Idiopathic trigeminal sensory neuropathy. A case report.

Idiopathic trigeminal sensory neuropathy is a rare clinical condition characterized by sensory disturbances on the face. Its symptoms may be permanent or temporary and a wide variety of diagnostic procedures is usually required to establish the diagnosis. Frequently, it is the first manifestation of a systemic disorder. In the majority of cases causal treatment is not possible, even though patients with trigeminal sensory neuropathy should be carefully monitored by physicians.

Maxillary sinus anatomy variation and nasal cavity width: structural computed tomography imaging.

Variability of the bony structures located in the maxillary sinus, and of the lateral nasal wall topography, have practical significance during surgical procedures conducted by maxillofacial surgeons or otolaryngologists. The retrospective analysis of 111 computed tomography examinations of patients (52 male and 59 female) diagnosed in our institution was made to evaluate anatomical variations of the maxillary sinus. In the study the frequency of the Haller cell was 29/222 (13%), and the prevalence of one or more septa per sinus was 49/222 (26%). The infraorbital recess was found in 6/222 (3%) of cases. The mean width of the nasal duct was enlarged at the side where the Haller cell was present (p < 0.01) or where bony septa were absent in the maxillary sinus (p < 0.01). Bony structures of the maxillary sinus and changes in topography of the lateral nasal wall should compel surgeons to carefully analyze the computed tomography scans before operations in this area.

Clinical anatomy of internal thoracic artery branches.

The broad clinical utilization of the internal thoracic artery (ITA), including the role of its branches in supplying circulation to the sternum, requires explicit anatomic knowledge of this vessel. Fifty-six ITAs (28 right, 28 left) were dissected from their point of origins after injection with a mixture of contrast medium and latex after perfusion with saline and immersion in 4% formaldehyde. All ITA branches were studied according to their course, size, and distribution within intercostal spaces with the aid of an operating microscope. The branches were divided in two main groups: proper (solitary) branches and common trunks. The proper branches consisted of four types: sternal, perforating, intercostal, and mediastinal. The four types of common trunks were: sternal/perforating, sternal/intercostal, perforating/intercostal, sternal/perforating/intercostal. Points of most frequent origin from main trunk of the vessel were established for each type. Mean external diameter of proper branches was 0.72 mm and common trunks was 1.06 mm. Mean length of common trunks was 3.0 mm. Those parameters (adequate diameter and length) allow for ligation of the common trunks close to the ITA so that their points of division can be preserved. This fact is crucial for creation of collateral blood supply to the sternum after bilateral ITA mobilizations.