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.

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.

scholarly journals Removal of firearm projectile from the maxillary sinus: a case report

2020 ◽  
Vol 68 ◽  
Author(s):  
Cristóvão Marcondes de Castro RODRIGUES ◽  
Izabella SOL ◽  
Daniela MENESES-SANTOS ◽  
Larissa Gonçalves Cunha RIOS ◽  
Jonas Dantas BATISTA ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Maxillary Sinus ◽  
Local Anesthesia ◽  
Paranasal Sinuses ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Hard Tissues ◽  
The Face ◽  
Maxillary Sinuses

ABSTRACT Foreign bodies in the paranasal sinuses after critical accidents are rare occurrences that have sporadically been reported worldwide. Firearm projectiles, daggers, knives, glass fragments, stones, teeth, and wood can get lodged in the soft and hard tissues of the face. The management and prognosis in these cases depend on the composition and location of the foreign body as well as on the presence or absence of infection. Although there are reports involving the soft tissues of the face, the ethmoid, sphenoid, frontal, and maxillary sinuses are the most frequently involved sites. The main manifestation of this condition is sinusitis arising from infection and/or inflammation caused by the foreign body, which is a contaminated object. We report a case of removal of a firearm projectile located in the maxillary sinus of a 34-year-old patient under local anesthesia.

scholarly journals The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia

2009 ◽  
Vol 10 (3) ◽  
pp. 43-50 ◽  
Author(s):  
Naser Asl Aminabadi ◽  
Ramin Mostofi Zadeh Farahani
Keyword(s):  
Injection Site ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Pain Perception ◽  
Pediatric Patients ◽  
Soft Tissues ◽  
Inferior Alveolar Nerve ◽  
Topical Anesthesia ◽  
Pediatric Pain ◽  
Dental Procedures

Abstract Aim The aim of the study was to evaluate the effect of cooling the soft tissue of injection sites on the pain perceptions of pediatric patients during the administration of local anesthesia for routine dental procedures. Methods and Materials A total of 160 children aged 5-6 years were included in the present study. On a random basis, the subjects were allocated to the without ice pretreatment (WIP) group (topical anesthesia + counterstimulation + distraction) or the ice pretreatment (IP) group (cooling + topical anesthesia + counterstimulation + distraction). During the administration of an inferior alveolar nerve block, the children's behavior was assessed using the sound, eye, and motor (SEM) scale. The statistical analysis of data was performed based on the analysis of variance (ANOVA). Results There were no significant differences within the groups between the values of the sound, eye, and motor components for either the WIP or the IP groups (P>0.05). All three components of the SEM in the IP group were consistently lower than the WIP group (P<0.05). Moreover, the SEM value for the WIP group surpassed the IP group (P<0.05). Conclusions Cooling the site of infiltration block prior to the injection of local anesthesia significantly reduced the pain perceived during injection of local anesthetic agent in pediatric patients. Clinical Significance Pre-cooling of the soft tissues of an injection site prior to the administration of a local anesthetic can minimize the discomfort and anxiety associated with the injection procedure and facilitates the management of pediatric patients during this phase of a dental procedure. Citation Aminabadi NA, Farahani RMZ. The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia. J Contemp Dent Pract 2009 May; (10)3:043-050.

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 Anti-predator behaviour of Rhinella major (Müller and Hellmich 1936), with insights into the Rhinella granulosa group

Herpetozoa ◽  
2021 ◽  
Vol 34 ◽  
pp. 195-200
Author(s):  
Fillipe Pedroso-Santos ◽  
Carlos Eduardo Costa-Campos
Keyword(s):  
Defensive Responses ◽  
Different Types ◽  
The Face ◽  
The Individual ◽  
Predator Behaviour

In anurans, the different types of anti-predator behaviour have been documented in isolation, but some species have shown synergistic strategies in different situations. The display of these types of behaviour may be related to the types of predators in the habitat, which boost defensive responses in their prey. However, most reports are mostly opportunistic and punctual observations, not systematic. Here, we report the occurrence of anti-predator behaviour in the toad Rhinella major (Müller and Hellmich 1936) (Amphibia, Anura, Bufonidae) in the face of different handling modes. Probably the disturbance caused by handling had elicited a predator deterrence response in the individual, causing it to rapidly exhibit such behaviour. These conditions are discussed along with an overview of anti-predator behaviour in species of the R. granulosa group and we re-interpreted these strategies for two species in the group.

