2008, Number 2
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Rev Hosp Jua Mex 2008; 75 (2)
Estandarización del método Klingler y su visualización tridimensional
Pérez CJC, Gallegos SSP, Garduño PP, Reyes SG, Valderrama GMR, Herrera VI, Arteaga MSM, Herrera SP, Delgado RL
Language: Spanish
References: 64
Page: 99-108
PDF size: 533.62 Kb.
ABSTRACT
Objective. To create a three dimensional (3D) plan model of dissections of medial part of the brain. To get this model we will
establish the concentration of formaldehyde, freezing degree and dissection instrumental that offers the best result in dissections of
structure of internal brain.
Material and methods. Fifteen brains were obtained; blood vessels, duramater and arachnoids meninges
were retired, they were divided for their study in four groups. In the three first groups we worked with formaldehyde concentrations,
freezing or no freezing degree, and dissection instrumental. In the fourth group, the cerebral hemispheres were immerse en 5%
formol fixation, during four weeks; freezed under 15
°C for eight days. Afterwards, topographic dissection in the medial part of the
brains with wooden spoonbills, microdissections instrumental and suctions system was carried out; after plans dissections, we
carried out a photographic technique for virtual reality and we created a software for 3D presentation of the structures.
Results.
The immersion of 5% of formol produced less compacting of the gray and white substances than the one immerse at 10%. The
freezing at 40
°C does not produce fragmentation of the gray substance matter separation of the white substance. The dissection with
wooden spoonbills, microdissection instrumental and suctions system cannulas, allowed a better dissections of the grey and white
substance of the brain. We then created and interface between a 3D model of the cerebral structures in anaglyph in each plan of
dissections.
Conclusion. The fixations of formol at 5%, freezing at 15
°C, and the use of wooden spoonbills, microdissection instru
mental and suctions systems, allows the dissection of tracts of 2 mm thickness as the subcallosum tract appears.
REFERENCES
Aziz MA, Mckenzie JC, Wilson JS, Cowie RJ, Ayeni SA, Dunn BK. The human cadaver in the age of biomedical informatics. Anat Rec (New Anat) 2002; 269: 20-32.
Moore NA. To dissect or not to dissect? (Commentary). Anat Rec (New Anat) 1998; 253: 8-9.
De Asis Flores y TF. Historia de la Medicina en México. 2a Ed. México: IMSS; 1982, p. 362.
Heimer L. Gross dissection of the human brain (Introduction). Neurosurg Focus 2005; 18(6b): 1-2.
Klingler J. Erleichterung der makroskopischen Praeparation des Gehirns durch den Gefrierprozess. Schweiz Arch Neurol Psychiatr 1935; 36: 247-56.
Klingler J, Gloor P. The connections of the amygdala and of the anterior temporal cortex in human brain. J Comp Neurol 1960; 115: 333-69.
Klingler J, Ludwig E. Atlas Cerebri Humani. NY: Karger, Basel; 1956.
Ebeling U, Cramon Dv. Topography of the uncinate fascicle and adjacent temporal fiber tracts. Acta Neurochir (Wien) 1992; 115: 143-8.
Ebeling U, Reulen HJ. Neurosurgical topography of the optic radiation in the temporal lobe. Acta Neurochir (Wien) 1988; 92: 29-36.
Sincoff EH, Tan Y, Abdulrauf SI. White matter fiber dissection of the optic radiations of the temporal lobe and implications for surgical approaches to the temporal horn. J Neurosurg 2004; 101: 739-46.
Fontana H, Belziti H, Requejo F. El espacio perforado anterior y zonas aledañas, con consideraciones funcionales, Parte I. Rev Argent Neuroc 2002; 17(1): 1-12.
Fontana H, Belziti H, Requejo F. El espacio perforado anterior y sus zonas aledañas, con consideraciones funcionales. Parte II. Rev Argent Neuroc 2003; 17(2): 1-10.
Requejo F, Fontana H, Belziti H, Recchia M. El tallo temporal. Descripción de su estructura anatómica. Rev Argent Neuroc 2005; 19(1): 1-11.
Tusa RJ, Ungerleider LG. The inferior longitudinal fasciculus; a reexamination in humans and monkeys. Ann Neurol 1985; 18: 583-91.
Coppens JR, Mahaney KB, Abdulrauf SI. An anteromedial approach to the temporal horn to avoid injury to the optic radiation fibers and uncinate fasciculus: anatomical and technical note. Neurosurg Focus 2005; 18(6b) E3: 1-6.
Haffajee MR. Brain preparation to show fibre tracts and nuclei. JISP 1996; 10(1): 6-7.
Yasargil MG, Ture U, Yasargil DCH. Surgical anatomy of supratentorial midline lesions. Neurosug Focus 2005; 18(6b) E1: 1-9.
