RESUMO
OBJECTIVE: The purpose of the present study was to describe an OrBitoZygomatic (OBZ) surgical variant that implies the drilling of the orbital roof and lateral wall of the orbit without orbitotomy. METHODS: Design : cross-sectional study. Between January 2010 and December 2014, 18 patients with middle fossa lesions underwent the previously mentioned OBZ surgical variant. Gender, age, histopathological diagnosis, complications, and percentage of resection were registered. The detailed surgical technique is described. RESULTS: Of the 18 cases listed in the study, nine were males and nine females. Seventeen cases (94.5%) were diagnosed as primary tumoral lesions, one case (5.5%) presented with metastasis of a carcinoma, and an additional one had a fibrous dysplasia. Age ranged between 27 and 73 years. Early complications were developed in four cases, but all of these were completely resolved. None developed enophthalmos. CONCLUSION: The present study illustrates a novel surgical OBZ approach that allows for the performance of a simpler and faster procedure with fewer complications, and without increasing surgical time or cerebral manipulation, for reaching lesions of the middle fossa. Thorough knowledge of the anatomy and surgical technique is essential for successful completion of the procedure.
RESUMO
En el presente trabajo se compararon dos grupos de niños mexicanos en edades comprendidas entre los 8 a 10 años, el primer grupo con trastorno específico en el aprendizaje (TEA), tanto en la precisión de la lectura como en el cálculo, y el otro con buen desempeño académico (BDA), por medio de Escala Wechsler de Inteligencia para Niños, en su cuarta versión (WISC-IV) y la batería de Evaluación Neuropsicológica Infantil (ENI), (subpruebas de Habilidades Académicas, Memoria, Atención y Habilidades Metalingüísticas), ambos instrumentos normados en población mexicana. Se encontraron diferencias significativas (p≤ 0.05) entre los niños BDA y TEA, mediante la U de Mann Whitney, en todas las subpruebas evaluadas a excepción del Índice Velocidad de Procesamiento (WISC), Conteo, Codificación/Evocación y Atención Auditiva, además de Atención visual (ENI). Mediante el Análisis de Componentes Principales se identificaron 5 subgrupos: 2 en los niños con BDA y 3 en los TEA. Las diferencias significativas (p≤ 0.05)entre las variables cognitivas y académicas fueron determinadas mediante la prueba de Kruskal-Wallis. Fue posible observar que los subgrupos TEA obtuvieron puntajes más bajos que los subgrupos BDA tanto en habilidades académicas como en otras variables cognitivas,siendo el Índice de Memoria de Trabajo en la escala Wechsler y las Habilidades Metalingüísticas de la ENI las que mejor diferenciaron a los subgrupos TEA de los BDA.Conclusión: La aplicación de instrumentos normados en la población bajo estudio resulta de gran utilidad para identificar subtipos neuropsicológicos tantoen niños con BDA como con TEA.
In this work two groups of Mexican children aged between 8 to 10 years old were compared, the first group with specific learningdisorder (SLD),in both reading accuracy as in the calculation, and the other compared to good performance academic (GPA) by Wechsler Intelligence Scale for Children, in its fourth version (WISC-IV) and battery Child Neuropsychological Assessment (ENI), (subtests Academic Skills, Memory, Attention and Metalinguistic Skills), both instruments normed in Mexican population. Significant differences (p ≤ 0.05) were found among SLD and GPA children, by Mann Whitney U Test, they were found in all subtests evaluated except Processing Speed Rate (WISC), Counting, Coding / Evocation and Auditory Attention, also Visual Attention (ENI). By the Principal Component Analysis were identified five subgroups: 2 children with GPA and 3 in the SLD. Significant differences (p ≤ 0.05) between cognitive and academic variables were determined by the Kruskal-Wallis Test. It was possible to observe that the TEA subgroups scored lower than the BDA subgroups in academic abilities as well as in other cognitive variables, with the Working Memory Index on the Wechsler scale as the subtests that evaluate the ENI Metalinguistic Skills the variables that give the best discrimination between the TEA and the BDA subgroups.Conclusion: The application of normed instruments in the population under study is useful to identify neuropsychological subtypes in children with GPA as SLD.
Assuntos
Humanos , Masculino , Feminino , Criança , Linguística , Memória de Curto Prazo , Transtorno de Aprendizagem Específico/diagnóstico , Testes de Inteligência , México , Testes Neuropsicológicos , Análise de Componente PrincipalRESUMO
La información sobre el efecto que ejercen las variables medioambientales en el desarrollo de la atención y la memoria es limitada. En este estudio se analizó la relación entre el nivel educativo de los padres, el tipo de escuela y el sexo en el desarrollo de la atención y la memoria. Participaron 476 niños (5 a 16 años) de escuelas públicas (EPu) y privadas (EPr) divididos en dos grupos de edad (G1 = 5 a 8 años y G2 = 9 a 16 años). Se analizaron las 15 sub-pruebas de la Evaluación Neuropsicológica Infantil-ENI que evalúan atención y memoria. Se encontró un efecto significativo de la edad en todas las pruebas: a mayor edad, mejor ejecución. También hubo un efecto significativo del sexo y el tipo de escuela en algunas tareas, donde las niñas superan a los varones y los estudiantes de EPr superan a los de EPu. Hubo una interacción significativa entre el tipo de escuela y el sexo: las niñas de EPr muestran mayor ejecución que el resto de los grupos en algunas tareas de atención y memoria, especialmente las que implican información verbal. Además hubo una correlación significativa entre el nivel educativo de los padres y la ejecución (9 a 16 años). Los hijos de padres con mayor escolaridad muestran mayor ejecución que aquéllos con padres de menor escolaridad. Los resultados se discuten en términos del impacto que ejercen las variables medioambientales en el desarrollo neuropsicológico.
Information about the influence of environmental factors on the development of attention and memory is scarce. This study analyzed the relationship between parents' educational level, school type and sex on the development of attention and memory. Four hundred and seventy six children (age 5 to 16 years) of public (PuS) and private schools (PrS) participated. The sample was divided in two age groups: G1, age 5 to 8 years and G2, age 9 to 16 years. Attention and memory sub-tests from the Evaluación Neuropsicológica Infantil-ENI (Matute, Rosselli, Ardila and Ostrosky, 2007) were analyzed. There was a significant effect of age on all sub-tests scores where older children obtained higher scores. Also, there was a significant effect of sex and type of school in some tasks, where girls had higher performance than boys and, the students of PrS scored higher than students of PuS. An interaction between type of school and sex was also evident: PrS girls show edhigher performance than other groups in some tasks of attention and memory, especially those that imply verbal information processing. There was a significant correlation between the parents educational level and the performance in G2. Sons of parents with high educational level show better performance than sons of parents with low educational level. The results are discussed in terms of the environmental variables effect on the development of attention and memory.
