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Authors
Abstract(s)
A variabilidade vascular de qualquer região anatómica é de grande importância para a
prática clínica e cirúrgica. O seu conhecimento permite interpretar possíveis alterações
vasculares de forma adequada, tomar decisões terapêuticas apropriadas, minimizando
riscos e possíveis complicações dos procedimentos médicos.
Para compreender a variabilidade vascular do território da articulação
temporomandibular (ATM), desenhamos um estudo prospetivo, incluindo doentes de
forma aleatória, submetidos a exames de imagiologia vascular com contraste
(tomografias computorizadas – TC), nomeadamente aos ramos cervicocraniais, no
contexto da ativação da “Via-verde do AVC” no Centro Hospitalar Universitário de
Lisboa Central e no Centro Hospitalar de São João.
Foram construídos modelos 3D com as imagens TC através de técnicas de renderização,
e foi desenvolvido um sistema de avaliação por quadrantes baseados em referências
anatómicas. Em cada quadrante foi avaliado o número de ramos arteriais e atribuído
um valor. Foram incluídos neste estudo 50 indivíduos (25 do Centro Hospitalar
Universitário de Lisboa Central e 25 do Centro Hospitalar de São João) com uma média
de idades de 62,9 anos. No total foram analisadas 100 ATM, de forma independente. Os
resultados obtidos neste estudo mostraram variabilidade vascular estatisticamente
significativa em alguns dos quadrantes, não havendo diferença entre homens e
mulheres. A variabilidade vascular encontrada neste estudo deve ser considerada pelos
diversos cirurgiões que usam este território para cirurgia da ATM, cirurgia da parótida,
procedimentos estéticos faciais ou para a radiologia de intervenção, de modo a evitar
ou planear as suas intervenções baseada no conhecimento adquirido neste estudo.
Recomendamos que futuros estudos possam incluir uma amostra maior de doentes e
uma possível identificação pormenorizada dos ramos vasculares nesta região.
The vascular variability of any anatomic region is of great importance for clinical and surgical practice. This knowledge allows an adequate evaluation of possible vascular variations, to make appropriate therapeutic decisions, to minimize risks and complications of certain medical procedures. To understand the temporomandibular joint territory vascular variability, we designed a prospective study, including randomly selected patients, who underwent contrasted vascular imaging tests (computerized tomographies - CT), focused on the cervicocranial branches, in the context of the “Via-verde do AVC” program, at the Centro Hospitalar Universitário de Lisboa Central and at Centro Hospitalar de São João. 3D models of these CT images were made using rendering techniques, and a quadrant evaluation system, based on anatomic references, was created. For each quadrant, the number of arterial branches found was counted and assigned a value. Fifty individuals (25 from Centro Hospitalar Universitário de Lisboa Central and 25 from Centro Hospitalar de São João) with na average age of 62.9 years were included in this study. The results showed evidence of statistically significant vascular variability in some of the quadrants, with no difference between men and women. The vascular variability found in this study should be considered by surgeons who use this area on TMJ surgery, parotid surgery, facial aesthetic procedures or on intervention radiology, to prevent risks or plan their new course of action based on this study information. We recommend future studies to include a larger sample of patients and to go further by identifying thoroughly the vascular branches in this area.
The vascular variability of any anatomic region is of great importance for clinical and surgical practice. This knowledge allows an adequate evaluation of possible vascular variations, to make appropriate therapeutic decisions, to minimize risks and complications of certain medical procedures. To understand the temporomandibular joint territory vascular variability, we designed a prospective study, including randomly selected patients, who underwent contrasted vascular imaging tests (computerized tomographies - CT), focused on the cervicocranial branches, in the context of the “Via-verde do AVC” program, at the Centro Hospitalar Universitário de Lisboa Central and at Centro Hospitalar de São João. 3D models of these CT images were made using rendering techniques, and a quadrant evaluation system, based on anatomic references, was created. For each quadrant, the number of arterial branches found was counted and assigned a value. Fifty individuals (25 from Centro Hospitalar Universitário de Lisboa Central and 25 from Centro Hospitalar de São João) with na average age of 62.9 years were included in this study. The results showed evidence of statistically significant vascular variability in some of the quadrants, with no difference between men and women. The vascular variability found in this study should be considered by surgeons who use this area on TMJ surgery, parotid surgery, facial aesthetic procedures or on intervention radiology, to prevent risks or plan their new course of action based on this study information. We recommend future studies to include a larger sample of patients and to go further by identifying thoroughly the vascular branches in this area.
Description
Keywords
Anatomia Vascular Articulação Temporomandibular Variabilidade Anatómica Vascularização Via-Verde do
Avc