O objetivo deste estudo é avaliar a correspondência anatômica entre a eminência arqueada e o canal semicircular superior na superfície da fossa craniana média. Este estudo transversal descritivo foi realizado em um hospital terciário. Setenta e cinco pacientes consecutivos (150 lados), submetidos à tomografia computadorizada de alta resolução dos ossos temporais, foram analisados por dois autores. Para cada exame, a relação anatômica entre a eminência arqueada e o canal semicircular superior foi classificada como coincidente ou não coincidente. Distâncias entre os parâmetros anatômicos de maior utilidade na cirurgia da fossa média e prevalência de deiscência do canal semicircular superior também foram estudadas. A eminência arqueada foi coincidente com o canal semicircular superior em apenas 31.3% dos casos. Não foi possível identificar a eminência arqueada em 33 exames (22.0%). Deiscência do canal semicircular superior foi encontrada em cinco casos (3.3%). Poucos milímetros separaram a cóclea do canal semicircular superior. As medidas secundárias foram caracterizadas por ampla variabilidade. A eminência arqueada não se sobrepõe sistematicamente ao canal semicircular superior e não deve ser usada rotineiramente como uma referência para a localização dessa estrutura. / The objective of this study is to evaluate the anatomical coincidence between the arcuate eminence and the superior semicircular canal at the middle cranial fossa surface. This crosssectional descriptive study was performed at a tertiary hospital. Seventy-five consecutive patients (150 sides) who underwent bilateral high-resolution temporal bone computed tomography scans were analyzed by two authors. In each scan, the anatomical relationship between the arcuate eminence and the superior semicircular canal was classified as coincident or non-coincident. Distances between the most applicable anatomical landmarks for middle cranial fossa surgery and the prevalence of superior semicircular canal dehiscence were also studied. The arcuate eminence matched the semicircular canal in only 31.3% of cases. It was impossible to identify the arcuate eminence in 33 scans (22.0%). Semicircular canal dehiscence was found in 5 cases (3.3%). A few millimeters separated the cochea from SSC; secondary measurements were characterized by broad variability. The arcuate eminence does not systematically overlie the superior semicircular canal and should not be routinely used as a reference for reaching this structure in the context of middle fossa surgery.

