scholarly journals Оптимізація місцевого знеболювання м’яких тканин бокової ділянки обличчя шляхом застосування розроблених методик анестезій лицевих гілок поверхневого шийного нервового сплетення

2017 ◽  
Author(s):  
O. Ya. Mokryk
Keyword(s):  
Pain Sensitivity ◽  
Posterior Part ◽  
Cervical Plexus ◽  
Cervical Nerve ◽  
Surgical Interventions ◽  
Facial Region ◽  
Parotid Region ◽  
Great Auricular Nerve ◽  
Conduction Anesthesia ◽  
The Face

The lateral facial region including zygomatic, parotid and buccal regions is innervated by trigeminal nerve branches: zygomatic, auriculotemporal, buccal, mental nerves as well as by branches of cervical plexus: great auricular and transverse cervical nerves. According to the classical Brown’s method, great auricular and transverse cervical nerves can be blocked at Erb’s point on the posterior border of the sternocleidomastoid muscle.Anesthesia of the listed nerves is commonly attained in the contemporary surgical practice during superfi cial cervical plexus block. However, due to the high probability of local complications such as external jugular veindamaging by the injection needle this technique can’t be used in the outpatient surgical dental practice.The aim of the study – to develop methods of conduction anesthesia of facial branches of cervical plexus (great auricular and transverse cervical nerves) on patient’s face considering individual topographic anatomical peculiarities.Materias and Methods. Clinical observation was conducted in 39 sheduled patients of different sex and age (18–60 years old) that were being on stationary treatment. In case the localization of pathological processes (benign tumors, keloid scars, fi stulas of migrating granulomas) in the parotid region (21 cases) surgical interventions were conducted under local conduction anesthesia of auriculotemporal nerve as well as facial branches of great auricular and transverse cervical nerves. In case the localization of pathological processes in the buccal region (18 cases) surgical interventions were conducted under local conduction anesthesia of buccal, mental nerves and facial branches of transverse cervical nerve (if necessary). Facial branches of great auricular nerve were blocked along the posterior border of mandible ramus – from the gonial angle to the neck of mandibular condyle. Anesthesia of facial branches of transverse cervical nerve was conducted along the inferior border of mandible. Individual topographic anatomical peculiarities of the facial part of the head in patients were determined by computing the facial index of each patient using Garson’s algorithm. Tactile and pain sensitivity were explored. In order to assess objectively the developed method of great auricular nerve block it was used stimulating electromyography. It is established that pathological processes did not infl uence the sensory function (tactile and pain sensitivity) of the zygomatic, parotid and buccal regions in patients before the planned surgical interventions on the lateral facial region.Results and Discussion. After the block of facial branches of great auricular nerve according to the developed technique it is revealed that in all cases the posterior part of the parotid region adjoining the mandible angleand posterior part of mandible ramus became insensitive. In 19 cases (93.1 %) an absolute anesthesia of this topographic anatomical region occurred. In 7 cases (33.4 %) the conduction anesthesia of facial branches oftransverse cervical nerve was carried out when this nerve took part in the innervation of the parotid region. It is clinically confi rmed that there are three types of ramifying on the human face of branches of great auricular and transverse cervical nerves (Bruno Ella classifi cation, 2015). The fi rst type of the lateral facial region innervation by the rami of cervical plexus occurred the most frequently, in 11 cases (52.4 %), and prevailed in patients with mesoprosopic form of facial part of the head. The second type of ramifying was observed in 7 cases (33.4 %), in patients with euriprosopic and mesoprosopic face shapes. The third type occurred in 14. 3 % cases in patients with mesoprosopic and leptoprosopic face shapes. In those people a major part of the lateral facial region was innervated by auriculotemporal nerve. In 55. 6 % cases a scattered type of buccal nerve ramifying was found on the face in patients prevailing in leptoprosops. In three patients transverse cervical nerve took part in the buccal region innervation. In all cases they were individuals with euriprosopic face shape. The loss of tactile and pain sensitivity on the skin cover of both the parotid and buccal regions as well as temporary absence of conductance along the facial branches of great auricular nerve that was detected during stimulating electromyography absolutely confi rmed the effectiveness of the developed methods of local conduction anesthesia. During surgical treatment the effi ciency of used methods of local anesthesia was evaluated on 4.7 ± 0.5 points – it was observed a stable anesthesia, without psychosomatic peculiarities as well as local and general complications, in patients; sometimes weakly expressed affective reactions took place, but they didn’t infl uence the course of the operation.Conclusions. The results of clinical observations confi rm the signifi cant variability of sensitive innervation of soft tissues of the lateral facial area, it varies in patients depending on their individual anatomical features.There are three types of branching in the parietal-chewing area of the facial branches of the surface cervical nerve plexus, which can spread to the cheek area. The use of techniques, conductive anesthetics of the facial branches of the large anus and transverse nerve of the neck, in combination with the traditional methods of local anesthesia, which we developed, provided painless surgical interventions on the lateral face of the face.

