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At least 613 records · Page 34Linked to original sources

Persistent foramen of Huschke: possible risk factor for otologic complications after arthroscopy of the temporomandibular joint.

Several cases of otologic injury after arthroscopy of the TMJ have been reported. This study describes the persistent foramen of Huschke, an area of incomplete ossification of the tympanic plate of the temporal bone present in some persons. The presence of this foramen may render middle and inner ear structures vulnerable to injury during arthroscopy of the TMJ.

Arthroscopy↗

Jugular foramen neuromas: a review of 14 cases.

We present 14 patients with jugular foramen neuromas treated in the professorial unit at the National Hospital, Queen Square, in the 20-year period from 1969 to 1989. The growth characteristics and associated symptomatology of these tumors are variable, and often they do not give rise to a typical jugular foramen syndrome, making differentiation from other low cerebellopontine angle tumors difficult and occasionally impossible. One tumor presented mainly in the neck, but the remaining 13 were predominantly intracranial and their anatomical relationships as defined radiologically determined the surgical approach used. Nine tumors were resected using a posterior fossa approach, three required a combined posterior fossa and neck dissection, and one a combined supratentorial and infratentorial craniotomy. The aim of operation was total excision of the tumor, which was achieved in 10 patients; the remaining three all suffered recurrence. There was no operative mortality and little long-term disability.

Adolescent↗

Unilateral hydrocephalus resulting from occlusion of foramen of Monro: a new procedure in the treatment: stereotactic fenestration of the septum pellucidum.

Obstruction at the foramen of Monro resulting in unilateral hydrocephalus is an uncommon entity that may be caused by a wide range of lesions including tumors, vascular malformations, and inflammatory conditions. A case of unilateral hydrocephalus secondary to congenital atresia of the foramen of Monro treated with stereotactic fenestration of the septum pellucidum is presented.

Cerebral Ventricles↗

Premature closure of the foramen ovale and hypoplasia of the left heart.

Although premature closure of the foramen ovale has been proposed as a possible cause of hypoplastic left heart syndrome, very few such cases have been described. We have seen two examples of the combination and no associated malformations. In both the foramen was firmly closed on its left atrial aspect and the dimensions of the left sided structures were well below normal values.

Cardiomegaly↗

Jugular foramen syndrome as a complication of metastatic melanoma.

INTRODUCTION: The jugular foramen (Vernet) syndrome with neuropathy of cranial nerves IX-XI is more commonly due to metastatic lesions than primary neoplasms. Hypoglossal nerve involvement is referred to as the Collet Sicard variant of the jugular foramen syndrome. MATERIALS AND METHODS: We report an elderly man who presents with dysphagia, dysarthria, hoarseness, and a 12-pound weight loss. Examination demonstrated paralysis of the right vagus and hypoglossal nerve. Communication and collaboration with the radiologist resulted in identification of the lesion. Computed tomographic (CT) guided needle aspiration confirmed metastatic melanoma. DISCUSSION: The onset of cranial neuropathy may allow the site of lesion to be predicted based on knowledge of the cranial base and neural anatomy. Diagnostic evaluation is tailored to evaluate the area in question. Active, multidisciplinary collaboration is essential for success.

Accessory Nerve↗

An unusual presentation of thyroid papillary carcinoma: enlargement of a cervical intervertebral foramen.

Isolated enlargement of the cervical intervertebral foramen is frequently associated with dumbbell neurogenic tumors. We present an unusual case of isolated enlargement of a cervical intervertebral foramen in a 77-year-old male with an aggressive papillary thyroid carcinoma. To our knowledge, this represents the first case describing a thyroid process as a cause of foraminal enlargement.

Aged↗

The foramen ovale. MR and CT correlation.

Six patients with lesions involving the foramen ovale are presented and analyzed. Anatomy, pathology and imaging of diseases occurring in the vicinity of the foramen ovale are reviewed. Computerized tomography (CT) and magnetic resonance imaging (MRI) are complimentary in the evaluation of pathology in this region. CT is better able to evaluate bony detail while MR imaging is useful in detailing the anatomical extent and tissue characteristics.

Adenoma↗

Diagnosis and management of restricted or closed foramen ovale in fetuses with congenital heart disease.

The incidence of foramen ovale restriction or closure is greater in fetuses with congenital heart defects (CHDs) and obligate atrial shunting and/or left atrial hypertension. Foramen ovale restriction or closure in fetuses with CHD can cause distress in utero or at birth. We suggest performing serial ultrasound assessment for at-risk fetuses with CHD to best assure fetal well-being plan the timing and mode of delivery, and develop management protocols for in utero and postnatal care. The future for these patients may be more optimistic as fetal intervention procedures are developed and mastered.

Blood Flow Velocity↗

[Massive pulmonary embolism and stroke due to thrombus across the foramen ovale].

We report the case of a man admitted for massive pulmonary embolism. Transthoracic echocardiography showed a serpentine thrombus in the right atrium across the foramen oval. Because of an acute worsening of the circulatory insufficiency, an intravenous thrombolysis was prescribed and the patient recovered progressively. An early control echocardiography showed the disappearing of the intracardiac thrombus and no evidence of abnormality of interatrial septum. While there was no evidence of venous thrombosis in legs, a renal cancer was diagnosed by echography. Silent stroke were highlighted at the scanner. This clinical case leads to discuss the origin of thrombus (in situ formation or thrombus migration) as well as the treatment (heparinotherapy, thrombolysis, surgical embolectomy, definitive closure of the foramen oval).

