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Malignant tumors of the superior maxilla
Abstracts of Current
Literature
ANESTHESIOLOGY When Will He Wake Up?
Prank Cole. Arch. Surg. 72: 405, March,
1956.
General anesthesia differs from natural sleep in that the person who is simply asteep can always be awakened immediately by stimulation, whereas the narcotized patient must go through a recovery period during which the depressant drug is detoxified or excreted. A series of 300 consecutive cases were studied to determine the average duration of the waking period. It was felt that knowing the waking period for different techniques would advise the anesthetist in any case in selecting his methods; it may enable him to manage the postanesthesia room more efficiently b.y shortening the waking period. The five factors considered in this excellent series were: the anesthetic, intubation, The average waking time was twentycurare, the operation, and the duration of surgery. T. .r. (‘. four minutes.
ORAL SURGERY Injuries of the Trigeminal Nerve, Its Ganglion and Its Divisions. Joseph Schomtein. Brit. J. Surg. 42: 561, May, 1955.
Geoffrey Jefferson and
Sixty-six patients with trigeminal nerve injury were studied. In this series, fourteen patients had penetrating wounds and fifty-two had blunt head injuries. loss, Patients who have ganglion injury will suffer permaueot and deep functional Posttraumatic patients comand occasionally there develops an annoying paresthesia. plain more of their numbness than do postoperative patients who have known beforehand the terrible pains of trigeminal neuralgia. While arterial lesions do, in small numbers, accompany such lesions as gunshot wounds of the trigeminal ganglion and its intracranial branches, it is significant that the surviving numbers of such patients are small. Blunt injuries, by far the commoner cause of trigeminal injury, produce also a wider variety of involvement, the greatest defect falling upon the infraorbital uerve. This is true because of the extensive course of the nerve through that part of the bone structures Six instances Of injury to the so commonly injured in craniomaxillofacial injury. nasoeiliary nerve are reported as the result of fracture of the floor of the anterior cranial fossa. In one patient autopsy revealed actual anatomic rupture of the sensory root xexr the ganglion. The motor root, as would be expected, was subject to a high degree of injury in all types of lesions. Concurrent injury of other cranial nerves is not particu2arJy ~aonuuo,, in the intracranial type of injury. 71. ,r. (I. Malignant
Tumors
of the Superior Maxilla.
M. G. Lynch.
South. M. J. 48: 569, 3 une, 1955.
Tumors of the superior maxilla account for a very small percentage of malignant growths in general and, when they do occur, 80 per cent involve the antrum. Neoplastic growths in the floor of the antrum frequently cause pain in the teeth. Metastatic extension from the floor of the sinus oaeurs first, usually in the submaxillary and carotid nodes which are surgieall>- aczc,cssiblc. Tumors from the upper part
686
ABSTRACTS
OF
CIJRRENT
LITERATURE
of the sinus usually metastasize earlier than those of the floor of the sinus, with ment of the retropharyngeal nodes, and may go on to extension in the orbit ethmoid bone. The author believes thorough radiation, would superior maxilla.
The Clinical Hyatt.
Evaluation
operation through an untouched lield, followed seem to be the treatment of choice in neoplastic
of Freeze-Dried
Bone Grafts.
involveand the
by extensive growths of the T. J. C.
Chalmers R. Carr and George W.
J. Bone Surg. 37-A: 549, June, 1955.
Immediately after procurement, the bone is placed in a glass unit and is stored at -70” C. prior to processing. The details of the freeze-dried technique are given. ThroughWith out the processing and final capping, the bone remains in its original glass unit. freeze-dried bone, the vacuum is required to prevent absorption of moisture from the atmosphere. The average freeze-drying cycle for bone takes two weeks. Freeze-dried bone is moderately friable in its dry state; however, it apparently will regain its elastic physical properties when physiologic saline solut,ion is added to the bone is usually reconstituted in this manner deposit until the operation is done. Cortical The ground cancellous bone is easier to pack into the operative area if it reovernight. mains in the dry state. This bone is then reconstituted in the patient’s hematoma. The likelihood apparently
authors believe that when bone is used, even for firm of nonunion from absorption than when rigid metallic forms a trellis for bridging callus.
The freeze-drying process time, and technical personnel. hospital.
fixation, plates
there is less are used. It
has the disadvantage of high initial cost in equipment, The process is not practical for adoption by the average T. J. C.
