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Cryoanalgesia in the management of chronic facial pain
CURRENT LlTERATURE intrathoracic and intragastric pressures, which caused sternal and rib fractures and gastric mucosal lacerations. The patient’s syncopal attack appeared to have been caused by cerebral vascular insufficiency secondary to aortic valvular stenosis. She was asymptomatic until eight hours after admission to the hospital, when she went into acute cardiovascular collapse. After vigorous resuscitative efforts lasting two hours, she was pronounced dead. Since this death was a direct result of cardiopulmonary resuscitation resulting in massive gastric hemorrhage clinicians and researchers from multiple lacerations, should strive to develop techniques to minimize gastric insufflation and to decrease the amount of pressure applied to the chest without losing the effectiveness of treatment. Additionally, aggressive surgical intervention should be immediately considered when hematemesis or other evidence of gastric rupture is present.-DoucLAS D. RICHARDSON
Bone Density and Serum Minerals in Cases of Residual Alveolar Ridge Atrophy. Mercier P, Inoue S. J Prosthet Dent 46:250, 1981 In healthy patients, bone resorption occurs as part of turnover in bone to maintain blood and tissue calcium at appropriate levels. Calcium levels are dependent on dietary intake, intestinal absorption, and vitamin D intake. Equilibrium is also affected by the rates of utilization and excretion of calcium. The serum calcium/phosphorus ratio is also kept in balance by parathyroid hormones and possibly by the thyroid glands. This study endeavored to establish a relationship between alveolar ridge bone deficiency and bone density. Bone mineral content was analyzed in 100 patients in relationship to severity of alveolar bone deficiency. Direct photon absorptiometry was used to detect bone mineralization. No statistically significant relationship could be established between the density of bone and the severity of alveolar bone deficiency. Severe or extremely severe bone deficiency was present in patients at both low and high levels of bone density. Serum mineral values were abnormal for 68% of the women and 68.75% of the men. The magnesium deficit was the outstanding finding. Magnesium plays an important role in bone metabolism by increasing parathyroid hormone formation and its release from the gland. This study recommends further study in magnesium depletion, hypocalcemia, and their relationship to alveolar bone deficiency.-C. W. HOWARD Cryoanalgesia Pain. Barnard 9:lOl. 1981
Management of Burns of the Head and Neck. Wachtel TL, Frank DH, Frank HA. Head Neck Surg 3:458, 1981 Bums of the head and neck, with or without respiratory tract injury, remain a serious and complex problem. The care of patients with this injury requires astute frequent clinical examinations, repeated laryngoscopy or flexible bronchoscopy, and serial laboratory investigations. Superb monitoring and care by the entire burn team, frequent dialogue among staff members with specialized knowledge, mature clinical judgment in regard to therapy, and long-term follow-up care will all help bum victims survive the injury and achieve the best possible functional ability and cosmetic appearance. There are no simple answers or rote decisions in the management of these injuries. The challenge requires the most innovative and creative care coupled with large amounts of hard work. Many of the recent advances in the management of bums of the head and neck have permitted patients to survive and have helped them to return to society as functioning members.
in the Management of Chronic Facial D, Lloyd J, Evans J. J Maxillofac Surg
The results of the use of cryoanalgesia to block peripheral branches of the trigeminal nerve in 43 patients with chronic facial pain are presented. The involved nerve was isolated and frozen with a fine cryoprobe. Minimum probe temperatures reached -60 to -80 C. In the group of 43 patients, a total of 85 blocks were followed up for as long as four years. Both pain relief and sensory function were assessed. A distinction was made between cases of nonherpetic neuralgia and postherpetic neuralgia due to residual sensory deficits often seen in postherpetic patients. In this series, the duration of pain relief (median 93 days) exceeded the period of sensory loss (median 60 days) in 67% of the patients with nonherpetic neuralgia. It is concluded that cryoanalgesia is a desirable technique in the treatment of chronic pain, as it does not produce irreversible damage to the nerve or precipitate secondary neuralgia, and it appears to result in prolonged relief for some patients.-DAVID A. BLAHA Fatal Gastric diopulmonary 573, 1981
Hemorrhage: Resuscitation.
New Book Annotations Pocket Guide to Injectable Drugs. Txissel TA. Washington DC, American Society of Hospital Pharmacists, 1981, 159 pp, paperback, $10.00 Seventy-six of the most commonly used drugs are discussed in a concise, informative manner. Each section contains a brief description of the drug, its trade names, and its concentrations, stability, and dosage. Also included is a table indicating compatability and incompatability, or equivocal results when used with other drugs or solutions. At least 58 of the drugs discussed are used by the oral and maxillofacial surgeon.
