scholarly journals Improvement of methods of diagnosis the hypertrophy of the styloid process of the temporal bone and stylohyoid syndrome in an outpatient and polyclinic conditions using functional tests

2021 ◽  
pp. 72-78
Author(s):  
Sergey M. Pukhlik ◽  
Anatolii P. Shchelkunov ◽  
Oleksandr A. Shchelkunov
Keyword(s):  
Temporal Bone ◽  
Neurological Diseases ◽  
Styloid Process ◽  
Functional Tests ◽  
Eagle’S Syndrome ◽  
Simple Method ◽  
Ct Examination ◽  
Great Vessels ◽  
Flow Through ◽  
The Brain

The Eagle's syndrome is a disease is caused by irritation of the nervous, vascular and muscular structures the surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deep part of the lateral region of the face, which irradiates in to the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are founding various otolaryngological, dental, neurological diseases. Aim: due to the lack of information on the development and course of the stylohyoid syndrome, conservative treatment and the complexity of diagnosis, the anatomical features of the hypertrophied styloid process, their length and angles of deviation and the need for local impact on the process, the stylohyoid ligament and the neurovascular bundle, to varying degrees presenting to the styloid process, it becomes necessary to develop the most effective and simple method for diagnosis a hypertrophied styloid process and to optimize the need for CT examination with contrasting of the great vessels of the neck and performing functional tests. Materials and methods: Over the past 9 years, we examined and treated 184 patients. The appeals were random, with no specific focus. Of these, there were 133 women (72.3%), men – 51 (27.7%); age – from 25 to 70 years old: 25-30 years old – 15 people (8.1%), 30-45 years old – 116 (63%), 45-60 years old – 38 (20.6%), 60-70 years old – 15 (8.1%); the duration of the disease is from 1 to 10-15 years. Our work was aimed at improving and simplifying the diagnosis of the hypertrophied styloid process during the initial treatment of the patient in an outpatient and polyclinic conditions using functional tests, determining the need to refer patients to CT examination to visualize the relationship of the elongated styloid process with the main vessels of the neck, the possibility of pressure of the append age on the vessels and nerves of the neck, both at rest and in the movement of the head and neck, the development of impaired blood circulation in the brain due to impaired blood flow through the arteries and impaired out flow through the veins, and the development of corresponding symptoms in addition to those described in the literature. Due to the difficulty of diagnosing hypertrophy of the styloid process of the temporal bone in an outpatient and polyclinic conditions and the lack of awareness of practical otolaryngologists about this problem, we proposed a scheme for examining patients with suspicion of this problem.

scholarly journals Features of CT scan for the diagnosis of hypertrophy of the styloid processes of the temporal bone and Eagle’s syndrome

2021 ◽  
pp. 54-59
Author(s):  
Sergey M. Pukhlik ◽  
Anatolii P. Shchelkunov ◽  
Oleksandr A. Shchelkunov
Keyword(s):  
Temporal Bone ◽  
Neurological Diseases ◽  
Styloid Process ◽  
Ct Images ◽  
Growth Options ◽  
Eagle’S Syndrome ◽  
X Ray ◽  
Great Vessels ◽  
Histological Data ◽  
Ct Data

Topicality: The Eagle's syndrome is a disease that is caused by irritation of the nervous, vascular and muscular structures that surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deep part of the lateral region of the face, which irradiates into the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are found in various otolaryngological, dental, neurological diseases. Purpose of the study: determine and evaluate the most significant and distinctive X-ray signs of hypertrophied styloid processes of the temporal bone; reveal differences in growth options and X-ray structure of the styloid processes of the temporal bone in accordance with histological data; eEvaluate the effect of conservative treatment of stylohyoid syndrome depending on different growth options for the styloid process of the temporal bone, according of the data of computed tomography. Materials and methods of research: at the process of our work based on diagnostics and treatment of stylohyoid syndrome, we analyzed 86 clinical cases: 61 women and 25 men. Patients age varies from 35 till 70 years. CT images with contrasting of the great vessels of the neck and functional tests. Based on the analysis, we developed a scheme for determining the variants of the styloid process growth, based on the CT data, in relation to the data of the histological examination of the styloid processes of the patients we operated on. Results: The analysis of CT images and histological studies allows us to divide the lengthening of the styloid processes of the temporal bone into two groups, which we give the name "ossification", that is, the actual growth of the styloid process and "calcification", that is, dystrophic changes and deposits of calcium salts in the ligament. Accordingly, we are developing approaches to conservative or to surgical treatment of this pathology, taking into account the CT data, depending on the growth options of the styloid process of the temporal bone.

scholarly journals Variants of the histological structure of the styloid processes of the temporal bone

2021 ◽  
pp. 40-45
Author(s):  
Sergey M. Pukhlik ◽  
Anatolii P. Shchelkunov ◽  
Oleksandr A. Shchelkunov ◽  
Tetiana O. Savenko
Keyword(s):  
Temporal Bone ◽  
Neurological Diseases ◽  
Styloid Process ◽  
Histological Structure ◽  
Eagle’S Syndrome ◽  
The Face ◽  
Actual Growth ◽  
Surgical Treatments ◽  
The Brain