CLINICAL EVALUATION OF THE EFFECTIVENESS OF THE DEVELOPED METHOD OF CONDUCTIVE ANESTHESIA OF THE FACIAL BRANCHES OF GREAT AURICULAR NERVE

2019 ◽  
Vol 72 (8) ◽  
pp. 1446-1446
Author(s):  
Oleg Mokryk ◽  
Svitlana Ushtan ◽  
Yuliya Izhytska
Keyword(s):  
Local Anesthesia ◽  
Pain Sensitivity ◽  
Soft Tissues ◽  
Mastoid Process ◽  
Benign Tumors ◽  
Clinical Group ◽  
Surgical Practice ◽  
Facial Region ◽  
Face Shape ◽  
Great Auricular Nerve

Introduction: The most common method of local anesthesia of maxillofacial region in the modern surgical practice is conductive anesthesia of the peripheral branches of trigeminal nerve. In order to reach the total anesthesia of the lateral facial region it is necessary to block not only auriculo-temporal and buccal nerves, but also facial branches of great auricular nerve taking part in the innervation of parotid-masticatory area and the part of the cheek. Topographic-anatomical investigations of corpses revealed the anatomical variability of the branching of great auricular nerve on the neck and the head. Taking into account the topographic-anatomical aspects of variability of innervation of the lateral facial region, we developed the method of conductive anesthesia of the facial branches of great auricular nerve. The aim: To evaluate the clinical effectiveness of the developed method of conductive anesthesia of the facial branches of great auricular nerve taking into account individual anatomical peculiarities of its branching in patients with the different forms of the skull. Materials and methods: Clinical observations were conducted on 69 patients of different age (from 18 to 70) and sex (43 males and 26 females). Under the local anesthesia we conducted surgery in the parotid-masticatory region including: disclosure of the abscesses, excision of migrating granulomas or lymph nodes (in the cases of chronic hyperplastic lymphadenitis); excision of the benign tumors of the soft tissues (atheromas, lipomas, fibromas and keratoacanthomas), excision of the salivary fistulas and keloid scars. Depending on the used methods of local anesthesia of the soft tissues of the parotid-masticatory region the patients were divided into two clinical groups. The first group (30 patients) was exposed to conductive anesthesia of great auricular nerve by the method of P. Raj (2002). according to which the blockade of the nerve is conducted ahead the apex of mastoid process of the temporal bone. 39 patients after the signing of the written agreement were exposed to the developed method of conductive anesthesia of the facial branches of great auricular nerve. In order to detect the individual anatomical features of the facial part of the head in patients, the facial index was determined by the Garson`s formula. Pain sensitivity and perception in patients were studied using subjective and objective methods. The data were analysed by means of the Pearson’s chi–square tests. Results: It is revealed that total anesthesia of the soft tissues of the parotid-masticatory region in all cases was reached in patients with euriprosopic face shape (broad-faced) – in 8 patients of the first clinical group and 10 patients of the second. The least effective was the anesthesia of the anterior branch of great auricular nerve conducted according to P. Raj’s method (2002) in patients with leptoprosopic face shape. In patients with leptoprosopic face shape of the second clinical group after administering anesthesia according to the developed method in 9 cases total anesthesia was reached, in 2 cases pain sensitivity in the inferior-anterior quadrant remained (χ2 = 5,70; р < 0,05). Generally, in patients of the first clinical group the method of conducted anesthesia by P. Raj was effective in 19 cases (63,3 %), and the developed method of conductive anesthesia of the facial branches of great auricular nerve – in 36 cases (92,3 %) – χ2 = 8,85, р < 0,01. Conclusions: The results of the research confirm that the developed method of conductive anesthesia of the facial branches of great auricular nerve is more effective in comparison to methods of anesthesia commonly used in today dentistry surgical practice. It allows to reach the total anesthesia of the soft tissues of the parotid-masticatory region in 92,3 % patients with different face shapes.