Este estudo avaliou por meio da Ressonância Magnética a intensidade de sinal do tecido retrodiscal associando a anatomia da eminência articular, derrame articular e deslocamento do disco com e sem redução. Para isto, foram analisadas imagens por RM de 48 ATM de 24 indivíduos sintomáticos, sendo 19 (79,2%) do gênero feminino e 5 (20,8%) do gênero masculino. Considerando o posicionamento sagital, cerca de 5 (10,4%) das articulações eram normais, 23 (47,9%) das articulações eram DDCR e 20 (41,7%) eram DDSR. Para a forma da eminência articular, cerca de 15 (31,3%) das articulações foram classificadas como tendo formato de caixa, 12 (25,0%) foram classificadas como sigmoide, 10 (20,8%) como aplainada e 11 (22,9%) das articulações foram classificadas como deformada. A maioria das articulações apresentaram derrame cerca de 32 (66,7%). Das articulações com DDSR, 16 (51,6%) apresentaram derrame e as com DDCR 15 (48,4%). As articulações com DDCR apresentaram 9 (39,15) em forma de caixa, 6 (26,1%) como sigmóide, 3 (13,0%) estavam aplainada e 5 (21,7%) deformadas; as ATM com DDSR apresentaram 5 (25,5%) como caixa, 4 (20,0%) como sigmóide, 6 (30,0%) aplainadas e 5 (25,5%) deformadas. A forma da eminência articular não está relacionada ao posicionamento sagital (p=0,520). O posicionamento sagital do disco não está relacionado à presença de derrame (p=0,281). A intensidade de sinal do TR foi estatisticamente menor no posicionamento sagital DDCR, quando comparado ao posicionamento sagital DDSR (p=0,016). Houve uma tendência da intensidade do sinal do tecido retrodiscal ser maior nas articulações com derrame quando comparado às sem derrame (p=0,065). Não houve relação entre posicionamento sagital do disco e derrame. E por fim, o presente estudo não conseguiu estabelecer uma relação entre o sinal do tecido retrodiscal e eminência articular (p=0,159). / This study evaluated MR signal intensity of retrodiscal tissue associated with articular eminence morphology, joint effusion status, and disc displacement with and without reduction (DDwR and DDwoR, respectively). Forty-eight TMJ MR images of 24 symptomatic subjects (19 females and 5 males) were analyzed. For the sagittal position, 5 (10.4%) joints were normal, 23 (47.9%) showed DDwR and 20 (41.7%) DDwoR. Regarding articular eminence morphology, 15 (31.3%) joints were classified as box-shaped, 12 (25.0%) as sigmoid, 10 (20.8%) flattened and 11 (22.9%) deformed. The majority of TMJs (32 or 66.7%) showed effusion. Sixteen (51.6%) of the TMJs with DDwoR had effusion versus 15 (48.4%) of those with DDDwR. Of TMJs with DDwR, 9 (39.1%) were box-shaped, 6 (26.1%) sigmoid, 3 (13.0%) flattened and 5 (21.7%) deformed. Among joints with DDwoR, 5 (25.5%) were boxshaped, 4 (20.0%) sigmoid, 6 (30.0%) flattened and 5 (25.5%) deformed. As a conclusion, articular eminence shape was not related to sagittal position of the disk (p = 0.520). Sagittal position of the disk was not related to presence of effusion (p = 0.281). Signal intensity of retrodiscal tissue (RT) was statistically lower in the DDwR sagittal position than in DDwoR cases (p = 0.016). There was a tendency for higher RT signal intensity in joints with effusion versus those without effusion (p = 0.065). No relationship between sagittal position of the disc and effusion was observed. No relationship between signal intensity of retrodiscal tissue and shape of articular eminence was identified (p = 0.159).

The intention of this research is to develop a homiletical approach that will better equip the preacher in proclaiming the Glory of God. The study comes in a context where there has been a legitimate shift in emphasis in the direction of the listener, but it is the contention of this study that the pendulum has swung away from the pre-eminence of God that should permeate sermons being preached. Having established the need for a renewed apprehension of God in preaching the writer examines the general preaching landscape leading up to and including the 21st century. This part of the study includes some of the influences on the present day understanding on the role of knowledge and the questioning of God’s ability to communicate truth to man. The study also shows how these influences have led to a focus in preaching on human feeling and experience. The weight of Gods glory is then examined with the consequent implication of God’s passion for His own glory and the need for all preaching therefore to be Theo-centric. This is reinforced by an examination of the transcendence of God, unfolding the dangers of domesticating God by eliminating a sense of mystery as to the infinite nature of God. An overview of more recent developments in homiletical theory is examined demonstrating the conspicuous absence of the pre-eminence of God in preaching. A summary of the following three preaching models is presented; expository, narrative and topical, to provide a basis for later comparison. Key theological convictions and practices necessary to proclaim the Glory of God are then identified from the literature study. These are then used in a questionnaire compiled to be used in churches where the listeners are exposed to the three identified preaching models. The results from the empirical study is then analysed in the light of the theory presented in the literature studies. On the basis of these outcomes the following guidelines were recommended: -- Guidelines on determining the content of the sermon. -- Guidelines on the focus of the sermon. -- Guidelines on the content of the sermon. -- Guidelines on believing that God is primarily concerned about Himself leading to greater confidence in God’s grace to sinful people. And then finally, concluding that if the desired goal of proclaiming the Glory of God is to be consistently accomplished, then the expository model of preaching is best suited to the task. / Thesis (PhD (Practical Theology))--University of Pretoria, 2007. / Practical Theology / unrestricted

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