Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 970
Filtrar
1.
Oper Neurosurg (Hagerstown) ; 24(2): 209-220, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36637306

RESUMO

BACKGROUND: Extracranial to intracranial bypass is used to augment and/or replace the intracranial circulation for various pathologies. The superficial temporal artery is the mainstay donor for pedicled bypasses to the anterior circulation but can be limited by its variable size, low native flow rates, and potential scalp complications. Interposition grafts such as the radial artery or greater saphenous vein are alternatives but are sometimes limited by size mismatch, length needed to reach the extracranial circulation, and loss of inherent vascular elasticity. Interposition grafts between the maxillary artery (IMA) and middle cerebral artery (MCA) address these limitations. OBJECTIVE: To explore the feasibility of harvesting the IMA through an endoscopic transnasal, transmaxillary approach to perform a direct IMA to MCA bypass. METHODS: Combined transcranial and endoscopic endonasal dissections were performed in embalmed human cadavers to harvest the IMAs for intracranial transposition and direct anastomosis to the MCA. Donor and recipient vessel calibers were measured and recorded. RESULTS: A total of 8 procedures were performed using the largest and distal-most branches of the IMA (the sphenopalatine branch and the descending palatine branch) as pedicled conduits to second division of middle cerebral artery (M2) recipients. The mean diameter of the IMA donors was 1.89 mm (SD ± 0.42 mm), and the mean diameter of the recipient M2 vessels was 1.90 mm (SD ± 0.46 mm). CONCLUSION: Endoscopic harvest of the IMA using a transnasal, transmaxillary approach is a technically feasible option offering an excellent size match to the M2 divisions of the MCA and the advantages of a relatively short, pedicled donor vessel.


Assuntos
Revascularização Cerebral , Artéria Cerebral Média , Humanos , Artéria Cerebral Média/cirurgia , Artéria Maxilar/cirurgia , Estudos de Viabilidade , Revascularização Cerebral/métodos , Endoscópios
2.
Zh Vopr Neirokhir Im N N Burdenko ; 86(5): 101-111, 2022.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-36252200

RESUMO

OBJECTIVE: To present the technique of extra-intracranial bypass surgery using the orifice of maxillary artery bypass, to evaluate the advantages and disadvantages of this and alternative revascularization options. MATERIAL AND METHODS: Radial artery graft harvesting was performed at the 1st stage. Simultaneously, the second team of surgeons performed a combined (submandibular and anterior) access to the donor artery (mandibular segment of maxillary artery behind the ramus of the mandible). Craniotomy and mobilization of potential recipient arteries (M2-M3 segments of the middle cerebral artery) were performed at the 2nd stage. Distal anastomosis in end-to-side fashion was formed with M3 segment of the middle cerebral artery. At the 3rd stage, radial artery was passed through a subcutaneous tunnel in zygomatic region. The orifice of maxillary artery was resected together with distal external carotid artery (ECA) and orifice of superficial temporal artery. After transposition of ECA and orifice of maxillary artery, proximal end-to-end anastomosis was performed with radial artery. After that, the main surgical stage was performed, i.e. exclusion of M3 segment of the middle cerebral artery together with aneurysm. RESULTS: Harvesting of mandibular segment of the maxillary artery as a donor vessel reduces the length of bypass graft to 12-14 cm since this branch is localized close to the skull base. You can also form optimal proximal end-to-end anastomosis for intracranial redirecting blood flow maxillary artery. CONCLUSION: The described method makes it possible to form anastomosis with a short bypass graft and reduce the risk of thrombosis. This procedure is effective for cerebral bypass in patients with skull base tumors, complex aneurysms, and occlusive-stenotic lesions of carotid arteries.


