RESUMEN
BACKGROUND: The trigeminocardiac reflex is the sudden-onset of dysrhythmia and hypotension during manipulation of any of the branches of the trigeminal nerve. The trigeminal nerve and cardioinhibitory vagus nerve constitute the afferent and efferent pathways in the reflex arc. The trigeminocardiac reflex has been reported to occur during craniofacial surgery, balloon-compression rhizolysis of the trigeminal ganglion, and tumour resection in the cerebellopontine angle. PATIENT & METHOD: A 2-year-old male patient with haemangioma near the sella turcica underwent rhizotomies of both sides of the dorsal sensory roots, of the trigeminal nerves for palliation of intractable trigeminal pain. RESULTS: In this report, we experienced two unexpected episodes of asystole after transection of the sensory roots of the trigeminal nerves. CONCLUSION: Sectioning of the intracranial dorsal sensory root of the trigeminal nerve provides clear evidence of the central role of the trigeminal nerve as the afferent pathway of the trigeminocardiac reflex arc.
Asunto(s)
Paro Cardíaco/etiología , Reflejo/fisiología , Rizotomía/efectos adversos , Nervio Trigémino/fisiología , Nervio Trigémino/cirugía , Neuralgia del Trigémino/cirugía , Anciano , Fosa Craneal Posterior , Hemangioma/complicaciones , Humanos , Neoplasias Infratentoriales/complicaciones , Masculino , Dolor Intratable/etiología , Dolor Intratable/cirugía , Recurrencia , Reflejo Oculocardíaco/fisiología , Neuralgia del Trigémino/etiologíaRESUMEN
The position of mandibular teeth is difficult to document in the neonatal patient. Panorex images are difficult to obtain in an uncooperative pediatric patient. The new technique presented by the authors uses computed tomographic data to create a curved, reformatted image of the mandible, and generates an image similar to a panorex image. This curved, reformatted mandibular image provides accurate visualization of the mandible and mandibular teeth. This technique allows for precise pin placement and osteotomy in distraction osteogenesis.
Asunto(s)
Imagenología Tridimensional/métodos , Mandíbula/diagnóstico por imagen , Micrognatismo/diagnóstico por imagen , Osteogénesis por Distracción , Humanos , Lactante , Masculino , Mandíbula/cirugía , Disostosis Mandibulofacial/diagnóstico por imagen , Disostosis Mandibulofacial/cirugía , Micrognatismo/cirugía , Planificación de Atención al Paciente , Síndrome de Pierre Robin/diagnóstico por imagen , Síndrome de Pierre Robin/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Over the past several years, surgery aided by the endoscope has come into favor for a number of reasons. Because it is minimally invasive surgery, it has less morbidity, thus, reduced postoperative pain and complications. It results in earlier mobilization and shorter hospitalization, and most importantly, it contributes to an improved cosmetic appearance as a result of a shortened incision line concealed within the hairline in most cases. We have proposed an alternative approach to the surgical resection of forehead masses by means of the endoscope, which has proven to be useful not only for diagnosis but also as a therapeutic tool for the removal of forehead lesions. This report described the clinical experience with the removal of forehead masses in four patients. The cases illustrated the feasibility and ease of resecting a variety of forehead masses with excellent cosmetic results. We hope that more plastic surgeons will use the proposed technique and will continue to explore the safe limits of endoscopic plastic surgery.
Asunto(s)
Endoscopía/métodos , Quiste Epidérmico/cirugía , Frente/cirugía , Lipoma/cirugía , Osteoma/cirugía , Neoplasias Craneales/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
This article reviews a number of well-known syndromes involving craniofacial synostosis and associated midface deficiencies. Syndromes discussed include Apert's, Crouzon's, Saethre-Chotzen, and Carpenter's. Clinical characteristics and genetic defects are discussed. A general approach to surgical management is outlined.
Asunto(s)
Acrocefalosindactilia , Craneosinostosis , Procedimientos de Cirugía Plástica/métodos , Acrocefalosindactilia/epidemiología , Acrocefalosindactilia/genética , Acrocefalosindactilia/patología , Acrocefalosindactilia/terapia , Adolescente , Craneosinostosis/epidemiología , Craneosinostosis/genética , Craneosinostosis/patología , Craneosinostosis/terapia , Femenino , Humanos , Recién Nacido , Masculino , PrevalenciaRESUMEN
A unique case of acute compartment syndrome of both lower legs caused by a ruptured tibial artery in a patient with polyarteritis nodosa is reported. No similar cases have been reported in the literature. A review of the literature on ruptured aneurysms in patients with polyarteritis nodosa is discussed.