Jaime Whyte Orozco

Defecto de cobertura del canal semicircular superior y su implicación clínica

INTRODUCTION AND OBJECTIVE The aetiology of the superior semicircular canal dehiscence is currently unknown. Our objective was to analyse and discuss different hypotheses about the origin of this pathology. METHODS In this study performed on 295 temporal bones, one case of partial alteration of the bony roof in the right superior semicircular canal was described from the anatomical and radiological points of view, and compared with the temporal bone on the other side. RESULTS Macroscopically, the superior semicircular canal shows deterioration in the bony roof, which consists exclusively of the inner or endosteal layer that separates the canal from the superior semicircular conduct. The Pöschl plane reconstruction showed a whole bony roof, but its thickness decreased from the canal curvature to the defect (from 0.6 to 0.3mm). CONCLUSION The presence of partial defects in the bony roof of the superior semicircular canal with absence of the external and middle layers, besides its lesser thickness, makes the canal susceptible to suffering a second event. This could produce its fracture and a dehiscence.

Ontogenic Development of the Incudostapedial Joint

Objective To study the development of the incudostapedial joint in human embryos and foetuses. Material and method 46 temporal bones with specimens between 9 mm and new-borns were studied. The preparations were sliced serially and dyed using the Martins trichrome technique. Results The incudostapedial joint takes on the characteristics of a spheroidal joint at 16 weeks of development. The cartilage covering the articular surfaces is formed by different strata that develop in succession: the superficial stratum at 19 weeks, the transitional between 20 and 23 weeks, and the radial from 24 weeks on. The subchondral bone develops after 29 weeks by the mechanisms of apposition and extension of the periosteal and endosteal bones, but it is not until week 34 that it completely covers the articular surfaces, following constitution of the bone fascicles transmitting the lines of force. The articular capsule is formed from the inter-zone, the surface zone develops the capsular ligament, and the internal surface develops the synovial membrane. Conclusions At the time of birth, the incudostapedial joint is completely developed.

Contribution to morphological knowledge of the development of the human incudo-mallear joint

Conclusion: At the time of birth, the incudo-mallear joint is completely developed. Objective. To study the development of the incudo-mallear joint in human embryos and fetuses. Materials and methods. In all, 46 temporal bones with ages between 9 mm and newborns were studied. The preparations were cut in a series and dyed using Martins’ trichrome technique. Results. The incudo-mallear joint acquires the characteristics of a saddle joint at 10 weeks of development. The cartilage that covers the articular surfaces is formed by different strata that develop successively: the superficial stratum at 14 weeks, the transitional between 15 and 19 weeks, and the radial from 20 weeks. The subchondral bone develops between weeks 25 and 28 by the mechanisms of apposition and extension of the periosteal and endosteal bones, but it is not until week 30 that it completely covers the articular surfaces, consisting of bone fascicles whereby the lines of force will be transmitted. The articular capsule is formed as from the inter-zone. The surface zone develops the capsular ligament, and the internal surface develops the synovial membrane. Even though it is not consistent, the primordium of the meniscus is seen at 18 weeks.

Desarrollo ontogénico de la articulación incudoestapedial

Objetivo Estudiar el desarrollo de la articulacion incudoestapedial en embriones y fetos humanos. Material y metodo Se han estudiado 46 huesos temporales con ejemplares comprendidos entre 9 mm y recien nacidos. Las preparaciones estaban cortadas en serie y tenidas con la tecnica de tricromico de Martins. Resultados La articulacion incudoestapedial adquiere las caracteristicas de una articulacion sinovial de tipo enartrosis a las 16 semanas de desarrollo. El cartilago que recubre las superficies articulares esta formado por diferentes estratos que se desarrollan sucesivamente: el superficial, a las 19 semanas; el de transicion, entre las 20 y las 23 semanas, y el radial, a partir de las 24 semanas. El hueso subcondral se desarrolla a partir de las 29 semanas por los mecanismos de aposicion y extension del periostal y el endostal, pero no es hasta la semana 34 cuando recubre por completo las superficies articulares, constituidos los fasciculos oseos por los que se transmitiran las lineas de fuerza. La capsula articular se forma a partir de la interzona, la zona superficial desarrolla el ligamento capsular y la interna, la sinovial. Conclusiones En el momento del nacimiento la articulacion incudoestapedial esta completamente desarrollada.

Conexiones entre la médula ósea de los osículos y el mesénquima del oído medio

Objetivo Determinar si existen conexiones entre la medula osea de los osiculos timpanicos y el mesenquima que rellena la futura cavidad timpanica. Material y metodos Se han examinado 90 huesos temporales pertenecientes a embriones y fetos, y se han seleccionado 15 de edades comprendidas entre las semanas 20 y 30 del desarrollo al presentar conexiones entre medula del osiculo y el mesenquima. Resultados Las conexiones son de tipo transitorio y aparecen en el martillo y el yunque entre las semanas 20 y 24 de desarrollo, mientras que en el estribo se manifiestan posteriormente, entre las semanas 24 y 28. Conclusiones Estas conexiones pueden tener un papel importante en la fagocitosis de los restos mesenquimales y sumarse a los mecanismos de eliminacion de los detritus producidos durante la regresion.

Connections between bone marrow and mesenchyme of the middle ear

Objective To investigate the presence of connections between the bone marrow of the ossicles and the mesenchyme that fills the future tympanic cavity. Material and methods Ninety temporal bones from embryos and foetuses were examined, selecting 15 aged between 20th to 30th weeks of development, to show connections between ossicle marrow and mesenchyme. Results The connections are transitory and appear in the malleus and the incus between 20th to 24th weeks of development, while in the stapes appear later, being between 24th to 28th weeks. Conclusions These connections may have an important role in the phagocytosis of the mesenchymal remains and join in the detritus elimination mechanisms produced during the regression.

Tonsillectomy in adults: Analysis of indications and complications

OBJECTIVE Tonsillectomy is one of the surgical techniques most practiced by otolaryngologists, and despite being a relatively simple technique; it presents a considerable percentage of complications, such as postoperative bleeding. The aim of this study is to describe the surgical indications and most frequent complications, analyze whether surgical suture of the tonsillar pillars has an influence on bleeding, and study the data of hospital stay and its importance for the control of complications. METHODS A retrospective study of 326 patients who underwent a tonsillectomy in our Department of Otolaryngology from 2006 to 2014 was conducted. The obtained data were statistically analyzed using the Excel and SPSS 21.0 programs. RESULTS The most frequent indication was recurrent tonsillitis, with a 74.85% (244) occurrence, and the most recurrent complication was bleeding, in 5.21% (17) of the tonsillectomies, requiring surgical revision 13 of the 17 patients. No statistically significant differences in the risk of bleeding were observed in patients in whom tonsil pillars were sutured comparing to those that were not. No statistically significant differences were detected associating surgical indication and oropharyngeal post-tonsillectomy hemorrhage. All operated patients were admitted, with a postoperative average hospital stay of 2.17 days, gaining a quick and effective control of the immediate complications. CONCLUSION Bleeding is the most common and important complication. No statistically significant association between bleeding and tonsil pillar suture or surgical indication was found. Tonsillectomy was not set as outpatient surgery at the time.