Anatomic relationship of the optic nerve channel with sphenoidal sinus: a computed tomography study

The sphenoid sinus, out of the facial sinuses, is certainly the most neglected as far as diagnosis is concerned. The surgical approach requires a detailed anatomical knowledge, considering the serious complications resulting from injuries of vital structures adjacent to this region. AIM: The objective of our research is to evaluate the anatomic relationship of the optic nerve with the sphenoid sinus making use of the computed tomography. STUDY DESIGN: Serie report. MATERIAL AND METHOD: The authors present a retrospective analysis of 203 computed tomographies of facial sinus belonging to individuals of both sexes aged 14 and over. The examinations were evaluated observing the course of the optic nerve, obtained through the degree of its projection on the wall of the sphenoid sinus. The method used was the modified classification of Delano, evaluating the absence of bone reduction (dehiscence) of the optic nerve in the sphenoid sinus. We analysed the degree of pneumatization of the sphenoid sinus, using Hammer's classification adapted by Guerrero, apart from the pneumatization of the anterior clinoidal process and pterigoid and the presence of the Onodi cell. RESULTS: Most of the patients (78.96%) presented their optic nerve with a Type 1 course. Type 2 was observed in 16.83% of the patients, Type 3 in 3.47% and Type 4 in 0.74%. The presence of dehiscence of the optic nerve in the wall of the sphenoid sinus was evidenced in 21.29% of the cases. Related to pneumatization, we noticed that the pre-selar type was observed in 6.44%, the post-selar type appeared in 39.11%, the selar type appeared in 54.45%, and the apneumatized type was not observed in any of the cases. The pneumatization of the anterior clinoidal process was verified in 10.64% of the cases, while the pterigoid process was apparent in 21.29% of the cases. The Onodi cell (sphenoetmoidal) was found in 7.92% of the cases. CONCLUSION: The presence of dehiscence of the optic nerve is related with the degree of pneumatization of the anterior clinoid and the pterigoid processes, the presence of the Onodi cell (sphenoetmoidal) and Course Types 2, 3 and 4 considered the relationship between the optic nerve and the sphenoid sinus.O seio esfenoidal entre os seios da face é certamente o mais negligenciado quanto ao diagnóstico. A abordagem cirúrgica requer conhecimento anatômico detalhado, levando-se em conta as graves complicações decorrentes de lesões de estruturas vitais adjacentes a esta região. OBJETIVO: O objetivo do nosso estudo é avaliar a relação anatômica do canal do nervo óptico com o seio esfenoidal utilizando a tomografia computadorizada. FORMA DE ESTUDO: Análise de série. MATERIAL E MÉTODO: Os autores apresentam a análise retrospectiva de 202 tomografias computadorizadas de seios da face de indivíduos de ambos os sexos com idade igual ou superior a 14 anos. Os exames foram avaliados observando o trajeto do canal do nervo óptico obtido pelo grau de projeção na parede do seio esfenoidal. Foi utilizada a classificação modificada de Delano. Foi avaliada a ausência de atenuação óssea (deiscência) do canal do nervo óptico no seio esfenoidal. O grau de pneumatização do seio esfenoidal foi analisado, sendo empregado a classificação de Hammer's adaptada por Guerrero, além da pneumatização do processo clinóide anterior e pterigóide e a presença da célula de Onodi. RESULTADOS: A maioria dos pacientes (78.96%) apresentou o canal do nervo óptico com trajeto do tipo 1, o tipo 2 foi observado em 16.83%, o tipo 3 em 3.47% e o tipo 4 em 0.74%. A presença de deiscência do nervo óptico na parede do seio esfenoidal foi evidenciada em 21.29% dos casos. Em relação à pneumatização, notamos que o tipo pré-selar foi observado em 6.44%, o tipo selar em 39.11%, o tipo selar em 54.45%, e o tipo apneumatizado não foi observado em nossos casos. A pneumatização do processo clinóide anterior foi constatado em 10.64% enquanto do processo pterigóide em 21.29% dos casos, a célula de Onodi foi verificada em 7.92% dos casos. CONCLUSÃO: A presença de deiscência do canal do nervo óptico está relacionado com o grau de pneumatização dos processos clinóide anterior e processo pterigóide, a presença de célula de Onodi e os tipos de trajeto 2, 3 e 4 da relação do nervo óptico com o seio esfenoidal.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Otorrinolaringologia e Distúrbios da Comunicação HumanaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Diagnóstico por ImagemUNIFESP, EPM, Depto. de Otorrinolaringologia e Distúrbios da Comunicação HumanaUNIFESP, EPM, Depto. de Diagnóstico por ImagemSciEL

