Mandibular Branch Of Trigeminal Nerve Research Articles

Efficacy of CT-guided partial radiofrequency ablation of bilateral responsible cranial nerves in the treatment of Meige syndrome

Objective: To evaluate the efficacy of CT-guided partial radiofrequency ablation of bilateral responsible cranial nerves in the treatment of Meige syndrome. Methods: The Clinical data of 56 patients with Meige syndrome in the Department of Pain Medicine, Affiliated Hospital of Jiaxing University from June 2019 to January 2023 were retrospectively analyzed [19 males and 37 females, aged 42-76 (58.6±8.3) years], including 51 cases of blepharospasm, 3 cases of oromandibular dystonia and 2 cases of blepharospasm concomitant with oromandibular dystonia. CT-guided partial radiofrequency ablation of bilateral responsible cranial nerves was performed on different types of Meige syndrome. And the efficacy and complications of the technique were observed. Results: Fifty-one patients with blepharospasm Meige syndrome underwent CT-guided radiofrequency of facial nerve through bilateral stylomastoid foramen punctures, the symptoms of blepharospasm disappeared completely, leaving bilateral mild and moderate facial paralysis symptoms. Three patients with oral-mandibular dystonia underwent CT-guided radiofrequency therapy by bilateral foramen ovale puncture of mandibular branches of trigeminal nerve, masticatory muscle spasm disappeared, the patients had no difficulty opening the mouth, and the skin numbness in bilateral mandibular nerve innervation area was left. Two cases of Meige syndrome with blepharospasm concomitant with oromandibular dystonia were treated by radiofrequency of facial nerve and mandibular branch of trigeminal nerve, and all symptoms disappeared. The patients were followed up for 1-44 months after the operation, and the symptoms of mild and moderate facial paralysis disappeared at (3.2±0.8) months after the operation, but the numbness did not disappear. Three patients with blepharospasm recurred at the 14, 18 and 22 months after the operation, respectively, while the rest cases did not recur. Conclusions: According to different types of Meige syndrome, CT-guided partial radiofrequency ablation of responsible cranial nerves can effectively treat the corresponding type of Meige syndrome. The complications are only mild and moderate facial paralysis which can be recovered, and/or skin numbness in the mandibular region.

A rare anatomical variation in foramen of Vesalius: A useful guide for maxillofacial surgeons

Background: Foramen of vesalius is an inconstant foramen that gives passage to an emissary vein that connects pterygoid venous plexus with cavernous sinus. It lies in the anteromedial side of the foramen ovale. Foramen ovale allows the passage for the mandibular branch of trigeminal nerve, the main site for the trigeminal rhizotomy. The presence and description of anatomical variations about the foramen of Vesalius is important during the surgical procedure on the trigeminal nerve which may injure the emissary vein in the foramen leading to intracranial bleeding. Objectives: The aim of the present study is to report the presence and to enlighten the anatomical variations of foramen vesalius which may serve as a guideline for surgeons. Methods: The study was conducted on 100 dry adult human skulls collected from the department of anatomy at Panimalar medical college hospital & research institute Chennai. The skulls were viewed both extracranially and intracranially to identify the presence of foramen of vesalius. The presence and variation of the foramen was noted and discussed. Result: A total of about 200 sides of 100 skulls were studied. Among them 20% of the skull showed presence of foramen of Vesalius bilaterally, 25% unilaterally and one particular skull showed doubled opening on the left side with the presence of a bony septum. This is a rare variation which was less documented in the literature. Conclusion: The knowledge of variations in foramen of Vesalius may help the surgeons for safer planning and execution of the trigeminal rhizotomy technique.