Peuskens D, van Loon J, van Calenberg F, van den Bergh R, Goffin J, Plets C. Anatomy of the anterior temporal lobe and the frontotemporal region demonstrated by fiber dissection. Neurosurgery 2004; 55(5): 1174-84.
Martínez F, Soria VR, Sgaribi N, Laza S, Prinzo H. Bases anatómicas de la hemisferotomía periinsular. Rev Med Uruguay 2004; 20: 208-14.
Recalde R, Sanz F, Coppola F, Zottis C, Bava E, De Oliveira E. Anatomía de las fibras blancas del lóbulo temporal en 3D. Rev Neurocirugía VIII 2006; 4: 106-10.
Shinohara H, Yasutaka S, Taniguchi Y, Kominami R, Kawamata S. Fiber dissection technique for demonstrating the lateral lemniscus of the human brain. Okajimas Folia Anat Jpn 2004; 80(5-6): 115-18.
Shinohara H, Yasutaka S, Kominami R. Gross anatomical fiber dissection technique and observation of nerve fasciculi in the human cerebrum. J Kanazawa Med Univ 2005; 30: 352-6.
de Castro I, de Holanda D, Paes Dos Santos D, Landeiro JA. Internal structure of the cerebral hemispheres. An introduction of the dissection technique. Arq Neuropsiquiatr 2005; 63(2- A): 252-8.
Rhoton AL Jr. The cerebrum. Neurosurgery 2002; 51(Suppl. 1): 1-51.
Rubino PA, Rhoton AL Jr, Tong X, de Oliveira E. Three-dimensional Relationships of the optic radiation. Neurosurgery 2005; 57(Suppl. 3): 219-27.
Choi C, Rubino PA, Fernadez-Miranda JC, Abe H, Rhoton AL. Meyer’s loop and the optic radiations in the transsylvian approach to the mediobasal temporal lobe. Neurosurgery 2006; 59(Suppl. 4); 228-36.
Vandewalle G, Beuls E, Vanormelingen L, Vandersteen M. Accessory intraventricular prominence of the occipital horn of the lateral ventricle. J Neurosurg 2003; 99: 151-5.
Kawashima M, Xiaoyong L, Rhoton AL Jr, Ulm AJ, Oka H, Fujji K. Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy. Surgical Neurology 2006; 65(5): 436-45.
Travers N, Destrieux C, Velut S. Etude micro-anatomique des fibres du faisceau uncine: applications dans la chirurgie frontotemporo- insulaire. Neurochirurgie 2004; 50(5): 586.
Oka DN, Travers N, Destrieux C, Velut S. Etude Microanatomique du faisceau occipito-frontal supérieur, á l´ ére de l´IRM en tenseur de diffusion. Neurochirurgie 2007; 53(5): 444-5.
Travers N. L’étude micro-anatomique des fibres du faisceau unciné et ses implications dans la chirurgie fronto-temporale. Neurochirurgie 2004; 50(1): 77.
Peltier J, Travers N, Destrieux C, Velut S. Optic radiations: a microsurgical anatomical study. J Neurosurg 2006; 105: 294- 300.
N’dri Oka D, Haidara A, Broalet E, Bazeze V. Etude micro anatomique du faisceau longitudinal superieur et ses implications cliniques. AJNS 2006; 26(2): 109-18.
Wu M, Haase P. Plastination of the neuroanatomical specimens: does freezing prior to dissection give better distinction between nuclei and fibre tracts? JISP 1996; 11(1): 26-7.
Roos ED. Localization of the pyramidal tract in the internal capsule by whole brain dissection. Neurology 1980; 30: 59-64.
Heimer L. Instructional video. Dissection of the human brain. Neurosurg Focus 2005; 18(6b) E4: 1-2.
Jellison BJ, Field AS, Medow J, Lazar M, Salamant MS, Alexander AL. Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. AJNR 2004; 25: 356-69.
Kier EL, Staib LH, Davis LM, Bronen RA. MR Imaging of the temporal stem: anatomic dissection ractography of the uncinate fasciculus, inferior occipitofrontal fasciculus, and Meyer’s loop of the optic radiation. AJNR 2004; 25: 677-91.
Kier EL, Staib LH, Davis LM, Bronen RA. Anatomic Dissection tractography: a new method for precise MR localization of white matter tracts. AJNR 2004; 25: 670-6.
Catani M, Jones DK, Donato R, Ffytche DH. Occipito-temporal connections in the human brain. Brain 2003; 126: 2093-107.
Makris N, Worth AJ, Sorensen AG, Papadimitriou GM, Wu O, Reese TG, et al. Morphometry of in vivo human white matter association pathways with diffusion-weighted magnetic resonance imaging. Ann Neurol 1997; 42: 951-62.