Aged, 80 and over↗

Improved technique to diagnose a patent foramen ovale during left ventricular assist device insertion.

Diagnosis of a patent foramen ovale prior to left ventricular assist device placement can be quite difficult, and if missed may result in a significant hypoxemia due to a right to left shunt. We describe a simple and precise way to increase the diagnostic accuracy of patent foramen ovale detection prior to initiating cardiopulmonary bypass for left ventricular assist device placement.

Adult↗

Cystic formation of the foramen ovale mimicking a right atrial myxoma.

A 65-year-old woman presented with shortness of breath, stenocardia, and tachycardia. She underwent several steps of examination. Echocardiography showed a suspicious formation in the right atrium extending into the inferior caval vein. The lesion was suspicious for a myxoma, a thrombus, or a malformation. Intraoperatively this formation presented as a cystic formation connected to the right atrial wall in the area of the foramen secundum and filled with blood and five calcified thrombi. We hypothesize that a slit-like opening in the foramen ovale produced a valve-like mechanism bulging parts of the septum secundum and produced this cystic formation.

Aged↗

Peripheral targeting of the trigeminal ganglion via the infraorbital foramen as a therapeutic strategy.

A unique interventional approach for modulating sensory signaling involves targeting neurons in the sensory ganglia through use of pharmacological or gene therapies. This has previously been accomplished in the trigeminal system via stereotactic ganglionic microinjections. However, this procedure can be time consuming and requires expensive stereotactic equipment. The current paper describes a percutaneous approach for injecting the trigeminal ganglion with an electrical-stimulation needle inserted through the infraorbital foramen, infraorbital canal and foramen rotundum. The needle tip was positioned in the ganglion by eliciting a twitch in the ipsilateral masseter following electrical stimulation. The technique was imaged using computerized tomography and methylene blue dye to verify the site of the injection. We validated this technique by reproducing the results from our prior study that involved injection of resiniferatoxin (RTX) into the trigeminal ganglion using the stereotactic approach. Both techniques for intraganglionic injection of RTX produced a specific deletion of C-fiber neurons, as demonstrated by inhibition of neurogenic-induced plasma extravasation and behavioral assays. Thus, we propose a novel and simple technique for studying mechanisms of peripheral sensory modulation of orofacial pain via direct application of drugs, tracers or viral vectors around trigeminal sensory neuronal cell bodies. This technique minimizes trauma to brain structures that may have an impact on pain perception.

Animals↗

Giant thrombus trapped in foramen ovale with pulmonary embolus and stroke.

We describe the case of a young man who, while he was in coma because of a traffic accident, had first a pulmonary embolus and immediately afterwards had a systemic (cerebral) embolus. A transesophageal echocardiographic image revealed a giant thrombi trapped in foramen ovale protruding in right and left ventricles, diagnosing, thus, a paradoxical embolism. The relationship between patent foramen ovale and pulmonary embolism has been reported in some series. Elevated right-chamber pressure caused by pulmonary hypertension could favor the establishment of a right-to-left shunt, causing, in some cases, paradoxical embolisms. We review the clinical implications.

Accidents, Traffic↗

Transit thrombus entrapped in a patent foramen ovale.

We describe the case of a 39-year-old man with a diagnosis of inferior vena cava compression caused by metastases of a testicular seminoma, who developed massive pulmonary embolism. Emergency operation was performed because of acute hemodynamic deterioration. Preoperatively, a free-floating mass was seen echocardiographically in the right atrium. Intraoperatively, a thrombus entrapped in a patent foramen ovale with a short free-floating end in the left atrium and a long end in the right atrium was found in addition to the pulmonary emboli. The thrombus was removed, the foramen ovale was closed by direct suture, and pulmonary embolectomy was performed. Histological examination confirmed thrombi but no malignant tissue. Further diagnostic studies documented a malignant seminoma with paraaortic lymph node metastases giving rise to the thrombembolism. Three years after oncologic therapy, he is alive and free from recurrence of embolic and malignant disease.

Adult↗

The role of eustachian valve and patent foramen ovale in sudden death.

Sudden unexpected cardiac death is the leading cause of death in industrialized countries. Patent foramen ovale and eustachian valve are two of cardiac diseases and they may be associated with clinical disorders as embolism, stroke, plathypnea-orthodeoxia syndrome, carcinoid heart disease, atrial flutter and endocarditis. The literature for the roles of patent foramen ovale and eustachian valve in the causes of sudden deaths are reviewed.

Death, Sudden↗

Core excision of the foramen cecum for recurrent thyroglossal duct cyst after Sistrunk operation.

The recurrence rate for thyroglossal duct cysts after a Sistrunk operation is 5% compared with 20% if the hyoid cartilage is not removed. However, few guidelines exist when a lesion recurs after an adequate Sistrunk operation. A 2-year-old boy was referred for recurrent thyroglossal duct cyst after complete and adequate resection. Reexploration of the wound and wider excision of the midline cervical tissues failed to treat the problem. Using a combined transoral/cervical approach, a core of tongue around the foramen cecum was removed. A cystic structure was found at pathologic examination. The child remains asymptomatic 24 months later. If thyroglossal duct cysts recur despite an adequate Sistrunk operation, an intralingual remnant should be suspected. Transoral excision of tongue tissue around the foramen cecum may offer a cure.

Abscess↗