Biomecánica del pilar canino en el cráneo humano basada en la geometría utilizando análisis de elementos finitos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)This study evaluated the stress distribution based on the canine pillar geometry in human skull, using a finite element analysis. Computed tomography of human skull was used to build a finite element model, which was composed by all bony structures of canine pillar: canine eminence, canine fossa, frontal process of maxilla, glabellum and superciliary arch. A support on the bite contact of maxillary canine tooth and a resultant force of the masticatory muscles was applied in the simulation. Equivalent Von-mises and maximum principal stresses were analyzed along the structures that compose the canine pillar geometry. Von-mises stress presented high stress concentrated at the canine fossa and frontal process of maxilla. Maximum principal stress showed compression areas at the canine fossa and part of frontal process and tensile stress at canine eminence and part of the frontal process. In conclusion, the different stress areas means different force concentrations transmitted along the canine pillar geometry during a peak canine bite.This study evaluated the stress distribution based on the canine pillar geometry in human skull, using a finite element analysis. Computed tomography of human skull was used to build a finite element model, which was composed by all bony structures of can321214220CAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL E NÍVEL SUPERIORCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)sem informaçãoEste estudio evaluó la distribución de la tensión sobre la geometría del pilar canino en el cráneo humano, utilizando análisis de elementos finitos. Se usó la tomografía computarizada de cráneo humano para construir un modelo de elementos finitos compuestBrazil for financial support and the Center for Information Technology “Renato Archer” (Campinas, Brazil) for technical and scientific suppor

Effects of pneumonectomy on nitric oxide synthase expression and perivascular edema in the remaining lung of rats

Pneumonectomy is associated with high mortality and high rates of complications. Postpneumonectomy pulmonary edema is one of the leading causes of mortality. Little is known about its etiologic factors and its association with the inflammatory process. The purpose of the present study was to evaluate the role of pneumonectomy as a cause of pulmonary edema and its association with gas exchange, inflammation, nitric oxide synthase (NOS) expression and vasoconstriction. Forty-two non-specific pathogen-free Wistar rats were included in the study. Eleven animals died during or after the procedure, 21 were submitted to left pneumonectomy and 10 to sham operation. These animals were sacrificed after 48 or 72 h. Perivascular pulmonary edema was more intense in pneumonectomized rats at 72 h (P = 0.0131). Neutrophil density was lower after pneumonectomy in both groups (P = 0.0168). There was higher immunohistochemical expression of eNOS in the pneumonectomy group (P = 0.0208), but no statistically significant difference in the expression of iNOS. The lumen-wall ratio and pO2/FiO2 ratio did not differ between the operated and sham groups after pneumonectomy. Left pneumonectomy caused perivascular pulmonary edema with no elevation of immunohistochemical expression of iNOS or neutrophil density, suggesting the absence of correlation with the inflammatory process or oxidative stress. The increased expression of eNOS may suggest an intrinsic production of NO without signs of vascular reactivity.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)CNP

