The Journal of craniofacial surgery
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Case Reports
Basicranial venous anomalies associated with complex nonsyndromic craniosynostosis in a child.
We report the radiological findings of severe bilateral jugular foraminal stenosis along with anomalous basicranial venous drainage in a child with a history of complex nonsyndromic craniosynostosis. CT with 3D reconstructions and MR venography revealed that the lateral sinuses were draining transosseously through several markedly enlarged emissary veins. ⋯ Basicranial venous anomalies are common among children with complex craniosynostosis, and although they may not resemble intracranial vascular outflow deficiencies, they can pose significant surgical risks. This case emphasizes the need for proper clinical assessment and documentation of anomalous basicranial venous anatomy to facilitate management of complex craniosynostosis patients.
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Randomized Controlled Trial Comparative Study
A randomized double-blinded placebo controlled study of four interventions for the prevention of postoperative nausea and vomiting in maxillofacial trauma surgery.
This study aimed to determine if preoperative oral administration of metoclopramide, chlorpromazine, gabapentin, or dexamethasone would effectively reduce postoperative nausea and vomiting (PONV) in the first 24 hours after surgery in patients undergoing maxillofacial trauma surgery. ⋯ Our results demonstrated that premedication with oral metoclopramide, gabapentin, or chlorpromazine can significantly decrease the incidence of PONV in patients undergoing maxillofacial trauma surgery.
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Comparative Study Controlled Clinical Trial
Comparison between routine and improved decompressive craniectomy on patients with malignant cerebral artery infarction without traumatic brain injury.
Malignant cerebral artery infarction is one kind of ischemic stroke with high mortality. The aim of this study was to analyze comparatively the preoperative and postoperative clinical data as well as the prognostic factors in these patients who underwent improved decompressive craniectomy or routine decompressive craniectomy. ⋯ In comparison with the routine decompressive craniectomy, the improved decompressive craniectomy can reduce the mortality rate and improve the neurologic outcome. However, it increases the incidence of encephalocele and pulmonary infection, which may cause secondary vital injury to patients after surgery. In addition, younger patients can gain a better further functional recovery by undergoing improved decompressive craniectomy.
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Comparative Study
Investigation of middle ear pressure changes during prone position under general anesthesia without using nitrous oxide.
The effects of different body positions on the middle ear were reported in several studies, but there are no data about the effects on patients under general anesthesia. The aim of this study is to determine the effect of prone position on middle ear pressure (MEP) during general anesthesia without using nitrous oxide. ⋯ The significant MEP increases during the prone position under general anesthesia depend on a number of reasons. Among them are inhaler agents, pressure changes in mucosal blood vessels due to venous congestion, and the mastoid bone volume. Further researches are required to determine and explain the mechanisms of increase in MEP during prone position.
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Comparative Study
Facial fractures of the upper craniofacial skeleton predict mortality and occult intracranial injury after blunt trauma: an analysis.
The aim of this article was to assess how regional facial fracture patterns predict mortality and occult intracranial injury after blunt trauma. ⋯ The association between facial fractures, intracranial injury, and death varies by regional involvement, with increasing insult in those with upper face fractures. Cognizance of the increased risk for intracranial injury in patients with upper face fractures may supplement existing triage tools and should increase suspicion for underlying or impending neuropathology, regardless of clinical picture at presentation.