A comparative morphologic and morphometric study about geniculate ganglion development in man and in rat.

CONCLUSIONS: Human-rat geniculate ganglion (GG) have multiple origins: (1) An initial proximity (20 µm) to the endocranial foramen of the IAM, suggests neural crest induction; and (2) The influence of epibranchial placodes: the tensor tympani muscle (TTM) and the otic apical coil. OBJECTIVES: This study was undertaken to determine the comparative development of human-rat GG. MATERIALS AND METHODS: A light microscopic study of the GG in human material obtained from spontaneous abortions at 9, 13, 14, 17, 18, and 30 weeks, and one neonate was done. This study examined Webster rat embryos and a post-natal series. Specimens were fixed in Bouin fluid, embedded in paraffin, cut, and stained with H&E. The histomorphometric data were obtained with image analysis software. RESULTS: The human fetus of 9 weeks presents two neuronal groups in the VII nerve: one near (20 µm) the IAM endocranial foramen, foraminal, and the other, tympanic. Neonate GG is located between the TTM and the cochlear apex (inwards). In the 16 day old rat embryo GG is placed within a canal containing the stapedial artery. In the adult rat the GG and the stapedial artery are placed within the IAM.

Antioxidant Treatments Recover the Alteration of Auditory-Evoked Potentials and Reduce Morphological Damage in the Inferior Colliculus after Perinatal Asphyxia in Rat.

Maturation of the auditory pathway is dependent on the central nervous system myelination and it can be affected by pathologies such as neonatal hypoxic ischemic (HI) encephalopathy. Our aim was to evaluate the functional integrity of the auditory pathway and to visualize, by histological and cellular methods, the damage to the brainstem using a neonatal rat model of HI brain injury. To carry out this morphofunctional evaluation, we studied the effects of the administration of the antioxidants nicotine, melatonin, resveratrol and docosahexaenoic acid after hypoxia-ischemia on the inferior colliculus and the auditory pathway. We found that the integrity of the auditory pathway in the brainstem was altered as a consequence of the HI insult. Thus, the auditory brainstem response (ABR) showed increased I-V and III-V wave latencies. At a histological level, HI altered the morphology of the inferior colliculus neurons, astrocytes and oligodendricytes, and at a molecular level, the mitochondria membrane potential and integrity was altered during the first hours after the HI and reactive oxygen species (ROS) activity is increased 12 h after the injury in the brainstem. Following antioxidant treatment, ABR interpeak latency intervals were restored and the body and brain weight was recovered as well as the morphology of the inferior colliculus that was similar to the control group. Our results support the hypothesis that antioxidant treatments have a protective effect on the functional changes of the auditory pathway and on the morphological damage which occurs after HI insult.

Effect of neonatal asphyxia on the impairment of the auditory pathway by recording auditory brainstem responses in newborn piglets: a new experimentation model to study the perinatal hypoxic-ischemic damage on the auditory system.

INTRODUCTION: Hypoxia-ischemia (HI) is a major perinatal problem that results in severe damage to the brain impairing the normal development of the auditory system. The purpose of the present study is to study the effect of perinatal asphyxia on the auditory pathway by recording auditory brain responses in a novel animal experimentation model in newborn piglets. METHOD: Hypoxia-ischemia was induced to 1.3 day-old piglets by clamping 30 minutes both carotid arteries by vascular occluders and lowering the fraction of inspired oxygen. We compared the Auditory Brain Responses (ABRs) of newborn piglets exposed to acute hypoxia/ischemia (n = 6) and a control group with no such exposure (n = 10). ABRs were recorded for both ears before the start of the experiment (baseline), after 30 minutes of HI injury, and every 30 minutes during 6 h after the HI injury. RESULTS: Auditory brain responses were altered during the hypoxic-ischemic insult but recovered 30-60 minutes later. Hypoxia/ischemia seemed to induce auditory functional damage by increasing I-V latencies and decreasing wave I, III and V amplitudes, although differences were not significant. CONCLUSION: The described experimental model of hypoxia-ischemia in newborn piglets may be useful for studying the effect of perinatal asphyxia on the impairment of the auditory pathway.

Neuroprotective effect of melatonin: a novel therapy against perinatal hypoxia-ischemia.