Trigeminal neuralgia as a presenting symptom of brain metastasis in advanced stage of breast cancer

Trigeminal neuralgia is defined as sudden, usually unilateral, severe, brief, stabbing, recurrent episodes of pain in the distribution of one or more branches of the trigeminal nerve. We report a case of trigeminal neuralgia which was a presenting symptom for the diagnosis of brain metatstasis in a patient with advanced stage of breast cancer. A 51 old female complained of right facial pain. She had been diagnosed invasive ductal carcinoma one year ago. Since the detection of cancer, she had multiple metastasis in bone, both lung and chest wall. Brief recurrent lanscinating right facial pain was persisted during 7 days without relief. On admission, pain was distributed in maxillary and mandibular division of trigeminal nerve. Neurologic examination revealed no contraction of masseter and temporalis on the same side. Hypestheia was accompanied in right maxillary and mandibular branch of trigeminal nerve. Brain MRI depicted multiple metastasis in right cavernous sinus, Meckel’s cave and bilateral cerebellum. Neurophysiologic study showed normal blink reflex response, but no potential for masseter reflex test. She was diagnosed with secondary trigeminal neuralgia and we prescribed oxcarbazepine with palliative chemotherapy. Malignant metastasis involving the path of trigeminal nerve could elicit neuralgic pain as a secondary cause of trigeminal neuralgia. In our patient, the neuralgic pain in the area of trigeminal nerve was the only presenting symptom of brain metastasis. Secondary cause of trigeminal neuralgia should be evaluated with extensive brain imaging especially in patient with cancer.

Topographic and microscopic anatomical description of the emissary sinus of foramen ovale in adult humans

ObjectiveAlthough the Emissary Sinus of Foramen Ovale (ESFO) was first described by Trolard in 1868, its definition remains confused and neglected in the medical literature. This structure represents a vein, two veins, a venous plexus, or a dural sinus? Does it really exist? To understand this topic, this work aimed to describe the anatomy, topography, and microscopic features of the ESFO, precisely characterizing its structure, routes and anatomical correlations. Patients and methodsESFO from the skull’s base of adults were dissected into fifty anatomical blocks and evaluated using Hematoxylin and Eosin, Picro-sirius red and Weigert staining, and by Scanning Electron Microscopy (SEM). ResultsESFO was always present between cavernous sinus and pterygoid plexus on both antimeres, its inferior route passing through the foramen ovale and/or sphenoidal emissary foramen (foramen of Vesalius), anterior to the mandibular branch of trigeminal nerve. Its microscopic arrangement resembled what was found on transverse sinus, that is composed by layers of collagen fibers oriented on transversal and longitudinal planes. It wasn’t possible to identify the media and adventitial tunica, features seen in veins, and the elastic layer was very thin near its lumen. SEM analysis showed that, like the transverse sinus, the ESFO was composed by parallel cells that presented a rhombus shape containing central rounded nuclei. ConclusionIn summary, the venous channel passing through the foramen ovale and/or sphenoidal emissary foramen (foramen of Vesalius) is a dural venous sinus constituted by dura mater layers and should be considered during surgical approaches near the foramen ovale in the middle cranial fossa.

Herpes Zoster with Postherpetic Neuralgia involving the Left Maxillary and Mandibular Branch of Trigeminal Nerve

Herpes Zoster with Postherpetic Neuralgia involving the Left Maxillary and Mandibular Branch of Trigeminal Nerve

Herpes Zoster Involving Maxillary and Mandibular Branch of Trigeminal Nerve in HIV Patient: A Case Report

Herpes Zoster Involving Maxillary and Mandibular Branch of Trigeminal Nerve in HIV Patient: A Case Report

Baş boyun alan enfeksiyonu ile Herpes Simpleks virüs birlikteliği

A six-year-old girl was admitted to our clinic with the complaints of swelling, trismus, pain in the submandibular, submental and masticator area and vesicular lesions on the mandibular branch of trigeminal nerve (C5, V3). We present this case of head and neck space infection presenting with Herpes Simplex virus, as it is rarely seen.

English

Adenoid cystic carcinoma of the paranasal sinuses is not a very common condition. It tends to arise from the maxillary antrum and can infiltrate into the surrounding tissue. They demonstrate perineural invasion into the maxillary and mandibular branches of trigeminal nerve.

