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PubMed1996

[Moebius syndrome: therapeutic proposals from 2 cases].

Moebius syndrome is a congenital bilateral palsy of the sixth and seventh cranial nerves. It results a total absence of facial expression and a severe strabismus. Social life is greatly disturbed. Other anomalies may be associated, especially other cranial palsies and Poland syndrome. The etiology of this syndrome isn't clearly established. Stem necrosis secondary to a vascular deficiency is often admitted. We report two observations. We emphasize the importance of a complete maxillo-facial treatment including maxillo-mandibular anomaly. Both patient underwent orthognathic surgery. The first one for class II and the second for class III anomaly. One patient underwent a facial reanimation by temporal muscle transfer. Orthognathic surgery must be realized prior to facial reanimation. A correction of the strabismus is possible. Moebius syndrome is a rare (200 observations) but very severe malformation. Maxillofacial surgery is able to improve the morphological and relational aspect of Moebius syndrome.

Adolescent↗
PubMed1998

Surgical treatment of ankyloses of the temporomandibular joint in children.

Ankylosis of the temporomandibular joint leads in children to serious disorders such as loss of dentition, growth retardation of the lower jaw, facial asymmetry etc. During the period from 1993 till 1997 we treated 12 children incl. eight who had unilateral and four bilateral ankylosis. In six patients, after elimination of the ankylosis, reconstruction of the head was made with a total of nine costochondral grafts. In entire all patients the temporal muscle or a silicone plate was interposed between the skull base and mandible. Postoperative complications were minimal. Surgical treatment, which is only half of the issue of treatment, must be followed by long-term careful rehabilitation. The results which were achieved contributed in a significant way to a more favourable further development of the children.

Adolescent↗
PubMed2002

Brain and body hyperthermia associated with heroin self-administration in rats.

Intravenous heroin self-administration in trained rats was accompanied by robust brain hyperthermia (+2.0-2.5 degrees C); parallel changes were found in the dorsal and ventral striatum, mediodorsal thalamus, and deep temporal muscle. Temperature began to increase at variable latency after a signal of drug availability, increased reliably (approximately 0.4 degrees C) before the first lever press for heroin, increased further (approximately 1.2 degrees C) after the first heroin injection, and rose more slowly after the second and third injections to stabilize at an elevated plateau (39-40 degrees C) for the remainder of the session. Brain and body temperature declined slowly when drug self-administration was terminated; naloxone precipitated a much more rapid decrease to baseline levels. Changes in temperature were similar across repeated daily sessions, except for the increase associated with the first self-administration of each session, which had progressively shorter latency and greater acceleration. Despite consistent biphasic fluctuations in movement activity associated with heroin self-administrations (gradual increase preceding the lever press, followed by an abrupt hypodynamia after drug infusion), mean brain temperature was very stable at an elevated plateau. Only mean muscle temperature showed evidence of biphasic fluctuations (+/-0.2 degrees C) that were time locked to and correlated with lever pressing and associated movements. Drug- and behavior-related changes in brain temperature thus appear to reflect some form of neuronal activation, and, because temperature is a factor capable of affecting numerous neural functions, it may be an important variable in the control of behavior by drugs of abuse.

Animals↗
PubMed2005

Zygomatic abscess with temporal myositis - a rare extracranial complication of acute otitis media.

Acute mastoiditis is the most common complication of acute otitis media (AOM) and its early recognition and management still poses a challenge due to potentially serious consequences. The incidences of extracranial and intracranial suppurative complications of AOM in children have decreased significantly, yet they remain a serious clinical problem, especially when caused by bacteria resistant to antibiotics. The authors presented a case of rare AOM complication - zygomatic abscess with temporal myositis. A 6-year-old boy was admitted to the ENT Department with 4 weeks of ear pain, treated for AOM with cefuroxime axetyl and amoxicilline, with acute mastoiditis and subsequent abscess formation in zygomatic and preauricular region. The inflammatory process spread through anterior air cells to the zygomatic cells leading to a fistula formation in the zygomatic bone and breakthrough into the temporal muscle. The surgical procedures applied were: myringotomy with drainage, cortical mastoidectomy and revision of zygomatic area and treatment with antibiotics (ceftriaxon). Enterococcus faecalis and Streptococcus viridans were found in the culture of middle ear and mastoid effusion. After half a year of follow-up the child had a normal hearing. Severe complications of AOM are rare today. An early diagnosis in order to promote adequate management and prevent inherently suppurative complications is essential.

Abscess↗
PubMed1991

Influence of occlusal splints on bilateral anterior temporal EMG activity during swallowing of saliva in patients with craniomandibular dysfunction.

