scholarly journals Neurocap Use for the Treatment of Iatrogenic Neuropathic Pain: Preliminary Operative Results in 3 Patients

2020 ◽  
pp. 014556132091204
Author(s):  
J. Alexander de Ru ◽  
Hans G. X. M. Thomeer ◽  
Bernard M. Tijink ◽  
Tristan P. C. van Doormaal
Keyword(s):  
Neuropathic Pain ◽  
Head And Neck ◽  
Marked Reduction ◽  
Nerve Stump ◽  
Operative Results ◽  
Traumatic Neuroma ◽  
Pain Scores ◽  
Neck Area ◽  
Viable Treatment

Painful neuromas are a devastating condition that is notoriously difficult to treat. The large number of techniques that have been attempted suggest that no one technique is superior. Neuromas often occur in the extremities, but iatrogenically caused pain in the head and neck area has also been described. This article describes 3 consecutive patients diagnosed with traumatic neuroma who underwent transection of the causative nerve, followed by capping of the nerve stump with a Neurocap. With a follow-up of 7 to 24 months, our results show a marked reduction in the pain scores of all 3 patients. The preliminary results indicate that this technique might be a viable treatment option for patients with a suspected neuroma in the head and neck area.

Cervical sparganosis: case reports with focus on radiological findings

2012 ◽  
Vol 126 (6) ◽  
pp. 641-644 ◽  
Author(s):  
H J Kim ◽  
B J Lee ◽  
J C Lee ◽  
C K Yeo
Keyword(s):  
Head And Neck ◽  
Case Reports ◽  
Rare Condition ◽  
Neck Mass ◽  
Lateral Neck ◽  
Radiological Findings ◽  
Cervical Mass ◽  
Neck Area ◽  
Serial Images

AbstractBackground:Cervical sparganosis is a rare condition that presents as a lateral neck mass. Its radiological findings have not previously been investigated. Thus, the important radiological findings of cervical sparganosis are presented herein.Methods:We report two patients with cervical sparganosis who presented with cervical masses, and we review the relevant head and neck literature. Computed tomography was performed three times over 13 months of follow up for one patient.Results:On follow-up radiological examination, a migratory lesion with a tubular appearance, seen on serial images, should be considered significant for cervical sparganosis.Conclusion:Radiologically, a migratory cervical mass in the head and neck area with a tubular appearance is suggestive of cervical sparganosis.

scholarly journals Cervical Spinal Cord Stimulation: An Analysis of 23 Patients with Long-term Follow-up

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. 203-212 ◽  
Author(s):  
Tilman Wolter
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Lower Limb ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Head Movements ◽  
Limb Pain ◽  
Pain Scores ◽  
Stimulation Parameters

Background: For more than 3 decades, spinal cord stimulation has successfully been employed to treat neuropathic pain. Cervical spinal cord stimulation, despite now being standard in many hospitals, has only rarely been subjected to a critical review within the literature. Objectives: The aim of this study was to determine the efficacy of cervical spinal cord stimulation (SCS) in a representative clinical sample. We also wanted to evaluate how factors such as stimulation parameters, unwanted paresthesia of the trunk and legs, and changes in paresthesia status due to head movement and how they affect SCS effectiveness. Study design: Retrospective study. Setting: Academic university interdisciplinary pain center. Methods: We reviewed the records of patients who had been treated at our institution with cervical neurostimulators from November 1, 2001 through October 31, 2011. Information regarding age, gender, diagnosis, age at time of implantation, duration of disease, lead position, hardware in use, revision operations, and stimulation parameters were recorded. In addition, a short telephone interview was conducted, which contained the following items: pain scores on the numeric analog scale (NAS) with and without stimulation, time intervals of stimulation, paresthesia coverage, changes in paresthesia coverage by head movements, unwanted paresthesia of the trunk and legs, treatment satisfaction, and medication intake. Results: Twenty-three patients were treated. Eighteen patients proceeded to an implantable pulse generator (IPG) implant. In one patient, the system was removed after 4 years despite optimal function, because the patient was no longer experiencing pain. Average NAS pain scores were 6.8 (range 5.5 - 10.0, standard deviation [SD] 1.7) without, and 2.8 (range 0 - 7.5, SD 2.2) with neurostimulation. Fourteen revisions (5 due to lead dislocation, 5 due to lead breakage and 4 IPG revisions) were necessary in 9 of the 18 patients during a mean follow-up of 6.2 years. Most patients reported complete paresthesia coverage. Four patients reported unwanted paresthesia of the trunk or lower limb and 11 patients reported changes in paresthesia with head movements. In both instances, pain reduction was not affected. Limitations: Retrospective study. Conclusions: Cervical spinal cord stimulation appears to be effective in the treatment of neuropathic upper limb pain. Complications are not significantly more frequent than in SCS for lower limb pain. Changes in paresthesia with head movements and unwanted paresthesia did not affect the outcome. Key words: Spinal cord stimulation, cervical, neuropathic pain, clinical efficacy, paresthesia, paresthesia coverage, changes in paresthesia, brachial plexus lesion, nerve root avulsion, stimulation parameters

scholarly journals Benign Fibrous Histiocytoma of the Buccal Mucosa: Case Report and Literature Review