One of the most common causes of mortality and morbidity in children is perinatal hypoxia-ischemia (HI). In spite of the advances in neonatology, its incidence is not diminishing, generating a pediatric population that will require an extended amount of chronic care throughout their lifetime. For this reason, new and more effective neuroprotective strategies are urgently required, in order to minimize as much as possible the neurological consequences of this encephalopathy. In this sense, interest has grown in the neuroprotective possibilities of melatonin, as this hormone may help to maintain cell survival through the modulation of a wide range of physiological functions. Although some of the mechanisms by which melatonin is neuroprotective after neonatal asphyxia remain a subject of investigation, this review tries to summarize some of the most recent advances related with its use as a therapeutic drug against perinatal hypoxic-ischemic brain injury, supporting the high interest in this indoleamine as a future feasible strategy for cerebral asphyctic events.

Principles of cranial base ossification in humans and rats.

CONCLUSIONS: 1. The principle of bilateral symmetry depends on the chordal cartilage that is the keystone in cranial base ossification in rats and humans, due to its anatomical situation and for the production of the chordin protein that regulates the bone morphogenetic protein BMP-7. 2. In humans and in rats, foramen lacerum closure follows a line of intramembranous ossification that depends on BMP-7, regulated by the first branchial pouch. 3. The cranial base ossification patterns and centres are similar in humans and in rats, except in the otic capsule, palate and the lateral pterygoid plate. 4. The neural crest may induce cranial ossification through the cranial nerves. OBJECTIVES: To study the patterns of cranial base ossification in humans and in rats, considering the chordal cartilage, and the otic, nasal and orbit capsules, as well as the participation of the branchial arches and pouches. METHODS: This was a light microscopy study of human fetal specimens obtained from spontaneous abortions with the following crown-rump-lengths (crl) 45, 74, 90, 134, 145 and 270 mm, and a 1-day-old neonate (360 mm crl), who had died of sudden death syndrome. We also examined Webster albino rat embryos of 16, 18 and 20 days of gestation and a postnatal series of rats 8 h and 1, 3, 4, 6, 7, 10 and 13 days old, as well as adult animals. RESULTS: In the 45 mm human fetus, the chordal cartilage with the nasal, otic and orbit capsules initiates cranial base ossification. Foramen lacerum closure begins in the 16-day-old rat embryo, following a line of membranous ossification between the external pterygoid process and the lateral alisphenoidal wing at ovalis foramen level. This is not a timing symmetrical process, which may persist until the 10th postnatal day in the rat. In the human fetus of 74 mm, the foramen lacerum space is closed by a membranous fusion ossification between the chordal cartilage and otic capsule, finishing at the 270 mm specimen. Endochondral ossification of the human otic capsule first appeared in the 145 mm (18 weeks) fetal specimen with four ossifying centres. The rat otic cartilaginous capsule showed rapid endochondral ossification, in the third and fourth postnatal day specimens.

[Analysis of the anthropometric, epidemiological, and clinical parameters in patients with snoring and obstructive sleep apnoea]. / Análisis de los parámetros antropométricos, epidemiológicos y clínicos en los pacientes con roncopatía y síndrome obstructivo de apnea-hipopnea del sueño.

OBJECTIVES: The existence of snoring, apnoeas and diurnal somnolence constitutes obstructive sleep apnoea (OSA), a disease of high prevalence that can cause serious complications. We have made a descriptive study of the epidemiological and clinical characteristics of patients with suspected OSA, with the main target of knowing the value of some of these characteristics in the evaluation of these patients. PATIENTS AND METHOD: We have had access to a retrospective sample of 433 patients (361 men and 72 women) with an average age of 47 (11.1) years (range, 18-75), referred due to suspected OSA. The variables and examinations studied were: age, gender, electrocardiogram, spirometry, blood pressure, smoking, neck perimeter, body mass index (BMI), daytime drowsiness (Epworth Sleepiness Scale), nasal and pharyngeal examination, Müller's manoeuvre, and Respiratory Disturbance Index (RDI). RESULTS: Patients with OSA included in this study are older and more obese, and they have a greater neck perimeter. In addition, they present greater daytime sleepiness and a greater frequency of pharyngeal collapse in Müller's mano-euvre than mere snorers. Clinical and epidemiological parameters were seen to correlate better with the existence of OSA in clearly obese individuals (BMI >30) than in individuals with normal BMI scores (<24) or even overweight (25-29). As far as age was concerned, the clinical and epidemiological parameters showed more statistically significant differences between patients with OSA and simple snorers among the youngest individuals in our sample (<43 years of age). CONCLUSIONS: Physical examination and the clinical and epidemiological data are useful to complete the diagnostic assessment of these patients.