A full-arch maxillary stabilization occlusal splint was made for each of 10 patients with craniomandibular dysfunction. These splints were divided into three sections (one anterior and two posterior). This procedure allowed variation in the anteroposterior centric localization of occlusal contacts, thus permitting the recording of the EMG effects produced by the different occlusal splint sections. The integrated EMG activity was recorded from the right and left anterior temporal muscles during swallowing of saliva in habitual occlusion and with the different occlusal splint sections inserted. EMG activity during swallowing of saliva was significantly lower with the different occlusal splints than in habitual occlusion. This supports the rationale for diurnal wear of the occlusal splint. No differences in EMG activity were found during swallowing of saliva when different sections of the occlusal splints were used. This fact points out the possibility for therapeutic use of different occlusal splints for improving swallowing function.

Adolescent↗
PubMed1989

[Angiogenic properties of various tissues utilized for synangiosis in moyamoya disease].

In order to evaluate the adequacy of materials utilized for synangiosis in Moyamoya disease, angiogenic activities of various human tissues were examined. Tissue samples were freshly obtained at operation. A small piece of the sample was placed on the chick chorioallantoic membrane (CAM), and, using an operative microscope, the production of neovascularization was evaluated 96 hours later. The scalp artery (STA and OA) showed the highest activity of angiogenesis, followed by the omentum and galea, while the temporal muscle, dura mater, and fat tissue showed poor activity. Histological examination confirmed the development of vasculature in CAM. The production of neovascularization is known to be related to the tissue content of the angiogenic factor (AF). The AF is known to be present in the vascular endothelial cell, fibroblast, tumor, brain, or omentum, etc. The rationale for the selection of materials for the neovascularization in Moyamoya disease was discussed in relation to its ability to produce new vessels.

Adipose Tissue↗
PubMed1998

Plasma cell granuloma extending from the extracranial to the intracranial space associated with Epstein-Barr virus infection.

A 70-year-old male presented with a plasma cell granuloma extending from the extracranial to the intracranial space. Findings of preoperative magnetic resonance imaging and intraoperative observation indicated that the lesion extended from the temporal muscle to the subarachnoid space, penetrating the frontal bone. The subarachnoid lesion was composed of neutrophils indicating the presence of acute or subacute inflammation. The final diagnosis of the resected tumor was plasma cell granuloma. High levels of antibodies against Epstein-Barr (EB) virus in the cerebrospinal fluid and the immunohistochemical demonstration of EB nuclear antigens in the plasma cell granuloma suggested that EB virus infection was associated with the development of plasma cell granuloma in this patient.

Aged↗
PubMed1995

Prosthodontic aspects of a new method for functional reconstruction following maxillectomy.

The prosthodontic aspects of a new method of reconstruction after maxillectomy are described. A custom-made titanium mesh tray filled with crushed autogenous hip bone is interposed between two layers of a pedicled temporal muscle flap. The titanium mesh tray is fabricated on a cast carved to represent the anatomy of the reconstructed maxilla. The tray is designed so that, after healing, osseointegrated implants can be placed in preplanned positions in the reformed maxilla. The buccal sulcus is recreated with a free mucosal graft from the contralateral cheek at the second implant surgical stage. The prosthodontic restoration is completed after healing of the free mucosal graft.

Bone Transplantation↗
PubMed2003

[Use of allogenic cartilage in reconstruction of the middle ear in patients with chronic otitis media].

We have analysed results treatment of 253 patients with chronic otitis media. Our tactic includes operation with application one-momental sanation and reconstruction of a middle ear. Sanational stage was performed in volume atticoantrotomia or radical operation. Reconstruction included reconstruction of a tympanic cavity and retrotympanic space. The shape of a plate was made so that to make a base for neotympanic membrane and to forma a lateral attic wall. Defect of a drum-type membrane restored free flap of a fascia temporal muscle. The mastoid process cavity was filled allogenic cartilage transplants the first variant of reconstruction formed artificial antrum cartilage by fragments and plates. At the second variant was acted similarly, however the artificial cavity wall of the antrum we made soft and mobile from the skin of external acoustical passage and neotympanic fascia flap. In postoperative period the position of a posterior wall of external acoustical passage was formed depending on intratympanic pressure, which depended on a acoustical tube function. Such technique allowed us to reduce formation retraction complications from 15% up to 6.7%.

Cartilage↗
PubMed1986

Influence of monoamine oxidase inhibitors and a dopamine uptake blocker on the distribution of 11C-N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, 11C-MPTP, in the head of the rhesus monkey.