Assuntos
Revascularização Cerebral , Aneurisma Intracraniano , Anastomose Cirúrgica/métodos , Revascularização Cerebral/métodos , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Artéria Maxilar/diagnóstico por imagem , Artéria Maxilar/cirurgia , Artéria Cerebral Média/cirurgia
3.
Clin Ter ; 173(5): 496-499, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36155736

RESUMO

Abstract: Tooth extraction is a common procedure that is performed routinely and is associated with very few risks. The formation of a pseudoaneurysm as a direct result of tooth extraction has not been widely reported in published studies; it is more frequent as a complication of orthognathic surgery (1). The purpose of this paper is to describe the literature of maxillary artery pseudoaneurysm and its diagnosis and treatment in the Emer-gency Department. The search engine we used is Pubmed. 39 studies were analyzed; mainly, they were case reports. In this study, we will analyze the cases of pseudoaneurysm formation following dental extraction and orthognotia surgery which are reported in literature.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Falso Aneurisma/cirurgia , Falso Aneurisma/terapia , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/métodos , Serviço Hospitalar de Emergência , Humanos , Artéria Maxilar
4.
Ear Nose Throat J ; 101(10_suppl): 40S-43S, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36047445

RESUMO

Internal maxillary artery (IMA) pseudoaneurysms are rare, and typically occur following trauma or orthognathic surgery. Pseudoaneurysms are life-threatening conditions, and expeditious workup and treatment is critical. Endoscopic treatment of an IMA pseudoaneurysm is a feasible option and should be considered when IR embolization is not available. The objective of this study is to review the literature on IMA pseudoaneurysms and present the first reported case of an IMA pseudoaneurysm successfully treated endoscopically.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Humanos , Artéria Maxilar , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Endoscopia
5.
J Craniofac Surg ; 33(8): e861-e863, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35882049

RESUMO

The external carotid artery divides terminally into the superficial temporal and maxillary arteries (MA), deep to the base of the neck of the mandible. Arterial fenestrations are commonly found in the vertebrobasilar and internal carotid systems but are rarely encountered, or reported, in the external carotid artery system. The archived computed tomography angiograms of a 70-year-old male patient were observed anatomically. Inferior to the posterior end of the lateral pterygoid muscle was found a fenestrated segment of the MA, oriented mediolaterally. The middle meningeal artery left the superior arm of that fenestration. The inferior arm of the fenestration gave off a temporoalveolar trunk, further divided into posterior deep temporal and inferior alveolar arteries. The MA fenestration and the temporoalveolar trunk are rare variations of the MA at the entrance in the infratemporal fossa. These make the MA prone to iatrogenic lesions during different surgical procedures addressed to this region.


Assuntos
Artéria Maxilar , Músculos Pterigoides , Masculino , Humanos , Idoso , Artéria Maxilar/diagnóstico por imagem , Artéria Carótida Externa/diagnóstico por imagem , Artérias , Angiografia
6.
World Neurosurg ; 164: e1123-e1134, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35654335

RESUMO

BACKGROUND: Cerebral revascularization strategies through extracranial to intracranial bypass have been adopted in the management of complex intracranial aneurysms. The internal maxillary artery used as a donor in a bypass is an effective method. At present, there are few quantitative analyses of cerebral blood flow perfusion. The main focus of this study was to evaluate the effectiveness of blood perfusion after bypass grafting. METHODS: From April 2015 to December 2017, 19 patients who underwent internal maxillary artery radial artery middle cerebral artery bypass surgery with unobstructed bypass vessels were selected. Cerebral blood flow perfusion before and after bypass surgery was quantitatively evaluated by computed tomography perfusion imaging. The cerebral blood perfusion in the region of interest was measured by computed tomography perfusion. RESULTS: The aneurysms were excised after trapping in 2 cases with mass effects and neural compression. Proximal occlusion of the parent artery was performed in 9 cases of fusiform or giant dissecting aneurysms. Trapping was performed after bypass surgery in 8 cases. Within 3 months after surgery, 17 patients had good outcomes. After the hypothesis test, there was a significant difference between the preoperative △cerebral blood volume and postoperative △cerebral blood volume in the anterior area of the semioval center cross section (P = 0.001 < 0.05). CONCLUSIONS: The internal maxillary artery as a bypass donor is an effective method that can provide sufficient intracranial blood perfusion, and there is usually no cerebral ischemia in the surrounding area.


