Endoscopic visualization to the anterior surface of the malleus and tensor tympani tendon in congenital cholesteatoma

Congenital cholesteatoma is a whitish mass in the middle ear medial to an intact tympanic membrane. It is often without symptoms and therefore incidentally diagnosed. Pediatric congenital cholesteatoma generally starts as a small pearl-like mass in the middle ear cavity that eventually expands to involve the ossicles, epitympanum, and mastoid. The location, size, histopathological type, and extent of the mass must be evaluated to select the appropriate surgical method. Although microscopic ear surgery has traditionally been performed to remove congenital cholesteatoma, a recently introduced alternative is endoscopic surgery, which allows a minimally invasive approach and has better visualization. Here, we report the first known case of a patient with congenital cholesteatoma in the anterior epitympanic recess and discuss the utility of an endoscopic approach in the removal of a congenital cholesteatoma in the hidden area within the middle ear.

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Atomic force microscopy comparative analysis of the surface roughness of two posterior chamber phakic intraocular lens models: ICL versus IPCL

BMC Ophthalmology ◽

10.1186/s12886-021-02039-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Juan Gros-Otero ◽

Samira Ketabi ◽

Rafael Cañones-Zafra ◽

Montserrat Garcia-Gonzalez ◽

Cesar Villa-Collar ◽

...

Keyword(s):

Surface Roughness ◽

Atomic Force Microscopy ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Anterior Surface ◽

Contact Mode ◽

Force Microscopy ◽

Atomic Force ◽

Phakic Intraocular Lenses ◽

Roughness Measurements

Abstract Background To compare the anterior surface roughness of two commercially available posterior chamber phakic intraocular lenses (IOLs) using atomic force microscopy (AFM). Methods Four phakic IOLs were used for this prospective, experimental study: two Visian ICL EVO+ V5 lenses and two iPCL 2.0 lenses. All of them were brand new, were not previously implanted in humans, were monofocal and had a dioptric power of − 12 diopters (D). The anterior surface roughness was assessed using a JPK NanoWizard II® atomic force microscope in contact mode immersed in liquid. Olympus OMCL-RC800PSA commercial silicon nitride cantilever tips were used. Anterior surface roughness measurements were made in 7 areas of 10 × 10 μm at 512 × 512 point resolution. The roughness was measured using the root-mean-square (RMS) value within the given regions. Results The mean of all anterior surface roughness measurements was 6.09 ± 1.33 nm (nm) in the Visian ICL EVO+ V5 and 3.49 ± 0.41 nm in the iPCL 2.0 (p = 0.001). Conclusion In the current study, we found a statistically significant smoother anterior surface in the iPCL 2.0 phakic intraocular lenses compared with the VISIAN ICL EVO+ V5 lenses when studied with atomic force microscopy.

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IV. Postscript to a paper “On the ganglia and nerves of the heart.”

Philosophical Transactions of the Royal Society of London ◽

10.1098/rstl.1849.0004 ◽

1849 ◽

Vol 139 ◽

pp. 47-48

Keyword(s):

Nervous System ◽

Left Ventricle ◽

Blood Vessels ◽

Coronary Arteries ◽

Royal Society ◽

Posterior Surface ◽

Anterior Surface ◽

Entire Surface ◽

Naked Eye ◽

Nervous Structure

Since the communication above referred to was presented to the Royal Society, I have made a very minute dissection in alcohol of the whole nervous system of the young heifer’s heart. The distribution of the ganglia and nerves over the entire surface of the heart, and the relations of these structures to the blood-vessels and muscular substance, are far more fully displayed in these preparations than in any of my former dissections. On the anterior surface, there are distinctly visible to the naked eye ninety ganglia or ganglionic enlargements on the nerves, which pass obliquely across the arteries and the muscular fibres of the ventricles from their base to the apex. These ganglionic enlargements are observed on the nerves, not only where they are crossing the arteries, but where they are ramifying on the muscular substance without the blood-vessels. On the posterior surface, the principal branches of the coronary arteries plunge into the muscular substance of the heart near the base, and many nerves with ganglia accompany them throughout the walls to the lining membrane and columnse carneæ. From the sudden disappearance of the chief branches of the coronary arteries on the posterior surface, the nervous structure distributed over a consider able portion of the left ventricle is completely isolated from the blood-vessels, and on these, numerous ganglionic enlargements are likewise observed, but smaller in size than the chains of ganglia formed over the blood-vessels on the anterior surface of the heart. In the accompanying beautiful drawings, Mr. West has depicted with the greatest accuracy and minuteness the whole nervous structures demonstrable in these preparations on the surface of the heart. But the ganglia and nerves represented in these drawings constitute only a small portion of the nervous system of the heart, numerous ganglia being formed in the walls of the heart which no artist can represent. It can be clearly demonstrated that every artery distributed throughout the walls of the Uterus and Heart, and every muscular fasciculus of these organs, is supplied with nerves upon which ganglia are formed.

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