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PubMed1985

Trigeminal afferents to cerebral arteries and forehead are not divergent axon collaterals in cat.

Horseradish peroxidase conjugated to wheat germ agglutinin (HRP-WGA), and bisbenzimide (a fluorescent dye) were used as retrograde axonal tracers to examine whether or not intracranial and extracranial trigeminal afferents represent divergent axon collaterals. HRP-WGA was applied to the proximal segment of the middle cerebral artery and bisbenzimide was injected into a branch of the ophthalmic nerve in 5 cats. Histologic examination of the ipsilateral trigeminal ganglion revealed HRP-labeled cell bodies located among clusters of cells exhibiting bisbenzimide fluorescence. Cells containing both labels were not observed. These results support the concept that divergent axon collaterals are probably not involved in the pathogenesis of referred pain during vascular headache.

Animals↗
PubMed2005

A simple and reliable landmark for identification of the supraorbital nerve in surgery of the forehead: an in vivo anatomical study.

PURPOSE: In this in vivo study, we set out to determine the reliability of the medial margin of the iris as a landmark for the course of the supraorbital neurovascular bundle at the supraorbital rim. PATIENTS AND METHODS: Seventy-five patients (73 women and 2 men) undergoing endoscopic brow lift procedures were enrolled, for a total of 150 sides. With the patient focused on a distant point, a line was constructed preoperatively along the mid-sagittal plane, tangential to the medial iris. After general anesthesia and initial dissection, a 27-gauge needle was placed (without the aid of the endoscope) through this line, parallel to the mid-sagittal plane at the orbital rim. Measurements were then taken following creation of the optical cavity. Measurements were taken from the course of the deep (lateral) branch of the supraorbital nerve to the needle. In addition, measurements were taken from the course of the supraorbital nerve to the course of the supratrochlear nerve. RESULTS: In 84 sides, the needle was at the nerve; in 48 sides, the needle was less than 1 mm to the nerve; and in 18 sides, the needle was 2 mm from the edge of the nerve. Overall, the nerve was an average of 0.56 +/- 0.7 mm from the needle, and in no case was the nerve course greater than 3 mm from the landmark. The supratrochlear nerve was located medial to the supraorbital nerve an average of 9.0 +/- 1.0 mm. CONCLUSIONS: Based on our findings, the medial iris, as opposed to the mid-pupil line, serves as a reliable topographical landmark for the course of the supraorbital nerve at the supraorbital rim.

Cephalometry↗
PubMed2006

Endoscopic brow and forehead lift: a case for new technology.

As with most things in life, the passage of time usually brings progress through advancing technologies. At one time, the horse was a state-of-the-art military fighting machine and a simple compass represented advanced navigational technology. Things come and go and while some leave a lasting impact others are replaced, never to be revisited. Surgical techniques are continually evolving, and while quantum strides have been made in the last century, just because something is new, this does not make it better. For this reason we all owe it to our respective professions to carefully evaluate emerging trends and technologies before abandoning procedures that are proven to be safe and effective. Some surgeons too eagerly embrace new technologies, while others are late in acceptance or in some cases never progress.

Endoscopy↗
PubMed2004

Anticipatory modulation of neck muscle reflex responses induced by mechanical perturbations of the human forehead.

The aim of this study was to test whether anticipation of upcoming head blow stimuli, which elicit reflex responses in the neck muscle, makes the reflex responses greater or not. In nine healthy subjects the reflex responses were elicited in the sternocleidomastoid (SCM) muscle in the eyes-open (EO) and eyes-closed (EC) conditions, which corresponded to the predictable and unpredictable conditions, respectively. The subjects were instructed not to resist the perturbations after the impact. The results demonstrated that the reflex response of the SCM muscle was significantly smaller in the predictable EO condition than in the unpredictable EC condition (P < 0.05), although no significant differences were observed in either the background EMG activities or the head accelerations. Further, this effect of anticipation was observed only in the later reflex EMG component, which most probably mediated the stretch reflex pathway. In contrast, no significant difference was observed in the early component, which was presumed to be the vestibular-collic reflex. The reduced stretch reflex response was suggested to be functionally relevant to the task requirement, i.e., to let the neck extension movement occur, and not to resist after the impact of the head blow. It was concluded that the anticipation has an effect on reducing the stretch reflex responses in the neck muscle, but does not have any effect on the presumed vestibular-collic reflex under the present experimental paradigm. It is suggested that the gain of the stretch reflex pathway is modulated by anticipatory information of upcoming mechanical event.

Adult↗
PubMed2003

The aging forehead.

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Biocompatible Materials↗