Transient neurological complications following mandibular nerve block.
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Ten patients who had ameloblastoma of the mandible underwent surgery for resection of the tumor followed by immediate mandibular reconstruction with free autogenous nerve grafting using the greater auricular nerve. One year after surgery pain perception and tactile sensibility were completely restored in eight of the ten patients.
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We report a case of trismus caused by tetanus in an 80-yr-old woman who developed severe and painful masseter spasms during which she violently bit the tip of her tongue with her dentures. Bilateral mandibular blocks were performed to remove the dentures. The patient fully recovered. We suggest that mandibular blocks are a useful tool in the management of oral events during trismus in conscious patients.
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A technique for repair of the inferior alveolar nerve of the rat involving a collagen tube conduit with laminin gel lining was compared with unguided regeneration in both large and small nerve gaps. No significant morphologic differences were noted between the groups with small defects. With large defects, however, only the tubular repairs were effective in restoring neural continuity. The implications of the results of this study are discussed.
This article describes conventional orthodontic treatment of an adult patient leading to lower lip paresthesia. The paresthesia subsided when the cross elastics to correct the patient's single molar crossbite were removed. It was determined with Digital Volumetric Tomography that the inferior alveolar nerve was located lingual to the lower second molar root and was impinged upon with the tipping force of the cross elastic. Treatment to resolve the crossbite without further paresthesia is discussed.
Local anesthesia is essential in treating many dental and oral disorders. However, many types of anatomical anomalies are seen in the nervous system of the mandible that interfere with achieving local anesthesia. The authors describe four such anomalies and offer ways to overcome them when trying to properly anesthetize affected patients.
The recent studies of the anatomy of the eustachian tube and related structures in the Rhesus monkey (Macaca mulatta) have shown that the monkey tubal system is similar to the human. This investigation in Rhesus monkeys was an attempt to verify previous studies in other animals that the tensor veli palatini muscle was the only dilator of the eustachian tube. Two unipolar stimulating electrodes were introduced into the foramen ovale, and the mandibular branch of the trigeminal nerve was electrically stimulated. Simultaneously, pressure-flow recordings through the eustachian tube were monitored. Stimulus-response relationships were obtained for five Rhesus monkeys. The degree of tubal dilation by the tensor veli palatini muscle contraction was shown to be a function of stimulating current levels. Artifically induced dilations were quite similar to the physiological dilations during swallowing when these animals were tested alert. Following complete transection of the tensor muscle, regardless of the stimulus level, no tubal dilations were observed. Stimulation of the nerve to the internal pterygoid and stimulation of the levator veli palatini muscle induced only constrictions of the tube. The tensor veli palatini muscle is the only paratubal muscle responsible for active dilation of the eustachian tube in the Rhesus monkey, and its motor innervation is the mandibular division of the trigeminal nerve.