1/60. Surgical treatment of recurrent trigeminal neuralgia.In this retrospective investigation 7 patients operated on for recurrent trigeminal neuralgia via a suboccipital enlarged burr hole trepanation were evaluated. The intraoperative findings indicate that neo-compressive effects due to foreign material used during prior surgery are more important than adhesions around the nerve. Furthermore, the results of recurrent operations are encouraging as 6 of the 7 patients were painfree without additional neurological deficits.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/60. Numerous transorbital wooden foreign bodies in the sphenoid sinus.A very rare case of numerous transorbital wooden foreign bodies penetrating into the sphenoid sinus in a 47-year-old male is reported. His right eye was nonreactive to light, and the oculomotor, trochlear and abducens nerves were completely disturbed. Although a minor injury was observed on the inner side of the right eyebrow, the wound was not serious or infectious. Computed tomographic scanning of the orbit and parasinus revealed an isodense linear shadow to muscle and an irregular shadow of the lamina papyracea. However, the findings were difficult to discriminate from an optic canal fracture preoperatively. We detected foreign bodies penetrating the optic nerve rise, which were successfully removed in combination with an endoscopic transethmoidal and transorbital approach. Various and careful imaging examinations are recommended to diagnose and manage paraorbital trauma, when a penetrating wound of the face is observed.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
3/60. Retrieval of a broken needle in the pterygomandibular space.BACKGROUND: Dental needle breakage can be a devastating experience for both practitioners and patients. The authors describe the surgical management for localizing a broken dental needle in the pterygomandibular space and how to prevent needle breakage. CASE DESCRIPTION: The authors present the case of a 35-year-old man who had a chief complaint of pain and the ability to feel a broken needle during mandibular movements after receiving an inferior alveolar nerve block from his general dentist before dental treatment. Surgical management involved localizing the broken needle using radiographs and removing the broken needle under general anesthesia. CLINICAL IMPLICATIONS: Preventing needle breakage is important, as it can be a traumatic experience for the patient. Practitioners should establish the patient's cooperation by explaining to him or her what to expect before injection. Practitioners also should routinely inspect dental needles before administering injections and minimize the number of repeated injections using the same needle.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
4/60. Unusual parotid gland foreign body.A foreign body in the parotid gland whether from the oral cavity or through the skin is extremely uncommon. A case is described of the tip of a golden-colored pencil accidentally piercing the deep lobe after a fall. Emergency surgical removal was performed, and the diagnosis of the foreign body was quite easy. In contrast, determination of the location in the gland had to be done by a microscope, with fluoroscopy during the operation and was quite difficult. During removal, great attention was paid to avoiding facial nerve injury. This was done by identifying the facial trunk at the pointer using a microscope. The dissolved material including copper and zinc metal powder, paste, and clay, was found in the deep lobe associated with the surrounding abscess. Although these materials are assumed to be harmless to human tissues, the complete and immediate removal is to prevent salivary fistule resulting from inflammation.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/60. Glossopharyngeal neuralgia following foreign body impaction in the neck.Glossopharyngeal neuralgia is rare, typically idiopathic and treated with carbamazepine. Surgery to decompress or transect the glossopharyngeal nerve root may be performed if conservative management fails. We present a case following trauma to the neck with foreign body impaction. To our knowledge this is the first case of glossopharyngeal neuralgia due to neck trauma.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/60. Patient tolerance of cervical esophageal metallic stents.PURPOSE: To demonstrate that proximal esophageal stenoses and tracheoesophageal fistulas can be adequately palliated with use of metallic stents without significant foreign-body sensation. MATERIALS AND methods: Between June 1994 and March 1999, 22 patients with lesions within 3 cm of the cricopharyngeus were treated by placement of metallic stents. The series was reviewed retrospectively. Twenty patients had surgically unresectable malignant lesions, two patients had benign disease. Ten patients had associated tracheoesophageal fistulas. In all, the upper limit of the stent was between C5 vertebral body inferior endplate and the T2 vertebral body superior endplate. The case-notes were reviewed until patient death (range, 6-198 days), or to date in the two surviving patients with benign disease. RESULTS: Immediate technical success was 93% (27 of 29). Dysphagia scores improved from a median of 3 to 2 after stent placement. Eighteen of 22 (82%) patients reported no foreign-body sensation. There have been no cases of proximal migration, periprocedural perforation, or deaths. The two patients with benign disease experienced significant complications. CONCLUSION: Lesions in proximity to the cricopharyngeus can be successfully palliated without significant foreign-body sensation in the majority of patients with use of metallic stents. The authors urge caution in placing stents in patients with benign disease.- - - - - - - - - - ranking = 0.7552904728177keywords = median (Clic here for more details about this article) |
7/60. Delayed presentation of transorbital intracranial pen.A 13 year old Fijian boy sustained a stab wound to the left orbit 3 years ago. It was not appreciated by the treating physicians in fiji that the plastic pen had crossed from the left orbit, through the nose, right orbit and right optic nerve, into the right middle cranial fossa and lodged in the right temporal lobe and that the pen remained in situ for the past 3 years. The boy presented to australia with a discharge from the entry wound in his left lower eyelid. The retained foreign body was not detected on computed tomography imaging, but was detected on subsequent magnetic resonance image. A combined neurosurgery/plastic surgery craniofacial approach was undertaken with successful complete removal of the retained pen, and preservation of vision in his only seeing eye.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
8/60. median nerve injury caused by missed foreign body. Case report.A 56-year-old woman sustained a delayed median nerve division after a penetrating injury of the right wrist by a piece of wood had gone unnoticed. There was no neurological damage at the time of the injury. The foreign body spread the median nerve apart, which subsequently reduced the sensitivity in the index finger. Removal of the wood resulted in complete recovery.- - - - - - - - - - ranking = 100.21175139746keywords = median nerve, nerve, median (Clic here for more details about this article) |
9/60. Treatment of inguinodynia after laparoscopic herniorrhaphy: a combined laparoscopic and fluoroscopic approach to the removal of helical tackers.Laparoscopic inguinal herniorrhaphy has become a popular operation for the treatment of inguinal hernia. However, injury and entrapment of the cutaneous nerves of the lumbar plexus by the staples or tackers used for mesh fixation have been described. Laparoscopic removal of the staples or tackers in the inguinal region has been attempted with variable success. The success of the laparoscopic approach for removal of helical tackers in particular is sometimes limited by the fact that the offending tackers are deeply embedded in the preperitoneal tissues and not readily located with a simple laparoscopic view. The authors report a case in which fluoroscopy was used to help identify tackers that could not be visualized laparoscopically. The neuralgia disappeared after successful removal of the offending tackers with no neurologic deficit. Liberal use of fluoroscopic guidance in the laparoscopic removal of helical tackers in similar cases is recommended.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
10/60. vocal cord paralysis secondary to impacted esophageal foreign bodies in young children.Impacted foreign bodies in the esophagus can result in respiratory symptoms including stridor and aphonia. Several mechanisms have been proposed to explain these symptoms, but the possibility of vocal cord paralysis and its cause has not been adequately emphasized. Two cases of young children with esophageal foreign body are described; both presented with respiratory symptoms, 1 with aphonia and the other with stridor. In both cases, the symptoms were secondary to vocal cord paralysis. A possible mechanism of recurrent nerve injury is proposed.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
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