A Complication of CarAnguilar J. J Trauma 21:
Management of Infections of the Oral and Maxillofacial Regions. Topazian RG, Goldberg MH, with ten contributors. Philadelphia, WB Saunders Co, 1981, 465 pp, 192 illustrations, $39.50
Until recently, trauma secondary to the application of cardiopulmonary resuscitation seemed only to contribute to patient morbidity and to contribute little or nothing to the cause of death. By contrast, the following case report deals with a death directly resulting from the application of cardiopulmonary resuscitative methods. When the patient fainted, well-meaning bystanders interpreted her clinical condition as cardiorespiratory arrest, and administered forceful ventilation and external cardiac massage. These measures resulted in intermittent increases of the
This book brings together the most current information on the diagnosis and treatment of infections of the oral, facial, and cervical areas. Also included are chapters on the organism-host relationship, microbiology, laboratory diagnostic techniques, principles of antibiotic therapy, and neurologic considerations. The various chapters are extensively illustrated and well referenced. 253
Bone Density and Serum Minerals in Cases of Residual Alveolar Ridge Atrophy. Mercier P, Inoue S. J Prosthet Dent 46:250, 1981 In healthy patients, bone resorption occurs as part of turnover in bone to maintain blood and tissue calcium at appropriate levels. Calcium levels are dependent on dietary intake, intestinal absorption, and vitamin D intake. Equilibrium is also affected by the rates of utilization and excretion of calcium. The serum calcium/phosphorus ratio is also kept in balance by parathyroid hormones and possibly by the thyroid glands. This study endeavored to establish a relationship between alveolar ridge bone deficiency and bone density. Bone mineral content was analyzed in 100 patients in relationship to severity of alveolar bone deficiency. Direct photon absorptiometry was used to detect bone mineralization. No statistically significant relationship could be established between the density of bone and the severity of alveolar bone deficiency. Severe or extremely severe bone deficiency was present in patients at both low and high levels of bone density. Serum mineral values were abnormal for 68% of the women and 68.75% of the men. The magnesium deficit was the outstanding finding. Magnesium plays an important role in bone metabolism by increasing parathyroid hormone formation and its release from the gland. This study recommends further study in magnesium depletion, hypocalcemia, and their relationship to alveolar bone deficiency.-C. W. HOWARD Cryoanalgesia Pain. Barnard 9:lOl. 1981
Management of Burns of the Head and Neck. Wachtel TL, Frank DH, Frank HA. Head Neck Surg 3:458, 1981 Bums of the head and neck, with or without respiratory tract injury, remain a serious and complex problem. The care of patients with this injury requires astute frequent clinical examinations, repeated laryngoscopy or flexible bronchoscopy, and serial laboratory investigations. Superb monitoring and care by the entire burn team, frequent dialogue among staff members with specialized knowledge, mature clinical judgment in regard to therapy, and long-term follow-up care will all help bum victims survive the injury and achieve the best possible functional ability and cosmetic appearance. There are no simple answers or rote decisions in the management of these injuries. The challenge requires the most innovative and creative care coupled with large amounts of hard work. Many of the recent advances in the management of bums of the head and neck have permitted patients to survive and have helped them to return to society as functioning members.
in the Management of Chronic Facial D, Lloyd J, Evans J. J Maxillofac Surg
The results of the use of cryoanalgesia to block peripheral branches of the trigeminal nerve in 43 patients with chronic facial pain are presented. The involved nerve was isolated and frozen with a fine cryoprobe. Minimum probe temperatures reached -60 to -80 C. In the group of 43 patients, a total of 85 blocks were followed up for as long as four years. Both pain relief and sensory function were assessed. A distinction was made between cases of nonherpetic neuralgia and postherpetic neuralgia due to residual sensory deficits often seen in postherpetic patients. In this series, the duration of pain relief (median 93 days) exceeded the period of sensory loss (median 60 days) in 67% of the patients with nonherpetic neuralgia. It is concluded that cryoanalgesia is a desirable technique in the treatment of chronic pain, as it does not produce irreversible damage to the nerve or precipitate secondary neuralgia, and it appears to result in prolonged relief for some patients.-DAVID A. BLAHA Fatal Gastric diopulmonary 573, 1981
Hemorrhage: Resuscitation.
New Book Annotations Pocket Guide to Injectable Drugs. Txissel TA. Washington DC, American Society of Hospital Pharmacists, 1981, 159 pp, paperback, $10.00 Seventy-six of the most commonly used drugs are discussed in a concise, informative manner. Each section contains a brief description of the drug, its trade names, and its concentrations, stability, and dosage. Also included is a table indicating compatability and incompatability, or equivocal results when used with other drugs or solutions. At least 58 of the drugs discussed are used by the oral and maxillofacial surgeon.
A Complication of CarAnguilar J. J Trauma 21:
Management of Infections of the Oral and Maxillofacial Regions. Topazian RG, Goldberg MH, with ten contributors. Philadelphia, WB Saunders Co, 1981, 465 pp, 192 illustrations, $39.50
Until recently, trauma secondary to the application of cardiopulmonary resuscitation seemed only to contribute to patient morbidity and to contribute little or nothing to the cause of death. By contrast, the following case report deals with a death directly resulting from the application of cardiopulmonary resuscitative methods. When the patient fainted, well-meaning bystanders interpreted her clinical condition as cardiorespiratory arrest, and administered forceful ventilation and external cardiac massage. These measures resulted in intermittent increases of the
This book brings together the most current information on the diagnosis and treatment of infections of the oral, facial, and cervical areas. Also included are chapters on the organism-host relationship, microbiology, laboratory diagnostic techniques, principles of antibiotic therapy, and neurologic considerations. The various chapters are extensively illustrated and well referenced. 253