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At least 1,063 records · Page 59Linked to original sources
PubMed1999

Treatment of progressive ethmoidal haematoma using intralesional injections of formalin in three horses.

Three Thoroughbred horses with unilateral progressive ethmoid haematomas were treated using intralesional injections of 10% formalin (4% formaldehyde solution). Injections were performed in the standing sedated horse through the nasal passages under endoscopic guidance and, when the ethmoid haematoma involved the paranasal sinuses, through holes trephined into the affected sinus. Regression of the lesions occurred in all cases after repeated injections. This technique appears to be a safe and effective treatment for progressive ethmoid haematomas in the horse.

Animals↗
PubMed2006

Orthostatic mesodiencephalic dysfunction after decompressive craniectomy.

An extreme syndrome of the trephined after decompressive craniectomy is reported here. The most extensive clinical syndrome observed was established over 4 weeks and consisted of bradypsychia, dysartria, and limb rigidity with equine varus feet predominating on the right. The syndrome was aggravated when the patient was sitting with the sequential appearance over minutes of a typical parkinsonian levodopa-resistant tremor starting on the right side, extending to all four limbs, followed by diplopia resulting from a left abducens nerve palsy followed by a left-sided mydriasis. All signs recovered within 1-2 h after horizontalisation. It was correlated with an orthostatic progressive sinking of the skin flap, MRI and CT scan mesodiencephalic distortion without evidence of parenchymal lesion. Brain stem auditory evoked potential wave III latency increases were observed on the right side on verticalisation of the patient. EEG exploration excluded any epileptic activity. Symptoms were fully recovered within 2 days after cranioplasty was performed. The cranioplasty had to be removed twice due to infection. Bradypsychia, speech fluency, limb rigidity and tremor reappeared within a week after removal of the prosthesis. While waiting for sterilisation of the operative site, the symptoms were successfully prevented by a custom-made transparent suction-cup helmet before completion of cranioplasty.

Adult↗
PubMed1992

The role of immediate operative intervention in severely head-injured children with a Glasgow Coma Scale score of 3.

In an attempt to improve and expedite the care of head-injured children, data have been published recommending burr hole exploration in lieu of computed tomography for children with signs of brain stem compression or with a Glasgow Coma Scale score of 3. Exploratory burr holes revealed a high incidence of subdural hematomas, and removal of the hematomas improved survival. We are reporting 19 consecutive children with Glasgow Coma Scale scores of 3. Coma score evaluation was confounded by intubation, sedation, pharmacological paralysis, and posttraumatic seizures. We found no radiographical or postmortem pathological evidence of intracranial hemorrhage, which would warrant operative intervention. A high incidence of multisystem injuries and high cervical spine injuries would have made early intervention both dangerous and inappropriate. Although there is a definite role for emergency trephination, routine exploratory burr holes for children with a Coma score of 3 is not justified.

Accidents, Traffic↗
PubMed1999

Role of intramarrow penetration in osseous repair: a pilot study in the rabbit calvaria.

BACKGROUND: The use of intramarrow penetration in combination with osseous reconstructive surgery has been recommended in various periodontal and oral surgical applications. The purpose of this pilot study was to evaluate the effect of intramarrow penetration on the rate of bone neogenesis in protected spaces created on the calvarial bone using occlusive titanium domes in 16 adult white rabbits. METHODS: In each rabbit, 2 standardized circular 1 mm deep slits were prepared in the bone, one on each side of the midline using a trephine. Within the perimeter of one of the slits, the external cortical surface of the skull bone was mechanically perforated using a carbide round bur (experimental site), while the bone surface within the other slit (control site) was left intact. Subsequently, 2 prefabricated titanium domes with an inner diameter of 4.8 mm and an inner height of 3.0 mm were anchored in the prepared slits. The animals were divided into 4 groups of 4 rabbits each and were sacrificed at 10, 21, 42, and 60 days. The specimens were assessed for the percentage bone fill and density of the newly formed bone within the boundaries of the domes. RESULTS: Histomorphometric analysis showed significantly increased bone neogenesis within the experimental domes at 10, 21, 42, and 60 days. A mean total area of 29% newly formed bone was demonstrated in the experimental sites at 21 days, while negligible bone formation (9%) occurred with the control domes at the same evaluation interval. Bone density was consistently higher in experimental domes at all healing intervals. CONCLUSIONS: Within the limits of this study, the results demonstrate that intramarrow penetration accelerates initial bone neogenesis and results in increased bone fill and density, suggesting that its use can be beneficial in bone regenerative procedures.

