phenylephrine-hydrochloride and Peripheral-Nervous-System-Diseases

Surgical access to the second (V2, maxillary) and third (V3, mandibular) branches of the trigeminal nerve (V) has been classically through a transoral approach. Increasing expertise with endoscopic anatomy has achieved less invasive, more efficient access to skull base structures. The authors present a surgical technique using an endoscopic endonasal approach for the treatment of painful V2 neuropathy.. Endoscopic endonasal dissections using a transmaxillary approach were performed in four formalin-fixed cadaver heads to expose the V2 branch of the trigeminal nerve. Relevant surgical anatomy was evaluated and anatomic parameters for neurectomy were identified.. Endoscopic endonasal transmaxillary approaches completed bilaterally to the pterygopalatine and pterygomaxillary fossae exposed the V2 branch where it emerged from the foramen rotundum. The anatomy defined for the location of neurectomy was determined to be the point where V2 emerged from the foramen rotundum into the pterygopalatine fossa. The technique was then performed in 3 patients with intractable painful V2 neuropathy.. In our cadaveric study and clinical cases, the endoscopic endonasal approach to the pterygopalatine fossa achieved effective exposure and treatment of isolated V2 painful neuropathy. Important surgical steps to visualize the maxillary nerve and its branches and key landmarks of the pterygopalatine fossa are discussed. This minimally invasive approach appears to be a valid alternative for select patients with painful V2 trigeminal neuropathy.

Topics: Adult; Cadaver; Humans; Maxillary Nerve; Natural Orifice Endoscopic Surgery; Nose; Pain; Peripheral Nervous System Diseases; Pterygopalatine Fossa; Sphenoid Bone; Trigeminal Nerve; Trigeminal Neuralgia

An epizootic of flaccid trunk paralysis began in free-ranging Zimbabwean elephants (Loxodonta africana) on the southern shore of Lake Kariba in 1989. It involved a selective neuropathy of peripheral nerves supplying the trunk, with axon and myelin degeneration, muscle atrophy, compensatory hypertrophy, and fine endomyseal fibrosis, without inflammatory changes.

Topics: Animals; Brain; Disease Outbreaks; Elephants; Female; Male; Mice; Mice, Inbred BALB C; Muscle Hypotonia; Muscle, Skeletal; Muscular Atrophy; Nose; Paralysis; Peripheral Nerves; Peripheral Nervous System Diseases; Zimbabwe

Rhinophony, which is a change of vocal sound, can appear as a major symptom in many peripheral or central disorders of childhood, adolescence and adulthood. Its investigation, aetiology and management from various points of view are discussed. These are considered broadly as rhinophony aperta (palatal paralysis, functional rhinophony aperta, congenitally short palate); as rhinophony clausa (organic in origin, functional nasal speech); and mixed types of rhinophony. Typical phoniatric problems related to cleft lip and palate are also presented.

Topics: Auscultation; Central Nervous System Diseases; Cleft Lip; Cleft Palate; Diagnosis, Differential; Humans; Jaw Abnormalities; Nose; Palate; Paralysis; Peripheral Nervous System Diseases; Speech Disorders; Voice

Topics: Humans; Nose; Peripheral Nervous System Diseases; Skin Diseases; Trigeminal Neuralgia; Ulcer

Topics: Humans; Nose; Peripheral Nervous System Diseases; Trigeminal Ganglion; Trigeminal Nerve Injuries; Ulcer

Topics: Humans; Nose; Peripheral Nervous System Diseases; Trigeminal Ganglion; Trigeminal Nerve Injuries; Ulcer