Computed tomography in the diagnosis of fenestral otosclerosis

AIM: To identify the main tomographic findings of fenestral otosclerosis and to evaluate the utility of the high resolution computed tomography (HRCT) as a diagnostic method of this osteodystrophy. STUDY DESIGN: A prospective and multicentric study using computed tomography (CT) of the temporal bone. MATERIAL AND METHOD: 54 patients with a clinical and surgical diagnosis of otosclerosis. A tomographic analysis has been performed to evaluate the sensitivity of CT scans in diagnosing fenestral otosclerosis, verifying the sites of predilection for otosclerotic lesions, the bilateralism and symmetry of the disease. In this study, 22 patients undergone CT scans of temporal bones have been included in order to investigate other otologic diseases and have constituted the control group. RESULTS: The CT scan was positive in 87% of the patients (77% of the ears). The tomographic findings were mostly bilateral (78,7%) and the fenestral focus more prevalent was the anterior focus to the oval window. CONCLUSIONS: The CT scan has shown a high index of positivity and the anterior focus to the oval window has been the most prevalent in this population, and it could be considered the highly suggestive tomographic finding for otosclerosis.OBJETIVO: Identificar os principais achados tomográficos da otosclerose fenestral e avaliar a utilidade da tomografia computadorizada de alta resolução (TCAR), como método diagnóstico dessa osteodistrofia. FORMA DE ESTUDO: Estudo prospectivo multicêntrico com tomografia computadorizada (TC) de ossos temporais. MATERIAL E MÉTODO: 54 pacientes com diagnóstico clínico e cirúrgico de otosclerose. Foi realizada uma análise tomográfica, em que foi avaliada a sensibilidade da TC no diagnóstico radiológico da otosclerose fenestral, sendo verificados os principais sítios de lesões dessa doença, como também a sua bilateralidade e simetria. Foram incluídos neste estudo 22 pacientes submetidos à TC de ossos temporais para investigação de outras afecções otológicas, que constituíram o grupo controle. RESULTADOS: A TC foi positiva em 87% dos pacientes (77% das orelhas). Os achados tomográficos foram bilaterais na maioria dos casos (78,7%), e o foco fenestral mais prevalente foi o foco anterior à janela oval (FAJO). CONCLUSÕES: A TC apresentou um alto índice de positividade e o FAJO foi o foco mais prevalente nessa população, podendo ser considerado um achado tomográfico altamente sugestivo de otosclerose.Hospital CemaUNIFESP-EPM Disciplina de OtorrinolaringologiaUNIFESP-EPM Departamento de Diagnóstico por ImagemUNIFESP, EPM, Disciplina de OtorrinolaringologiaUNIFESP, EPM Depto. de Diagnóstico por ImagemSciEL