Animals↗
PubMed1986

Double-headed stereotaxic carrier apparatus for insertion of depth electrodes. Technical note.

A carrier device has been developed for use with a sterotaxic apparatus. It can be attached to the OBT frame or to any Leksell-type frame. With this carrier, intracranial insertion of commercially available depth electrodes with built-in connectors is possible. By using two different heads mounted on a single carrier, the surgeon can perform a transcutaneous twist-drill trephination and attach the screws through a chuck, adjust the device in the horizontal plane, and then insert and anchor the electrodes by using a small platform with a hinged roof.

Electrodes↗
PubMed1992

Two examples of ancient skull surgery.

The author, while a research illustrator at the Smithsonian Institution National Museum of Natural History, studied two ancient skulls from the Incan period in Peru, both with trephination. Her conclusions and illustrations of the skulls are included in this paper.

Craniotomy↗
PubMed1976

[Cerebral arachnoid cysts in children with local bulging of the skull (author's transl)].

A series is reported of 9 cases of supratentorial arachnoid cysts in children under the age of 14 years. The predominant clinical and radiological sign is local bulging of the skull, caused by the underlying cyst. The characteristic angiographic findings and anomalies in the phlebogram are discussed. Operative measures (trephination and ventriculo-auricular shunt) aim at restoration of the disturbed cerebrospinal fluid circulation and resection of the wall of the cyst. Selection of patients for operative measures and results of treatment are discussed.

Adolescent↗
PubMed1975

Full-thickness eye wall biopsy. I. An experimental approach to the tissue diagnosis and study of choroidal and retinal lesions.

A surgical approach to full-thickness eye wall biopsy is proposed as a method that may be applied to poorly understood diseases of the retina and choroid. An eye basket is sutured to the eye for stabilization, and two trephines mark an area to which diathermy is applied until penetration is achieved. The specimen is removed with fine forceps and scissors. A scleral homograft closes the defect. In ten rabbits, no eyes were lost and all ten retinas were intact. All biopsy specimens were suitable for histologic study.

Animals↗
PubMed2001

[Attempts at surgical treatment of nasal septum deformities in the XIX century with instruments powered by an "electric motor"].

The methods of surgical treatment of nasal spetum deformations by electrical instruments in the XIX century were used especially in United States of America. In the begining of seventieth of the XIX century D.H. Goodwillie used the machine by foot. In the half of eightieth of the XIX century and later the nasal trephine was used by C. Astier, W. Wróblewski, J. Wright, M. Schmidt, J. Wolff, F. Kretschmann and others, G. Spiess employed the special protected speculum. The special saws were also in prewailing use (G. Spiess and others). Those methods were generally not many effective.

Electric Power Supplies↗
PubMed1975

Empyema of the equine paranasal sinuses.

A survey of 28 cases of chronic purulent infection of the sinuses in the horse showed a relationship between incidence and age, and a probable relationship with breed. Dental disease was apparently the cause of half the cases. The conventional treatment of trephination followed by irrigation with antiseptic solutions resulted in freedom from recurrence of the disease for over 1 year in 17 of the 28 horses. Antibiotic therapy appears to be useless in chronic empyema. The prognosis is adversely affected by the development of facial swelling, a sign seen usually only in long-standing cases.

Animals↗
PubMedDate not supplied

Immediate implant placement following a modified trephine/osteotome approach: success rates of 116 implants to 4 years in function.

PURPOSE: A technique is presented which utilizes a trephine with a 3.0-mm external diameter followed by an osteotome to implode a core of maxillary posterior alveolar bone prior to immediate implant placement. MATERIALS AND METHODS: The technique and its indications and contraindications are described in detail. RESULTS: One hundred sixteen implants were placed and uncovered utilizing this technique. Two implants were mobile at the time of uncovering. DISCUSSION: One hundred fourteen implants were restored and have been functioning successfully for up to 4 years according to the Albrektsson criteria, yielding a success rate of 98.3%. CONCLUSION: No implants have been lost or are failing in function.

Adult↗
PubMedDate not supplied

[The differentiated treatment of traumatic intracranial hematomas].