Análisis de los parámetros antropométricos, epidemiológicos y clínicos en los pacientes con roncopatía y síndrome obstructivo de apnea-hipopnea del sueño / Analysis of the anthropometric, epidemiological, and clinical parameters in patients with snoring and obstructive sleep apnoea

Objetivos: Los ronquidos, las apneas y la somnolencia diurna constituyen el síndrome de apnea-hipopnea obstructiva del sueño (SAHOS), enfermedad de elevada prevalencia que puede causar graves complicaciones. Hemos realizado un estudio descriptivo de las características epidemiológicas y clínicas de los pacientes con sospecha de SAHOS, con el objetivo principal de conocer el valor de algunas de esas características en la evaluación de los pacientes. Pacientes y método: Hemos dispuesto de una muestra retrospectiva de 433 pacientes, 361 varones y 72 mujeres, con una media ± desviación estándar de edad de 47 ± 11,1 (intervalo, 18-75) años, remitidos por sospecha de SAHOS. Las variables y exploraciones estudiadas fueron edad, sexo, electrocardiograma, espirometría, presión arterial, tabaquismo, perímetro del cuello, índice de masa corporal (IMC), test de somnolencia diurna (Epworth Sleepiness Scale), exploración nasal y faríngea, maniobra de Müller e índice de apnea-hipopnea (IAH). Resultados: Los pacientes con SAHOS incluidos en este estudio tienen más edad, son más obesos y tienen mayor perímetro cervical. Además, presentan más somnolencia diurna y mayor frecuencia de colapso faríngeo en la maniobra de Müller que los roncadores simples. Por otra parte, se observó que los parámetros clínicos y epidemiológicos se correlacionan mejor con el diagnóstico de SAHOS en los individuos con obesidad franca (IMC > 30) que en los individuos con IMC normal (< 24) e incluso con sobrepeso (IMC 25-29). En cuanto a la edad, los parámetros clínicos y epidemiológicos mostraron más diferencias estadísticamente significativas entre los pacientes con SAHOS y los roncadores simples en los individuos más jóvenes de nuestra muestra (menores de 43 años). Conclusiones: La exploración física y los datos epidemiológicos y clínicos son útiles para completar la evaluación diagnóstica de estos pacientes

Objectives: The existence of snoring, apnoeas and diurnal somnolence constitutes obstructive sleep apnoea (OSA), a disease of high prevalence that can cause serious complications. We have made a descriptive study of the epidemiological and clinical characteristics of patients with suspected OSA, with the main target of knowing the value of some of these characteristics in the evaluation of these patients. Patients and method: We have had access to a retrospective sample of 433 patients (361 men and 72 women) with an average age of 47 (11.1) years (range, 18-75), referred due to suspected OSA. The variables and examinations studied were: age, gender, electrocardiogram, spirometry, blood pressure, smoking, neck perimeter, body mass index (BMI), daytime drowsiness (Epworth Sleepiness Scale), nasal and pharyngeal examination, Müller’s manoeuvre, and Respiratory Disturbance Index (RDI). Results: Patients with OSA included in this study are older and more obese, and they have a greater neck perimeter. In addition, they present greater daytime sleepiness and a greater frequency of pharyngeal collapse in Müller’s mano-euvre than mere snorers. Clinical and epidemiological parameters were seen to correlate better with the existence of OSA in clearly obese individuals (BMI >30) than in individuals with normal BMI scores (<24) or even overweight (25-29). As far as age was concerned, the clinical and epidemiological parameters showed more statistically significant differences between patients with OSA and simple snorers among the youngest individuals in our sample (<43 years of age). Conclusions: Physical examination and the clinical and epidemiological data are useful to complete the diagnostic assessment of these patients

The predictive value of clinical and epidemiological parameters in the identification of patients with obstructive sleep apnoea (OSA): a clinical prediction algorithm in the evaluation of OSA.

We sought to analyze the predictive value of anthropometric, clinical and epidemiological parameters in the identification of patients with suspected OSA, and their relationship with apnoea/hypopnoea respiratory events during sleep. We studied retrospectively 433 patients with OSA, 361 men (83.37%) and 72 women (16.63%), with an average age of +/-47, standard deviation +/-11.10 years (range 18-75 years). The study variables for all of the patients were age, sex, spirometry, neck circumference, body mass index (BMI), Epworth sleepiness scale, nasal examination, pharyngeal examination, collapsibility of the pharynx (Müller Manoeuvre), and apnoea-hypopnoea index (AHI). Age, neck circumference, BMI, Epworth sleepiness scale, pharyngeal examination and pharyngeal collapse were the significant variables. Of the patients, 78% were correctly classified, with a sensitivity of 74.6% and a specificity of 66.3%. We found a direct relationship between the variables analysed and AHI. Based on these results, we obtained the following algorithm to calculate the prediction of AHI for a new patient: AHI = -12.04 + 0.36 neck circumference +2.2286 pharyngeal collapses (MM) + 0.1761 Epworth + 0.0017 BMI x age + 1.1949 pharyngeal examinations. The ratio variance in the number of respiratory events explained by the model was 33% (r2 = 0.33). The variables given in the algorithm are the best ones for predicting the number of respiratory events during sleep in patients studied for suspected OSA. The algorithm proposed may be a good screening method to the identification of patients with OSA.