Assuntos
Revascularização Cerebral , Aneurisma Intracraniano , Artéria Carótida Interna/cirurgia , Revascularização Cerebral/métodos , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Artéria Maxilar/diagnóstico por imagem , Artéria Maxilar/cirurgia , Imagem de Perfusão , Tomografia Computadorizada por Raios X
7.
J Clin Neurosci ; 101: 217-220, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35636057

RESUMO

It has been suggested that the variations in the trajectory of the maxillary artery (MA) near the lateral pterygoid muscle (LPM) play a critical role in Botulinum neurotoxin (BoNT) injections in patients with jaw-opening/deviation dystonia (JOD). In the case of a lateral course to the LPM, an extraoral injection entails risks of MA injury, pain, and hematoma. Previous reports suggest geographical differences in variations of the MA-LPM relationship. We aimed to determine these variations in Turkish individuals and highlight the need to establish a consensus on approach to LPM injections. In 284 individuals, contrast-enhanced magnetic resonance angiography (MRA) images were evaluated by two radiologists on both sides for the variations in the course of the MA in the infratemporal fossa. Images of 44 were excluded due to trauma, arteriovenous malformation, mass, surgery, and imaging artifacts. Of the included, 62.1% were female. In 480 evaluations of 240 individuals, the MA passed lateral to the LPM in 65.6% (n = 315). No sex difference was noted. In 51 individuals (21.3%), the MA course differed on the right and left sides (medial-lateral asymmetry). These results confirm that the lateral course of the MA is more frequent. In patients with JOD, the trajectory of the MA should be determined with imaging prior to extraoral BoNT injections. In the case of a lateral course, an intraoral approach seems to be safer to avoid a potential MA injury.


Assuntos
Toxinas Botulínicas Tipo A , Distonia , Toxinas Botulínicas Tipo A/uso terapêutico , Feminino , Humanos , Masculino , Artéria Maxilar/diagnóstico por imagem , Músculos Pterigoides/diagnóstico por imagem
8.
Surg Radiol Anat ; 44(4): 543-550, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35244749

RESUMO

PURPOSE: The pterygomeningeal (accessory meningeal) artery arises from the middle meningeal or maxillary artery. Although there is the potential that this artery may be wounded by the surgery for the temporomandibular joint disorder, the current state of anatomical knowledge is insufficient. This study investigated the appearance and the branching pattern of this artery as a means to its characterization. METHODS: The pterygomeningeal artery was dissected in 14 cadavers and its branches and their distributions to the muscles inside the mandible were examined. RESULTS: The maxillary artery passed lateral to the lateral pterygoid muscle. The pterygomeningeal artery arose from the middle meningeal or maxillary artery. It ascended anteriorly and coursed medial or lateral to the mandibular nerve. It passed above the pterygospinous ligament and then descended. The ascending trunk gave some lateral branches to the lateral pterygoid muscle. The branches sometimes passed lateral to the mandibular nerve even if the pterygomeningeal artery coursed medial. The descending trunk was divided into middle and medial branches, which supplied the medial pterygoid muscle and the tensor veli palatini, respectively. The pterygomeningeal artery was sometimes equally bifurcate near the origin, and the counterparts passed lateral and medial to the mandibular nerve. The distributions of the medial and lateral counterparts were equivalent to those of the descending trunk and the lateral branches, respectively. CONCLUSION: The pterygomeningeal artery contains three groups of muscular branches, which sometimes appear in a bifurcate form. Their positions relative to the mandibular nerve and the pterygospinous ligament characterize the artery; this information may help to avoid iatrogenic injury.