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Paraskevi Giovani ◽  
Anna Patrikidou ◽  
Aris Ntomouchtsis ◽  
Soultana Meditskou ◽  
Henri Thuau ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Head And Neck ◽  
Buccal Mucosa ◽  
Clinical Characteristics ◽  
Fibrous Histiocytoma ◽  
Relevant Literature ◽  
Benign Fibrous Histiocytoma ◽  
Neck Area

Benign fibrous histiocytoma is an interesting and challenging entity even in its most usual, cutaneous presentation. Noncutaneous presentation is extremely limited, even more so for the mucosa of the head and neck area. We herein report such a case, describing the clinical characteristics of the lesion, complete diagnostic evaluation, management, and follow-up. Diagnostic histopathological challenges are specifically illustrated. A complete review of the relevant literature is also included.

Longitudinal Perioperative Pain Assessment in Head and Neck Cancer Surgery

2017 ◽  
Vol 126 (9) ◽  
pp. 646-653 ◽  
Author(s):  
Marisa R. Buchakjian ◽  
Andrew B. Davis ◽  
Sebastian J. Sciegienka ◽  
Nitin A. Pagedar ◽  
Steven M. Sperry
Keyword(s):  
Neuropathic Pain ◽  
Head And Neck Cancer ◽  
Postoperative Pain ◽  
Head And Neck ◽  
Neck Cancer ◽  
Pain Assessment ◽  
Preoperative Pain ◽  
Pain Diary ◽  
Perioperative Pain ◽  
Pain Scores

Objective: To evaluate perioperative pain in patients undergoing major head and neck cancer surgery and identify associations between preoperative and postoperative pain characteristics. Methods: Patients undergoing head and neck surgery with regional/free tissue transfer were enrolled. Preoperative pain and validated screens for symptoms (neuropathic pain, anxiety, depression, fibromyalgia) were assessed. Postoperatively, patients completed a pain diary for 4 weeks. Results: Twenty-seven patients were enrolled. Seventy-eight percent had pain prior to surgery, and for 38%, the pain had neuropathic characteristics. Thirteen patients (48%) completed at least 2 weeks of the postoperative pain diary. Patients with moderate/severe preoperative pain report significantly greater pain scores postoperatively, though daily pain decreased at a similar linear rate for all patients. Patients with more severe preoperative pain consumed greater amounts of opioids postoperatively, and this correlated with daily postoperative pain scores. Patients who screened positive for neuropathic pain also reported worse postoperative pain. Conclusion: Longitudinal perioperative pain assessment in head and neck patients undergoing surgery suggests that patients with worse preoperative pain continue to endorse worse pain postoperatively and require more narcotics. Patients with preoperative neuropathic pain also report poor pain control postoperatively, suggesting an opportunity to identify these patients and intervene with empiric neuropathic pain treatment.

Long-term follow-up in patients treated with electrochemotherapy for non-melanoma skin cancer in the head and neck area

2019 ◽  
Vol 139 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Stefan Kristiansson ◽  
Johan Reizenstein ◽  
Mathias von Beckerath ◽  
Fredrik Landström
Keyword(s):  
Skin Cancer ◽  
Head And Neck ◽  
Non Melanoma Skin Cancer ◽  
Neck Area ◽  
Long Term Follow Up ◽  
Melanoma Skin

Deep brain stimulation of the posterior limb of the internal capsule in the treatment of central poststroke neuropathic pain of the lower limb: case series with long-term follow-up and literature review

2020 ◽  
Vol 133 (3) ◽  
pp. 830-838 ◽  
Author(s):  
Andrea Franzini ◽  
Giuseppe Messina ◽  
Vincenzo Levi ◽  
Antonio D’Ammando ◽  
Roberto Cordella ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Lower Limb ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Vas Score ◽  
The Mean ◽  
Deep Brain ◽  
Stimulation Of