The Posterior Perforated Substance: A Brain Mystery Wrapped in an Enigma

2020 ◽  
Vol 19 (32) ◽  
pp. 2991-2998 ◽  
Author(s):  
Vladimir N. Nikolenko ◽  
Leonid A. Gridin ◽  
Marine V. Oganesyan ◽  
Negoriya A. Rizaeva ◽  
Yury S. Podolskiy ◽  
...  
Keyword(s):  
Point Of View ◽  
Interpeduncular Nucleus ◽  
Surgical Interventions ◽  
Medial Habenula ◽  
Mental Diseases ◽  
Different Types ◽  
Psychiatric Conditions ◽  
The Individual ◽  
Positive Results ◽  
Surgical Operations

Background: There is a dearth of published information on the posterior perforated substance as compared to the anterior perforated substance. We managed to glean facts about the posterior perforated substance that can serve as a landmark for surgical operations in the adjacent regions of the midbrain and the vessels passing through it. Moreover, the posterior perforated substance contains the interpeduncular nucleus responsible for the mental state of the individual. Objectives: 1) To describe the topography of the blood vessels supplying the posterior perforated substance area from the surgical point of view; 2) to investigate the functions of the interpeduncular nucleus. Methods: We assembled and analyzed results from source databases by Elsevier, NCBI MedLine, Scopus, Scholar. Google and Embase. Each article was studied in detail for practically useful information about the posterior perforated substance. Results: The P1-segment perforating branches of the posterior cerebral artery supply the posterior perforated substance. This area is especially vulnerable in the case of vascular pathologies. The posterior communicating artery can block the surgeon’s view and impede maneuverability of the tool in the area of the posterior perforated substance, which may be addressed using the separation technique, which can lead to positive results. In addition, the medial habenula-interpeduncular nucleus in the posterior perforated substance is associated with various addictions and psychiatric conditions. Conclusions: The posterior perforated substance area is of great interest for surgical interventions. Future studies of the interpeduncular nucleus anticipate the development of drugs to affect different types of dependencies and some mental diseases.

Sequencing of panfacial fracture repair

2021 ◽  
pp. 827-830
Author(s):  
Jiten D. Parmar ◽  
Lachlan M. Carter
Keyword(s):  
Soft Tissues ◽  
Fracture Repair ◽  
Three Dimensions ◽  
Facial Skeleton ◽  
Multiple Fractures ◽  
Face Height ◽  
The Face ◽  
Panfacial Fractures ◽  
The Individual ◽  
Panfacial Fracture

Panfacial fractures involve multiple fractures of the upper, middle, and lower thirds of the face. In management of panfacial fractures, the individual fracture techniques and approaches described in the previous chapters in Section 7 are combined to restore bony continuity of the facial skeleton and provide an aesthetic and functional drape of the overlying soft tissues. The aim in treatment of panfacial fractures is to restore the anatomical buttresses of the face in three dimensions, thus restoring vertical face height, horizontal width, and anteroposterior projection.

Facial Aesthetics following Edgewise and Fränkel Appliance Therapy: The Application of Chernoff Faces

1994 ◽  
Vol 21 (2) ◽  
pp. 139-149
Author(s):  
Joanna M. Battagel ◽  
N. J. Battagel
Keyword(s):  
Soft Tissues ◽  
Lower Face ◽  
Pictorial Presentation ◽  
Lower Jaw ◽  
Division 1 ◽  
The Face ◽  
Graphical Technique ◽  
The Individual ◽  
Single Figure ◽  
Relationship Of

