RESUMEN
A new technique involving the use of a local block to anesthetize the inferior alveolar nerve (V3), a branch of the mandibular division of the trigeminal or fifth cranial nerve, is described. Clinicians fail to administer a successful mandibular block in as many as 15 per cent of all cases. This paper reviews and outlines some of the more common reasons for this failure, and how to avoid them. A short description of other techniques are presented, some of which should be reserved for isolated cases and not used on a routine basis. By avoiding or eliminating the reasons for mandibular block failure, and using the new block described in this paper, clinicians should be able to reduce the failure rate to much lower levels.
Asunto(s)
Nervio Mandibular , Bloqueo Nervioso/métodos , Anestesia de Conducción , Anestésicos Locales/administración & dosificación , Anestésicos Locales/química , Diseño de Equipo , Falla de Equipo , Humanos , Inyecciones/efectos adversos , Inyecciones/instrumentación , Nervio Mandibular/anatomía & histología , Agujas/efectos adversos , Bloqueo Nervioso/efectos adversos , Factores de Riesgo , Propiedades de Superficie , Factores de TiempoRESUMEN
Atlantoaxial instability has been reported to occur in 9-31% of persons with Down syndrome. The authors studied a subsample of patients with this chromosomal disorder who had both routine roentgenograms and computerized tomographic examinations. Computerized tomography revealed numerous skeletal anomalies of the C1-C2 region as well as spinal cord compression that were not visualized on plain roentgenograms. In addition, an apparent discrepancy of the atlanto-dens interval measurements between the two procedures was noted. The measurements of the plain roentgenograms were significantly greater than those obtained by computerized tomography, which is due to the magnification factor in plain roentgenograms.
Asunto(s)
Articulación Atlantoaxoidea/diagnóstico por imagen , Síndrome de Down/complicaciones , Inestabilidad de la Articulación/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Vértebras Cervicales/anomalías , Niño , Humanos , Inestabilidad de la Articulación/complicaciones , Apófisis Odontoides/anomalías , Espina Bífida Oculta/complicaciones , Espina Bífida Oculta/diagnóstico por imagen , Compresión de la Médula Espinal/complicaciones , Compresión de la Médula Espinal/diagnóstico por imagenRESUMEN
A 34-year-old black man underwent a left hemimandibulectomy with disarticulation for eradication of an extensive ameloblastoma. The resected mandible was immediately reconstructed by means of a titanium crib with an attached artificial condyle, which was overpacked with particulate bone removed from the iliac crest. Postoperative function and esthetics have been satisfactory. Histopathologic examination of the lesion disclosed an ameloblastoma with some features similar to those of a calcifying odontogenic cyst.
Asunto(s)
Ameloblastoma/patología , Neoplasias Mandibulares/patología , Adulto , Humanos , MasculinoRESUMEN
This report describes a case of bilateral post-traumatic carotid-carotid-cavernous fistulae (CCF), of both typical and atypical types, with delayed clinical deterioration. Unusual neuropathological lesions, distinctive from those due to direct cerebral trauma, are related to combined arterial ischemia and venous hypertension. Atypical CCF is not necessarily a benign disorder. Radiological monitoring is essential to detect spontaneous progressive intracranial shunting, to predict areas that are at risk from venous hypertension, and to identify remote sites of circulatory vulnerability.
