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Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Surgical endodontics specifically describes a procedure combining root-end resection, apical curettage, and root-end filling. Other procedures such as apical curettage or root resection alone, hemisection, intentional replantation, and regenerative procedures have not been included.
Radiosurgical Techniques
Published in Jeffrey A Sherman, Oral Radiosurgery, 2020
An apicoectomy or root resection is a surgical procedure used to remove the apical portion of the root of a tooth and curette the adjacent periapical tissue. This procedure is indicated when there is extensive destruction of the periapical tissue or bone, or when cystic material is evident at the root apex.
Surgical endodontics
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Surgical endodontics aims to treat microbial infection of the root canal and peri-radicular tissues which persist following conventional orthograde treatment. Surgical procedures include apicectomy (root-end resection) usually in association with retrograde root filling, lateral perforation repair, root resection and hemisection. Root resection and hemisection will not be considered in detail, but the surgical principles are broadly similar. The most frequently performed procedure is apicectomy with retrograde root filling usually following unsuccessful orthograde treatment.
Improving outcomes of surgery for acute type A aortic dissection
Published in Scandinavian Cardiovascular Journal, 2023
Markus Bjurbom, Magnus Dalén, Anders Franco-Cereceda, Christian Olsson
Patients were operated with median sternotomy, extracorporeal circulation, cold blood cardioplegic arrest and hypothermic circulatory arrest (HCA) with antegrade cerebral perfusion (ACP). Strategy for arterial cannulation and the conduct of HCA and ACP were at the discretion of the surgeon. Moderate–mild hypothermia (target core temperature of 28–30 °C) was typically employed (Table 1). ACP with separate 12 French balloon-inflated perfusion cannulae from the arterial line placed in each cervical vessel directly through the ostia was the standard set-up. The cerebral perfusion was maintained at 20 °C at 500–600 ml/min flow rate with bilateral radial artery pressure as well as bi-frontal near-infrared spectroscopy monitoring. A strict definition of a ‘hemiarch’ as resection of the minor curvature of the aortic arch requiring a beveled anastomosis was used and the procedure otherwise defined as a straight supracoronary graft. Root replacement with either mechanical or biological valve substitute or valve-sparing (David) or partial root-resection (noncoronary sinus resection) was performed ad lib, as was partial or total arch replacement with reimplantation of one or more arch vessels, with or without concomitant elephant trunk procedure.
Giant spinal nerve sheath tumours – Surgical challenges: case series and literature review
Published in British Journal of Neurosurgery, 2019
Ming-Te Lee, Sasan Panbehchi, Priyank Sinha, Jagan Rao, Neil Chiverton, Marcel Ivanov
When GTR is deemed not feasible, surgeons may try to achieve best possible subtotal resection (STR). There are several obstacles to GTR of schwannomas, the main one being the tight adherence of the tumour to the affected neural or vascular structures due to bleeding, inflammation or sub-pial location of the tumour. There are instances in the literature whereby GTR was achieved by sacrificing the nerve roots involved, with clinically negligible neurological consequence.6,11,13,21 Kim et al. evaluated the incidence and extent of neurological deficits in 31 patients who had undergone nerve root resection as part of total resection of the schwannoma. They found that only 23% of patients developed mild neurological deficit.8 The mild neurological deficits observed after root resection was attributed to the fact that adjacent unaffected nerve roots can occasionally compensate for the functional deficits of the nerve root affected by the spinal schwannoma.8,13 In smaller tumours, intraoperative neurophysiological techniques, specifically direct stimulation of the exposed nerve root and recording of the evoked action potential can be utilised to identify functional roots for preservation. Non-functional roots can then be excised with the tumour.28,29 All our patients had intraoperative neurophysiological monitoring. Even though the risk of tumour recurrence after complete tumour excision is very low, our unit’s policy is to perform yearly surveillance MRI for the first 4 years and then once every alternate years for the following 6 years (10 year total follow up).
Ethical questions arising from Otfrid Foerster’s use of the Sherrington method to map human dermatomes
Published in Journal of the History of the Neurosciences, 2022
Brian Freeman, John Carmody, Damian Grace
Foerster published an analysis of dermatomes for the first time following a lecture in Breslau to the founding meeting of the Association of South-East German Neurologists and Psychiatrists. In a long report (Foerster 1926), he reviewed all available methods for dermatomal mapping and described his results with three physiological methods in the living: (a) sequential dorsal rhizotomies while sparing a root in the middle (the method of Sherrington, remaining sensibility, or isolation); (b) a constructive method, which allowed the determination of the superior or inferior border of a dermatome following dorsal rhizotomy of a sequence of roots; and (c) an antidromic vasodilatation method, in which electrical (“faradic”) stimulation of the distal end of a sectioned dorsal root produced a zone of cutaneous vasodilatation (erythema), the focus of which Foerster claimed corresponded to the dermatome of the root being stimulated. He summarized his findings as follows: The most accurate method is Sherrington’s well-known method of remaining sensibility. Here a number of adjacent roots are severed, a single root remains intact, and caudal from this a number of roots are also severed. … In this way, Sherrington has demonstrated most dermatomes in dogs and monkeys and has demonstrated the broad overlapping of single dermatomes. Naturally, in humans, this method has hitherto been of very little use, because the transection of a large number of spinal roots, in the middle of which a single root is left intact, is undertaken relatively seldomly. However, in several cases where I resected L2, L3, L5, S1, S2 for severe spastic paralysis, I was able to determine the shape and location of the fourth lumbar dermatome by the method of remaining sensibility. … To my knowledge, the fourth lumbar dermatome is the only one that has so far been able to be determined in humans using the method of remaining sensibility. However we can at least determine the average shape and extent of numerous dermatomes of man per constructionem, if we consider the numerous cases in which a number of specific roots have been surgically severed. It is clear that the oral border of the sensory defect found after such a root resection is the caudal border of the dermatome located orally to uppermost root and that the caudal border of the sensory defect constitutes the oral border of the dermatome corresponding to the next root below the cut roots. (Foerster 1926, 653–54; authors’ translation; italics added)