Yakovlev PI, Locke S. Limbic nuclei of the thalamus and connections of limbic cortex. III. Corticocortical connections of the anterior cingulated gyrus, the cingulum, and the subcallosal bundle in monkey. Arch Neurol 1961; 5: 364-400.
Duffau H, Capelle L, Sichez N, Denvil D, Lopes M, Sichez JP, et al. Intraoperative mapping of the subcortical language pathways using direct stimulations. An anatomo-funcional study. Brain 2002; 125: 199-214.
Türe U, Yasargil MG, Pait TG. Is there a superior occipitofrontal fasciculus? A microsurgical anatomic study. Neurosurgery 1997; 40(6): 1226-32.
Türe U, Yasargil DCH, Al-Mefty O, Yasargil MG. Topographic anatomy of the insular region. J Neurosurgery 1999; 90(4): 720-33.
Türe U, Yasargil MG, Friedman AH, Al-Mefty O. Fiber dissection technique: lateral aspect of the brain. Neurosurgery 2000; 47(2): 417-27.
Yasargil MG, Türe U, Yasargil DCH. Impact of temporal lobe surgery (Editorial). J Neurosurg 2004; 101: 725-38.
Jamieson EB. The means of displaying, by ordinary dissection, the larger tracts of white matter of the brain in their continuity. J Anat Physiol 1909; 18: 225-34.
Ulmer D. Fixation. The key to good tissue preservation. JISP 1994; 8(1): 7-10.
Riepertinger A. Fixation of the human brain for plastination: special considerations. JISP 1988; 2 (1): 8-12.
McIntosh J, Fildes P. The fixation of arsenic by the brain after intravenous injections of salvarsan. Proceedings of the Royal Society of the London. Series B, Containing papers of the biological character 1914; 88(603): 320-6.
Ohmichi K, Komiyama M, Matsuno Y, Takanashi Y, Miyamoto H, Kadota T, et al. Formaldehyde exposure in a gross anatomy laboratory. Personal exposure level in higher than indoor concentration. ESPR-Environ Sci Pollut Res 2006; 13(2): 120-4.
Dingle P, Tapsell P, Hu S. Reducing Formaldehyde exposure in office environments using plants. Bull Environ Contam Toxicol 2000; 64: 302-8.
Coleman R, Kogan I. An improved low-formaldehyde embalming fluid to preserve cadavers for anatomy teaching (Correspondence). J Anat 1998; 192: 443-6.
Gómez JA. Disección de fibras cerebrales, una buena alternativa en el aprendizaje tridimensional de la anatomía cerebral (Tesis). México, DF: Hospital Juárez de México; 2004.
Tomás V, Dorta D. La realidad virtual dibujada: como una nueva manera de hacer computación. Primera conferencia Venezolana sobre aplicación de computadoras en arquitectura FAU-UCV - CARACAS, 1999, p. 175-82.
Isolan GR, Rowe R, Al-Mefty O. Microanatomy and surgical approaches to the infratemporal fossa: an anaglyphic three-dimensional stereoscopic printing study. Skull Base 2007; 17(5): 285-302.
Shimizu S, Tanaka R, Rhoton AL Jr, Fukushima Y, Osawa S, Kawashima M, et al. Anatomic dissection and classic three-dimensional documentation: a unit of education for neurosurgical anatomy revisited. Neurosurgery 2006; 58(5): 1000-2.
Ribas GC, Bento RF, Rodríguez AJ Jr. Anaglyphic three-dimensional stereoscopic printing: revival of an old method for anatomical and surgical teaching and reporting (Technical note). J Neurosurg 2001; 95: 1057-66.
Kakizawa Y, Hongo K, Rhoton AL Jr. Construction of a threedimensional interactive model of the skull base and cranial nerves. Neurosurgery 2007; 60(5): 901-10.
Mason TP, Applebaun EL, Rasmusen M, Millman A, Evenhouse R, Panko W. Virtual temporal bone: Creation and application of a new computer-based teaching tool. Otolaryngol Head Neck Surg 2000; 122: 168-73.
Yasargil MG. From the microsurgical laboratory to the operating theatre (Editorial). Acta Neurochir (Wien) 2005; 147: 465-68.
De Jongh E, Pereira FR, Pereira R. Modelo simulador para entrenamiento en neuroendoscopia y neuroanatomía. Rev Cubana Cir 2005: 44(1): 0-0.
Ravera F, Yañez A, Cerda J, Valenzuela S. Laboratorio de microneuroanatomía y microcirugía: una necesidad real para la práctica neuroquirúrgica. Rev Chil Neurocirug 2006; 26: 44-8.