1/11. Inferior alveolar nerve injury related to mandibular third molar surgery: an unusual case presentation.Perforation of the lower third molar roots by the inferior alveolar nerve is uncommon and can be difficult to determine by conventional radiographic methods. Presented is a case of perforation that was treated by coronectomy, and showed an unusual complication in that the retained root erupted, moving the canal with it. The radiographic assessment of root perforation and the imaging modalities used to assess such cases are discussed.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/11. Skull-base trauma: neurosurgical perspective.Trauma to the cranial base can complicate craniofacial injuries and lead to significant neurological morbidity, related to brain and/or cranial nerve injury. The optimal management involves a multidisciplinary effort. This article provides the neurosurgeon's perspective in management of such trauma using a 5-year retrospective analysis of patients sustaining skull-base trauma. The salient features of anterior and middle skull-base (temporal bone) trauma are summarized, and the importance of frontal basilar trauma as well as brain injury is evident. With these injuries, all cranial nerves (except 9 to 12) are at risk; the olfactory nerve and the facial nerve are the first and second, respectively, to sustain injuries. This retrospective analysis provides a better understanding of cranial base trauma and its management. It emphasizes the multifaceted nature of such trauma and the need to recognize anterior skull-base complications, including cerebrospinal fluid leak and brain injury.- - - - - - - - - - ranking = 0.068265129568808keywords = spinal (Clic here for more details about this article) |
3/11. Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment.We experienced two cases of inferior alveolar nerve paresthesia caused by root canal medicaments, which were successfully relieved by microscopic endodontic treatment. In the first case, the paresthesia might have been attributable to infiltration of calcium hydroxide into the mandibular canal through the root canals of the mandibular left second molar tooth. In the second case, the paresthesia might have been attributable to infiltration of paraformaldehyde through the root canals of the mandibular right second molar tooth. The paresthesia was relieved in both cases by repetitive microscopic endodontic irrigation using physiological saline solution in combination with oral vitamin B12 and adenosine triphosphate.- - - - - - - - - - ranking = 4keywords = canal (Clic here for more details about this article) |
4/11. Inferior alveolar nerve injury caused by thermoplastic gutta-percha overextension.Injuries to the inferior alveolar nerve following trauma resulting in a mandibular fracture are well documented and are a well-known risk when surgical procedures are planned for the mandible in the region of the inferior alveolar canal. Such injuries are relatively rare following endodontic therapy. This article reports a case of combined thermal and pressure injury to the inferior alveolar nerve, reviews the pathogenesis of such an injury and makes suggestions for its management.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
5/11. Jugular foramen tumors: diagnosis and treatment.OBJECT: Jugular foramen tumors are rare skull base lesions that present diagnostic and complex management problems. The purpose of this study was to evaluate a series of patients with jugular foramen tumors who were surgically treated in the past 16 years, and to analyze the surgical technique, complications, and outcomes. methods: The authors retrospectively studied 102 patients with jugular foramen tumors treated between January 1987 and May 2004. All patients underwent surgery with a multidisciplinary method combining neurosurgical and ear, nose, and throat techniques. Preoperative embolization was performed for paragangliomas and other highly vascularized lesions. To avoid postoperative cerebrospinal fluid (CSF) leakage and to improve cosmetic results, the surgical defect was reconstructed with specially developed vascularized flaps (temporalis fascia, cervical fascia, sternocleidomastoid muscle, and temporalis muscle). A saphenous graft bypass was used in two patients with tumor infiltrating the internal carotid artery (ICA). facial nerve reconstruction was performed with grafts of the great auricular nerve or with 12th/seventh cranial nerve anastomosis. Residual malignant and invasive tumors were irradiated after partial removal. The most common tumor was paraganglioma (58 cases), followed by schwannomas (17 cases) and meningiomas (10 cases). Complete excision was possible in 45 patients (77.5%) with paragangliomas and in all patients with schwannomas. The most frequent and also the most dangerous surgical complication was lower cranial nerve deficit. This deficit occurred in 10 patients (10%), but it was transient in four cases. Postoperative facial and cochlear nerve paralysis occurred in eight patients (8%); spontaneous recovery occurred in three of them. In the remaining five patients the facial nerve was reconstructed using great auricular nerve grafts (three cases), sural nerve graft (one case), and hypoglossal/facial nerve anastomosis (one case). Four patients (4%) experienced postoperative CSF