Incidence Of The Ossified Pterygoalar Ligament In Brazilian Human Skulls And Its Clinical Implications

The ossified pterygoalar ligament is formed between the lateral lamina of the pterygoid process and the infratemporal surface of the sphenoid bone or its greater wing and was not connected to the sphenoid spine. The aim of this study was to evaluate the incidence of the ossified pterygoalar ligament in Brazilian human skulls and analyzing its clinical importance. 183 Brazilian adult (between 30 to 60 years old) dry human skulls were evaluated. Was evaluated the incidence of skulls with complete or partial ossification of the pterygoalar ligament, bilaterally and unilaterally and in the presence on the right and left sides. Were found 5 skulls had the ossified pterygoalar ligament, resulting in an overall incidence of 2.73%. There was 1 skull in the presence of the incomplete ossification of the pterygoalar ligament, unilaterally and on the left side resulting in incidence of 0.54%. There were 4 skulls in the presence of the complete ossification of the pterygoalar ligament, unilaterally and on the right side resulting in incidence of 2.18%. The ossified pterygoalar ligament is a major cause of the entrapment of the lingual nerve or a branch of the mandibular nerve and may cause mandibular neuralgia. The incidence of the ossified pterygoalar ligament and the pterygoalar foramen is low in the Brazilian population. However, these structures have clinical significance as this ligament establish relationships with the ovale foramen and difficulty in accessing in this foramen in a therapeutic approach.2816971Antonopoulou, M., Piagou, M., Anagnostopoulou, S., An anatomical study of the pterygospinous and pterygoalar bars and foramina - their clinical relevance (2008) Journal of Cranio-Maxillofacial Surgery, 36 (2), pp. 104-108Das, S., Paul, S., Ossified pterygospinous ligament and its clinical implications (2007) Bratislavské Lekárske Listy, 108 (3), pp. 141-143Erdogmus, S., Pinar, Y., Celik, S., A cause of entrapment of the lingual nerve: Ossified pterygospinous ligament - A case report (2009) Neuroanatomy, 8, pp. 43-45Kapur, E., Dilberović, F., Redzepagić, S., Berhamović, E., Variation in the lateral plate of the pterygoid process and the lateral subzygomatic approach to the mandibular nerve (2000) Medicinski Arhiv, 54 (3), pp. 133-137Krmpotic-Nemanic, J., Vinter, I., Hat, J., Jalsovec, D., Mandibular neuralgia due to anatomical variations (1999) European Archives of Oto-Rhino-Laryngology, 256 (4), pp. 205-208. , DOI 10.1007/s004050050141Ludinghausen, M., Kageyama, I., Miura, M., Alkhatib, M., Morphological peculiarities of the deep infratemporal fossa in advanced age (2006) Surgical and Radiologic Anatomy, 28, pp. 284e-292eNayak, S.R., Saralaya, V., Prabhu, L.V., Pai, M.M., Vadgaonkar, R., D'Costa, S., Pterygospinous bar and foramina in Indian skulls: Incidence and phylogenetic significance (2007) Surgical and Radiologic Anatomy, 29 (1), pp. 5-7. , DOI 10.1007/s00276-006-0154-4Patnaik, W.G., Rajan Singla, K., Bala, S., Bilateral pterygo-alar bar and porus crotaphitico-buccinatorius e a case report (2001) Journal of the Anatomical Society of India, 50, pp. 161-162Peker, T., Karakose, M., Anil, A., Turgut, H.B., Gulekon, N., The Incidence of Basal Sphenoid Bony Bridges in Dried Crania and Cadavers: Their Anthropological and Clinical Relevance (2002) European Journal of Morphology, 40 (3), pp. 171-180. , DOI 10.1076/ejom.40.3.171.16686Peuker, E.T., Fischer, G., Filler, T.J., Entrapment of the lingual nerve due to an ossified pterygospinous ligament (2001) Clinical Anatomy, 14 (4), pp. 282-284. , DOI 10.1002/ca.1048Piagkou, M.N., Demesticha, T., Piagkos, G., Androutsos, G., Skandalakis, P., Mandibular