Size Of Fossa Research Articles

Patterns in the Evolution of Ungulate Jaw Shape

A survey of biomechanically significant aspects of the jaw apparatus in 13 orders of recent and fossil ungulates indicates that an expanded angular process evolved independently at least 12 times. Temporal fossa size is reduced inmost ungulatesof modern aspect, but not in many early ungulates. Expansion of the masseter and internal pterygoid musculature (inferred from the expanded angular process) may represent an adaptation for enhanced control of grinding action in mastication.

がく口くう系機能異常におけるがく関節に関するＸ線的研究 Ｉ 関節かとか頭の大きさおよびか頭の形態異常について

がく口くう系機能異常におけるがく関節に関するＸ線的研究 Ｉ 関節かとか頭の大きさおよびか頭の形態異常について

Morphologic alterations in Macaca mulatta following destruction of the motor nucleus of the trigeminal nerve

In two adolescent male Macaca mulatta monkeys, small unilateral electrolytic lesions were produced in the motor nucleus of the trigeminal nerve. The side contralateral to the muscle paralysis served as the control side. The animals were killed 130 and 300 days postoperatively. One animal (animal A) was prepared as a dry skull preparation. Alterations in craniofacial form were noted clinically in both animals and included paralysis and atrophy of the muscles of mastication on the lesion side and mandibular asymmetry. In animal A (300 days postoperative survival), alterations in form included dental and mandibular asymmetry, the appearance of an anterior open-bite on the affected side, and a decrease in the size of the infratemporal fossa on the affected side Remodeling changes were evident in the condylar process, the zygomatic arch, the orbit, and the zygomaticotemporal and zygomaticofrontal sutures on the lesion side but were not apparent on the contralateral side.

REDUCTION OF PITUITARY-TUMOUR SIZE IN PATIENTS WITH PROLACTINOMAS AND ACROMEGALY TREATED WITH BROMOCRIPTINE WITH OR WITHOUT RADIOTHERAPY

69 patients with prolactin-secreting or growth-hormone-secreting pituitary tumours were treated with bromocriptine with or without pituitary irradiation and followed up for 6 months to 61/2 years. Of 26 patients with prolactinomas, 11 had external pituitary irradiation in addition to bromocriptine. There was evidence of shrinkage of the pituitary tumour (either a reduction in fossa size or loss of visual-field defects) in 6 of these patients (23%), 3 of whom had been treated with bromocriptine alone. Of 43 acromegalic patients, 30 received external pituitary irradiation. 8 (19%) showed evidence of shrinkage of the pituitary tumour, including 2 who had received no radiotherapy. 1 patient treated with bromocriptine alone showed striking reduction in the size of his suprasellar extension, as assessed by serial computed-tomography scans over 11 months. At the same time his visual-field defects resolved and his deficient corticotrophin and thyrotrophin reserves returned to normal. Bromocriptine can reduce the size of both prolactin-secreting and growth-hormone-secreting pituitary tumours, and this is of potential importance in their management.

Pituitary fossa size and facial type

T he pituitary fossa is a depression in the superior surface of the body of the sphenoid and is limited anteriorly by the middle clinoid processes and posteriorly by the dorsum sella which carries the posterior clinoid processes on either side of its superior margin. All of the pituitary body, with the exception of the base of the infundibulum, lies within the confines of this bony area. It is necessary to be familiar with this osteology to appreciate the structure of the sella turcica as depicted on a lateral x-ray film of the skull. Numerous studies have been undertaken to determine whether a relationship exists between the size of the pituitary fossa and other body dimensions. Gordon and Bell4 studied the sellae of 104 normal children and found a marked variation in the size of the sella for any particular age and no definite relationship between the shape of the sella and skull size. They divided the sellae in these children into three general groups according to shape, namely, circular, oval, and flat. The oval sellae were the most common and were seen in 67 percent of the children, while the flat type was the rarest and was always found in small heads. Not all small heads, however, exhibited this type of fossa. Gordon and Bell5 subsequently studied 228 abnormal children and found that the sellae of these children were morphologically similar to those which they had described in their normal group. The size and shape of sellae did not appear to be influenced by any of the diseases studied, which included mongolism, anterior pituitary deficiency, mental retardation, and hyperand hypothyroidism. Silverman16 studied the sellae of 320 children and associated hypothyroidism with enlargement of this fossa. He established normal ranges for pituitary fossa size in North American children from birth to 16 years of age and also showed that the lateral radiographic area of sella bears a reasonable relationship to its volumetric size. Israel’ reported that the pituitary fossa increases in size throughout life and that the average annual increment varies between 0.2 and 1.1 percent. Haas found the normal adult pituitary area on a lateral skull film, when the target-to-film distance is 3 feet, to be 86 sq. mm. (Standard deviation, 15 sq. mm.). According to Haas, measuring the sellar area is more satisfactory than measuring its diameters, and he described a method for accomplishing this. Hurxtha17 also believed that this method has merit, especially when one is undertaking longitudinal studies of sellar size. The present study was undertaken, first, to determine the average size of sella as seen in lateral cephalographic radiographs and, second, to determine whether any correlation exists between the size of the pituitary fossa and some facial dimensions.