Ritenzione dentale in una paziente affetta da osteosclerosi idiopatica

Objectives To assess the influence of Idiopathic osteosclerosis (IO) on dental impaction through the analysis of a case report. Methods A patient reported a persistent neuralgic pain for about one year in the region of mandibular branch of trigeminal nerve. Panoramic x-rays and CT revealed a round radiopaque area located between lower left bicuspids. Results Surgical excision of the osteosclerotic lesion and decompression of the inferior alveolar nerve at mental foramen was followed by complete remission of neuralgic symptoms and spontaneous eruption of lower second left premolar. Conclusions IO generally requires a simple follow-up; nevertheless, these lesions require a specific treatment in rare cases when they are in close relationship with dental and/or nervous structures.

Incidence, morphology and morphometry of the foramen of Vesalius: complementary study for a safer planning and execution of the trigeminal rhizotomy technique

The foramen of Vesalius (FV) is located in the greater wing of the sphenoid bone between the foramen ovale (FO) and the foramen rotundum in an intracranial view. The FO allows the passage of the mandibular branch of trigeminal nerve, which is the target of the trigeminal radiofrequency rhizotomy. We analyzed its location, morphology, morphometry and interrelation among other foramina. 400 macerated adult human skulls were examined. A digital microscope (Dino-Lite plus) was used to capture images from the FV. A digital caliper was used to perform the measurements of the distance between the FV and other foramina (FO, foramen spinosum and the carotid canal) in an extracranial view of the skull base. In the 400 analyzed skulls, the FV was identified in 135 skulls (33.75%) and absent on both sides in 265 skulls (66.25%). The FV was observed present bilaterally in 15.5% of the skulls. The incidence of unilateral foramen was 18.25% of the skulls of which 7.75% on right side and 10.5% on left side. The diameter of the FV was measured and we found an average value of 0.65 mm, on right side 0.63 mm and on the left side 0.67 mm. We verified that positive correlations were statistically significant among the three analyzed distances. This study intends to offer specific anatomical data with morphological patterns (macroscopic and mesoscopic) to increase the understanding of the FV features as frequency, incidence and important distances among adjacent foramina.

Comparative Morphology of Trigeminal Ganglion in Some Species of Vertebrates

The reported examinations were carried out on turtles, Japanese quails and chinchillas of either sex. The trigeminal nerve was studied with the modified thiocholine method and routine histological techniques. The trigeminal ganglion of the turtle is a single, compact structure connected with the trigeminal nerve. Analysis of consecutive sections showed a presence of ganglionic neurocytes only at the medial side of the trigeminal nerve. A small number of nerve cells and large number of fibres is characteristic for the investigated structure.The trigeminal ganglion of Japanese quail is a structure connected with two branches (ophthalmic and mandibular) of the trigeminal nerve. Both parts of the ganglion distinctly differ in their morphology. The part connected with the ophthalmic branch – V1 forms a thickening of the nerve, which becomes narrow approaching the orbital cavity. The second part connected with the mandibular branch – V2 is of regular shape. This part of the ganglion is located in the vicinity of a delicate maxillary branch. Histological investigations allow us to observe a characteristic arrangement of neurocytes with only one layer of nerve cells on the surface of the ganglion. The trigeminal ganglion in chinchilla is a single, irregular cluster of neurocytes closely connected with trigeminal nerve where this nerve divides into ophthalmic and maxillary nerves. Agglomerations of neurocytes allow us to distinguish two parts of trigeminal ganglion. From the medial aspect, the nasal part of ganglion is connected with this part of the trigeminal nerve, which is not distinctly divided into ophthalmic and maxillary branches. The caudal part of the trigeminal ganglion is connected with the mandibular branch of trigeminal nerve. These two parts are separated from each other by the motor radix of the trigeminal nerve. From the lateral side all parts of the ganglion form one structure and it is difficult to distinguish precisely different cell aggregations corresponding to the particular branches of trigeminal nerve.