Computed tomography in the diagnosis of retrofenestral otosclerosis

AIM: To identify the main tomographic findings of retrofenestral otosclerosis. METHODS: A prospective and multicentric study using computed tomography (CT) of the temporal bone in 54 patients with a clinical and surgical diagnosis of otosclerosis. A tomographic analysis has been performed to evaluate the utility of CT scans in diagnosing retrofenestral otosclerosis, verifying the sites of predilection for otosclerotic lesions. In this study, 22 patients undergone CT scans of temporal bones have been included in order to investigate other otologic diseases and have constituted the control group. RESULTS: The tomographic findings were mostly bilateral and the retrofenestral focus more prevalent was the pericochlear focus. CONCLUSIONS: The CT scan was useful in the identification of the retrofenestral focuses. The evidence of this focuses and the presence of the endosteal involvement of the cochlea can suggest a higher activity of the disease.OBJETIVO: Identificar os principais achados tomográficos da otosclerose retrofenestral. MÉTODO: Estudo prospectivo multicêntrico com tomografia computadorizada (TC) de ossos temporais em 54 pacientes com diagnóstico clínico e cirúrgico de otosclerose. Foi realizada uma análise tomográfica, em que foi avaliada a utilidade da TC no diagnóstico radiológico da otosclerose retrofenestral, sendo verificados os principais sítios de lesões dessa doença. Foram incluídos neste estudo 22 pacientes submetidos à TC de ossos temporais para investigação de outras afecções otológicas, que constituíram o grupo controle. RESULTADOS: Os achados tomográficos foram bilaterais na maioria dos casos e o foco retrofenestral mais prevalente foi o foco pericoclear. CONCLUSÕES: A TC monstrou-se útil na identificação dos focos retrofenestrais. A evidência tomográfica desses focos juntamente com o envolvimento endosteal da cóclea podem sugerir uma maior atividade da doença.UNIFESP - EPMHospital CemaUNIFESP-EPM Departamento de Diagnóstico por ImagemUNIFESP, - EPMUNIFESP, EPM Depto. de Diagnóstico por ImagemSciEL

Spatial and temporal changes in bird assemblages in forest fragments in an eastern Amazonian savannah

We investigated the effects of forest fragmentation on bird assemblages in an Amazonian savannah landscape with forest fragments that have been isolated for more than 100 years. The study was conducted in areas surrounding the village of Alter do Chão (2°31'S, 55°00'W), Santarém, Brazil. Bird surveys and measurements of tree density were undertaken in 25 areas, with 19 plots in forest fragments of different sizes and six in an area of continuous forest. Data on forest-fragment size, perimeter, and isolation were obtained from a georeferenced satellite image. Variation in number of bird species recorded per plot was not related to vegetation structure (tree density). The number of bird species recorded per plot increased significantly only with fragment area, but was not influenced by fragment shape or degree of isolation, even when considering species from the savannah matrix in the analysis. Fragments had fewer rare species. Multivariate ordination analyses (multiple dimensional scaling, [MDS]) indicated that bird species composition changed along a gradient from small to large forest fragments and continuous-forest areas. In the Amazonian savannah landscapes of Alter do Chão, the organization and composition of bird assemblages in forest fragments are affected by local long-term forest-fragmentation processes. Differences in the number of bird species recorded per plot and assemblage composition between forest fragments and continuous forest were not influenced by forest structure, suggesting that the observed patterns in species composition result from the effects of fragmentation per se rather than from preexisting differences in vegetation structure between sites. Nevertheless, despite their long history of isolation, the forest fragments still preserve a large proportion (on average 80%) of the avifauna found in continuous-forest areas. The fragments at Alter do Chão are surrounded by natural (rather than planted) grassland, with many trees in the savannah matrix and the landscape has vast areas covered by forest, which may have helped to ameliorate the influences of forest fragmentation. © 2013 The Authors

Management of Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vestibular vertigo. It is caused by free-floating otoconia moving freely in one of the semicircular canals (canalolithiasis) or by otoliths adhered to the cupula (cupulolithiasis). The posterior canal is the most common canal affected, followed by the lateral canal. Diagnosis of the side affected is critical for successful treatment;therefore, suppressing visual fixation is essential to examination of these patients' eye movement. On the basis of our experience, we have adopted the Zuma maneuver and the modified Zuma maneuver for both apogeotropic and geotropic variants of lateral canal BPPV. Knowledge of the anatomy and pathophysiologic mechanisms of the semicircular canals is essential for correct management of these patients. Hence, using a single maneuver and its modification may facilitate daily neurotological practice

Effects of fragmentation on Thamnophilus stictocephalus (aves, Thamnophilidae) in semideciduous forest of Alter-do-Chão, Pará.

