Association of the superior semicircular canal and tegmen tympani dehiscences and its relationship with the pneumatisation of the temporal bone.

PURPOSE: To analyse the degree of pneumatisation of the temporal bone when there is an association between dehiscence of the superior semicircular canal and dehiscence of the tegmen tympani. MATERIALS AND METHODS: We analysed a retrospective CT study of 124 selected cases. A single inclusion criterion was applied: the presence of a dehiscence of the tegmen tympani. On the other hand, the degree of temporal pneumatisation was assessed by axial and coronal planes, and has been divided into the following grades O, I, II and III, according to the status and relationship of the mastoid, the bony labyrinth, the petrous segment of the carotid canal and sigmoid sinus. RESULTS: Of the 124 cases studied, 35 (28.2%) presented both dehiscences. In 26 of the 35 (47.3%), grade II pneumatisation, 4 (14,8%), grade I, and 5 (11,9%) grade III was observed, with a statistically significant relationship (p < 0.001). On the other hand, we did not find a significant relationship when relating both dehiscences in any age or sex group. However, when relating the degree of pneumatisation to sex, among those with grade III pneumatisation, the proportion of men (52.4%) was significantly higher than that of women (47.6%) (p = 0.017). CONCLUSION: We have detected a statistically significant relationship between the coexistence of grade II pneumatisation and the presence of both dehiscences in the temporal bone.

[Laparoscopic cystoprostatovesiculectomy and ureterosigmoidostomy. Experimental surgical model]. / Cistoprostatovesiculectomia y ureterosigmoidostomía laparoscópicas. Modelo quirúrgico experimental.

The authors have performed 26 experimental laparoscopic cystoprostatovesiculectomies in pigs, 17 of which were followed by ureterosigmoidostomies, also laparoscopically. Using a 10 mm trocar at the umbilical level (optics), another 10 mm at the hypogastric level (pliers and titanium staple applicator), a third 5 mm in left iliac fossa (pliers) and another 5 mm in right iliac fossa (electric shears), cystectomy is performed with a routine technique: stapling and section of deferents, umbilical arteries, vesical lateral pedicles and prostate-seminal pedicles. A double ligature precedes the section of the urethra in the pelvian fundus. A plier passed within an Amplatz jacket (previously introduced through the anus) assists the laparoscopic ureterosigmoidostomy "in elephant trunk" which is performed by sero-muscle suture using 3-zero reabsorbable single-strand material. Overcoming the anatomical differences existing with humans, the illustrated experimental model confirms the possibility of performing this type of procedures in human beings, which would considerably curtail the morbidity associated with this type of surgery.

[Laparoscopic nephrectomy: experimental surgical model]. / Nefrectomía laparoscópica: modelo quirúrgico experimental.

Presentation of 39 experimental laparoscopic nephrectomies carried out in pig. With the animals under general anaesthesia and using 4 laparoscopic trocars the authors dissected the kidney and clipped separately the ureter, renal arteria and vein. Once these elements were sectioned, they placed the kidney inside a small plastic pouch (introduced within the peritoneal cavity through one of the trocars) and after extracting its neck through the hole in the abdominal wall created by the 11 mm trócar, they performed different intra-abdominal fragmentation procedures on the extirpated kidney. Following fragmentation testing with a 7 and 10 mm punch, resectoscopic electric loop, arthroscopic cutter and ultrasonic tissue aspiration procedures, they concluded stating that an increase in the power of these last equipment would convert them into an ideal procedure for laparoscopic exeresis of any intra-abdominal organ.