nerve entrapment in the infratemporal fossa (2010) Surgical and Radiologic Anatomy, 10Shaw, J.P., Pterydospinous and pterygoalar foramina: A role in the etiology of trigeminal neuralgia? (1993) Clinical Anatomy, 6, pp. 173e-178eSkrzat, J., Walocha, J., Srodek, R., An anatomical study of the pterygoalar bar and the pterygoalar foramen (2005) Folia Morphologica, 64 (2), pp. 92-96Suazo Galdames, I., Zavando Matamala, D., Smith, R.L., Anatomical study of the pterygospinous and pterygoalar bony bridges and foramens in dried crania and its clinical relevance (2010) International Journal of Morphology, 28 (2), pp. 405-408Williams, P.L., Bannister, L.H., Berry, M.M., Collin, P., Dyson, M., Dussek, J.E., Ferguson, M.W.J., (2000) Gray's Anatomy, pp. 588-801. , 38th ed. New York: Churchill Livingston

Trigeminal Neuralgia: Literature Review

The trigeminal nerve, fifth equal of cranial nerves, a mixed nerve is considered by possessing motor and sensitive components. The sensitive portion takes to the Nervous System Central somesthesics information from the skin and mucous membrane of great area of the face, being responsible also for a neural disease, known as the Trigeminal Neuralgia. The aim of this study was to review the literature on the main characteristics of Trigeminal Neuralgia, the relevant aspects for the diagnosis and treatment options for this pathology. This neuralgia is characterized by hard pains and sudden, similar to electric discharges, with duration between a few seconds to two minutes, in the trigeminal nerve sensorial distribution. The pain is unchained by light touches in specific points in the skin of the face or for movements of the facial muscles, it can be caused by traumatic sequels or physiologic processes degenerative associate the vascular compression. Prevails in the senior population, frequently in the woman. In a unilateral way it attacks more the maxillary and mandibular divisions, rarely happens in a simultaneous way in the three branches of trigeminal nerve three branches.30115Adams, R.D., Victor, M., (1985) Principles of Neurology, , New York: Mc Graw-Hill Book CompanyBayer, D.B., Stenger, T.G., Trigeminal Neuralgia: An overview (1979) Oral Surgery, 48 (5), pp. 393-399. , http://dx.doi.org/10.1016/0030-4220(79)90064-1Bennetto, L., Patel, N.K., Fuller, G., (2007) Trigeminal Neuralgia and Its Management, 334, pp. 201-205. , http://dx.doi.org/10.1136/bmj.39085.614792.BE, BMJ, PMid:17255614 PMCid:1782012Brow, J.A., Percutaneous balloon compression for trigeminal Neuralgia (2009) Clinical Neurosurgery, 56, pp. 73-76. , PMid:20214036Eskandar, E., Barker, F.G., Rabinov, J.D., Case records of the Massachusetts General Hospital. Case21-2006. A61-year-old man with left-sided facial pain (2006) New England Journal of Medicine, 355, pp. 183-188. , http://dx.doi.org/10.1056/NEJMcpc069011, PMid:16837683Fardy, M.J., Patton, D.W., Complication associated with peripheral alcohol injections in the management of trigeminal neuralgia (1994) British Journal of Oral and Maxillofacial Surgery, 32 (6), pp. 387-391. , http://dx.doi.org/10.1016/0266-4356(94)90031-0Frizzo, H.M., Hasse, P.N., Veronese, R.M., Neuralgia do Trigêmeo: Revisão Bibliográfica Analítica (2004) Revista De Cirurgia E Traumatologia Buco-Maxilo-Facial, 4 (4), pp. 212-217Galassi, C., Blasi, G., Galassi, G., Serra, M., Faverio, A., Nevralgie trigeminali ed altre algie del capo (1985) Parodontologia E Stomatologia (nuova), 2, pp. 45-160Goto, F., Ishizaki, K., Yoshikawa, D., Obata, H., Arii, H., Terada, M., The long lasting effects of peripheral nerve blocks for trigeminal neuralgia using a high concentration of tetracaine dissolved in bupivacaine (1999) Pain, 79, pp. 