Aneurisma del cayado de la aorta como causa de paralisis de la cuerda vocal / No disponible

Describimos el caso clínico de una paciente de 66 añosde edad, que acudió a nuestra consulta por presentar unepisodio de disfonía de 2 meses de evolución. En lalaringoscopia se observaba la existencia de una parálisisde la cuerda vocal izquierda. En la T.A.C. torácica realizadase objetivaba la presencia de un aneurisma delcayado de la aorta, una causa poco frecuente de parálisisdel nervio laríngeo recurrente. En este artículo hacemosuna revisión de la etiología, la sintomatología, eldiagnóstico y el tratamiento de este tipo de parálisis delas cuerdas vocales

We present a case of a 66 years old male patient whopresented a 2 months history of dysphonia. Laryngoscopyshowed a left vocal cord palsy. Toracic ComputedTomography indicated the existence of an aortic archaneurysm, an unusual cause of the left recurrent laryngealnerve palsy. In this article, we review ethiologic factors,symptomathology, diagnostic procedures and treatmentof this kind of vocal cords palsies

Quiste del primer arco branquial y fístula con tricofoliculoma. Presentación de un caso clínico / No disponible

Describimos el caso clínico de una paciente de 18 años de edad, que acudió a nuestra consulta por presentar un episodio febril con odinofagia, de 10 días de evolución. El paciente presentaba una fístula preauricular derecha y un tracto fibroso que progresaba en sentido caudal y anterior hacia el cuello. La inspección de la cavidad oral demostraba la existencia de una protusión amigdalar derecha. En la T.A.C. y R.M.N. realizadas se objetivaba una tumoración quística periamigdalar que se comunicaba mediante un trayecto fistuloso con un orificio preauricular. El informe anatomo-patológico de la pieza quirúrgica nos informó de la existencia de un Quiste Branquial y de un trayecto fistuloso afectado por la existencia de un Tricofoliculoma, una tumoración benigna cervico-facial de escasa incidencia en lo referente a su localización en el primer arco branquial

We report a case of a 18 years old male patient who presented a ten days history of fever and odinophagia.The patient presented a preauricular fistule and a fibroustract in the right side. Oral cavity inspection showed atonsil displacement.Computed Tomography and Magnetic Resonance images indicated the existence of a first branchial arch cyst. The histophatologhical study confirmed the presence of a Branchial Cyst and a Trichofolliculoma in the fistule, an unusual benign tumour originated in the first branchialarch

Fibroma osificante de seno etmoidal / Ethmoidal sinus ossifying fibroma

En este artículo describimos el caso clínico de una paciente de 12 años de edad, que acudió a nuestra consulta por presentar exoftalmos unilateral izquierdo de 1 año de evolución. Las T.A.C. y la R.M.N. realizadas demostraban la existencia de un tumor de Seno Etmoidal posterior izquierdo. El informe anatomopatológico de la pieza quirúrgica nos informó de la existencia de un Fibroma Osificante, un tumor osteofibroso de escasa incidencia en su localización en los senos paranasales (AU)

Tumor desmoide del espacio retroestiloideo / Desmoid tumor of the retrostiloid space

En este artículo describimos el caso clínico de un paciente 74 años de edad, que acudió a nuestra consulta por presentar una tumoración cervical derecha de 6 meses de evolución. La T.A.C., R.M.N., y arteriografía realizadas informaban de la existencia de un tumor no capsulado, avascular, que se extendía por los espacios carotideo, retrofaríngeo y prevertebral. El informe anatomopatológico de la pieza quirúrgica nos informó de la existencia de un tumor desmoide: una fibromatosis profunda de tipo extrabdominal de muy escasa incidencia en su localización en el cuello; y que aunque carece de capacidad maligna o metastatizante, tiene un carácter localmente invasivo y con tendencia a la recurrencia (AU)