Effects of fragmentation on biodiversity have received much attention in recent decades, as fragmentation can greatly reduce viable areas for living organisms. We studied its effect on Thamnophilus stictocephalus (Thamnophilidae), an understory bird, in semideciduous forest fragments in Alter-do-Chão, Santarém, Pará. We tested whether the density of Thamnophilus stictocephalus was a function of fragment size and shape, density of vegetation, or arthropod biomass. Density of Thamnophilus was positively related to fragment size, but not to the other factors analyzed. Arthropod biomass was positively related to fragment size. The density of T. stictocephalus in fragments was significantly higher than it was in continuous forest. Fragmentation processes had a pronounced effect on the relative density of T. stictocephalus

Laser therapy in the treatment of dentine hypersensitivity

Cervical dentine hypersensitivity is the most frequent complaint among reported odontalgias. Thus, this study evaluated the effectiveness of two types of lasers (660 nm wavelength red, and 830 nm wavelength infrared) as dentine desensitizers, as well as both the immediate and late therapeutic effects in individuals 25 to 45 years of age. A total of 40 teeth with cervical exposure were treated in 4 sessions. They were divided into 2 groups according to treatment. A 660 nm wavelength red diode laser and an 830 nm wavelength infrared diode laser were used. Dentine sensitivity to cold nociceptive stimulus was evaluated by means of a pain numeric scale from zero to 10 before each treatment session, at 15 and 30 min after irradiation, and in a follow-up period of 15, 30 and 60 days after the end of treatment. Significant levels of dentinal desensitization were only found in patients ranging in age from 25 to 35 years. The 660 nm red diode laser was more effective than the 830 nm infrared laser and a higher level of desensitization was observed at the 15 and 30 minute post-irradiation examinations. The immediate and late therapeutic effects of the 660 nm red diode laser were more evident in 25-35-year-old patients compared with those of the 830 nm infrared diode laser, in terms of the different age groups.A hipersensibilidade dentinária cervical é a queixa mais frequente entre os relatos de odontalgia. Este estudo avaliou a eficácia de dois tipos de lasers, vermelho com 660nm e infravermelho com 830nm de comprimento de onda, como dessensibilizadores dentinários, como também os efeitos terapêuticos imediato e tardio em indivíduos de 25 a 45 anos de idade. Um total de 40 dentes com exposição cervical foram tratados em 4 sessões, divididos em 2 grupos - laser vermelho e infravermelho. A sensibilidade dentinária ao estímulo nociceptivo frio foi avaliada por meio de uma escala numérica de dor, de 0 a 10, antes de cada sessão de tratamento, aos 15 e 30 minutos após a irradiação e num período de seguimento de 15, 30 e 60 dias após o término do tratamento. Níveis significantes de dessensibilização dentinária foram apenas encontrados em pacientes com idade entre 25 a 35 anos. O laser díodo vermelho de 660nm foi mais eficaz comparado com laser infravermelho de 830nm e foi observado um nível mais alto de dessensibilização nas mensurações realizadas aos 15 e 30 minutos após irradiação. O efeito terapêutico imediato e tardio do laser díodo vermelho de 660nm é maior quando comparado com o infravermelho de 830nm em ambas faixas etárias.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Federal University of São Paulo EPMFederal University of Bahia School of Dentistry Laser CenterCamilo Castelo Branco University Laser CenterUNIFESP, EPMSciEL

Composição florística e cobertura vegetal das savanas na região de Alter do Chão, Santarém - PA

