The Journal of craniofacial surgery
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The objectives of this work are to report the outcomes of our finding during microvascular decompression (MVD) for patients with recurrent trigeminal neuralgia (TN) and to introduce the sling retraction technique. ⋯ Arachnoid adhesion of the Teflon felt and vascular compression to the nerve were main causes of recurrence. The sling retraction technique is still an effective and useful treatment for recurrent TN after MVD.
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The purpose of this study was to analyze the imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma. ⋯ Lymphoplasmacyte-rich meningioma is a seldom-seen subtype meningioma of WHO grade I, often accompanying anemia or polyclonal immunoglobulin hyperplasia, which can recover to normal state after removing the masses. The masses showed higher density and without clear boundary in plain CT scan, and most of the tumors appear with irregular shape, obvious edema, and significant enhancement in the MRI scan. The prognosis is favorable after surgical resection and the recurrence rate is low.
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Randomized Controlled Trial Comparative Study
Comparison of different administration of ketamine and intravenous tramadol hydrochloride for postoperative pain relief and sedation after pediatric tonsillectomy.
Tonsillectomy is the oldest and most frequently performed surgical procedure practiced by ear, nose, and throat physicians. In this study, our aim was to compare the analgesic effects of peritonsillar, rectal, as well as intravenous infiltration of ketamine and intravenous tramadol hydrochloride infiltration for postoperative pain relief and sedation after tonsillectomy in children. ⋯ Perioperative, low-dose IV, rectal, or peritonsillar ketamine infiltration provides efficient pain relief without any adverse effects in children who would undergo adenotonsillectomy.
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Randomized Controlled Trial
Remifentanil, ketamine, and propofol in awake nasotracheal fiberoptic intubation in temporomandibular joint ankylosis surgery.
Nasotracheal intubation of patients with temporomandibular joint (TMJ) ankylosis is a challenge for anesthesiologists. Awake fiberoptic intubation (AFOI) is the safest technique in patients with difficult airway. This study compares 3 different techniques of conscious sedation during AFOI in patients with TMJ ankylosis. ⋯ Remifentanil was the best agent for AFOI, because it provided shorter intubation time, better intubation conditions, and least patient's complaint.Iranian registry no.: IRCT 201208061674N4 (www.irct.ir).
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Surgery for craniosynostosis is associated with the potential for significant blood loss. Multiple technologies have been introduced to reduce the volume of blood transfused. These are preoperative autologous donation; preoperative erythropoietin; intraoperative cell salvage (CS); acute normovolemic hemodilution; antifibrinolytic drugs such as tranexamic acid, ε-aminocaproic acid, and aprotinin; fibrin sealants or fibrin glue; and postoperative drain reinfusion. ⋯ The production of high-quality evidence on the interventions to minimize blood loss and transfusion in children undergoing surgery for craniosynostosis is difficult. Most of the literature is nonrandomized and noncomparative. Several areas remain unaddressed. Erythropoietin and tranexamic acid are comparatively well studied; CS, acute normovolemic hemodilution, and aprotinin are less so. There is only 1 comparative study on the use of fibrin glue and drain reinfusion, with no studies on preoperative autologous donation and [Latin Small Letter Open E]-aminocaproic acid. Tranexamic acid is clinically effective in reducing allogeneic blood transfusion. There is some evidence that CS and erythropoietin may be clinically effective. None of the interventions studied are shown to be cost-effective because of lack of evidence.