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Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

  • Leung, Yiu Yan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.5
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    • pp.233-240
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    • 2019
  • Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar

  • Cely, Adriana Marcela Gonzalez;Triana, Carlos Enrique;Triana, Lina Maria
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.262-266
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    • 2019
  • Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.

An unusual complication during arthrocentesis: N. facialis paralysis, with N. lingualis and N. alveolaris inferior anesthesia

  • Aliyev, Toghrul;Berdeli, Eynar;Sahin, Onur
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.2
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    • pp.115-118
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    • 2019
  • This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.

Ocular manifestations in a patient with de novo Fabry disease

  • Lee, You Hyun;Shim, Kyu Young;Park, Sung Bae;Kim, Yu Cheol
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.232-235
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    • 2018
  • Fabry disease (FD) is an X-linked, recessively inherited, rare, progressive, disorder of glycosphingolipid metabolism affecting multiple organs resulting in organ dysfunction. It is rare to find only one FD affected subject with a de novo mutation. Here we report a case of a 41-year-old Asian male diagnosed with de novo FD. Comprehensive ophthalmological evaluation was performed using slit lamp, color fundus photography, optical coherence tomography, fluorescein angiography, and indocyanine green angiography. On slit lamp examination, cornea verticillata and slightly tortuous, and aneurysmal dilatation of inferior bulbar conjunctival vessels were observed. Other imaging modalities showed unremarkable findings. Cornea verticillata and inferior bulbar conjunctival vascular abnormalities may be detected earlier than other ocular abnormalities in de novo FDs like hereditary FDs.

Intrathyroid Thyroglossal Duct Cyst Extending into the Mediastinum: A Case Report and Review of Literature (종격동내 위치한 갑상선 내 갑상설관 낭종: 증례 보고 및 문헌 고찰)

  • Lee, Chan Mi;Hong, Yong Tae
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.65-68
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    • 2022
  • Thyroglossal duct cyst (TGDC) is the most common congenital cyst in the neck and usually presents in children. It is most commonly located at the infrahyoid level. However, intrathyroid TGDC in the adult is extremely rare and its pathogenesis remains unclear. Curiously, an intrathyroid TGDC was found on the lateral aspect of the inferior pole of the thyroid gland. Given the unique position of this lesion, and its capacity to stimulate other nodules in the thyroid, it should be differentiated from other lateral neck masses, such as: thymic cysts, branchial cleft cysts, cystic hygroma, lipomas, lymphadenopathies, cervical teratomas, and lymphomas. In this case, a separate cystic mass was found in the right inferior pole of the thyroid gland and extended to the mediastinum. We confirmed it as TGDC by pathology and histological examination.

Arteriography and Embolization of Lateral Inferior Genicular Artery of Recurrent Spontaneous Hemarthrosis after Total Knee Arthroplasty (인공 슬관절 치환술 후 발생한 재발성 혈관절증의 치료를 위해 시행한 혈관조영술 및 하외슬동맥색전술)

  • Chon, Je-Gyun;Kang, Jong-Won;Yoon, Ja-Yeong;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.173-177
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    • 2021
  • Recurrent spontaneous hemarthrosis is a relatively rare complication of total knee arthroplasty. This paper reports a case of a patient treated with arterial embolization for recurrent spontaneous hemarthrosis even after undergoing arthroscopic surgery. The patient had several relapses after total knee arthroplasty.

Isolated ipsilateral abducens nerve palsy and contralateral homonymous hemianopsia associated with unruptured posterior cerebral artery aneurysm: A rare neurological finding

  • Sandeep Mishra;Saurav Mishra;Sabina Regmi;Kanwaljeet Garg;Shailesh Gaikwad
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.3
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    • pp.318-323
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    • 2024
  • Cranial nerve palsies can be presenting signs of intracranial aneurysms. There is a classic pairing between an aneurysmal vessel and adjacent nerves leading to cranial neuropathy. Isolated abducens nerve palsy can be a localizing sign of an unruptured vertebrobasilar circulation aneurysm. Aneurysms involving Anterior Inferior Cerebellar Artery (AICA) and Posterior Inferior Cerebellar Artery (PICA) have been reported to be associated with abducens nerve palsy. The symptoms in unruptured aneurysms are due to the mass effect on adjacent neurovascular structures. Most of the abducens nerve palsy resolves following microsurgical clipping. Here, we present a rare case of an unruptured Posterior Cerebral Artery (PCA) aneurysm presenting with abducens nerve palsy and diplopia associated with contralateral hemianopsia which markedly improved following endovascular coil embolization.

Multiple venous variations at the abdominopelvic region: a case report

  • Satheesha Badagabettu Nayak;Soumya Kodimajalu Vasudeva
    • Anatomy and Cell Biology
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    • v.55 no.3
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    • pp.394-397
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    • 2022
  • Knowledge of vascular variations of the abdominopelvic junction is of importance to surgeons, radiologists, orthopaedic surgeons and other medical disciplines. We report a rare combination of venous variations observed at the abdominopelvic junction of an adult male cadaver. The right common iliac vein was absent. The inferior vena cava was formed by the union of the right external iliac vein and the left common iliac vein. The right internal iliac vein was a tributary of the left common iliac vein. The left common iliac vein was larger than usual in size and its wall was adhered to the right common iliac artery. We discuss the functional, developmental and clinical issues related to the case.