The article deals with the analysis of the clinical and computed tomography data, treatment, and outcomes in 94 patients with traumatic intracerebral hematomas (TICH). The indications for nonoperative treatment of TICH are a level of consciousness of the patient of no lower than 10 marks of the Glasgow coma scale, hematoma diameter of less than 4 cm, and the absence of clinical and computed tomography signs of brain stem compression. Osteoplastic trephination and encephalotomy is the principal surgical method. Puncture evacuation of the TICH may be resorted to if more than three fourths of its volume can be aspirated. The stereotaxic method is recommended for removal of TICH situated in the region of the basal ganglia.

Adolescent↗
PubMed1992

[The clinical picture, diagnosis and treatment of chronic subdural hematomas].

A study is presented of 37 cases of chronic subdural hematomas. Initial manifestations: headache, epileptic seizures, mental disorders. Involvement of the III, V, VII cranial nerves, anisocoria almost in 50% on the contralateral side were noted. CSF xanthochromia is of certain diagnostic significance. Carotid angiography is the most informative method. Osteoplastic trephination with evacuation of the hematoma is the method of choice.

Adolescent↗
PubMedDate not supplied

[Neurological paleopathology in the pre-Columbine cultures of the coast and the Andean plateau (II). The history of cranial trepanations].

INTRODUCTION AND AIMS: Trepanation is one of the earliest examples of a surgical procedure being carried out by human beings and was performed from the Neolithic period onwards in a large number of primitive cultures throughout the five continents. Trepanation and cranial deformation were both common in the pre-Columbine cultures. The aim of this work was to study the trepanations carried out by the ancient Paraca, Nazca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. DEVELOPMENT: In the pre-Columbine cultures, trepanation was performed on both men and women for therapeutic purposes (depressed fractures, epilepsy, vascular headaches and those associated to artificial cranial deformations) and as a ritual. Signs of trepanation have been found in 5% of skulls and 80% of these show evidence of the 'patient' having survived such an intervention. Some of them have several holes in different stages of healing. The trephining procedure involved the use of obsidian knives with wooden handles and tumis, which were ceremonial knives that were used to cut the scalp. Gold and silver cranioplasty plates have also been found in some skulls. CONCLUSIONS: Cranial trepanation was very successful despite the rudimentary methods and instruments employed to perform it.

Culture↗
PubMed2005

[Craniotomy for organized subdural hematoma].

We reported 3 cases of organized chronic subdural hematoma (CSDH), which required radical treatment by craniotomy. All patients were in the 70s (male, two; female, one). Two cases had previously received craniotomy and neck clipping for intracranial aneurysm. All of them received trephine evacuation of hematoma more than two times, although the hematoma was not removed due to organization. Because of this, we performed craniotomy and removal of the hematoma with its thick outer membrane. In order to obliterate the subdural space completely, we stripped the dura mater from the skull and attached it to the inner membrane with fibrine glue. After a period of more than two years of followed-up, no recurrences had been discovered.

Aged↗
PubMedDate not supplied

Analysis of methods to assess frontal sinus extent in osteoplastic flap surgery: transillumination versus 6-ft Caldwell versus image guidance.

BACKGROUND: The aim of this study was to compare three common methods (transillumination, plain radiographs, and computerized tomography [CT] image guidance) for estimating the position and extent of pneumatization of the frontal sinus in osteoplastic flap surgery. METHODS: Axial CT scans and 6-ft Caldwell radiographs were performed on 10 cadaver heads. For each head, soft tissue overlying the frontal bone was raised and the anticipated position and extent of the frontal sinus at four points was marked using three common methods. The silhouette of the frontal sinus from the Caldwell plain radiograph was excised and placed in position. Four points at the periphery also were made using information obtained from a passive optically guided image-guided surgery device, and transillumination via a frontal trephination also was used to estimate sinus extent. The true sinus size was measured at each point and compared with experimental values. RESULTS: The use of CT image guidance generated the least difference between measured and actual values (mean = 1.91 mm; SEM = 0.29); this method was found statistically superior to Caldwell (p = 0.040) and transillumination (p = 0.007). Image guidance did not overestimate the size of the sinus (0/36) and was quicker than the Caldwell approach (8.5 versus 11.5 minutes). There was no learning curve appreciated with image guidance. CONCLUSION: Accurate and precise estimation of the position and extent of the frontal sinus is crucial when performing osteoplastic flap surgery. Use of CT image guidance was statistically superior to Caldwell and transillumination methods and proved to be safe, reproducible, economic, and easy to learn.

Cadaver↗