1/9. Regional head and face pain relief following lower cervical intramuscular anesthetic injection.BACKGROUND: Although cervical trigger point intramuscular injections are commonly used to relieve localized neck pain, regional head pain relief from lower cervical paravertebral injections has not been reported previously. PURPOSE: To evaluate the safety and efficacy of such injections in a selected group of patients with intractable head or face pain. methods: In a series of patients with chronic head or face pain, local anesthetic was injected into the lower cervical spine paravertebral musculature approximately 1 to 2 inches lateral to the seventh cervical spinous process. RESULTS: In addition to producing rapid relief of palpable scalp or facial tenderness (mechanical hyperalgesia and allodynia pain), this lower cervical intramuscular injection technique alleviated associated symptoms of nausea, photophobia, and phonophobia in patients with migrainous headache. CONCLUSION: Our results suggest that lower cervical intramuscular anesthetic injection may be an effective treatment for head or face pain.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
2/9. herpes zoster in hiv infection with osteonecrosis of the jaw and tooth exfoliation.BACKGROUND: herpes zoster (HZ) infection of the trigeminal nerve is associated with complications such as postherpetic neuralgia, facial scarring, loss of hearing ability and conjunctivitis. Until 2005, postherpetic alveolar necrosis and spontaneous tooth exfoliation have been described in 20 cases unrelated to hiv infection. OBJECTIVE: The aim of this study was to describe hiv infection in patients (two women, two men, average age 30 years) who suffered from HZ attacks to their trigeminal nerves. MAIN OUTCOME MEASURES: None of the patients had received antiherpetic medications or antiretroviral therapy. hiv infection was only diagnosed after the development of HZ. Facial scarring with depigmentation and hyperesthesia (postherpetic neuralgia) was diagnosed in all four patients. Oral findings consisted of spontaneous loss of both maxillary or mandibular teeth. osteonecrosis of varying extent was also found. Treatment consisted of extractions of teeth and administration of antibiotics and analgesics. Healing of alveolar wounds was unremarkable. CONCLUSION: Complications affecting the alveolar bone and teeth seem to be rare in hiv-infected patients.- - - - - - - - - - ranking = 92.191703942396keywords = alveolar (Clic here for more details about this article) |
3/9. Further observations on dental parameters of trigeminal and atypical facial neuralgias.One hundred thirty-one patients with primary trigeminal neuralgia and 77 patients with atypical facial neuralgia or pain were treated by oral surgical procedures, with complete or almost complete pain remission in 88% of the cases and without persistent residual anesthesias, dysesthesias, or dysalgesias. The following conditions were related to patients' pain perceptions: cavities in alveolar bone at tooth extraction sites, bone fistulas, periodontal infections, and maxillary sinus infections draining into alveolar bone. The bone cavities and fistulas mentioned above were usually not visualized by standard x-ray diagnostic procedures, and their detection required a new diagnostic approach which is described. Microbiologic findings indicated involvement of a mixed, variable flora in the above conditions. Histopathologic observations of scrapings from involved bone showed a variable incidence of bone necrosis, predominantly chronic inflammatory cell populations and fibrous tissue.- - - - - - - - - - ranking = 61.461135961598keywords = alveolar (Clic here for more details about this article) |
4/9. Progressive leptomeningeal fibrosis: a clinico-pathological case report.A female patient developed persistent facial pain beginning at age 19 years. Intermittent motor and sensory disturbances referable to one hemisphere began nine years later and by the age of 41 she had developed signs of increased intracranial pressure. Exploratory craniotomy revealed replacement of the leptomeninges by thick, fibrous tissue. The histological appearance was that of a chronic, benign and minimally infiltrative process with a mild, non-specific inflammatory component, underlying cortical ischaemic changes, and white matter oedema. The lesion resembled nodular fasciitis, a soft tissue process. No cause of the reactive fibrosis of the meninges in this case is known.- - - - - - - - - - ranking = 2keywords = process (Clic here for more details about this article) |
5/9. Obliteration of fat planes by perineural spread of squamous cell carcinoma along the inferior alveolar nerve.Squamous cell carcinoma showed perineural spread along the inferior alveolar nerve. Key CT features of this spread were foramen enlargement, resurfacing of tumor, and asymmetry of fat spaces.- - - - - - - - - - ranking = 153.65283990399keywords = alveolar (Clic here for more details about this article) |
6/9. The styloid process syndrome: aetiological factors and surgical management.The literature on the syndromes associated with the styloid process is reviewed. The anatomy and embryology of the styloid apparatus are then discussed in relation to the development of these conditions; attention is drawn to the significance of elongation of the process. Eighty styloids measured at post-mortem examination enabled a mean length to be determined as well as a range of normals. The possible aetiological factors are then listed. Four cases of elongated styloid process are described, three treated by excision via an external approach and the fourth presenting as an asymptomatic lump in the neck, not requiring treatment. The authors' preference for the external approach is explained.- - - - - - - - - - ranking = 7keywords = process (Clic here for more details about this article) |
7/9. Stereotactic radiosurgical treatment of sphenopalatine neuralgia. Case report.Sphenopalatine neuralgia is a rare craniofacial pain syndrome that is characterized by unilateral pain in the orbit, mouth, nose, and posterior mastoid process. During attacks of pain, vasomotor activity often results in ipsilateral nasal drainage, eye irritation, and lacrimation. The authors present a patient with a 15-year history of sphenopalatine neuralgia who underwent stereotactic radiosurgery targeted at the sphenopalatine ganglion, with initial pain relief, and repeated radiosurgery 17 months later for partial pain recurrence. Two years following radiosurgery, the patient is pain free, no longer suffering from nasal discharge and eye irritation.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |
8/9. Exogenous estrogen may exacerbate thrombophilia, impair bone healing and contribute to development of chronic facial pain.A 32 year old white female, in apparently good health, failed to respond to conservative wound care for alveolar osteitis after a routine mandibular first molar extraction. curettage and biopsy of necrotic alveolar bone from the #30 socket escalated her pain such that hospitalization was necessary for pain management with intravenous morphine. Twelve months prior to admission she had been placed on exogenous estrogen (Premarin, 0.625 mg/day) after a partial oophorectomy. While hospitalized, she was found to have resistance to activated protein c (APCR). Premarin was discontinued. After discharge, weekly changes of an antibiotic impregnated dressing allowed for progressive regeneration of bone and epithelium with gradual reduction in her pain. She was found to be heterozygous for the mutant factor v Leiden, a heritable factor for increased tendency to form thrombi, so-called thrombophilia. We speculate that the exogenous estrogen administration exacerbated the thrombophilia associated with the factor v Leiden mutation by compounding the patient's resistance to activated protein c thereby contributing to her development of osteonecrosis and severe alveolar neuralgia.- - - - - - - - - - ranking = 92.191703942396keywords = alveolar (Clic here for more details about this article) |
9/9. Chondromyxoid fibroma of the petrygo-palatine space.A patient who for five years had obstinate unilateral facial pain, difficult to interpret, was found to have an expanding process in the left retromaxillary space. Histological examination of a biopsy specimen revealed chondromyxoid fibroma. This tumour is rarely seen in the bones of the face and has never before been described in this area. The clinical and histological findings are described and discussed.- - - - - - - - - - ranking = 1keywords = process (Clic here for more details about this article) |