The Eagle’s syndrome is a disease that is caused by irritation of the nervous, vascular and muscular structures that surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deeppart of the lateral region of the face, which irradiates into the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are found in various otolaryngological, dental, neurological diseases. Purpose of the study: identify and evaluate the most significant histologic features of hypertrophied styloid processes of the temporal bone; identify differences in variants of their growth, according to histological differences; to estimate influence of conservative therapy, that prior to the surgical treatment, to the histological structure of the subulate processes. Materials and methods: at the course of our work based on the diagnosis and treatment of the Eagle’s syndrome, we performed 32 operations for resection of the styloid processes of the temporal bone, despite the ineffectiveness of conservative treatment. All fragments of there moved styloid processes of the temporal bone were sent to histological examination. The performed histological researches al low at present conditionally, according to a small number of the examined patients, to carry out classification of the styloid processes of the temporal bone into two groups. Give names to groups: “ossification”, i.e. the actual growth of the styloid process and “calcification”, i.e. dystrophic changes due to the deposition of calcium salts. Accordingly, we are developing approaches to conservative or surgical treatments of this pathology.

scholarly journals The gender and side asymmetry of length of the styloid process

1970 ◽  
Vol 8 (1) ◽  
Author(s):  
Jan HT Smit ◽  
H Breen
Keyword(s):  
Temporal Bone ◽  
Styloid Process ◽  
Eagle’S Syndrome ◽  
Normal Length ◽  
Sample Group ◽  
The Mean ◽  
The Right ◽  
Base Of The Skull ◽  
Two Sides ◽  
Side Asymmetry

The styloid process is a sharp bony projection, at the base of the skull, and part of the temporal bone. Muscles and ligaments are attached to this process, but they are rarely of any clinical significance unless the styloid process is fractured or severely elongated. Pathology of the styloid process is referred to as Eagle’s syndrome. This was after a publication by Eagle (1937) in which he reported a 4% prevalence of elongated styloid processes. Later studies reported much higher percentages of elongated processes. The aims of this study was to investigate the mean length of the styloid process and compare this with what is accepted as the “normal” length after the Eagle publication. The study also looked at evidence of asymmetry between the two sides within the same specimen. Comparison in the lengths between the two sexes were also made. Forty-five styloid processes from 28 different individuals were measured for comparison. The sample group consisted out of 18 males- and 10 female subjects. The lengths of the styloid processes varied from 7.17 – 50.54mm, with a mean of 27.48mm. Styloid processes were on average 0.87mm longer on the right side and 3.12mm longer in the male specimens. This mean length of 27mm supports the claim by Eagle that the “normal” length is around 25mm. Ten out of 25 individuals (40%) exhibited “elongated” styloid processes measuring over 25mm. These findings were higher than those reported by Eagle. Elongated styloid processes are clinically important in order to make the correct diagnosis.Keywords: Styloid process; Eagel’s Syndrome; Elongated (abnormal length) styloid process.

scholarly journals A Simple Method to Avoid Brain Shift during Neuronavigation: Technical Note

2020 ◽  
Author(s):  
Jair Leopoldo Raso
Keyword(s):  
Dura Mater ◽  
Brain Area ◽  
Conventional Technique ◽  
Technical Note ◽  
Cortical Surface ◽  
Brain Shift ◽  
Simple Method ◽  
Cortex Area ◽  
Neuronavigation System ◽  
The Brain

Abstract Introduction The precise identification of anatomical structures and lesions in the brain is the main objective of neuronavigation systems. Brain shift, displacement of the brain after opening the cisterns and draining cerebrospinal fluid, is one of the limitations of such systems. Objective To describe a simple method to avoid brain shift in craniotomies for subcortical lesions. Method We used the surgical technique hereby described in five patients with subcortical neoplasms. We performed the neuronavigation-guided craniotomies with the conventional technique. After opening the dura and exposing the cortical surface, we placed two or three arachnoid anchoring sutures to the dura mater, close to the edges of the exposed cortical surface. We placed these anchoring sutures under microscopy, using a 6–0 mononylon wire. With this technique, the cortex surface was kept close to the dura mater, minimizing its displacement during the approach to the subcortical lesion. In these five cases we operated, the cortical surface remained close to the dura, anchored by the arachnoid sutures. All the lesions were located with a good correlation between the handpiece tip inserted in the desired brain area and the display on the navigation system. Conclusion Arachnoid anchoring sutures to the dura mater on the edges of the cortex area exposed by craniotomy constitute a simple method to minimize brain displacement (brain-shift) in craniotomies for subcortical injuries, optimizing the use of the neuronavigation system.

scholarly journals Molecular mechanisms of metabotropic GABAB receptor function

2021 ◽  
Vol 7 (22) ◽  
pp. eabg3362
Author(s):  
Hamidreza Shaye ◽  
Benjamin Stauch ◽  
Cornelius Gati ◽  
Vadim Cherezov
Keyword(s):  
G Protein ◽  
Molecular Mechanisms ◽  
Gabab Receptor ◽  
Neurological Diseases ◽  
Activation Mechanism ◽  
Allosteric Modulators ◽  
Inhibitory Neurotransmitter ◽  
Therapeutic Drugs ◽  
G Protein Coupled ◽  
The Brain