In this study, we determined the floristic composition in 38 plots of 3.75 ha (250 m x 150 m) distributed throughout 30.000 ha of savannas of "Alter do Chão", Santarém Municipality. Our surveys revealed 130 species in 45 families. The only species of dicotoledons that covered 1% or more of the area in the herb-shrub layer were Dioclea bicolor Benth. and Lafoensia pacari A. St.-Hil. Most of the area was covered by the grasses Paspalum carinatum Humb. & Bonpl. ex Flügge (16%) and Trachypogon plumosus (Humb. & Bonpl. ex Willd.) Nees (22%). The grass Axonopus canescens (Nees ex Trin.) Pilg. and the sedge Rhyncospora hirsuta Vahl also covered slightly more than 1% of the area. Only eight species, Anacardium occidentale L., Himatanthus fallax (Müll. Arg.) M. M. Plumel, Lafoensia pacari A. St.-Hil., Byrsonima coccolobifolia Kunth, Byrsonima crassifolia (L.) Kunth, Pouteria ramiflora (Mart.) Radlk., Qualea grandiflora Mart. and Salvertia convallariodora A. St.-Hil. had canopies in the tree layer which projected over more than 1% of the area. Of these, only B. crassifolia (5.7%), S. convallariodora (6.0%) and P. ramiflora (2.1%) projected over more than 2% of the area. Most of the area (mean = 53%) did not have any grass, bush or sedge cover and 45% also had no tree-canopy cover. Grasses and sedges covered a mean of 39.2% of the plots, and shrubs 11.0%. The correlations between similarity matrices based on species in different vegetation strata and taxonomic groups were generally low and there was little correlation between matrices based on quantitative data and matrices based on presence/absence. Therefore, caution should be exercised in comparisons among savanna areas based on only one vegetative stratum or on only one taxonomic group

Modelagem do crescimento do tambaqui (Colossoma macropomum Cuvier, 1816): Seleção de modelos e inferência multimodelos

The tambaqui, Colossoma macropomum, is one of the most commercially valuable Amazonian fish species, and in the floodplains of the region, they are caught in both rivers and lakes. Most growth studies on this species to date have adjusted only one growth model, the von Bertalanffy, without considering its possible uncertainties. In this study, four different models (von Bertalanffy, Logistic, Gompertz and the general model of Schnüte-Richards) were adjusted to a data set of fish caught within lakes from the middle Solimões River. These models were adjusted by non-linear equations, using the sample size of each age class as its weight. The adjustment evaluation of each model was based on the Akaike Information Criterion (AIC), the variation of AIC between the models (Δi) and the evidence weights (wi). Both the Logistic (Δi = 0.0) and Gompertz (Δi = 1.12) models were supported by the data, but neither of them was clearly superior (wi, respectively 52.44 and 29.95%). Thus, we propose the use of an averaged-model to estimate the asymptotic length (L∞). The averaged-model, based on Logistic and Gompertz models, resulted in an estimate of L∞=90.36, indicating that the tambaqui would take approximately 25 years to reach average size

Efeito do isolamento e das variáveis ambientais na estrutura de comunidades de peixes do interflúvio madeira-purus na amazônia Brasileira

Due to the existence of terrestrial barriers to freshwater fish dispersion, it is believed that its distribution is strongly associated with historical factors related to the formation of the habitats they occupy. By the other hand, some studies reveal the influence of abiotic conditions (such as size of water bodies, pH, conductivity) on the composition of fish fauna occurring in small streams. This study aimed to investigate whether drainage basins, because catchment boundaries are potential barriers to fish dispersion, or the physical structure and physico-chemical characteristics of water have a greater influence on fish community structure in small streams. We sampled 22 streams belonging to five drainage basins in the Madeira-Purus interfluve. Fish were caught with dip nets and a small trawl, and data were simultaneously obtained on structural characteristics of the streams and physico-chemical characteristics of the water. Community composition was analyzed using Non-Metric Multidimensional Scaling (NMDS), and variables related to structural and physico-chemical characteristics were summarized by Principal Component Analysis (PCA). Two explanatory models relating faunal composition to environmental factors were constructed: the first using only continuous variables and the second including the drainage basin as a categorical variable. The Akaike Information Criterion (AIC) and AIC weight were used to select the best model. Although structural and physico-chemical variables significantly contributed to explaining faunal composition, the model including the drainage basin was clearly the better of the two models (more than 90% support in the data). The importance of drainage basins in structuring fish communities in streams may have significant consequences for conservation planning in these environments