Surgically assisted rapid maxillary expansion is the treatment of choice for correcting maxillary transverse deficiency in adults. Traditionally, the appliance for expansion is tooth-borne and tissue-tooth-borne devices (Hyrax and Haas). Although a number clinical and radiographic studies have evaluated the surgically assisted rapid maxillary expansion, only limited information is available to study the transverse movement of the midpalatal suture with computed tomography. Forty adult patients of both sexes, ranging in age from 18 to 38 years, with bilateral transverse maxillary deficiency were operated on. Twenty patients had Hyrax expander, and 20 had Haas expander. Under general anesthesia, subtotal Le Fort I osteotomy was performed including pterygomaxillary dysjunction. The width of the midpalatal suture opening was measured at the anterior edge of the midpalatal suture and at the junction of the midpalatal suture and palatal bones, using computed tomography in axial acquisition, obtained in the preoperative period and immediately after the end of expansion. A digital caliper was used to measure Haas and Hyrax distance on the central jackscrew preoperatively and postoperatively. The proportion between the midpalatal suture expansion and the amount of expansion on the jackscrew was evaluated. The mean of midpalatal suture opening and screw opening for Haas group was 5.19 and 8.78 mm, and for the Hyrax group, 5.85 and 8.51 mm, respectively. Both groups showed parallel-shaped separation of the midpalatal opening with no significant difference in the anterior and posterior portion. Midpalatal/jackscrews opening proportion was greater in the Hyrax group (69,2%) than in the Haas group (60%).

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ObjectiveTo use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms.Materials and MethodsWe selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant.ResultsThe interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom.ConclusionVascular loops do not appear to be associated with otoneurological manifestations.

Os nossos objetivos foram estabelecer a eficácia da tomografia computadorizada sem contraste em diagnosticar a ureterolitíase, calcular a freqüência dos principais sinais tomográficos e medir a concordância interobservador, comparando-a com os resultados obtidos na urografia excretora, realizando estudo prospectivo duplo-cego em 25 pacientes com cólica nefrética. Em ambos os procedimentos avaliamos a existência de aumento renal, hidronefrose e cálculo ureteral. Deste último, descrevemos a sua localização e dimensão. Nos exames de tomografia computadorizada sem contraste procuramos também por estrias perirrenais, edema periureteral e o sinal do halo. Em 23 dos 25 exames de tomografia computadorizada sem contraste (92%) e em 17 das 25 urografias excretoras (68%) houve concordância dos resultados entre os dois observadores. Em 21 dos 25 pacientes os resultados dos dois métodos foram concordantes. Concluímos que a tomografia computadorizada sem contraste apresenta eficácia superponível à urografia excretora na avaliação de pacientes com cólica nefrética, sendo um método reprodutível e sem promover o desconforto do uso do contraste endovenoso.