OBJECTIVE: Precise entry to the upper posterior calyx is key to a successful and safe upper pole access PCNL. The surgeon's knowledge of the average skin to calyceal distance can serve as a guide to avoid inadvertent injury to both the kidney and collateral organs during the percutaneous puncture.
METHODS: The authors analyzed the radiologic images of 84 patients who underwent unenhanced 64-slice helical CT scan (Toshiba®). Skin-to-calyceal distance (SCD) to the upper posterior calyx were measured using the Vitrea® software inherent to the CT scan.
RESULTS: The mean SCDs is non-hydronephrotic kidneys were 54.9 ± 13.7 mm and 61.4 ± 12.5 mm on the right and left, respectively while in hydronephrotic kidneys, the mean SCDs were 60.3 ± 11.8 mm and 58.6 ± 13.1 mm on the right and left, respectively. There was no statistically significant difference between the right and left upper pole SCD in both groups (p = 0.84).
CONCLUSION: The mean SCD to the upper posterior calyx among Filipino adults is about 6.0 cm. By limiting the depth of the initial puncture to within the distance, the endourologist may avoid overshooting the targeted calyx, thus avoiding undue injury to the kidney or intraabdominal structures.

Human ; Male ; Female ; Adult ; Young Adult ; Kidney Calices ; Tomography, X-ray Computed ; Kidney ; Tomography, Spiral Computed ; Punctures ; Surgeons

Objective: To describe the cochlear anatomy among Filipinos through high resolution computed tomography (HRCT) imaging. Methods: Design: Retrospective Study Setting: Tertiary Private University Hospital Patients: Cochlear images retrospectively obtained from computed tomography (CT) scans of subjects who underwent cranial, facial, paranasal sinus and temporal bone computed tomography from October 2009 to July 2010 were reconstructed and analyzed. Results: 388 cochlear images were obtained from the scans of 194 subjects (101 males and 93 females, aged 1 to 90 years old, mean = 52 years) and reconstructed for analysis. The mean coiled cochlear height measured 4.36 mm on the right (A.D.) and 4.34 mm on the left (A.S.). Measurement from the oval window to the distal end of the basal turn (equivalent to the horizontal dimension of the cochlea or the mean length of the basal turn) was 7.55 mm A.D. and 7.60 mm A.S. The vertical and horizontal dimensions of right and left cochleas were identical in all subjects (S.D. = 0.35). The right and left cochlear turns were identical in each subject, exhibiting 2 1/2 turns in 92.3% of subjects and 2 3/4 turns in 7.7% of subjects.The cochlear dimensions were similar in all subjects, regardless of age. No cochlear ossification or malformation was noted on any CT image. Conclusion The 7.55 mm mean length of the cochlear basal turn among Filipinos in this study was 1.24 mm shorter than the average length of the basal turn of 8.81 mm reported elsewhere. Further studies of the cochlear dimensions in specific age groups and its correlation to audiometric status are recommended to determine other significant physiologic correlations.
Cochlea ; Magnetic Resonance Imaging