive therapy. Despite having a poor prognosis, visual rehabilitation should be attempted. The two cases presented were successfully treated with eye-patching


Subject(s)
Humans , Female , Child, Preschool , Child , Amblyopia/therapy , Fundus Oculi , Transdermal Patch , Anisometropia/therapy , Cerebrum/diagnostic imaging , Tomography, Emission-Computed/methods , Nerve Fibers/radiation effects , Esotropia/diagnosis
15.
Arch Argent Pediatr ; 116(3): 216-219, 2018 06 01.
Article in English, Spanish | MEDLINE | ID: mdl-29756712

ABSTRACT

Ocular trauma is a signifcant problem worldwide. The objective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.


El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.


Subject(s)
Cataract Extraction/methods , Cataract/etiology , Eye Injuries/complications , Wounds, Nonpenetrating/complications , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Visual Acuity
16.
Arch Soc Esp Oftalmol (Engl Ed) ; 93(6): 300-302, 2018 Jun.
Article in English, Spanish | MEDLINE | ID: mdl-29398227

ABSTRACT

CLINICAL CASES: The cases are presented on 2 female patients with Straatsma syndrome, with satisfactory treatment of amblyopia. DISCUSSION: The level of anisometropia and myelination of retinal nerve fibres were different in these two patients. However, both achieved 0.20 (logMAR) visual acuity with correction in both eyes following amblyopia treatment with ocular patching. Visual prognosis of amblyopia associated with myelination of retinal nerve fibres and anisometropia is poorer than anisometropic amblyopia without myelination. It is well known that the former is refractory to occlusive therapy. Despite having a poor prognosis, visual rehabilitation should be attempted. The two cases presented were successfully treated with eye-patching.


Subject(s)
Amblyopia/therapy , Anisometropia/therapy , Occlusive Dressings , Child , Child, Preschool , Female , Humans , Myelin Sheath/pathology , Myopia , Ophthalmoscopes , Optic Nerve/pathology , Syndrome
17.
Arch. argent. pediatr ; 116(1): 77-80, feb. 2018. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1038407

ABSTRACT

Introducción. La obstrucción congénita de la vía lagrimal es una patología común, de poca morbilidad, pero no exenta de complicaciones sin el diagnóstico y manejo correcto. Población y métodos. Estudio retrospectivo de 2005 a 2015 en pacientes que fueron sometidos a un procedimiento de sondaje. Se identificó edad al momento del procedimiento, género, lateralidad y presencia o ausencia de éxito con el procedimiento. Resultados. Se analizaron 137 ojos. La mediana de edad fue de 17 meses y la tasa de éxito total fue del 85,4%. Conclusión. La obstrucción congénita de la vía lagrimal con adecuado manejo conservador inicial tiene alta tasa de resolución espontánea y, en pacientes mayores de 12 meses, el sondaje tiene una alta tasa de éxito.


Introduction. The congenital nasolacrimal duct obstruction is a common pathology, with low morbidity, but not exempt of complications without the correct diagnosis and management. Methods. Retrospective study from 2005 to 2015 in patients who were submitted to a probing procedure. We identified age at procedure, gender, laterality and presence or absence of success with the procedure. Results. One hundred thirty-seven eyes were analyzed. The median age was 17 months and the total success rate was 85.4%. Conclusion. In congenital nasolacrimal duct obstruction there is a high rate of spontaneous resolution with the proper initial conservative management and, in patients older than 12 months, probing has a high rate of success.


Subject(s)
Humans , Infant , Child, Preschool , Surgical Procedures, Operative , Lacrimal Apparatus Diseases , Lacrimal Duct Obstruction
18.
Arch Argent Pediatr ; 116(1): 77-80, 2018 Feb 01.
Article in Spanish | MEDLINE | ID: mdl-29333844

ABSTRACT

INTRODUCTION: The congenital nasolacrimal duct obstruction is a common pathology, with low morbidity, but not exempt of complications without the correct diagnosis and management. METHODS: Retrospective study from 2005 to 2015 in patients who were submitted to a probing procedure. We identified age at procedure, gender, laterality and presence or absence of success with the procedure. RESULTS: One hundred thirty-seven eyes were analyzed. The median age was 17 months and the total success rate was 85.4%. CONCLUSION: In congenital nasolacrimal duct obstruction there is a high rate of spontaneous resolution with the proper initial conservative management and, in patients older than 12 months, probing has a high rate of success.