Pathogenesis of the Arnold-Chiari malformation: the significance of hydrocephalus and aqueduct stenosis.

In 24 cases of spina bifida, correlations were made comparing the degree of hydrocephalus with the cross-sectional area of the supratentorial compartment, posterior fossa, hindbrain prolapse, size of myelocele, and degree of fibrovascular reaction at the base of the brain. The size and postion of the aqueduct and fourth ventricle were compared with the degree of hydrocephalus. The results demonstrate that the aqueduct stenosis is usually due to external compression of the mesencephalon. The results also suggest that the size of the posterior fossa and hindbrain prolapse are secondary to hydrocephalus. It is postulated that the hydrocephalic process may be initiated by fibrovascular occlusion of the basal subarachnoid space.

THE EFFECT OF YTTRIUM‐90 IMPLANTATION ON ENDOCRINE FUNCTION AND VISUAL FIELDS IN PATIENTS WITH ‘FUNCTIONLESS’ PITUITARY TUMOURS, WITH BIOPSY AND RADIOLOGICAL FINDINGS

Thirty patients with symptoms from "functionless" pituitary tumours were treated by yttrium-90 implants, and we report here the effects on symptoms, pituitary function and visual fields. On biopsy, about a third of the tumours showed some hormone granules. In the sixteen fully assessed at 1 year, pituitary function was improved in 25%, unchanged in 62-5%, and reduced in 12-5%. Improvement was confined to those in whom gonadotrophin secretion was the only function impaired pre-implant. Visual field defects were present pre-implant in ten patients (twenty eyes); at 1 year post-implant these defects had lessened in 80% and deteriorated in only 5% of eyes. Subsequently, within 5 years of the implant the field defects had worsened or recurred in four patients, all with initially extensive suprasellar projection; further treatment was then given. Remineralization of the sella was seen after implantation in seven cases, with reduction in fossa size in five. Thus pituitary implantation appears to be a practicable and reasonably simple procedure suitable for the treatment of most cases of "functionless" pituitary tumour. The "supressive" doses of irradiation used are adequate to shrink most tumours without loss of pituitary function.

Pituitary deficiency in patients with pituitary tumours.

SUMMARYIn 44 cases of tumours of the pituitary gland, the incidence of pituitary deficiency was determined; eight patients were severely hypopituitary, 16 had partial pituitary deficiency, and in 20 there was no evidence of loss of endocrine function. There was an increased incidence of hypopituitarism in patients with purely chromophobe tumours and in those with an upward extension above the diaphragma sellæ of more than 1·5 cm. There was no relation between the incidence of hypopituitarism and the size of the pituitary fossa on X‐ray examination.In the 28 patients explored by transfrontal craniotomy, there was a close association between the development of both severe hypopituitarism and diabetes insipidus and damage to the median eminence of the hypothalamus or the infundibulum.Despite some difficulty in the accurate classification of pituitary function, this investigation has demonstrated the importance of the integrity of the hypothalamic‐hypophyseal neuro‐vascular connections in the maintenance of pituitary function, even in the presence of a pituitary tumour. It is hoped that this will be of value in the management of patients undergoing operations for pituitary tumours, and in rare cases may influence the type of surgical procedure employed.

SMALL PITUITARY FOSSA IN CUSHING'S SYNDROME DUE TO ADRENAL NEOPLASM.

IN the differentiation of adrenal hyperplasia from adrenal neoplasm as the cause of Cushing's syndrome the size of the pituitary fossa may be a useful diagnostic aid. Previous studies have indicated that the sella is enlarged in approximately 10 to 15 per cent of patients in whom Cushing's syndrome resulted from adrenal hyperplasia.1 , 2 In the case presented below a thirteen-and-a-half-year-old boy had Cushing's syndrome due to adrenal adenoma. In this patient the initially small pituitary fossa increased to normal size after removal of the adrenal neoplasm. Case Report A 13 1/2-year-old boy of Portuguese descent had begun 3 years previously . . .

The size of the pituitary fossa in adults.