N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, MPTP, is a neurotoxic substance known to induce a parkinsonian syndrome in primates. The distribution of intravenously injected 11C-labelled MPTP (11C-MPTP) in the head of Rhesus monkeys was studied by means of positron emission tomography, PET. The influence of pretreatment with two monoamine oxidase (MAO) inhibitors, namely pargyline and clorgyline, and a dopamine uptake blocker, nomifensine, on the distribution was also evaluated. The 11C-radioactivity was taken up in all brain regions and maximum radioactivities were found 3-8 min after intravenous administration of MPTP. The 11C-MPTP-derived radioactivity showed a constant value throughout the study period in areas corresponding to the striatum and mesencephalon in monkeys not pretreated and in monkeys pretreated with clorgyline and with nomifensine. Pargyline pretreatment, however, resulted in consecutive elimination of 11C-MPTP-derived radioactivity from the different brain regions with half-lives of 40-60 min. The total radioactivity in blood was also higher after pargyline pretreatment indicating successful inhibition of metabolism. The eyes and temporal muscle each showed radioactivity values of the same order in all monkeys irrespective of pretreatment. The results support findings by other authors that MPTP was rapidly converted in the brain to a reactive metabolite which concentration remained constant in the brain during the PET study. Pargyline in the dosage used is known to be a non-selective MAO inhibitor and it prevented the metabolism of 11C-MPTP to the products retained in the brain.(ABSTRACT TRUNCATED AT 250 WORDS)

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1993

[Angiogenesis on encephalo-myo-synangiosis. The effect of basic fibroblast growth factor].

Moyamoya disease is characterized occlusion of Willis' artery ring and abnormal "moyamoya" vessels. By supplying sufficient blood flow to the distal area of the stenosis or occlusion, ischemic symptom could be improved and the risk of the hemorrhage are lessen. Encephalo-Myo-Synangiosis (EMS) can increase the blood supply from external carotid artery to the ischemic area just put the temporal muscle on the brain surface. A kind of growth factor are thought to be exist around the brain of the Moyamoya disease patient. Basic fibroblast growth factor (bFGF) contribute angiogenesis in vitro and in vivo. This effect is considered to grow tumors and many experiments are done to use it for therapy by blocking this effect. Few trials are done to utilize the angiogenetic effect for therapy. We studied the effect of the bFGF on angiogenesis after EMS by using rats. We operated EMS on 10 male SDrats. 0.1 microgram of the bFGF was poured on 5 rats between the brain and muscle. On the other 5 rats just saline was poured. One week after rats were sacrificed, new vessels were observed with light microscope and scanning electron microscope. Molding models were also observed. bFGF group grew larger new vessels between the brain and muscle than non bFGF group. On the surface of brain, bFGF had more larger vessels (diameter is over 6 um) and non bFGF group had more small vessels (less than 6 um). Total area of vessel of bFGF group was twice as large as that of non bFGF group. On molding models many closed end of vessels were seen and they were thought to be the growing vessels. In molding models, bFGF group also has larger vessels than non bFGF group. We could prove that bFGF promotes angiogenesis on EMS of the rats, and we also expect that bFGF help the supplying blood flow of the Moyamoya patient.

Animals↗
PubMed2002

Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction.

Temporomandibular joint (TMJ) ankylosis is a pathological process caused by damage of the mandibular condyle. When this event takes place in subjects during the developmental age, it results in an alteration of the entire maxillofacial complex. Therefore, surgical methods able to remove the temporomandibular ankylosis also include necessary operations to correct the secondary maxillofacial deformity. The distraction osteogenesis has induced our center to modify the surgical protocol for the therapy of patients who have developed TMJ ankylosis and secondary maxillomandibular deformity. We have treated four patients with monolateral ankylosis of the TMJ and serious deformities of the maxillomandibular complex secondary to functional limitation. During the same operation, arthroplasty was performed with the removal of the ankylotic block and the interposition of a temporal muscle flap in the new articular space; an intraoral osteodistractor was also positioned to lengthen the mandible. All patients showed recovery of the eurhythmy of the face and good re-establishment of the symmetry. An average 12-month follow-up showed the average opening of the mouth to be at least 35 mm. The combination of TMJ arthroplasty and intraoral osteodistraction provides good functional and aesthetic results in patients affected by ankylosis who have developed secondary maxillofacial deformities.

Adolescent↗
PubMed2001

Ethanol modulates cortical activity: direct evidence with combined TMS and EEG.