Metabotropic γ-aminobutyric acid G protein–coupled receptors (GABAB) represent one of the two main types of inhibitory neurotransmitter receptors in the brain. These receptors act both pre- and postsynaptically by modulating the transmission of neuronal signals and are involved in a range of neurological diseases, from alcohol addiction to epilepsy. A series of recent cryo-EM studies revealed critical details of the activation mechanism of GABAB. Structures are now available for the receptor bound to ligands with different modes of action, including antagonists, agonists, and positive allosteric modulators, and captured in different conformational states from the inactive apo to the fully active state bound to a G protein. These discoveries provide comprehensive insights into the activation of the GABAB receptor, which not only broaden our understanding of its structure, pharmacology, and physiological effects but also will ultimately facilitate the discovery of new therapeutic drugs and neuromodulators.

scholarly journals Human Monocytes Plasticity in Neurodegeneration

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 717
Author(s):  
Ilenia Savinetti ◽  
Angela Papagna ◽  
Maria Foti
Keyword(s):  
Neurodegenerative Disorders ◽  
Current Knowledge ◽  
Neurological Diseases ◽  
Surface Marker ◽  
First Line ◽  
Surface Marker Expression ◽  
Physiological Properties ◽  
Attractive Therapeutic Target ◽  
The Brain ◽  
Lateral Sclerosis

Monocytes play a crucial role in immunity and tissue homeostasis. They constitute the first line of defense during the inflammatory process, playing a role in the pathogenesis and progression of diseases, making them an attractive therapeutic target. They are heterogeneous in morphology and surface marker expression, which suggest different molecular and physiological properties. Recent evidences have demonstrated their ability to enter the brain, and, as a consequence, their hypothetical role in different neurodegenerative diseases. In this review, we will discuss the current knowledge about the correlation between monocyte dysregulation in the brain and/or in the periphery and neurological diseases in humans. Here we will focus on the most common neurodegenerative disorders, such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis and multiple sclerosis.

scholarly journals Molecular mechanisms of cell death in neurological diseases

2021 ◽  
Author(s):  
Diane Moujalled ◽  
Andreas Strasser ◽  
Jeffrey R. Liddell
Keyword(s):  
Cell Death ◽  
Neurodegenerative Diseases ◽  
Molecular Mechanisms ◽  
Neuronal Development ◽  
Neurological Diseases ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Response To Therapy ◽  
Signalling Cascades ◽  
The Brain

AbstractTightly orchestrated programmed cell death (PCD) signalling events occur during normal neuronal development in a spatially and temporally restricted manner to establish the neural architecture and shaping the CNS. Abnormalities in PCD signalling cascades, such as apoptosis, necroptosis, pyroptosis, ferroptosis, and cell death associated with autophagy as well as in unprogrammed necrosis can be observed in the pathogenesis of various neurological diseases. These cell deaths can be activated in response to various forms of cellular stress (exerted by intracellular or extracellular stimuli) and inflammatory processes. Aberrant activation of PCD pathways is a common feature in neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS), Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease, resulting in unwanted loss of neuronal cells and function. Conversely, inactivation of PCD is thought to contribute to the development of brain cancers and to impact their response to therapy. For many neurodegenerative diseases and brain cancers current treatment strategies have only modest effect, engendering the need for investigations into the origins of these diseases. With many diseases of the brain displaying aberrations in PCD pathways, it appears that agents that can either inhibit or induce PCD may be critical components of future therapeutic strategies. The development of such therapies will have to be guided by preclinical studies in animal models that faithfully mimic the human disease. In this review, we briefly describe PCD and unprogrammed cell death processes and the roles they play in contributing to neurodegenerative diseases or tumorigenesis in the brain. We also discuss the interplay between distinct cell death signalling cascades and disease pathogenesis and describe pharmacological agents targeting key players in the cell death signalling pathways that have progressed through to clinical trials.

Use of a sternocleidomastoid muscle flap to protect the carotid artery during laryngectomy

2021 ◽  
pp. 1-4
Author(s):  
J C Fleming ◽  
A R Fuson ◽  
H Jeyarajan ◽  
C M Thomas ◽  
B Greene
Keyword(s):  
Carotid Artery ◽  
Marked Reduction ◽  
Muscle Flap ◽  
Sternocleidomastoid Muscle ◽  
Simple Method ◽  
Initial Surgery ◽  
Great Vessels ◽  
Prevertebral Fascia ◽  
Sternocleidomastoid Muscle Flap ◽  
Salvage Laryngectomy

Abstract Objectives This paper describes a simple method of securing tissue coverage of the great vessels at the initial surgery by rotating the divided sternal heads of the sternocleidomastoid muscle, a routine step during laryngectomy, and approximating them to the prevertebral fascia. The paper presents an illustrated case example where this technique in a salvage laryngectomy repair resulted in a protected vascular axis following a salivary leak. Results Since utilising this technique, there has been a marked reduction in the requirement of subsequent flap procedures to protect vessels, and no episodes of threatened or actual carotid blowout.

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