PONDÉ, J. M.; ANDRADE, R. N.; VIA, J. M.; METZGER, P. & TELES, A. C. Anatomical variations of the frontal sinus. Int. J. Morphol., 26(4):803-808, 2008.SUMMARY: An anatomical study of the frontal sinus in 100 macerated skulls. The study introduces an innovation on the literature by means of the measurement of the sinus's volume. All the found information in the literature attained to other aspects including the diameters of the sinus and the geometric area of the same. Objective: Evaluation of the measures of the frontal sinus frequently involved in cranial base surgeries and supraorbital craniotomies in order to help the surgical approaches that cross this anatomical route Methods: The measurement included: sagital, transverse and antero-posterior diameter acquired with a paquimeter and the volume obtained after filling the sinus with sand. Results: They are in accordance with the literature that shows the male's predominance in all measurements done.

PALAVRAS-CHAVESíndrome do túnel carpal, hanseníase, nervo mediano.

RESUMO PALAVRAS-CHAVE

A B S T R A C TLeprosy is a disease that potentially affects adults with a long latency period of 3 to 5 years. However, children are prone to acquire the disease especially in places of high prevalence and poor epidemiologic control. The surgical decompression is an ancillary method of treatment, although recent investigations call attention for the similarity of results of conservative management. The objective of this study, then, was to call attention for surgical indication in leprosy patients with ulnar impairment soon after failure of conservative management. The authors describe and analyze a case of an outpatient operated child with ulnar nerve involvement by leprosy after 1 year of clinical treatment and failure. The predominant symptoms were pain and physical deformity. There was a great improvement following the surgery even after delayed operation. The surgical intervention is sometimes necessary to avoid deformities although more randomized series must confi rm the superiority of surgery in relation to clinical management in some cases.

RESUMO -Relatamos nossa experiência com a minicraniotomia supraorbital em uma série de 36 pacientes operados, com resultados satisfatórios. Foram operados 31 aneurismas 4 adenomas hipofisários, um astrocitoma anaplásico e um cisto aracnóide. Houve um óbito na série. A técnica foi descrita em detalhes. Concluimos que a minicraniotomia é um método seguro para o tratamento de várias patologias parasselares, devendo ser avaliada a sua eficácia em estudos comparativos com as técnicas tradicionais.PALAVRAS-CHAVE: craniotomia supraorbital, cirurgia minimamente invasiva, aneurismas intracranianos, tumores cerebrais.Supraorbital craniotomy to approach the sellar and the parasellar regions Supraorbital craniotomy to approach the sellar and the parasellar regions Supraorbital craniotomy to approach the sellar and the parasellar regions Supraorbital craniotomy to approach the sellar and the parasellar regions Supraorbital craniotomy to approach the sellar and the parasellar regions ABSTRACT -We report on the experience with supraorbital minicraniotomy in a series of 36 operated cases with good results: 31 aneurysms, 4 pituitary adenomas, 1 anaplastic astrocytoma and 1 arachnoid cyst. One death occurred in this series. The technique is detailed. We conclude that the minicraniotomy is a safe method for the treatment of several parasellar pathologies.The efficacy must be evaluated in clinical trials concerning other approaches.KEY WORDS: supraorbital craniotomy, minimally invasive surgery, intracranial aneurysms, brain tumors. Diferentes abordagens para lesões da base do crânio têm sido descritas nos últimos anos, existindo de comum nestas abordagens as exposições relativamente grandes do encéfalo. Embora as ressecções ósseas extensas minimizem a retração sobre o tecido cerebral 1-3 , certos autores têm relatado abordagens menores causando menor morbidade [4][5][6][7][8] . O objetivo deste estudo é descrever a técnica cirúrgica de minicraniotomia supraorbital e mostrar uma série de casos em que foram abordadas lesões vasculares e tumorais com resultados equivalentes aos obtidos com as abordagens tradicionais. MÉTODOForam operados 36 pacientes por via subfrontal utilizando-se a minicraniotomia supraorbital, sendo 30 pacientes portadores de aneurismas intracranianos e 6 portadores de lesões expansivas intracranianas assim distribuídas: 4 pacientes com tumores de hipófise, 1 com cisto aracnóideo da fissura inter-hemisférica e 1com astrocitoma anaplásico.O total de aneurismas clipados foi 31, tendo as seguintes localizações: 8 de artéria carótida direita, 7 de artéria carótida esquerda, 14 de artéria comunicante anterior, 2 de bifurcação de carótida, tendo um 1 caso sido de aneurisma múltiplo envolvendo as artérias carótida e comunicante anterior. A média de idade nesta série foi 42,5 anos, variando de 17 a 73 anos.Técnica cirúrgica Os pacientes foram colocados em posição supina, com a cabeça girada lateralmente para o lado oposto ao da craniotomia, cerca de 10 a 30 graus dependendo da localização da lesão, com leve retroflexão, m...

Objective To describe axillary approach for axillary nerve transfer with radial nerve branch in brachial plexus lesions. Methods Six patients aged 24 to 54 (mean 30) years with traumatic superior trunk brachial plexus injury underwent axillary approach between October 2011 and April 2012. On physical examination prior to surgery, they could not perform shoulder abduction, external rotation, or elbow flexion. Surgical approach was made through axillary pathway without any muscular section. The transfer was done with the radial branch to the medial head of triceps. In addition to transfer to axillary nerve, each patient had spinal accessory nerve transferred to suprascapular nerve and ulnar nerve fascicle transferred to musculocutaneous nerve. Conclusion The axillary approach allows easy access to axillary nerve and, therefore, is a feasible pathway to transferences involving this nerve.