101-103. , http://dx.doi.org/10.1016/S0304-3959(98)00156-0Gusmão, S., Magaldi, M., Arantes, A., Rizotomia trigeminal por radiofrequência para tratamento da neuralgia do trigêmeo: Resultados e modificação técnica (2003) Arquivos De Neuro-Psiquiatria, 61 (2), pp. 434-440. , http://dx.doi.org/10.1590/S0004-282X2003000300020, PMid:12894280Hotta, T.H., Bataglion, A., Bataglion, C., Bezzon, O.L., Involvemente of dental occlusion and trigeminal neuralgia: A clinical report (1997) Journal of Prosthetic Dentistry, 77 (4), pp. 343-345. , http://dx.doi.org/10.1016/S0022-3913(97)70155-0Jacob, R.P., Rhoton, J.A.L., Diagnosis and Nonoperative Management of Trigeminal Neuralgia (1996) In: YOUMANS, JR. Neurological Surgery, 5, pp. 3376-3385. , 4th Ed. W. B. Saunders CompanyJanneta, P.G., Gross (Mesoscopic) description of the human trigeminal nerve and ganglion (1963) Journal of Neurosurgery, 20, pp. 109-111Katusic, S., Beard, M.B., Bergstralh, E., Kurland, L.T., Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota:1945-1984 (1990) Annals of Neurology, 27, pp. 89-95. , http://dx.doi.org/10.1002/ana.410270114, PMid:2301931Krafft, R.M., Trigeminal neuralgia (2008) American Family Physician, 77, pp. 1291-1296. , PMid:18540495Linskey, M.E., Jho, H.D., Jannetta, P.J., Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar compression (1994) Journal of Neurosurgery, 81, pp. 1-9. , http://dx.doi.org/10.3171/jns.1994.81.1.0001, PMid:8207508Loh, H.S., Ling, S.Y., Shanmuhasuntharam, P., Zain, R., Yeo, J.F., Khoo, S.P., Trigeminal neuralgia. A retrospective survey of a sample of patients in Singapore and Malaysia (1998) Australian Dental Journal, 43 (3), pp. 188-191. , PMid:9707784Luna, E.B., Graça, L.F.A., Silva, D.C.O., Bérzin, F., Silva, Z., Souza, G.C., Mitri, F.F., Aspectos Anatômicos e Patológicos da Neuralgia do Trigêmeo: Uma revisão da literatura para estudantes e profissionais da saúde (2010) Bioscience Journal, 26 (4), pp. 661-674Maestri, J.M., Holzer, F., Fisiopatología de la neuralgia del trigémeno (1993) Revista Chilena De Neuro-Psiquiatria, 31 (3), pp. 317-321Mattos, J.M.B., Bueno, F.V., Mattos, L.R., Neuralgia do Trigêmeo: Um novo protocolo de tratamento clínico (2005) Revista Dor, 6 (4), pp. 652-656Meneses, M.S., Clemente, R., Russ, H.H., Traitement microchirurgical de la névralgie du trijumeau (1995) Neurochirurgie, 41 (5), pp. 349-352. , PMid:8577355Monzillo, P.H., Sanvito, W.L., Costa, A.R., Cluster-Tic, S., Syndrome: Report of five new cases (2000) Arquivos De Neuro-Psiquiatria, 58, pp. 518-521. , http://dx.doi.org/10.1590/S0004-282X2000000300019, PMid:10920416Neville, B.W., Damm, D.D., Allen, C.M., Bouquot, J.E., (2004) Patologia Oral E Maxilofacial.2.ed, pp. 865-867. , Rio de Janeiro: Guanabara KooganNurmikko, T.J., Eldridge, P.R., (2001) Trigeminal Neuralgia: Pathophysiology, Diagnosis and Current Treatment. BJA: British Journal of Anaesthesia, 87, pp. 117-132. , http://dx.doi.org/10.1093/bja/87.1.117Patterson, C.W., Trigeminal neuralgia-a dental diagnosis challenge (1999) Northwest Dentistry, 78 (3), pp. 19-24Peters, G., Nurmikko, T.J., Peripheral and gasserian ganglion-level precedures for the treatment of trigeminal neuralgia (2002) Clinical Journal of Pain, 18 (1), pp. 28-34. , http://dx.doi.org/10.1097/00002508-200201000-00005, PMid:11803300Quesada, G.A.T., Baptista, C.E., Daiana, S.P., Douglas, L.F., Neuralgia Trigeminal-do diagnóstico ao tratamento (2005) Revista Dentística, (11)Siqueira, S.R.D.T., Nóbrega, J.C.M., Valle, L.B.S., Teixeira, M.J., Siqueira, J.T.T., Clinical aspects and dental procedures (2004) Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, 98 (3), pp. 311-315Toda, K., Trigeminal neuralgia: Symptoms, diagnosis, classification, and