scholarly journals Robotic Stroking on the Face and Forearm: Touch Satiety and Effects on Mechanical Pain

2021 ◽  
Vol 2 ◽  
Author(s):  
Pankaj Taneja ◽  
Lene Baad-Hansen ◽  
Sumaiya Shaikh ◽  
Peter Svensson ◽  
Håkan Olausson
Keyword(s):  
Pain Sensitivity ◽  
Pain Modulation ◽  
Pain Thresholds ◽  
Facial Region ◽  
Thermal Pain ◽  
Tactile Stimuli ◽  
Pressure Pain Thresholds ◽  
The Face ◽  
The Right ◽  
Over Time

Background: Slow stroking touch is generally perceived as pleasant and reduces thermal pain. However, the tactile stimuli applied tend to be short-lasting and typically applied to the forearm. This study aimed to compare the effects of a long-lasting brushing stimulus applied to the facial region and the forearm on pressure pain thresholds (PPTs) taken on the hand. Outcome measurements were touch satiety and concurrent mechanical pain thresholds of the hand.Methods: A total of 24 participants were recruited and randomized to receive continuous stroking, utilizing a robotic stimulator, at C-tactile (CT) favorable (3 cm/s) and non-favorable (30 cm/s) velocities applied to the right face or forearm. Ratings of touch pleasantness and unpleasantness and PPTs from the hypothenar muscle of the right hand were collected at the start of stroking and once per minute for 5 min.Results: A reduction in PPTs (increased pain sensitivity) was observed over time (P &lt; 0.001). However, the increase in pain sensitivity was less prominent when the face was stroked compared to the forearm (P = 0.001). Continuous stroking resulted in a significant interaction between region and time (P = 0.008) on pleasantness ratings, with a decline in ratings observed over time for the forearm, but not on the face. Unpleasantness ratings were generally low.Conclusion: We observed touch satiety for 5 min of continuous robotic brushing on the forearm confirming previous studies. However, we did not observe any touch satiety for brushing the face. Mechanical pain sensitivity, measured in the hand, increased over the 5-min period but less so when paired with brushing on the face than with brushing on the forearm. The differential effects of brushing on the face and forearm on touch satiety and pain modulation may be by the differences in the emotional relevance and neuronal pathways involved.

scholarly journals Clinical evaluation of the developed method effectiveness of anesthesia of the zygomaticofacial nerve

2019 ◽  
pp. 49-55
Author(s):  
O. Ya. Mokryk
Keyword(s):  
Local Anesthesia ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Soft Tissues ◽  
Classical Method ◽  
Surgical Interventions ◽  
Anatomical Features ◽  
Different Types ◽  
The Face ◽  
The Individual