Assuntos
Artéria Maxilar , Músculos Pterigoides , Cadáver , Humanos , Mandíbula , Nervo Mandibular/anatomia & histologia , Músculos Pterigoides/irrigação sanguínea
9.
Surg Radiol Anat ; 44(4): 535-542, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35254493

RESUMO

PURPOSE: The aim of this study is to evaluate the branching patterns and topographical features of the third part of the maxillary artery (t-MA) and descending palatine artery (DPA) by 3-Dimensional Rotational Angiography (3DRA) images and to define the radiological classification of their variations, based upon the previous cadaveric studies and a review of the literature. METHOD: This study was conducted from May 2020 through June 2021. All consecutive adult patients who were examined with 3D-RA were enrolled in the study. The morphological evaluations and measurements of t-MA, DPA and their branches were made on maximum intensity projection images with 10-20 mm slice thickness. RESULTS: Eighty-five hemifaces, including 58 females and 45 right sides, were evaluated. The diameter of the t-MA was measured as 1.73 ± 0.30 mm. The most common pattern of the t-MA according to its course was loop type (63/85, 74.1%) and according to branching pattern was Type Ib (29/85, 34.1%). The mean diameter of DPA was 1.19 ± 0.20 mm. The DPA presented as a single trunk in 11/85 cases. Type II, which was defined as one lesser palatine artery originating from distal-DPA, was the most common morphological variation (51.8%). CONCLUSIONS: 3DRA imaging provides valuable information for vascular anatomical studies. The most common morphological variation related to t-MA, DPA is the distal branching pattern.


Assuntos
Artéria Maxilar , Fossa Pterigopalatina , Adulto , Angiografia , Artérias/diagnóstico por imagem , Feminino , Humanos , Artéria Maxilar/anatomia & histologia , Artéria Maxilar/diagnóstico por imagem , Fossa Pterigopalatina/anatomia & histologia , Fossa Pterigopalatina/diagnóstico por imagem
10.
J Craniofac Surg ; 33(7): 2001-2004, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-35288496

RESUMO

ABSTRACT: Temporomandibular joint (TMJ) ankylosis in children can alter facial development and affect oral hygiene and function. Surgical release of the ankylosis is the mainstay of treatment. The authors hypothesize that preoperative arterial coil embolization is safe and effective in preventing major blood loss during TMJ surgery (loss prompting blood transfusion or hemodynamic instability requiring vasoactive medication administration) in children with TMJ ankylosis. Patients < 16 years who were diagnosed with TMJ ankylosis (<15 maximal interincisal opening) and had embolization before surgery in the last 5 years were included. Out of 9 initial search results, 3 patients were excluded (age > 16). Information gathered were patient demographics, diagnostic imaging, procedural details, complications, and clinical outcomes. Six patients, mean age 11.14 years (range 7-15 years) year and a mean weight of 40.8 ± 19 kg were included. Underlying etiologies for TMJ ankylosis: Pierre Robin Syndrome (n = 2), juvenile rheumatoid arthritis (n = 1), Goldenhar's syndrome (n = 1), trauma (n = 1), and micrognathia (n = 1). Neck computed tomography angiogram before embolization demonstrated an intimate approximation between the internal maxillary artery (IMAX) and/or external carotid artery and ankylotic mass in all patients. Eight successful embolizations were performed without procedural complication. In 1 patient with angiographic evidence of surgical internal maxillary artery ligation, embolization was performed via collaterals. Surgery was performed within 48 hours of embolization. Airway access during surgery was via nasal intubation (n = 4), oral intubation (n = 3). The estimated blood loss (EBL) during surgery was 78.33 ± 47.08 ml. Three patients had subsequent TMJ surgery with a mean estimated blood loss of 73.33 ± 46.18 ml. After a mean follow-up of 17 ± 15 months, patients showed a 13.8mm mean increment of maximal interincisal opening with 95% CI (5.74-21.9), P < 0.007.