OBJECTIVECentral poststroke neuropathic pain is a debilitating syndrome that is often resistant to medical therapies. Surgical measures include motor cortex stimulation and deep brain stimulation (DBS), which have been used to relieve pain. The aim of this study was to retrospectively assess the safety and long-term efficacy of DBS of the posterior limb of the internal capsule for relieving central poststroke neuropathic pain and associated spasticity affecting the lower limb.METHODSClinical and surgical data were retrospectively collected and analyzed in all patients who had undergone DBS of the posterior limb of the internal capsule to address central poststroke neuropathic pain refractory to conservative measures. In addition, long-term pain intensity and level of satisfaction gained from stimulation were assessed. Pain was evaluated using the visual analog scale (VAS). Information on gait improvement was obtained from medical records, neurological examination, and interview.RESULTSFour patients have undergone the procedure since 2001. No mortality or morbidity related to the surgery was recorded. In three patients, stimulation of the posterior limb of the internal capsule resulted in long-term pain relief; in a fourth patient, the procedure failed to produce any long-lasting positive effect. Two patients obtained a reduction in spasticity and improved motor capability. Before surgery, the mean VAS score was 9 (range 8–10). In the immediate postoperative period and within 1 week after the DBS system had been turned on, the mean VAS score was significantly lower at a mean of 3 (range 0–6). After a mean follow-up of 5.88 years, the mean VAS score was still reduced at 5.5 (range 3–8). The mean percentage of long-term pain reduction was 38.13%.CONCLUSIONSThis series suggests that stimulation of the posterior limb of the internal capsule is safe and effective in treating patients with chronic neuropathic pain affecting the lower limb. The procedure may be a more targeted treatment method than motor cortex stimulation or other neuromodulation techniques in the subset of patients whose pain and spasticity are referred to the lower limbs.

Long-Term Follow-up on an Intensified Treatment Regimen for Advanced Resectable Head and Neck Squamous Cell Carcinomas

2001 ◽  
Vol 19 (2) ◽  
pp. 127-136 ◽  
Author(s):  
John C. Grecula ◽  
David E. Schuller ◽  
Roy Smith ◽  
Chris A. Rhoades ◽  
Subir Nag ◽  
...  
Keyword(s):  
Head And Neck ◽  
Treatment Regimen ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Long Term Follow Up

scholarly journals Differential effects of epidermal growth factor receptor inhibitors in a single patient with neuropathic pain

2021 ◽  
Vol 14 (3) ◽  
pp. e239385
Author(s):  
Marte Grønlie Cameron ◽  
Christian Kersten
Keyword(s):  
Epidermal Growth Factor Receptor ◽  
Neuropathic Pain ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Growth Factor Receptor ◽  
Differential Effects ◽  
Pain Scores ◽  
Medical Need ◽  
Epidermal Growth ◽  
Egfr Family

Neuropathic pain (NP) represents an unmet medical need, where analgesic responses to different epidermal growth factor receptor inhibitors (EGFR-Is) have been described. The human EGFR family of receptors consists of four members (human epidermal growth factor receptor, HER 1–4), signalling via different homodimer and heterodimer combinations. A 52-year-old man was treated with the EGFR-I cetuximab in a trial of severe NP. Pain scores decreased dramatically after blinded cetuximab, but not after placebo. On pain recurrence after the trial, he was prescribed the oral EGFR-Is erlotinib, gefitinib, and lapatinib without relief. However, treatment with the pan-HER-inhibitor afatinib was effective. After 4 years on afatinib, pain control remains excellent with manageable side effects. This is the first reported observation of differential effects of EGFR-Is on NP in the same patient and the first report describing NP relief with afatinib. Further understanding of the underlying pathophysiology could lead to development of EGFR-Is specifically targeting NP.

Neutrophilic Dermatosis of Hands as Oncological Finding: Importance of Follow-Up

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Jérôme R. Lechien ◽  
Daphné Delplace ◽  
Mohamad Khalife ◽  
Sven Saussez
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Paraneoplastic Syndrome ◽  
Tobacco Consumption ◽  
Neutrophilic Dermatosis ◽  
Pharyngeal Cancer ◽  
Head And Neck Malignancy ◽  
Neck Malignancy

Neutrophilic febrile dermatosis (NFD) is a rare paraneoplastic syndrome that may be found in patients with head and neck cancer. NFD may appear before the neoplasia and may only concern the dorsal faces of the hands. This article reports the NFD findings of a patient with pharyngeal cancer, which was developed 2 years after the occurrence of NFD. The development of NFD in patient with alcohol and tobacco consumption should lead otolaryngologists and dermatologists to suspect head and neck malignancy. In cases of normal otolaryngological examination, patients have to be followed.

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