ABSTRACT
A 38-year-old white woman came to the emergency department complaining of severe, unilateral jaw pain. She had consulted her primary care physician and dentist without achieving the correct diagnosis or significant relief of her symptoms. The emergency physician made the diagnosis of trigeminal neuralgia by obtaining a history of severe paroxysmal ipsilateral facial pain activated by numerous facial stimuli. A light stimulation of the trigger point precipitated the pain. Her pain relief from carbamazepine lent further credence to the diagnosis of trigeminal neuralgia and appropriate referral to a neurosurgeon. Pain relief was ultimately achieved for the last 8 months by a neurectomy of the right infraorbital nerve.
Subject(s)
Emergencies , Trigeminal Neuralgia/diagnosis , Adult , Analgesics, Non-Narcotic/therapeutic use , Carbamazepine/therapeutic use , Denervation , Female , Humans , Referral and Consultation , Trigeminal Neuralgia/physiopathology , Trigeminal Neuralgia/therapyABSTRACT
Lacrimal canaliculitis is an infection of the lacrimal duct system. The classic features of lacrimal canaliculitis are mild to severe swelling of the canaliculus, mucopurulent discharge from the punctum, and a red, pouting punctum. Canaliculotomy with systemic or topical antibiotics is the most appropriate treatment for this disorder.
Subject(s)
Actinomycosis/diagnosis , Lacrimal Apparatus Diseases/microbiology , Actinomycosis/drug therapy , Actinomycosis/surgery , Adult , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Dacryocystorhinostomy , Drug Therapy, Combination/therapeutic use , Female , Humans , Lacrimal Apparatus Diseases/drug therapy , Lacrimal Apparatus Diseases/surgery , Lacrimal Duct Obstruction/drug therapy , Lacrimal Duct Obstruction/microbiology , Neomycin/therapeutic use , Polymyxin B/therapeutic useABSTRACT
Lactomer and the Polyglactin 910 are coated synthetic braided absorbable sutures commonly used for dermal wound closure. Biomechanical performance tests demonstrated superior performance characteristics of the Lactomer sutures. Using narrow diameter sutures, the Lactomer sutures exhibited superior knot holding forces over the Polyglactin 910 sutures. Moreover, knot security could be reliably achieved with asymmetric and symmetric knots using the Lactomer sutures.
Subject(s)
Sutures , Biomechanical Phenomena , Polyglactin 910 , PolymersABSTRACT
Medpor is a porous polyethylene biomaterial used in plastic and reconstructive surgery in the craniofacial skeleton. Its porous nature allows for substantial vascular and soft-tissue ingrowth. Medpor is available in a variety of implants including block, sheet, and preformed shapes. In vitro and in vivo studies have demonstrated that Medpor has been successfully used in the reconstruction of the orbital floor and external ear, and in augmentation of the chin, mandibular, nasal, and malar regions.
Subject(s)
Biocompatible Materials , Facial Bones/surgery , Polyethylenes , Prostheses and Implants , Humans , Prosthesis Implantation/methodsABSTRACT
Hydroxyapatite compounds and a new anorganic bovine bone mineral are materials that offer an alternative to autologous bone grafting. Ceramic hydroxyapatite implants are limited in their usefulness due to difficulty in contouring the cortical form and the tendency for the granular form to exist outside the reconstruction site. These limitations have been overcome by the advent of a hydroxyapatite cement paste exhibiting good biocompatibility, contour manipulation, implant stability and osseoinduction. Preliminary studies indicate that a new resorbable anorganic bovine bone mineral with a chemical composition and structure similar to human bone promotes initial bony healing more readily than its synthetic hydroxyapatite counterpart, and therefore may serve as an excellent alternative for craniofacial reconstruction.