Surgical treatment of extracranial internal carotid artery aneurysms.
(1/5)
PURPOSE: Extracranial internal carotid artery aneurysms (EICAs) can be treated by carotid ligation or surgical reconstruction. In the consideration of the risk of stroke after internal carotid artery (ICA) occlusion, the aim of this study was to report the results of reconstructive surgery for these aneurysms, including lesions located at the base of the skull. METHODS: From 1980 to 1997, 25 ICA reconstructions were performed for EICA: 22 male patients and 3 female patients (mean age, 54.4 years). The cause was atherosclerosis (n = nine patients), dysplasia (n = 12 patients), trauma (n = three patients), and undetermined (n = one patient). The symptoms were focal in 15 cases (12 hemispheric, three ocular), nonfocal in three cases (trouble with balance and visual blurring), and glossopharyngeal nerve compression in one case. Six cases were asymptomatic, including three cases that were diagnosed during surveillance after ICA dissection. In nine cases, the upper limit of the EICA reached the base of the skull. A combined approach with an ear, nose, and throat surgeon allowed exposure and control of the ICA. RESULTS: After operation, there were no deaths, one temporary stroke, two transient ischemic attacks, and 11 cranial nerve palsies (one with sequelae). The ICA was patent on the postoperative angiogram in all but one case. During follow-up (mean, 66 months), there were two deaths (myocardial infarction), one occurrence of focal epileptic seizure at 2 months, and one transient ischemic attack at 2 years. In December 1998, duplex scanning showed patency of the reconstructed ICA in all but one surviving patient. CONCLUSION: Surgical reconstruction is a satisfactory therapeutic choice for EICA, even when located at the base of the skull. (+info)
Transient palsy of peripheral cranial nerves following open heart surgery.
(2/5)
A 32-year-old man developed hoarseness of voice, inability to swallow and restricted movement of the tongue after open heart surgery. Peripheral injury of the cranial nerves IX, X and XII was suspected, and it was thought that the duration of the surgery together with the endotracheal tube cuff and trans-oesophageal echocardiography probe pressure, as well as the head and neck position might have been the causes of this complication. (+info)
Glossopharyngeal nerve transection impairs unconditioned avoidance of diverse bitter stimuli in rats.
(3/5)
A 3D cone beam computed tomography study of the styloid process of the temporal bone.
(4/5)
BACKGROUND: To investigate the length and three-dimensional orientation and to detail the morphological variations of the styloid process. MATERIALS AND METHODS: Forty-four patients undergoing temporal bone evaluation for different reasons were randomly selected and included in the present study. The length, angulation in the coronal and sagittal planes, as well as morphological variations of the styloid processes were assessed using conebeam computer tomography. Pearson's correlation coefficient was used to test possible associations between the length of styloid process and angulations, as well as between angulations. Student's t-test was used to compare the differences between the sample mean length and angulations in normal and elongated styloid process groups. RESULTS: The sagittal angle showed weak positive correlations with the styloid process length and the transverse angle (r = 0.24, p = 0.02, n = 88). A medium positive correlation was found between the sagittal and transverse angulations in the elongated styloid process group (r = 0.49, p = 0.0015, n = 38). There was a statistical significant difference between the mean sagittal angulation in elongated styloid and normal styloid process groups (p = 0.015). The styloid process morphology also varied in terms of shape, number, and degree of ossification. CONCLUSIONS: The morphometric and morphologic variations of the styloid process may be important factors to be taken into account not only from the viewpoint of styloid syndromes, but also in preoperatory planning and during surgery. (+info)
Motor speech deficit following carotid endarterectomy.
(5/5)
Stroke as a complication of carotid endarterectomy has been extensively reviewed. Considerably less attention has been directed to local injuries of the cranial nerves and their branches. Verta, Hertzer, Imparato, DeWeese, and Matsumoto have reported experience with these injuries. DeWeese found a 9.7% rate of cranial nerve injury, while in Hertzer's series, 15% of patients had nerve dysfunction in the early postendarterectomy period. In 1980, Liapis in a preliminary report found that when postoperative examination was supplemented by detailed evaluation by speech pathologists, the incidence of early abnormalities reached 27%. The purpose of this study was to expand upon Liapis' early observation and to clarify the contribution of the speech pathologists in identifying cranial nerve dysfunctions, specifically those resulting in motor speech abnormalities, following carotid endarterectomy. (+info)