Assuntos
Anquilose , Transtornos da Articulação Temporomandibular , Adolescente , Anquilose/etiologia , Anquilose/cirurgia , Criança , Humanos , Artéria Maxilar/cirurgia , Articulação Temporomandibular/lesões , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/cirurgia
11.
Br J Neurosurg ; 36(5): 654-657, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33236931

RESUMO

We report the case of a 41-year-old male who presented with an enlarging aneurysm neck one year after clipping. The patient underwent an IMAX-MCA bypass followed by endovascular coil occlusion of the aneurysm neck incorporating an MCA branch origin. To our knowledge, this case represents the first documented IMAX-MCA bypass from a European centre. This case demonstrates that for neurosurgeons experienced in EC-IC bypass surgery, IMAX-MCA bypass is feasible and can be performed safely as long as careful attention is paid to anatomical landmarks and vascular anastomosis principles. CTA-based neuronavigation and micro-Doppler are essential intraoperative tools for identifying the IMAX.


Assuntos
Revascularização Cerebral , Aneurisma Intracraniano , Masculino , Humanos , Adulto , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Artéria Cerebral Média/diagnóstico por imagem , Artéria Cerebral Média/cirurgia , Artéria Maxilar/cirurgia , Neuronavegação
12.
Oral Maxillofac Surg ; 26(1): 139-146, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34024006

RESUMO

PURPOSE: The close topographic relationship between vascular and osseous structures in the condylar and subcondylar region and marked variability in the arterial course has been revealed by both imaging and cadaveric studies. This study aimed to verify the previously published information in a large sample and to determine a safe surgical region. METHODS: We analyzed the three-dimensional time-of-flight magnetic resonance angiography images of 300 individuals. RESULTS: The mean distance between the middle meningeal artery and the apex of the condyle or the most medial point of the condyle was 18.8 mm (range: 11.2-25.9 mm) or 14.5 mm (range: 8.8-22.9 mm) respectively. The course of the maxillary artery relative to the lateral pterygoid muscle was medial in 45.7% of cases and lateral in 54.3%. An asymmetric course was evident in 66 patients (22%). The mean distance between the maxillary artery and condylar process at the deepest point of the mandibular notch was 6.2 mm in sides exhibiting a medial course (range: 3.7-9.8 mm) and 6.6 mm in sides exhibiting a lateral course (range: 3.9-10.4 mm). The distances were significantly influenced by age, gender, and the course of the maxillary artery. CONCLUSION: Our study emphasizes the marked inter- and intra-individual variability of the maxillary and middle meningeal arterial courses. We confirmed the proximity of the arteries to the condylar process. Extensive surgical experience and thorough preparation for each individual case are essential to prevent iatrogenic vascular injury.


Assuntos
Artéria Maxilar , Artérias Meníngeas , Humanos , Angiografia por Ressonância Magnética , Mandíbula , Côndilo Mandibular/diagnóstico por imagem , Artéria Maxilar/diagnóstico por imagem , Artérias Meníngeas/diagnóstico por imagem
13.
Oral Radiol ; 38(3): 344-348, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34403076

RESUMO

PURPOSE: The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies the lateral sinus wall and overlying membrane. This artery is one among several arteries in which arterial damage during surgery can cause massive and fatal bleeding. The purpose of this study was to detect the PSAA using multi-detector row computed tomography (MDCT) by age. MATERIALS AND METHODS: The present study was approved by our university ethics committee (EC19-010). The study included 230 patients (110 males, 120 females; ages 5-91 years, average age 42.5 years) who underwent MDCT of the jaw. The subjects were divided into two groups, one group in which the PSAA was observable and another in which the PSAA was not observable, to perform the Mann-Whitney U test. To perform the Tukey-Kramer multiple comparison test, the subjects were divided into the following ten groups depending on their age: 5-9 years, 10-19 years, 20-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, 80-89 years, and 90-91 years. RESULTS: The PSAA was identified in 74.5% (5-91 years) of the maxillary sinuses. The average age of subjects in whom the PSAA was observable was 33.4 years, and the average age of subjects in whom the PSAA was not observable was 11.3 years, indicating a significant difference between these two groups (p < 0.01). A comparison by age group showed a significant difference (p < 0.05). CONCLUSIONS: The detection ratio for the PSAA using MDCT increased with increasing age of the subject, reaching a high detection ratio of 94% in adults. This study has shown that MDCT is a very useful tool to observe the PSAA.