related disorders (2007) Oral Science International, 4 (1), pp. 1-9. , http://dx.doi.org/10.1016/S1348-8643(07)80006-1Tronnier, V.M., Rasche, D., Hamer, J., Treatment of idiopathic trigeminal neuralgia: Comparison of long-term outcome after radiofrequency rhizotomy and microvascular decompression (2001) Neurosurgery, 48, pp. 1261-1268. , PMid:11383728Türp, J.C., Gobetti, J.P., Trigeminal neuralgia versus atypical facial pain: A review of the literature and case report (1996) Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, 81 (4), pp. 424-432Yoon, K.B., Wiles, J.R., Miles, J.B., Nurmikko, T.J., Long-term outcome of percutaneous thermocoagulation for trigeminal neuralgia (1999) Anaesthesia, 54 (80), pp. 798-808Yoshimasu, F., Kurland, L.T., Elvelvack, L.R., Tic dolourex in Rochester, Minnesota (1972) Neurology, 22, pp. 952-956. , http://dx.doi.org/10.1212/WNL.22.9.952, 1945-1969. PMid:467338

Emissary Foramens Of The Human Skull: Anatomical Characteristics And Its Relations With Clinical Neurosurgery [forámenes Emisarios Del Cráneo Humano: Características Anatómicas Y Sus Relaciones Con La Neurocirugía Clínica]

The recognition of emissary foramens is important not only for understanding the regional neurovascular anatomy, but also to distinguish normal from potentially abnormal structures. Thus, the aim of this study was to review the literature on anatomical and clinical aspects of the mastoid, parietal and sphenoid emissary foramens. It was found that the emissary foramen presents importance in clinical practice because it acts as a route of spread of extracranial infection to the intracranial structures and also possible complications in neurosurgery, due to its influence in the performance of techniques such as radiofrequency rhizotomy for treatment of trigeminal neuralgia. The anatomical knowledge of the emissary foramens is important due to variability in their incidence in the human skull and its relation to the dura mater sinuses.311287292Bergman, R.A., Afifi, A.K., Miyauchi, R., (1995) Illustrated Encyclopedia of Human Anatomic Variation: Opus V: Skeletal systems: CraniumBoyd, G.I., Emissary foramina of cranium in man and the anthropoids (1930) J. Anat., 65, pp. 108-121Casella, A.M.B., Monteiro, M.L.R., Rgensteiner, D.B.W., Caldeira, J.B.F., Regeneração aberrante do nervo do oculomotor após tromboflebite do seio cavernoso (1998) Arq. Bras. Oftalmol., 51, pp. 135-137Currarino, G., Normal variants and congenital anomalies in the region of the obelion (1976) Am. J. Roentgenol., 127 (3), pp. 487-494El Kettani, C., Badaoui, R., Fikri, M., Jeanjean, P., Montpellier, D., Tchaoussov, J., Pulmonary edema after venous air embolism during craniotomy (2002) Eur. J. Anaesthesiol., 19, pp. 846-848Falk, D., Evolution of cranial blood drainage in hominids: Enlarged occipital/marginal sinuses and emissary foramina (1986) Am. J. Phys. Anthropol., 70, pp. 311-324Goucha, S., Mnif, M., Bouhala, T., Tenzakhti, F., El Andaloussi, H., Fazaa, B., Hamza, R., Kamoun, M.R., Value of imaging in GAPO syndrome (2002) J. Radiol., 83, pp. 153-156Gözil, R., Kadioglu, D., Calguner, E., Occipital emissary foramen in skulls from Central Anatolia (1995) Act. Anat., 153, pp. 325-326Gray, H., Bannister, L.H., Berry, M., William, P.L., Osteology (1995) Gray's Anatomy., , In. Gray, H.Bannister, L.H.Berry, M. & William, P.L. 38th ed. London: Churchill LivingstoneGupta, N., Ray, B., Ghosh, S., Anatomic characteristics of foramen Vesalius (2005) Kath. Univ. Med. J., 3 (2), pp. 155-158Gusmão, S., Magaldi, M., Arantes, A., Rizotomia trigeminal por radiofrequência para tratamento da neuralgia do trigêmio (2003) Arq. Neuropsiq., 61 (2), pp. 434-440Kaalin, R.J., Robinson, W.A., Septic cavernous