INTRODUCCIÓN: La obstrucción congénita de la vía lagrimal es una patología común, de poca morbilidad, pero no exenta de complicaciones sin el diagnóstico y manejo correcto. POBLACIÓN Y MÉTODOS: Estudio retrospectivo de 2005 a 2015 en pacientes que fueron sometidos a un procedimiento de sondaje. Se identificó edad al momento del procedimiento, género, lateralidad y presencia o ausencia de éxito con el procedimiento. RESULTADOS: Se analizaron 137 ojos. La mediana de edad fue de 17 meses y la tasa de éxito total fue del 85,4%. CONCLUSIÓN: La obstrucción congénita de la vía lagrimal con adecuado manejo conservador inicial tiene alta tasa de resolución espontánea y, en pacientes mayores de 12 meses, el sondaje tiene una alta tasa de éxito.


Subject(s)
Dacryocystorhinostomy , Lacrimal Duct Obstruction/congenital , Female , Humans , Infant , Male , Remission Induction , Retrospective Studies , Time Factors
19.
Oper Neurosurg (Hagerstown) ; 13(5): 622-626, 2017 10 01.
Article in English | MEDLINE | ID: mdl-28922882

ABSTRACT

BACKGROUND: The pterional approach (PA), together with its variants, is still one of the most common methods used by surgeons to reach the anterior and middle cranial base. A highly important technical detail during a PA is the preservation of the frontotemporal branch of the facial nerve, which can be achieved through an interfascial dissection. OBJECTIVE: To describe the anatomy of the interfascial vein (IFV), highlighting its recognition as a significant anatomic reference to perform an interfascial dissection (IFD). METHODS: Eight adult cadaveric heads, fixed with formaldehyde and injected with colored silicone, were studied. In 6 heads, an IFD was performed, simulating a PA. In the 2 remaining heads, the IFV was dissected. In addition, an IFD was performed in 10 patients, studying the IFV anatomy. RESULTS: In the 6 cadaveric heads in which the PA with an IFD was performed, and in the 10 patients who underwent a PA with an IFD, the IFV was found. If the interfascial space is divided into thirds, in all cases, the IFV was located within the middle third of the interfascial fat pad. On the 2 cadaveric heads in which the IFV was anatomically dissected, the IFV was also located within the middle third of the interfascial space. CONCLUSION: Recognizing the IFV in the interfascial space is of great help as an anatomic landmark to confirm that one is actually between both layers of the superficial temporal fascia.


Subject(s)
Craniotomy/methods , Facial Nerve/anatomy & histology , Facial Nerve/surgery , Microsurgery/methods , Adipose Tissue , Adult , Cadaver , Humans , Temporal Muscle/anatomy & histology
20.
Rev. Col. Méd. Cir. Guatem ; 156(1): 39-42, 2017 jul. tab
Article in Spanish | LILACS | ID: biblio-981651

ABSTRACT

Objetivo: La retinopatía del prematuro es una alteración proliferativa de los vasos sanguíneos de la retina. En Guatemala son pocos los datos que se tienen de la enfermedad; por lo que se realizó un estudio para caracterizar y determinar la prevalencia de retinopatía del prematuro en el Hospital Nacional de Chimaltenango. Material y métodos: Se realizó un estudio prospectivo, descriptivo, observacional; durante los meses de octubre de 2015 a septiembre de 2016 en el Hospital Nacional de Chimaltenango. Se examinaron 76 neonatos prematuros. Se incluyeron pacientes con peso al nacer 2000 gramos y/o edad gestacional 37 semanas. Resultados: 17 (22,36%) pacientes con retinopatía del prematuro, de los cuales 3 (3,95%) recibieron tratamiento. La edad gestacional promedio de los pacientes que desarrollaron enfermedad plus fue de 35,33 semanas (DS 1,15); con un peso promedio de 1861,67 gramos (DS 734,76). De los 76 neonatos evaluados 48,00% estaban fuera de lo recomendado para el tamizaje en Latinoamérica y de éstos el 18,00% presentaron RP, incluyendo uno de los casos que ameritó tratamiento. Conclusiones: La prevalencia es similar a otros estudios reportados en países en vías de desarrollo. Sin embargo, este estudio mostró la importancia de contar con datos propios de cada Unidad de Cuidados Intensivos Neonatales; ya que se encontraron pacientes fuera de los parámetros recomendados para el tamizaje en Latinoamérica.(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Retinopathy of Prematurity/epidemiology , Infant, Low Birth Weight , Infant, Small for Gestational Age , Prospective Studies , Guatemala/epidemiology
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