Assuntos
Artéria Maxilar , Seio Maxilar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Artéria Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Estudos Retrospectivos , Adulto Jovem
14.
J R Coll Physicians Edinb ; 51(4): 366-368, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34882135

RESUMO

We describe two cases of giant cell arteritis where involvement of the superficial temporal artery and maxillary artery were demonstrated using colour doppler ultrasonography. Maxillary artery involvement is responsible for the symptoms of jaw claudication and toothache, and even headaches might be due to the involvement of the middle meningeal artery which is a branch of the maxillary artery. The maxillary artery has been difficult to visualise until now. There are international consensus definitions of ultrasonographic abnormalities seen in the superficial temporal artery affected by giant cell arteritis. We have used those definitions to demonstrate hypoechoic changes in the maxillary artery affected by giant cell arteritis. The maxillary artery can be visualised in the infratemporal fossa from an echo window between the condylar and coronoid processes of the mandible. This is the first proof of concept evidence that maxillary arteries can be visualised using bedside ultrasonography in giant cell arteritis.


Assuntos
Arterite de Células Gigantes , Arterite de Células Gigantes/complicações , Arterite de Células Gigantes/diagnóstico por imagem , Humanos , Artéria Maxilar/diagnóstico por imagem , Artérias Temporais/diagnóstico por imagem , Ultrassonografia , Ultrassonografia Doppler em Cores
15.
Am J Case Rep ; 22: e932443, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34752442

RESUMO

BACKGROUND Pseudoaneurysms of the head and neck region are relatively rare and consequently there are few reports in the literature. The main causes of pseudoaneurysms in the head and neck area are associated with blunt or penetrating injuries in this area or are iatrogenic, originating during surgical procedures. CASE REPORT The authors illustrate a case of a 16-year-old boy who had an accident on a scooter. A maxillary artery hemorrhage occurred after multiple craniofacial trauma including bilateral fracture of the condylar processes and treatment with intravascular embolization. Due to the anatomical location of the injury and deep location of the maxillary artery, it was impossible to control the bleeding by direct pressure; the only option was vessel embolization using interventional radiology or surgical intervention. The authors describe symptoms of pseudoaneurysm: pain in the area of the temporomandibular joint on the left side, persistent bilateral swelling of the cheeks and parotideomasseteric region with a greater asymmetry on the left side, as well as peripheral paresis of the facial nerve on the left side. The diagnosis was based on magnetic resonance imaging, ultrasound, and angio-CT. A reduction in the clotted pseudoaneurysm size on the left side was confirmed after 6 and 10 months through monitoring ultrasound examination of the neck vessels. CONCLUSIONS No similar case of a patient has been reported in the available literature. The development of bilateral pseudoaneurysms after injury is very rare. However, doctors should be alert to this possibility in the case of massive post-traumatic or postoperative bleeding.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Adolescente , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Humanos , Masculino , Artéria Maxilar/diagnóstico por imagem , Hemorragia Pós-Operatória , Ultrassonografia
16.
Rev. Hosp. Ital. B. Aires (2004) ; 41(3): 123-126, sept. 2021. ilus
Artigo em Espanhol | LILACS, BINACIS, UNISALUD | ID: biblio-1363041