sinus thrombosis (1984) Ann. Emerg. Med., 13, pp. 449-455Kaplan, M., Erol, F.S., Ozveren, M.F., Topsakal, C., Sam, B., Tekdemir, I., Review of complications due to foramen ovale puncture (2007) J. Clin. Neurosci., 14 (6), pp. 563-568Keats, T.E., (1992) Atlas of normal roentgen variants that may simulate disease., , 5th edition. St. Louis, Mosby Year BookKeskil, S., Gözil, R., Calgüner, E., Common surgical pitfalls in the skull (2003) Surg. Neurol., 59 (3), pp. 228-231Kocaogullar, Y., Avci, E., Fossett, D., Caputy, A., The extradural subtemporal keyhole approach to the sphenocavernous region: Anatomic considerations (2003) Minim. Invas. Neurosurg., 46 (2), pp. 100-105Lang, J., (1983) Clinical anatomy of the head, neurocranium, orbit and craniocervical region., , Springer, BerlinLouis Jr., R.G., Loukas, M., Wartmann, C.T., Tubbs, R.S., Apaydin, N., Gupta, A.A., Spentzouris, G., Ysique, J.R., Clinical anatomy of the mastoid and occipital emissary veins in a large series (2009) Surg. Radiol. Anat., pp. 31139-31144Mann, R.W., Enlarged parietal foramina and craniosynostosis in an American Indian child (1990) Am. J. Roentgenol., 154 (3), p. 658O'Rahilly, R., Twohig, M.J., Foramina parietalia permagna (1952) Am. J. Roentgenol., 67 (4), pp. 551-561Ramalho, J.C., Sousa-Rodrigues, C.F., Rodas, P.M.M., Lins, C.J.P., Lima, R.L., Neto, E.T.D.L., Neto, J.A.B.S., A incidência e as relações morfométricas do forame emissário do esfenóide em crânios humanos (2007) Int. J. Morphol. (abstract)., 25 (1), p. 145Reis, C., Deshmukh, V., Zabramski, J.M., Crusius, M., Desmuskh, P., Spetzler, R.E., Preul, M.C., Anatomy of the mastoid emissary vein and venous system of the posterior neck region: Neurosurgical implications (2007) Neurosurg., 61, pp. ONS193-ONS201Reymond, J., Charuta, A., Wysocki, J., The morphology and morphometry of the foramina of the greater wing of the human sphenoid bone (2005) Folia Morphol., 64 (3), pp. 188-193Rossi, A.C., Freire, A.R., Prado, F.B., Caria, P.H.F., Botacin, P.R., Morphological characteristics of foramen of Vesalius and its relationship with clinical implications (2010) J. Morphol. Sci., 27 (1), pp. 26-29Shapiro, R., Robinson, F., The foramina of the middle fossa: A phylogenetic, anatomic and pathologic study (1967) Am. J. Roentgenol., 101, pp. 779-794Shinohara, A.L., Melo, C.G.S., Silveira, E.M.V., Lauris, J.R.P., Andreo, J.C., Rodrigues, A.C., Incidence, morphology and morphometry of the foramen of Vesalius: Complementary study for a safer planning and execution of the trigeminal rhizotomy technique (2010) Surg. Radiol. Anat., 32, pp. 159-164Sicher, H., DuBrul, E.L., (1977) Oral Anatomy., , 6th ed. Rio de Janeiro: Guanabara KooganSimon, R.P., Parameningeal infections (1996) Cecil textbook of medicine., , In: Bennett, J.C. &ampPlum, F. 20th. Philadelphia: SaundersSindou, M., Keravel, Y., Abdennebi, B., Szapiro, J., Traitement neurochirurgical de la névralgie trigéminale: Abord direct ou métode percutané? (1987) Neurochirur., 33, pp. 89-111Standring, S., (2005) Gray's anatomy., , 39th edition. Elsevier Churchill Livingstone, EdinburghSweet, W.H., Trigeminal neuralgias (1968) Facial pain., , In: Alling, C.C. Philadelphia: Lea & FebigerTator, C.H., Rowed, D.W., Fluoroscopy of foramen ovale as an aid to thermocoagulation of the gasserian ganglion (1976) J. Neurosurg., 44, pp. 254-257Topinard, P., (1878) Anthropology., , London, Chapman and HallWysocki, J., Reymond, J., Skarzynski, H., Wróbel, B., The size of selected human skull foramina in relation to skull capacity (2006) Folia Morphol., 66 (4), pp. 301-308Yoshioka, N., Rhoton, A.L., Abe, H., Scalp to meningeal arterial anastomosis in the parietal foramen (2006) Neurosurg., 58 (1), pp. 123-12