The motor cortex of 10 healthy subjects was stimulated by transcranial magnetic stimulation (TMS) before and after ethanol challenge (0.8 g/kg resulting in blood concentration of 0.77 +/- 0.14 ml/liter). The electrical brain activity resulting from the brief electromagnetic pulse was recorded with high-resolution electroencephalography (EEG) and located using inversion algorithms. Focal magnetic pulses to the left motor cortex were delivered with a figure-of-eight coil at the random interstimulus interval of 1.5-2.5 s. The stimulation intensity was adjusted to the motor threshold of abductor digiti minimi. Two conditions before and after ethanol ingestion (30 min) were applied: (1) real TMS, with the coil pressed against the scalp; and (2) control condition, with the coil separated from the scalp by a 2-cm-thick piece of plastic. A separate EMG control recording of one subject during TMS was made with two bipolar platinum needle electrodes inserted to the left temporal muscle. In each condition, 120 pulses were delivered. The EEG was recorded from 60 scalp electrodes. A peak in the EEG signals was observed at 43 ms after the TMS pulse in the real-TMS condition but not in the control condition or in the control scalp EMG. Potential maps before and after ethanol ingestion were significantly different from each other (P = 0.01), but no differences were found in the control condition. Ethanol changed the TMS-evoked potentials over right frontal and left parietal areas, the underlying effect appearing to be largest in the right prefrontal area. Our findings suggest that ethanol may have changed the functional connectivity between prefrontal and motor cortices. This new noninvasive method provides direct evidence about the modulation of cortical connectivity after ethanol challenge.

Adult↗
PubMed2003

[The Temporal Smile. Speech therapy for facial palsy patients after temporal lengthening myoplasty].

We present our approach to speech therapy developed for patients with definitive peripheral facial palsy treated by temporal lengthening myoplasty. The main goal is to rehabilitate smiling function, a major component in social communication codes, by transferring labial and jugal functions to the transferred temporal muscle. Several phases are involved. The first phase, termed the Mandibular Smile involves mobilization of the mandible (original function of the temporal) by contraction of the transferred temporal and inducing an elevation of the commissura labiorum. The second phase, the Voluntary Temporal Smile is obtained by contraction of the temporal independently of mandibular movement which remains under voluntary control. The smile produces should become as symmetrical as possible. Finally, the last phase is designed to achieve a spontaneous smile independent of mandibular movement Spontaneous Temporal Smile. Temporal contraction should produce both a "real" expressive smile and good quality articulate speech, saliva evacuation, prehension, and labial junction. Acquisition of the Temporal Smile involves cerebral plasticity implying rehabilitation processes both on the peripheral and central levels.

Adolescent↗
PubMed1999

Body position effects on EMG activity of the temporal and suprahyoid muscles in healthy subjects and in patients with myogenic cranio-cervical-mandibular dysfunction.

This study was conducted in order to determine the effects of body position on integrated electromyographic (IEMG) activity of anterior temporal and suprahyoid muscles. The study was performed on 15 patients with myogenic cranio-cervical-mandibular dysfunction (CMD) and 15 healthy subjects. IEMG recordings at rest and during swallowing of saliva and maximal voluntary clenching were performed by placing surface electrodes on the anterior temporal and suprahyoid muscles in the following body positions: standing, seated, supine, and lateral decubitus position. Insignificant changes in IEMG activity of both muscles were observed upon variations in the body position. Insignificant differences in IEMG activity were observed between patients with myogenic CMD and healthy subjects. A pattern of higher IEMG at rest and during swallowing of saliva was observed in the suprahyoid muscles than in the anterior temporal muscles, whereas during maximal clenching activity, an opposite pattern was observed. Results of the present study seem to suggest that for the anterior temporal and suprahyoid muscles there is no specific body position that could be relevant to initiate and/or to perpetuate a craniomandibular dysfunction.

Adult↗
PubMed1982

The influence of experimental interfering occlusal contacts on the postural activity of the anterior temporal and masseter muscles in young adults.

The effects of an intercuspal occlusal interference on the pattern of postural activity of the anterior temporal and masseter muscles were studied in eleven volunteers with complete, natural dentitions. The results indicate that, in man, there is postural activity in the anterior temporal and sometimes in the masseter muscles. The pattern of postural activity is influenced by the occurrence of an experimental occlusal interference, sometimes as early as 1 h after the insertion. After 48 h there was a significant increase of the activity in the anterior temporal muscles. This increased activity persisted until the interference was removed 1 week later and had almost disappeared 1 week after the removal.

Adult↗
PubMed1986

A clinical and electromyographic study of the long-term effects of an occlusal splint on the temporal and masseter muscles in patients with functional disorders and nocturnal bruxism.

The postural activity of the temporal and masseter muscles in thirty-one patients with signs and symptoms of functional disorders were studied: before, during and after 3-6 months of occlusal splint therapy. The fluctuating signs and symptoms, as well as the postural activity of the temporal and masseter muscles were significantly reduced after treatment. Further, the coefficients of correlation within pairs of postural activity of the right and left muscles increased significantly. After cessation of the splint therapy the signs and symptoms recurred to the pre-treatment level within 1-4 weeks in about 80% of the patients. The results indicate that an occlusal splint can eliminate or diminish signs and symptoms of functional disorders and re-establish symmetric and reduced postural activity in the temporal and masseter muscles, which can facilitate procedures, such as functional analysis and occlusal adjustment.

Adolescent↗