leakage, and four (4.2%) died after surgery. Two of them died of aspiration pneumonia complicated with septicemia. Of the remaining two, one died of pulmonary embolism and the other of cerebral hypoxia caused by a large cervical hematoma that led to tracheal deviation. CONCLUSIONS: Paragangliomas are the most common tumors of the jugular foramen region. Surgical management of jugular foramen tumors is complex and difficult. Radical removal of benign jugular foramen tumors is the treatment of choice, may be curative, and is achieved with low mortality and morbidity rates. Larger lesions can be radically excised in one surgical procedure by using a multidisciplinary approach. Reconstruction of the skull base with vascularized myofascial flaps reduces postoperative CSF leaks. Postoperative lower cranial nerves deficits are the most dangerous complication.- - - - - - - - - - ranking = 0.068265129568808keywords = spinal (Clic here for more details about this article) |
6/11. Avellis syndrome after minor head trauma: report of two cases.Avellis syndrome is a rare condition that usually occurs in association with infarction of the medulla oblongata or mass lesions around the jugular foramen; this syndrome has rarely been reported after trauma. Two cases of Avellis syndrome that occurred following minor head trauma are presented. The mechanism by which Avellis syndrome is produced is briefly discussed. The relative resistance to damage of the spinal accessory nerve was thought to play an important role in producing the peripheral type of Avellis syndrome. The outcome was favorable in both cases.- - - - - - - - - - ranking = 0.068265129568808keywords = spinal (Clic here for more details about this article) |
7/11. Reconstruction of the spinal accessory nerve with autograft or neurotube? Two case reports.Injury to the spinal accessory nerve is most commonly iatrogenic, but can be related to cervical trauma or resection of tumor. Of the two most recent publications related to injury of the spinal accessory nerve, one describes transfer of the levator scapulae muscle to restore shoulder function, while the other reports on the results of six surgical repairs, three of which used a sural nerve graft to reconstruct a short neural defect. The present report describes the results obtained in two patients when an iatrogenic injury to the XIth nerve was reconstructed at 3 months after the loss of shoulder function. denervation of the XIth nerve was confirmed by a first EMG at 6 weeks, and a second one at 12 weeks. At surgery, each XIth nerve was found to have an in-continuity neuroma, most probably related to electrocoagulation. Intraoperative electrical stimulation did not pass the region of nerve injury. In the first patient, the XIth nerve was reconstructed with an autograft from the greater auricular nerve. In the second patient, the XIth nerve was reconstructed with a bioabsorbable conduit, the Neurotube. The patient with the Neurotube reconstruction reached M5 trapezius function by 3 months after surgery, and had no nerve graft donor-site morbidity, while the patient with the autograft reached M4 function by 6 months after reconstruction, and has persistent numbness of the ear lobe. This is the first reported case of a cranial motor nerve being reconstructed with a bioabsorbable conduit.- - - - - - - - - - ranking = 0.40959077741285keywords = spinal (Clic here for more details about this article) |
8/11. Mental nerve paresthesia associated with endodontic paste within the mandibular canal: report of a case.The present study describes a case of endodontic paste (Endomethasone) penetration within and along the mandibular canal from the periapical zone of a lower first premolar following endodontic treatment of the latter. The clinical manifestations comprised anesthesia of the right side of the lower lip and paresthesia of the gums in the fourth quadrant, appearing immediately after endodontic treatment. The lip anesthesia was seen to decrease, with persistence of the gingival paresthesia, after 7 months.- - - - - - - - - - ranking = 5keywords = canal (Clic here for more details about this article) |
9/11. Inferior alveolar nerve injury related to surgery for an erupted third molar.Removal of third molars is one of the most common operations performed in oral surgery. A well recognized serious complication of mandibular third molar extraction is injury to the inferior alveolar nerve (IAN). We describe a case of an unusual nerve passage discovered after the extraction of a completely erupted third molar. The likelihood of direct damage to the IAN can be predicted with more specific information obtained by the use of a preoperative computerized tomography scan when conventional radiography does not clearly show the nerve canal.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
10/11. Traumatic atlantooccipital dislocation. Case report.A case of traumatic atlantooccipital dislocation is presented and the literature reviewed. This type of traumatic dislocation is probably produced by violent hyperextension of the upper cervical spine. cranial nerve injuries and spinal cord injuries are common. Early fusion is recommended.- - - - - - - - - - ranking = 0.068265129568808keywords = spinal (Clic here for more details about this article) |
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