The branching of the trigeminal nerve on the face has an individual anatomical variability.  The individual variability of innervation of soft tissues of the maxillofacial area should be taken into account during their local anesthesia. During the blockade of the zygomaticofacial nerve in accordance with the well-known technique, only 74 % of the cases of anesthesia in the buccal and zygomatic areas were completely anesthetized. The aim of the study – to give a сlinical evaluation of the effectiveness of the developed method of anesthesia of the zygomaticofacial nerve. Materials and Methods. In the clinical observation  41 stationary  stomatological patients with planned surgical interventions on the lateral facial area took part (in the buccal area – 16 patients, in the zygomatic area – 25 patients).  In order to detect the individual anatomical features of the facial part of the head in patients, the facial index was determined by the Garson`s formula as the relation between the morphological height of the face and its width multiplied by 100. These patients were applied a developed method of conductive anesthesia of the zygomaticofacial nerve and compared its effectiveness with a known method. Pain sensitivity and perception in patients were studied using subjective and objective methods. Pain sensitivity was determined by injection of a needle (pinprick) into the epidermis. Pain perception during local anesthesia administration was evaluated by the Sounds, Eyes and Motor (SEM) scale. Results and Discussion.  Taking into account the results of craniometric studies as well as the individual topographic and anatomical features of zygomaticofacial nerve branching in people with different types of skull structure, the technique of conduction anesthesia of the branches of the zygomaticofacial nerve was developed. During surgical treatment the effectiveness of the local anesthetic developed method was evaluated as good – it was observed in patients a stable anesthesia, without psychosomatic peculiarities as well as local and general complications. Conclusions. Application in clinical conditions of the technique of conductive anesthesia of the zygomaticofacial nerve, developed by us, in combination with the classical method of local anesthesia of the buccal nerve provides painless surgical interventions on the lateral area of the face. For the successful local anesthesia of the zygomatic and buccal regions, it is necessary to take into account the anatomical variability of the branch on the face of the zygomaticofacial nerve in patients with different types of skull structure and face shape.

The Development of an Identification Photo Booth System based on a Deep Learning Automatic Image Capturing Method

2020 ◽  
Author(s):  
Yu-Xiang Zhao ◽  
Yi-Zeng Hsieh ◽  
Shih-Syun Lin
Keyword(s):  
Deep Learning ◽  
Experimental Results ◽  
Automatic Annotation ◽  
Learning Method ◽  
Facial Region ◽  
Facial Landmarks ◽  
Image Capturing ◽  
The Face ◽  
Facial Contours

With advances in technology, photo booths equipped with automatic capturing systems have gradually replaced the identification (ID) photo service provided by photography studios, thereby enabling consumers to save a considerable amount of time and money. Common automatic capturing systems employ text and voice instructions to guide users in capturing their ID photos; however, the capturing results may not conform to ID photo specifications. To address this issue, this study proposes an ID photo capturing algorithm that can automatically detect facial contours and adjust the size of captured images. The authors adopted a deep learning method (You Only Look Once) to detect the face and applied a semi-automatic annotation technique of facial landmarks to find the lip and chin regions from the facial region. In the experiments, subjects were seated at various distances and heights for testing the performance of the proposed algorithm. The experimental results show that the proposed algorithm can effectively and accurately capture ID photos that satisfy the required specifications.

Performing Distance Measurements in Curved Facial Regions: A Comparison between Three-Dimensional Surface Scanning and Ultrasound Imaging

2021 ◽  
Author(s):  
Michael Alfertshofer ◽  
Konstantin Frank ◽  
Dmitry V. Melnikov ◽  
Nicholas Möllhoff ◽  
Robert H. Gotkin ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Dimensional Accuracy ◽  
Ultrasound Measurement ◽  
Surface Scanning ◽  
Distance Measurements ◽  
Surgical Performance ◽  
Facial Region ◽  
3D Surface ◽  
The Face ◽  
The Mean

