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Neurosurgery: Neuroendocrine lesions
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
A large series by Flynn and Nemergut reported that the requirement for postoperative analgesics is minimal in patients after transsphenoidal surgery (35). The authors hypothesized that the pituitary gland contains the highest concentration of endogenous opioids, which are released during surgical manipulation. Most patients present with headache, which can be managed by nonopioid analgesics like paracetamol. In addition to this, bilateral maxillary nerve block, infraorbital nerve, and sphenopalatine blocks are reported to be effective in controlling postoperative pain after TSS (27,28). Opioid use should be judicious, as it might aggravate airway obstruction, especially in patients with OSA, and also geriatric patients are more sensitive to opioids.
Trigeminal nerve – interdisciplinarity between the areas of dentistry and audiology
Published in J. Belinha, R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz, João Manuel, R.S. Tavares, Biodental Engineering V, 2019
Fernanda Gentil, J.C. Reis Campos, Marco Parente, C.F. Santos, Bruno Areias, R.M. Natal Jorge
The branches of the maxillary nerve are the: Zygomatic;Infraorbital;Superior alveolar branches;Pterygopalatine nerves.
Anatomy and Embryology of the Mouth and Dentition
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The upper lip is supplied by the infraorbital branch of the maxillary nerve (Figure 41.9). Running along the floor of the orbit in the infraorbital canal, it enters the face at the infraorbital foramen, where its labial branch runs downwards to supply the upper lip. The mental nerve is a terminal branch of the inferior alveolar nerve and exits the mandible at the mental foramen to supply the lower lip (see Figure 41.9).
Neuromodulation for the treatment of primary headache syndromes
Published in Expert Review of Neurotherapeutics, 2019
The clinical efficacy of SPG stimulation in cluster headache has been demonstrated in the sham-controlled pathway CH-1 study [17]. In this study 28 patients with refractory chronic cluster headache used the handheld device during 30 attacks or until a maximum treating period of eight weeks was completed. Patients were instructed to stimulate 15 min during attacks that had at least moderate intensity and refrain from using acute medications in this period. The device randomly (1:1:1) delivered either a full stimulation, a subthreshold stimulation (85% of the amplitude that provoked a sensory perception) or no stimulation. The study reached its primary endpoint defined as pain-relief within 15 min of the start of neurostimulation. The probability of pain relief after 15 min reached 67.1% compared to 7.4% under sham stimulation while the probability of being pain-free after 15 min of stimulation was 34.1% compared to 1.5% after sham stimulation. In 12 out of the 28 patients, a reduction in attack frequency was observed. In these patients attack frequency was reduced by 88%. In total the CH-1 trial showed that 68% of the patients receiving full stimulation had either an acute response, a frequency response, or both. With respect to the observed adverse events, the majority of patients reported a loss of sensation in maxillary nerve regions that was mostly transient as 65% of the recorded events resolved within three months [17]. A second RCT (NCT02168764) has been conducted in the United States to confirm these findings but the results have not been published yet.
Post-concussion Syndrome Light Sensitivity: A Case Report and Review of the Literature
Published in Neuro-Ophthalmology, 2022
Mohammad Abusamak, Hamzeh Mohammad Alrawashdeh
Sympathetic efferents (via the short and long ciliary nerves) reach the orbital structures and carry innervation to the ocular and orbital blood vessels and pupils, respectively. Furthermore, the ophthalmic division of the trigeminal nerve via the long ciliary nerves innervates the cornea.4 The long ciliary branches of the nasociliary nerve also innervate the bulbar conjunctiva. The superior palpebral conjunctiva is innervated by both the frontal and lacrimal branches of the ophthalmic division, while the inferior palpebral conjunctiva is innervated by both the infraorbital branch of the maxillary nerve and the lacrimal branch of the ophthalmic nerve.16 When the superior cervical ganglion is stimulated, pain results.1
Bilateral suprazygomatic maxillary nerve block versus palatal block for cleft palate repair in children: A randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2018
Mohamed M. Abu Elyazed, Shaimaa F. Mostafa
With the exception of the middle meningeal nerve, maxillary nerve branches are located within the pterygopalatine fossa [11]. Blocking the maxillary nerve can achieve sensory blockade of both soft and hard palate [8]. Ultrasound-guided technique for maxillary nerve block allows direct visualization of the internal maxillary artery, proper needle positioning, and LA spread thus less risk of iatrogenic vessel or nerve damage [11]. In the suprazygomatic approach used in our study, the maxillary artery is situated inferior and ventral to the nerve and thus it is much safer than the infrazygomatic approach [11]. Moreover, the suprazygomatic approach avoids the risk of ocular injury previously reported with infrazygomatic and infraorbital blocks [14].