The Journal of craniofacial surgery
-
Trigeminal neuralgia is the worst pain that human beings have ever experienced. Few researches have illustrated perioperative pain in patients with trigeminal neuralgia undergoing radiofrequency thermocoagulation (RFT) of the gasserian ganglion under local anesthesia. Because there are some undeniable drawbacks of using intravenous short-term anesthesia during the intervention repeatedly, some physicians keep patients awake throughout the puncture procedure, using local anesthesia. ⋯ The RFT of the gasserian ganglion alleviated pain obviously. Most patients (94.2%) responded to the operation, and the operation got high analgesia satisfaction scores (8.9 [0.7]). The results demonstrate that preoperative pain in patients with trigeminal neuralgia undergoing RFT of the gasserian ganglion is prevalent and undertreated and that intraoperative pain is severe under local anesthesia during cannulation.
-
Randomized Controlled Trial Comparative Study
The effects of sevoflurane and isoflurane in nasal septal surgery.
The objective of this study was to evaluate the effect of sevoflurane and isoflurane in nasal septal surgery in terms of intraoperative blood loss, operation time, recovery time, and especially postoperative pain. ⋯ Sevoflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding, postoperative pain, and operation time than isoflurane during nasal septal surgery.
-
The Boston bombing incident was a recent civilian mass casualty terrorist event that demonstrated effective transfer of the lessons of combat casualty care to inform effective civilian medical care. Thirty-nine patients were seen at Brigham and Women's Hospital and thirteen patients received emergency surgery in the first few hours after the event. The subsequent management, total hospital days 181, total number of operative procedures 72, and discharging service listing of these thirteen patients illustrate the intensive surgical resources necessary after a civilian bomb attack. ⋯ We believe that prepositioned collaborative relationships of plastic surgery, vascular surgery, trauma surgery and orthopedic surgery may offer a model of collaboration for limb salvage that can be applied in military and mass casualty medical care if resources permit. In this attack, effective use of tourniquets was implemented by prehospital medical providers that saved lives and limbs and these actions reaffirm the important lessons learned from combat casualty care. Unfortunately, it is likely that more centers will deal with similar events in the future and it is imperative that we as a community of providers take what lessons we can from battlefield medicine and that we collectively prepare for and engage this future.
-
Peripheral odontogenic fibroma is considered a gingival tumor characterized by a proliferation of relatively cellular fibrous or fibromyxomatous connective tissue which exhibits variable amounts of odontogenic epithelium and sometimes foci of calcification in the form of dentinoid, cementicles, or bone. It is considered the extraosseous counterpart of central odontogenic fibroma. ⋯ Conservative local excision is the treatment frequently adopted and its recurrence rate varies widely, and its biologic behavior is still unknown. In this study, the authors discuss 3 cases of peripheral odontogenic fibroma, and present their clinical and histopathological features and management.