AbstractFacial flap surgery depends strongly on thorough preoperative planning and precise surgical performance. To increase the dimensional accuracy of transferred facial flaps, the methods of ultrasound and three-dimensional (3D) surface scanning offer great possibilities. This study aimed to compare different methods of measuring distances in the facial region and where they can be used reliably. The study population consisted of 20 volunteers (10 males and 10 females) with a mean age of 26.7 ± 7.2 years and a mean body mass index of 22.6 ± 2.2 kg/m2. Adhesives with a standardized length of 20 mm were measured in various facial regions through ultrasound and 3D surface scans, and the results were compared. Regardless of the facial region, the mean length measured through ultrasound was 18.83 mm, whereas it was 19.89 mm for 3D surface scans, with both p < 0.0001. Thus, the mean difference was 1.17 mm for ultrasound measurements and 0.11 mm for 3D surface scans. Curved facial regions show a great complexity when it comes to measuring distances due to the concavity and convexity of the face. Distance measurements through 3D surface scanning showed more accurate distances than the ultrasound measurement. Especially in “complex” facial regions (e.g., glabella region and labiomental sulcus), the 3D surface scanning showed clear advantages.

Skin diseases affecting the oro-facial region

2018 ◽  
Author(s):  
Max Robinson ◽  
Keith Hunter ◽  
Michael Pemberton ◽  
Philip Sloan
Keyword(s):  
Skin Diseases ◽  
Systemic Disease ◽  
Lymphatic Vessels ◽  
Medical Practitioner ◽  
Skin Tumours ◽  
Facial Region ◽  
Malignant Skin ◽  
Common Skin ◽  
The Face ◽  
Direct Inoculation

Examination of the face and hands can identify significant skin diseases and also provide clues to the presence of underlying systemic disease. Many patients ignore even malignant skin tumours because they are often painless, subtle in appearance, and may be slow-growing. Dental healthcare professionals should be aware of how to recognize malig­nant skin tumours. If suspicious, but unsure of the nature of the lesion, the patient should be referred to their general medical practitioner for further evaluation. If malignancy is obvious, then an urgent referral to an appropriate specialist (dermatologist, plastic surgeon, or oral and max­illofacial surgeon) should be made using the ‘2-week wait’ (2WW) path­way (Chapter 1). Benign lesions and inflammatory diseases are more common and are important considerations in the differential diagnosis of head and neck skin abnormalities. It is important that the dental healthcare professional should be able to recognize common skin infections involving the oro-facial region. Some infections, such as erysipelas, can mimic cellulitis associated with a dental infection. When infection is diagnosed, it is vital to consider the underlying or predisposing factors, as these may be not only important diagnoses, but also may require treatment to achieve an effective clin­ical outcome. The adage ‘infection is the disease of the diseased’ is a useful reminder when dealing with patients presenting with infection. Direct inoculation of Streptococcus into skin through minor trauma is the most common initiating factor for erysipelas, which occurs in iso­lated cases. Infection involves the upper dermis and, characteristically, spreads to involve the dermal lymphatic vessels. Clinically, the disease starts as a red patch that extends to become a fiery red, tense, and indurated plaque. Erysipelas can be distinguished from cellulitis by its advancing, sharply defined borders and skin streaking due to lymphatic involvement. The infection is most common in children and the elderly, and whilst classically a disease affecting the face, in recent years it has more frequently involved the leg skin of elderly patients. Although a clinical diagnosis can be made without laboratory testing, and treat­ment is antibiotic therapy, when the diagnosis is suspected in dental practice, referral to a medical practitioner is recommended.

