[Dysfunction of the temporomandibular joint and arthroscopy].
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Arthroscopy↗
Biomedical subjects
R Gola
Publications and source records attributed to R Gola.
[Hemorrhagic mandibular metastasis of renal origin: usefulness of therapeutic embolization].
BACKGROUND: Vascular metastatic tumors of the mandible are unusual and management of bleeding may be difficult. CASE REPORT: An 83-year-old woman with a mandibular metastasis from a renal-cell carcinoma developed oral pain and episodes of bleeding of 2-weeks duration. Embolization was successful in stopping blood loss which occurred during surgical biopsy. Eight months after embolization, the patient is pain free and no bleeding has recurred. DISCUSSION: Embolization during arteriography procedures for tumor exploration can be useful in acute situations to improve survival and patient comfort. The aim may be palliative care or preparation for curative excision.
Aged↗
[The forehead cutaneo-musculo-aponeurotic unit and aging of the forehead. Anatomo-physiological considerations and surgical implications].
The occipitofrontalis muscle, as it is described in classical anatomy text books, does not exist. The epicranial aponeurosis or galea aponeurotica receives the occipitalis muscle on its deep surface and the frontalis muscle on its superficial surface. The frontalis muscle plays a fundamental role not only in forehead expression, but also in the support and elevation of the eyelids. This revised and corrected anatomy gives rise to the concept of the forehead cutaneomusculoaponeurotic unit, composed of skin, galea and frontalis muscle (forehead CMAU), resulting in a new forehead facelift which corrects forehead ageing, essentially related to recession of the forehead and relaxation of the galea.
Adult↗
[Conservative forehead facelift. Design and preliminary results].
The digastric occipitofrontalis muscle, as described in classical anatomy text books, does not exist. The epicranial aponeurosis or galea aponeurotica receives the occipitalis muscle on its deep surface and the frontalis muscle on its superficial surface. This revised anatomy of the concept of the frontal cutaneo-musculo-aponeurotic unit, combining skin, galea and frontalis muscle (frontal CMAU) is the basis for a new forehead facelift which corrects ageing of the forehead, essentially related to recession of the forehead and relaxation of the galea. The essential advantage of this new facelift is preservation of the frontalis muscle which plays a fundamental role not only in forehead expression, but also in support and elevation of the eyelids. The absence of any direct procedure on the frontalis muscle decreases the extent of skin resection and avoids or minimizes sensory or motor neurological complications.
Adult↗
Adenosine and migraine.
BACKGROUND: Adenosine is a powerful natural vasodilator that participates in the control of cerebral and meningeal blood flow. In this context, it could be involved in the pathophysiology of migraine, since it was previously reported that intravenous adenosine can precipitate crises in migraine patients. METHODS: We have investigated circulating adenosine levels in 12 patients suffering from migraine without aura, during crises and in crisis-free periods, and have compared the levels noted to those of a population of 10 controls. To determine if there are interactions between adenosine and serotonin, we examined the effect of adenosine and antagonists on the uptake and the release of (14C) serotonin by platelets. RESULTS AND CONCLUSION: We have reached a dual conclusion: 1) during migraine headaches there is an increase (mean 68%) in circulating adenosine levels and this increase may participate in cephalalgia; 2) activation of A2 receptors by adenosine causes a dose-dependent serotonin uptake by platelets. This inhibition of uptake could participate in the rapid elimination of serotonin in migraine sufferers. As a result of this, the use of adenosine antagonists could be an effective complementary treatment for migraine.
Adenosine↗
[The contribution of standard radiographs in the evaluation of masticatory system dysfunction].
Conventional x-ray films (orthopantomogram, teleradiogram) visualize many signs of dysfunction of the manducatory apparatus (DAM). Progress in our knowledge of the pathophysiology of DAM has brought new light to these radiographic signs. The orthopantomogram allows an assessment of modifications in muscle insertion zones secondary to their dysfunction and, more difficulty, the articular remodeling of the TMJ, mainly of the mandibular condyle and the articular space. The lateral teleradiogram studied by architectural and structural analysis provides information on the biomechanical balance of the cranio-facial structures and, especially, on the position of the mandibular rami. These standard radiograms are indispensable in the differential diagnosis, useful in the etiological diagnosis and are preliminary examinations prior to using other imaging techniques (MRI, CT). Standard films are easily reproducible for post-therapy follow-up.
Biomechanical Phenomena↗
[Valentin's nerve, its role in the innervation of the chin region. Preliminary report].