Literature
ANESTHESIOLOGY When Will He Wake Up?
Prank Cole. Arch. Surg. 72: 405, March,
1956.
General anesthesia differs from natural sleep in that the person who is simply asteep can always be awakened immediately by stimulation, whereas the narcotized patient must go through a recovery period during which the depressant drug is detoxified or excreted. A series of 300 consecutive cases were studied to determine the average duration of the waking period. It was felt that knowing the waking period for different techniques would advise the anesthetist in any case in selecting his methods; it may enable him to manage the postanesthesia room more efficiently b.y shortening the waking period. The five factors considered in this excellent series were: the anesthetic, intubation, The average waking time was twentycurare, the operation, and the duration of surgery. T. .r. (‘. four minutes.
ORAL SURGERY Injuries of the Trigeminal Nerve, Its Ganglion and Its Divisions. Joseph Schomtein. Brit. J. Surg. 42: 561, May, 1955.
Geoffrey Jefferson and
Sixty-six patients with trigeminal nerve injury were studied. In this series, fourteen patients had penetrating wounds and fifty-two had blunt head injuries. loss, Patients who have ganglion injury will suffer permaueot and deep functional Posttraumatic patients comand occasionally there develops an annoying paresthesia. plain more of their numbness than do postoperative patients who have known beforehand the terrible pains of trigeminal neuralgia. While arterial lesions do, in small numbers, accompany such lesions as gunshot wounds of the trigeminal ganglion and its intracranial branches, it is significant that the surviving numbers of such patients are small. Blunt injuries, by far the commoner cause of trigeminal injury, produce also a wider variety of involvement, the greatest defect falling upon the infraorbital uerve. This is true because of the extensive course of the nerve through that part of the bone structures Six instances Of injury to the so commonly injured in craniomaxillofacial injury. nasoeiliary nerve are reported as the result of fracture of the floor of the anterior cranial fossa. In one patient autopsy revealed actual anatomic rupture of the sensory root xexr the ganglion. The motor root, as would be expected, was subject to a high degree of injury in all types of lesions. Concurrent injury of other cranial nerves is not particu2arJy ~aonuuo,, in the intracranial type of injury. 71. ,r. (I. Malignant
Tumors
of the Superior Maxilla.
M. G. Lynch.
South. M. J. 48: 569, 3 une, 1955.
Tumors of the superior maxilla account for a very small percentage of malignant growths in general and, when they do occur, 80 per cent involve the antrum. Neoplastic growths in the floor of the antrum frequently cause pain in the teeth. Metastatic extension from the floor of the sinus oaeurs first, usually in the submaxillary and carotid nodes which are surgieall>- aczc,cssiblc. Tumors from the upper part
686
ABSTRACTS
OF
CIJRRENT
LITERATURE
of the sinus usually metastasize earlier than those of the floor of the sinus, with ment of the retropharyngeal nodes, and may go on to extension in the orbit ethmoid bone. The author believes thorough radiation, would superior maxilla.
The Clinical Hyatt.
Evaluation
operation through an untouched lield, followed seem to be the treatment of choice in neoplastic
of Freeze-Dried
Bone Grafts.
involveand the
by extensive growths of the T. J. C.
Chalmers R. Carr and George W.
J. Bone Surg. 37-A: 549, June, 1955.
Immediately after procurement, the bone is placed in a glass unit and is stored at -70” C. prior to processing. The details of the freeze-dried technique are given. ThroughWith out the processing and final capping, the bone remains in its original glass unit. freeze-dried bone, the vacuum is required to prevent absorption of moisture from the atmosphere. The average freeze-drying cycle for bone takes two weeks. Freeze-dried bone is moderately friable in its dry state; however, it apparently will regain its elastic physical properties when physiologic saline solut,ion is added to the bone is usually reconstituted in this manner deposit until the operation is done. Cortical The ground cancellous bone is easier to pack into the operative area if it reovernight. mains in the dry state. This bone is then reconstituted in the patient’s hematoma. The likelihood apparently
authors believe that when bone is used, even for firm of nonunion from absorption than when rigid metallic forms a trellis for bridging callus.
The freeze-drying process time, and technical personnel. hospital.
fixation, plates
there is less are used. It
has the disadvantage of high initial cost in equipment, The process is not practical for adoption by the average T. J. C.