Chronic Pain and Overview or Differential Diagnoses of Nonodontogenic Orofacial Pain

2018 ◽  
Vol 7 (4) ◽  
pp. 71-82
Author(s):  
Tara Renton
Keyword(s):  
Chronic Pain ◽  
Orofacial Pain ◽  
Correct Diagnosis ◽  
Temporomandibular Joint Disorders ◽  
Primary Headaches ◽  
Medical Treatments ◽  
Surgical Interventions ◽  
Idiopathic Pain ◽  
The Face ◽  
Chronic Pain Conditions

Orofacial pain is defined as pain arising from the regions of the face and mouth. Dental pain is the most common inflammatory pain presenting in this region; however, chronic pain conditions presenting frequently, including temporomandibular joint disorders (TMDs), primary headaches (neurovascular), neuropathic pain and idiopathic pain conditions, can often mimic toothache. Dentists are familiar with TMDs but have no training or experience in diagnosing or treating headaches that mainly present in the first trigeminal division. The anatomical complexity of the region and the potential possible diagnoses, mean that correct diagnosis is often delayed resulting in patients often undergoing inappropriate surgical and medical treatments that themselves may complicate the presentation of the pain by changing its phenotype and further complicating diagnosis and appropriate management. Due to the variable pain presentation of toothache, it can mimic many different chronic episodic orofacial pain conditions, resulting in many inappropriately prescribed courses of antibiotics and surgical interventions. Dentists are not the only profession to fall foul of the misdiagnosis but ear, nose and throat (ENT) and maxillofacial surgeons fall into the same trap.

Traumatic injuries to the facial nerve: diagnosis and assistance

2020 ◽  
pp. 7-13
Author(s):  
Marufzhon Kh. KADYROV ◽  
Gafur M. KHODZHAMURADOV ◽  
Maksudzhon M. KADYROV ◽  
Mirali F. ODINAEV
Keyword(s):  
Facial Nerve ◽  
Complete Recovery ◽  
Partial Recovery ◽  
Main Trunk ◽  
Nerve Branch ◽  
Surgical Interventions ◽  
Traumatic Injuries ◽  
Nerve Suture ◽  
The Face ◽  
Surgical Treatments

We performed detection, examination and surgical treatment of trauma injuries of the main trunk or branches of the facial nerve among 16 patients. The main complaints of patients were related to aesthetic defects of tissues and organs within certain areas of the face or the whole half on the side of the injury and their functional disorders. The most frequent cause of injury was yatrogenic nerve damage. In the case of yatrogenic causes of injury, there are following groups of surgical interventions: surgery of the peritoneal salivary gland; aesthetic operations of the face in case of pathological processes or traumatic injuries of the temporal-lower joint and lower zone of the face. The following surgical treatments were used to repair damage to facial nerve structures: nerve suture; transposition of facial nerve branches; neuroplasticity; miofastsialny plasticity; neuroplasty in combination with the transplant of the revascularized neuromuscular transplant of the gentle soapy. In the distant postoperative period, complete recovery of facial nerve branch function and effectors, respectively, occurred among 10 patients. Partial recovery of their function - among 3 patients and recovery were absent among 3 clinical cases.

scholarly journals Fracture of the coronoid and pterygoid processes by firearms: case report

2007 ◽  
Vol 18 (2) ◽  
pp. 168-170 ◽  
Author(s):  
David Moraes de Oliveira ◽  
Ricardo José de Holanda Vasconcellos ◽  
José Rodrigues Laureano Filho ◽  
Rafael Vago Cypriano
Keyword(s):  
Ct Scan ◽  
Speech Therapy ◽  
Clinical Signs ◽  
Mouth Opening ◽  
Parotid Region ◽  
Comminuted Fracture ◽  
3D Ct Scan ◽  
The Face ◽  
The Right

A rare case of fracture of the coronoid and the pterygoid process caused by firearms is described. A 28-year-old male was hit by a bullet in the face, resulting in restricted mouth opening, difficulty in chewing and pain when opening the mouth. Clinical examination revealed a perforating wound in the right parotid region and a similar wound on the left side of the same region. A CT scan showed comminuted fracture of the left coronoid process and bilateral comminuted fracture of the pterygoid processes. Treatment was conservative, speech therapy was conducted and it was successful. Details of the clinical signs, radiology (3D-CT scan), treatment and follow-up are presented.

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