The mylo-hyoid nerve, a branch of the inferior alveolar nerve, gives rise to many motor and sensory branches. Motor branches innervate the anterior belly of the digastric muscle. Sensitive branches innervate the submandibular gland and also the skin just under the bony chin. Valentin's nerve, the terminal cutaneous branch of the myo-hyoid nerve (described by Valentin in 1843), can be damaged by horizontal mentoplasty (sliding-mentoplasty). Sensory disorders (hypoesthesia, anesthesia) can occur in case of Valentin's nerve injury without lesions to the mental nerve.
Adult↗
[Recent progress in facial esthetic surgery (excluding endoscopic technics)].
Recent advances offer a new approach to cosmetic surgery of the frontal, cervico-facial and orbito-palpebral areas. Conservative frontal lifting procedures displace the entire frontal muscle (without section or resection) over the underlying bone and periosteal planes by raising the galea and the antagonist muscles. This repositioning reduces or eliminate wrinkles by preventing hyperfunction of the frontal muscle. The risk of sensorial or motor nerve lesions is reduced and the forehead and eyelids have a natural appearance. Unlike extensive lifting of the cervico facial areas, physiological conservative cervico-facial lifting maintains the cutanéomusculo-aponeurotic unity which associates the skin with the superficial musculo-aponeurotic system. The procedure limits detachment in the parotido-masseter region. Early results on the lower cheeks and platysmal cords are significant. The absence of cutaneous detachment preserves the natural appearance of the palpebral complex and the orbital fat allowing improved function and a pleasant aspect of the eyelids. This surgery should be widened beyond the orbito-palpebral area and be used in the frontal, jugal and, in certain cases, the endonasal areas.
Adipose Tissue↗
[Zona of the cranial nerves. Current aspects].
Recurrence of the chickenpox virus, herpes zoster localizes in cranial nerves in 30% of cases, with a predilection for the ophthalmic nerve. In young patients, clinicians must search for a herpes zoster-HIV association as well as oculomotor proprioception impairment in herpes zoster ophthalmicus. Enhanced MRI allows good objective view of the facial nerve lesions in herpes zoster facial paralysis. Finally, the gravity and aftereffects of cephalic herpes zoster can be decreased by an appropriate therapeutic approach.
AIDS-Related Opportunistic Infections↗
Comparison of different materials for interposition arthroplasty in treatment of temporomandibular joint ankylosis surgery: long-term follow-up in 25 cases.
A variety of interposition materials have been used to prevent recurrence after arthroplasty in treatment of temporomandibular joint ankylosis. The purpose of this retrospective study of our experience was to compare the different materials (skin, temporal muscle, homologous cartilage) used for interposition arthroplasty over a period of 22 years. A total of 25 patients (32 joints) with at least 3 years of follow-up were included. Good results were achieved in 92% of cases using total full thickness skin graft and 83% of cases using temporal muscle flap. Homologous cartilage gave poor results.
Adolescent↗
[Oto-mandibular ligaments: disco-mallear and malleo-mandibular ligaments].
Phylogenesis, embryology and anatomy are emphasizing that two ligaments are found between the temporo-mandibular joint and the middle ear. These two oto-mandibular ligaments are named the disco-mallear ligament and the malleo-mandibular ligament. Originating from the first arch, these ligaments are not involved in the otologic manifestations of the temporo-mandibular joint syndrome. The disco-mallear ligament is a brake applied to the anterior excursion of the disc. When this disco-mallear ligament is stretched the disc can be displaced anteriorly breeding disc displacement, hypermobility and temporo-mandibular dislocation. The malleo-mandibular ligament is a remainder of the Meckel's cartilage: its role is not clear. When excessive forces are applying on the mandible, ossicles dislocation can be seen the forces being transmitted through it.
Branchial Region↗
[Conservative cervico-facial facelift. Concept and preliminary results].
A new cervico-facial facelift is presented, taking into account the cervico-facial cutaneomusculo-aponeurotic unit (CMAU) comprising skin, subcutaneous adipose tissue, superficial musculo-aponeurotic system and the particular mechanism of cervico-facial ageing. The undermining, limited to the parotido-masseretic region, is not subcutaneous, but immediately submusculoaponeurotic. The advantage of this facelift is to replace all of the CMAU over the underlying musculo-aponeurotic or osteo-periosteal planes, without modifying superficial relations. The cutaneous detachment preserves the natural appearance of the face and avoids the classical complications of facelift.
Face↗
[Hypoglossia-hypodactylia syndrome: apropos of a case with maxillo-mandibular synostosis, glossopalatine ankylosis and cleft palate].