This study investigates an application of the graphical technique of multivariate data description, ‘Chernoff faces’, to orthodontics. This method of pictorial presentation allows the simultaneous examination of several measurements in a single figure. Each variable is represented by a scaled feature of the human face: the size and position of the ears, eyes, eyebrows, nose, and mouth, as well as the face itself, are used to display data in a diagrammatic form. Using this method, the individual post-treatment results of 62 severe Class II division 1 cases treated by either Fränkel or Edgewise appliance therapy were compared. Nine cephalometric variables were chosen, describing the profile and the antero-posterior positions of the lower jaw and teeth, and stylized cartoon faces drawn for each child. These were compared with a control face prepared from untreated children of the same sex and age. Overall, children treated with Fränkel appliances showed a more normal relationship of the lips to Ricketts' aesthetic line and a greater prominence of the lower face. This difference between the two groups was most marked in the soft tissues. In a few cases, however, the appearance of the Edgewise treated children was indistinguishable from that of the controls. It is concluded that Chernoff faces, by portraying several pertinent aspects of data simultaneously, may be a useful adjunct to the presentation of orthodontic findings.

scholarly journals Pain-free resting-state functional brain connectivity predicts individual pain sensitivity

2019 ◽  
Author(s):  
Tamas Spisak ◽  
Balint Kincses ◽  
Frederik Schlitt ◽  
Matthias Zunhammer ◽  
Tobias Schmidt-Wilcke ◽  
...  
Keyword(s):  
Resting State ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Brain Connectivity ◽  
Brain Activity ◽  
Treatment Strategies ◽  
Functional Brain ◽  
Individual Susceptibility ◽  
Brain Connectome ◽  
The Individual

AbstractIndividual differences in pain perception are of key interest in basic and clinical research as altered pain sensitivity is both a characteristic and a risk factor for many pain conditions. It is, however, unclear how individual susceptibility to pain is reflected in the pain-free resting-state brain activity and functional connectivity.Here, we identified and validated a network pattern in the pain-free resting-state functional brain connectome that is predictive of interindividual differences in pain sensitivity. Our predictive network signature (https://spisakt.github.io/RPN-signature) allows assessing the individual susceptibility to pain without applying any painful stimulation, as might be valuable in patients where reliable behavioural pain reports cannot be obtained. Additionally, as a direct, non-invasive readout of the supraspinal neural contribution to pain sensitivity, it may have broad implications for translational research and the development and assessment of analgesic treatment strategies.

scholarly journals Demonstration of the possibilities of reconstructive surgical interventions for closure of the exposed bones of the facial skeleton and cranial vault due to extensive defects of various etiologies

2021 ◽  
Vol 27 (2) ◽  
pp. 163-168
Author(s):  
S.B. Bogdanov ◽  
◽  
G.A. Zabunyan ◽  
D.N. Marchenko ◽  
A.N. Blazhenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
Greater Omentum ◽  
Cortical Plate ◽  
Facial Skeleton ◽  
Surgical Interventions ◽  
Aesthetic Result ◽  
Complete Restoration ◽  
The Face ◽  
The Aesthetic

Introduction Surgical treatment of patients with tissue defects of the scalp and face is challenging for surgeons. It is an integral part of the social and labor rehabilitation of such patients. Exposure of the skull bones after extensive polyetiological resections creates a difficult task for reconstruction of complete or partial loss of soft tissues of the head. Autologous dermoplasty, simple in its technical implementation, is impractical on the bones of the facial and cerebral skull because insufficient vascularization of the wound bed creates a risk of early rejection of the graft. The aim of the study was development and evaluation of the effectiveness of the method of restoring the integrity of the skin of the head and face inh extensive defects with exposure of the bones of the skull. Materials and methods Аnalysis of the methods and results of reconstructive surgical treatment of three patients with extensive defects in the tissues of the scalp and face at the Research Institute of the Ochapovsky Regional Clinic Hospital No.1 in 2018-2020. Results The immediate result of surgical treatment was a complete restoration of the skin with the maximum possible preservation of underlying deep anatomical structures after a radical one-step removal of non-viable tissues, both soft and bony. Subjectively, the patients were satisfied. The aesthetic result obtained in all cases satisfied both the patients and the surgical team. Conclusion The treatment of extensive defects of the soft tissues of the face and bones of the skull is a doable task, provided certain conditions are met. Removal of the affected tissues with simultaneous plasty of the resulting wound defect with a autologous greater omentum and skin autografts allows one to simultaneously solve the problem of plastic closure of wound defects of such localization. When performing osteonecrectomy of the outer cortical plate of the skull to the bleeding layer, conditions are created for survival of a free skin autograft on the bone.

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