RESUMO

Se describe el caso clínico de una paciente de 84 años que tuvo epistaxis recidivante por padecer enfermedad de Rendu-Osler-Weber. Tuvo antecedentes de diversos tratamientos quirúrgicos que incluyeron el cierre de la fosa nasal izquierda (operación de Young). Por la persistencia de epistaxis izquierda se indicó una angiografía y embolización. Esta última no se hizo porque se diagnosticaron anastomosis entre el sistema carotídeo externo y el interno. Se realizó un abordaje intraoral paramaxilar asistido con endoscopios para cauterizar la arteria maxilar interna en la fosa infratemporal y un abordaje externo para cauterizar la arteria etmoidal anterior solucionando la epistaxis. (AU)


The clinical case of an 84-year-old patient who had recurrent epistaxis due to Rendu-Osler- Weber disease is described. She had a history of various surgical treatments including closure of the left nostril (Young's operation).Due to the persistence of left epistaxis, angiography and embolization were indicated. The latter was not done because anastomosis between the external and internal carotid system was diagnosed. An intraoral paramaxillary approach assisted with endoscopes was performed to cauterize the internal maxillary artery in the infratemporal fossa and an external approach to cauterize the anterior ethmoidal artery solving the epistaxis. (AU)


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Telangiectasia Hemorrágica Hereditária/cirurgia , Cauterização , Artéria Maxilar/cirurgia , Telangiectasia Hemorrágica Hereditária/terapia , Epistaxe/terapia
17.
J Am Dent Assoc ; 152(11): 943-946, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34373081

RESUMO

BACKGROUND AND OVERVIEW: Mönckeberg arteriosclerosis is a disease of unknown etiology characterized by dystrophic calcifications within the tunica media of small- and medium-sized arteries, leading to reduced arterial compliance. The authors report a case discovered incidentally on dental radiographs. CASE DESCRIPTION: A 78-year-old man with a complex medical history was seen for routine oral health care. Panoramic and bite-wing radiographs revealed a tortuous, linear calcification in the area of the left mandibular first molar anterior to the angle of the mandible and suggestive of a calcified facial artery. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Medical radiologists have used the presence of arterial calcifications to determine the severity and prognosis of such diseases as primary hyperparathyroidism, secondary hyperparathyroidism, coronary artery disease, and diabetes. The presence of Mönckeberg arteriosclerosis on dental radiographs can help oral health care professionals identify patients with undiagnosed systemic disease.


Assuntos
Arteriosclerose , Calcinose , Esclerose Calcificante da Média de Monckeberg , Idoso , Arteriosclerose/complicações , Arteriosclerose/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Humanos , Masculino , Artéria Maxilar , Esclerose Calcificante da Média de Monckeberg/diagnóstico por imagem , Radiografia Panorâmica , Túnica Média
18.
J Craniofac Surg ; 32(8): e742-e744, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34224457

RESUMO

ABSTRACT: Epistaxis after Le Fort I osteotomy is one of the relatively common postoperative complications. It can be controlled with conservative treatment, such as nasal packing, and will usually improve in a few days. However, if the epistaxis is repeated, the outcome can be life-threatening. A 22-year-old woman underwent Le Fort I osteotomy in order to correct her malocclusion. Postoperatively, pseudoaneurysm was formed in the descending palate artery, causing repeated epistaxis. Then, angiography and embolization were performed. Before the onset of epistaxis, there was discomfort around the nasal area. The patient remained asymptomatic during the 6-month follow-up. Some epistaxis after Le Fort I osteotomy is due to pseudoaneurysm formation in the maxillary artery. It is very rare. The epistaxis is delayed and recurrent. It can cause massive bleeding, and so, requires proper diagnosis and treatment. There may be signs of bleeding as in this case.