This paper is presented as the first comprehensive series of pituitary fossa measurements made from radiographs taken on the Schonander skull table at 28 in. F.F.D. A total of 250 normal adult subjects was examined. Measurements included the sellar length, depth and width, lateral area and fossa volume. The technique of actual measurement of the sella was discussed and the results were compared with other published works. The writer is of the opinion that the fossa volume is a more accurate measure of pathologically enlarged sellae than lateral area. The range of 700 to 2,000 cu.mm is presented as the normal limits of the radiological sellar volume in adults.

ATROPHIC RHINITIS AND ENDOCRINE DISTURBANCE

The concentraton of 17-ketosteroid and 1311 excretion in urine, the modified Thorn test and the size and form of the pituitary fossa in atrophic cases. The cases with the manifest endocrine dysfun- ction (pituitary, adreno-cortical and thyroid distur-bance) were studied rhinologically and radiologi-cally. The result of the modified maxillo-turbinalpla-sty after Kitamura were compared with the data of their endocrinological studies. This consideration shows that the cases of atrophic rhinitis have a more frequent latent endocrine dysfunction than these of the non-atrophic.If classified after Kitamura, these disturbances were more spotted in type Iab ane II, but not in cess of severe inflammatory process in the nasal and paranasal mucosa, but Ic can be interpreted as a sequela of a process of endarteritis. Therefore endocrine disorder in early stage of life has a great influence on the development of paranasal cavities tes the inflammatory process of the nasal cavity and causes atrophy. This investigation coincides with our actual concept on atrophic rhinitis that its causes are not single, but many causes may evoke its symptoms. Many different causes may produce atrophy of the nasal mucosa, but others may only provoke the clinical symptoms.

CLINICAL STUDY ON THE RELATION BETWEEN THE CHRONIC TONSILLITIS AND LIVER FUNCTION

Effects of tonsillectomy upon the liver function were ovserved in 26 patients with chrcnic tonsillitis accompanied with dysfunction of the liver. In 11 out of the 26 cases the liver function was restored to normal after tonsillectomy. It was probable that the dysfunction of the liver in these cases had its primary foci in their tonsils and therefore such favourable effects were brought about by the exstirpation of the tonsils together with an improvement in general condition which was a result of the exstirpation. This probability was sustained also by the fact that a relief in a subjective symptom, headache, which is one of general toxic symptoms, was more remarkable in the improved group as compared with the un-improved group. The effect of tonsillectomy was more favourable in male and younger patients, and the shorter the history of chronic tonsillitis, the more fanourable results were obtained by the operation. With regard to the shape and weight of the tonsils, degree of the projection, size and depth of the supratonsillar fossa, whether plug, mucus and pus were present or not, no particular differences could be found between the improvd and the un-improved group. Of all metabolic functions of the liver, the improvement of the proteometabolic function was most remarkable after tonsillectomy.

CLINICAL STUDY-ON THE RELATION BETWEEN THE CHRONIC TONSILLITIS AND LIVER FUNCTION

Effects of tonsillectomy upon the liver function were ovserved in 26 patients with chrcnic tonsillitis accompanied with dysfunction of the liver. In 11 out of the 26 cases the liver function was restored to normal after tonsillectomy. It was probable that the dysfunction of the liver in these cases had its primary foci in their tonsils and therefore such favourable effects were brought about by the exstirpation of the tonsils together with an improvement in general condition which was a result of the exstirpation. This probability was sustained also by the fact that a relief in a subjective symptom, headache, which is one of general toxic symptoms, was more remarkable in the improved group as compared with the un-improved group. The effect of tonsillectomy was more favourable in male and younger patients, and the shorter the history of chronic tonsillitis, the more fanourable results were obtained by the operation. With regard to the shape and weight of the tonsils, degree of the projection, size and depth of the supratonsillar fossa, whether plug, mucus and pus were present or not, no particular differences could be found between the improvd and the un-improved group. Of all metabolic functions of the liver, the improvement of the proteometabolic function was most remarkable after tonsillectomy.

IMPROVED INTRANASAL PACKING: A Rubber Pneumatic Pack

This report concerns the develpoment of an intranasal pack or splint which is made of rubber tissue and is inflated with air when in position. Many attempts have been made to improve the effectiveness of nasal packing either for postoperative use or in the control of hemorrhage while improving the patient's comfort. All of these efforts have been appreciated by the surgeon, but the latter consideration chiefly influences the patient. Discomfort and often pain make the patient dread the period following a nasal operation. The factors which limit the problem are well known, viz., the sensitivity of the nasal mucosa to foreign material, the small size of the vestibule in comparison to the size of the nasal fossa, the irregular and intricate contour of the fossa, the variation in the contour and size of one fossa with that of its partner and with that of other nasal fossae