BACKGROUND: The hypoglossia-hypodactylia syndrome, a combination of limb hypogenesis and micrognathia is exceptionally associated with glossopalatine ankylosis and cleft palate. CASE REPORT: A twin girl from monochorionic pregnancy had hypoglossia and micrognathia with anterior maxillo-mandibular fusion, glossopalatine ankylosis and cleft palate. Her left foot was amputated distal to the talus and calcaneous; her right foot had only one phallange. The second phallange of the second finger was hypoplastic on her right hand. There was no abnormality on left hand. Her sister was unaffected. The maxillo-mandibular fusion was divided on second day. The infant was able to suckle on the tenth day. Episodes of airway obstruction occurred on cardiorespiratory recording and the patient was further monitored at home. CONCLUSION: This case suggests that the hemodynamic disorders due to multiple vascular connections from monochorionic pregnancies may have induced ischemic lesions of hypoglossia-hypodactylia. Other malformations and signs of brain stem dysfunction should be detected.
Abnormalities, Multiple↗
Clinical results of therapeutic temporomandibular joint arthroscopy: a prospective study of 34 arthroscopies with prediscal section and retrodiscal coagulation.
Thirty-four therapeutic temporomandibular arthroscopies were done during a 24-month period for patients with debilitating joint disorders (mainly disc displacements with or without reduction) who had not responded to non-invasive treatment. Lysis and lavage with prediscal section and retrodiscal coagulation were the techniques used. Analysis of the results indicated subjective improvement of pain in 71% of cases, noise in 78%, jaw opening in 88% and diet in 97% and objective evidence of disappearance of noise in 29% and improvement of jaw opening in 94% (mean 9.24 mm). In jaw opening, improvement was highly significant, compared with the preoperative results, P < 0.01. We conclude that temporomandibular arthroscopy is safe and indicated in disc displacements and joint luxation if medical treatment has failed.
Adolescent↗
Adenosine and neuropathic pain.
Recent studies have reported the possibilities of relieving neuropathic pain by administering adenosine or its analogs. In order to determine if there exists a metabolic anomaly of this nucleoside in patients with neuropathic pain, circulating adenosine levels were compared in three patient groups. The first was composed of individuals suffering from neuropathic pain, the second of patients with nervous system lesions in the absence of pain, and the third was composed of patients suffering from pain resulting from excessive nociception. The adenosine blood levels of these patients were compared to those of a control group. Finally, adenosine in the cerebrospinal fluid (CSF) of some patients was also assayed. The results show that there are reduced levels of blood and CSF adenosine in patients with neuropathic pain. This adenosine deficiency could explain the potential therapeutic effects of administering adenosine or its analogs.
Adenosine↗
[Proposal of a new topographic classification of mandibular fractures].
There has been a certain amount of confusion in publications concerning fractures of the mandible due to the lack of consensus on classification. Starting with the embryological, anatomic, biomechanical, pathogenic and epidemiological features of these fractures, we propose a new terminology and a new distribution of the units and subunits of the mandible in traumatology. The main point is to incorporate the angle subunit into the ramus unit.
Adult↗
[The value of an osteosynthesis arch-plate combination in the application zone in the treatment of fractures of the body of the mandible].
Fractures of the tooth-bearing part of the mandibular body require both orthopedic stabilization of the maxillomandibular joint and surgical fixation. From an evaluation of the anatomic and biomechanical features of the mandible, we propose the notion of a useful zone for fixation. The useful zone is basically submitted to traction forces and includes both the teeth and the teeth-bearing bone situated above the mandibular canal in the body and the entire symphysis. Applying an arch-plate on the useful zone has the advantage of providing initial stability, progressive loading and reduction in risk of displacement or secondary infection. This therapeutic approach gives better results than simple plate fixation.
Adult↗
[Mandibular condyle hyperplasia. Therapeutic review].
Excessive cartilage growth on the condyle process of the mandible can result from primary hyperreactivity of the growth cartilage or be a secondary adaptation to an imbalance in occlusive and/or cervicofacial conditions. Treatment depends on the distinction between these two forms. Primary active overgrowth is treated by condylectomy sparing the distal apparatus although conservative surgery to re-centering the temporomandibular joint and re-establish symmetry without condylectomy may be used in quiescent moderately active forms saving the joint. For secondary forms, the joint is re-centering and symmetry is re-established without condylectomy. If started early enough, orthopaedic treatment can avoid the development of secondary forms resulting an imbalance in occlusive and/or cervicofacial conditions.
Diagnosis, Differential↗