Assuntos
Falso Aneurisma , Artéria Maxilar , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Craniotomia , Epistaxe/etiologia , Feminino , Humanos , Maxila/cirurgia , Artéria Maxilar/cirurgia , Osteotomia de Le Fort/efeitos adversos , Adulto Jovem
19.
Surg Radiol Anat ; 43(12): 1969-1977, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34091716

RESUMO

PURPOSE: The presence of a persistent primitive maxillary artery is described in the literature dealing with the development of the cavernous carotid inferolateral trunk, and the relevant similarities of the cranial circulation of the human and dog. The literature includes no dissection photographs of the above-mentioned two human fetal arteries, only diagrammatic representations. This study's objectives were to analyze photographs of fetal dissections for the presence of these two arteries, and also investigate the possibility of obtaining, in preserved dog specimens, high-resolution micro-CT imaging of arteries homologous with the above-mentioned two human arteries. METHODS: The literature describing the embryologic development of the cavernous carotid inferolateral trunk, the persistent primitive maxillary arteries, and their homologies in the dog was reviewed. Relevant dissections of fetal specimens were analyzed. High-resolution micro-CT images of un-dissected dog arteries were produced and analyzed. RESULTS: Photographs of fetal specimen dissections demonstrate the cavernous carotid inferolateral trunk. A separate persistent primitive maxillary artery was not present in the dissected specimens. High-resolution micro-CT images of the dog demonstrate homologous arteries with segments of the human inferolateral trunk, and other skull base and brain arteries. CONCLUSION: This investigation provides the only photographs in the literature of dissected human fetal cavernous carotid inferolateral trunks. A persistent primitive maxillary artery was not present in the dissected specimens and is a non-existent structure, likely a previously misidentified carotid inferolateral trunk. High-resolution micro-CT images of the dog visualized arteries that are homologous to segments of the human cavernous carotid inferolateral trunk artery.


Assuntos
Artéria Carótida Interna , Artéria Maxilar , Animais , Artérias Carótidas/diagnóstico por imagem , Cães , Base do Crânio , Microtomografia por Raio-X
20.
Arq. bras. neurocir ; 40(1): 51-58, 29/06/2021.
Artigo em Inglês | LILACS | ID: biblio-1362225

RESUMO

Introduction The purpose of this study was to define the anatomical relationships of the pterygopalatine fossa (PPF) and its operative implications in skull base surgical approaches. Methods Ten cadaveric heads were dissected at the Dianne and M Gazi Yasargil Educational Center MicrosurgicaLaboratory, in Little Rock, AK, USA. The PPF was exposed through an extended dissection with mandible and pterygoid plate removal. Results The PPF has the shape of an inverted cone. Its boundaries are the pterygomaxillary fissure; themaxilla, anteriorly; themedial plate of the pterygoid process, and greater wing of the sphenoid process, posteriorly; the palatine bone,medially; and the body of the sphenoid process, superiorly. Its contents are the maxillary division of the trigeminal nerve and its branches; the pterygopalatine ganglion; the pterygopalatine portion of the maxillary artery (MA) and its branches; and the venous network. Differential diagnosis of PPF masses includes perineural tumoral extension along the maxillary nerve, schwannomas, neurofibromas, angiofibromas, hemangiomas, and ectopic salivary gland tissue. Transmaxillary and transpalatal approaches require extensive resection of bony structures and are narrow in the deeper part of the approach, impairing the surgical vision and maneuverability. Endoscopic surgery solves this problem, bringing the light source to the center of the surgical field, allowing proper visualization of the surgical field, extreme close-ups, and different view angles. Conclusion We provide detailed information on the fossa's boundaries, intercommunications with adjacent structures, anatomy of the maxillary artery, and its variations. It is discussed in the context of clinical affections and surgical approaches of this specific region, including pterygomaxillary disjunction and skull base tumors.


Assuntos
Fossa Pterigopalatina/anatomia & histologia , Fossa Pterigopalatina/cirurgia , Fossa Pterigopalatina/lesões , Artéria Maxilar/anatomia & histologia , Cadáver , Neoplasias da Base do Crânio/cirurgia , Dissecação/métodos , Cirurgia Endoscópica por Orifício Natural/métodos , Microcirurgia/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...