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Medial branch

Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
November 2016: Journal of Orthopaedic Trauma
B Verillaud, L Robard, J Michel, V Pruliere Escabasse, E Béquignon, L Crampette, O Malard
OBJECTIVES: The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on second-line treatment of epistaxis in adults, after failure of anterior and/or anterior-posterior nasal packing. METHODS: A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience...
October 17, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Kun Hwang
The aim of this paper was to review the origins and history of deltopectoral flaps and the pectoralis major myocutaneous flap.The first published paper on the deltopectoral flap was written by Aymard in 1917. He described raising a medially based fasciocutaneous flap from the shoulder skin, which was then tubed and used for staged nasal reconstruction. Conley introduced the laterally based deltopectoral flap, which was supplied by the lateral thoracic and thoracocranial branches. Bakamjian used a medially based deltopectoral flap for pharyngoesophageal reconstruction; this was an axial flap based medially on the intercostal perforating vessels of the internal mammary artery...
October 2016: Journal of Craniofacial Surgery
J Willis Kiessling, Dean A Hertzler, David E M Drucker, Heather S Spader
BACKGROUND: This case report illustrates the need to evaluate the possibility of multiple arterial sources when presented with a frontal epidural hematoma associated with facial trauma. CASE DESCRIPTION: Our patient presented after being struck in the face by a baseball. Computed tomography (CT) of the brain revealed a large frontal epidural hematoma. Intraoperatively, bleeding from a frontal branch of the middle meningeal artery was encountered and cauterized, and the hematoma was removed...
October 14, 2016: World Neurosurgery
Nima Toosizadeh, Homayoon Harati, Tzu-Chuan Yen, Cindy Fastje, Jane Mohler, Bijan Najafi, Michael Dohm
BACKGROUND: This study examined short- and long-term improvements in motor performance, quantified using wearable sensors, in response to facet spine injection in degenerative facet osteoarthropathy patients. METHODS: Adults with confirmed degenerative facet osteoarthropathy were recruited and were treated with medial or intermediate branch block injection. Self-report pain, health condition, and disability (Oswestry), as well as objective motor performance measures (gait, balance, and timed-up-and-go) were obtained in five sessions: pre-surgery (baseline), immediately after the injection, one-month, three-month, and 12-month follow-ups...
October 11, 2016: Clinical Biomechanics
Eva Placheta, Ines Tinhofer, Melanie Schmid, Lukas F Reissig, Igor Pona, Wolfgang Weninger, Thomas Rath, David Chwei-Chin Chuang, Chieh-Han John Tzou
INTRODUCTION: Facial reanimation surgery is performed in severe cases of facial palsy to restore facial function. In a 1-stage procedure, the spinal accessory nerve can be used as a donor nerve to power a free gracilis muscle transplant for the reanimation of the mouth. The aim of this study was to describe the surgical anatomy of the spinal accessory nerve, provide a guide for reliable donor nerve dissection, and analyze the available donor axon counts. METHODS: Dissections were performed on 10 nonembalmed cadavers (measurements of 20 nerves)...
October 6, 2016: Annals of Plastic Surgery
Maarten van Eerd, Arno Lataster, Micha Sommer, Jacob Patijn, Maarten van Kleef
The cervical facet joints, also called the zygapophyseal joints, are a potential source of neck pain (cervical facet joint pain). The cervical facet joints are innervated by the cervical medial branches (CMBs) of the cervical segmental nerves. Cervical facet joint pain has been shown to respond to multisegmental radiofrequency denervation of the cervical medial branches. This procedure is performed under fluoroscopic guidance. Currently, three approaches are described and used. Those three techniques of radiofrequency treatment of the CMBs, classified on the base of the needle trajectory toward the anatomical planes, are as follows: the posterolateral technique, the posterior technique, and the lateral technique...
October 13, 2016: Pain Practice: the Official Journal of World Institute of Pain
Long Xie, John B Pluta, Sandhitsu R Das, Laura E M Wisse, Hongzhi Wang, Lauren Mancuso, Dasha Kliot, Brian B Avants, Song-Lin Ding, José V Manjón, David A Wolk, Paul A Yushkevich
RATIONALE: The human perirhinal cortex (PRC) plays critical roles in episodic and semantic memory and visual perception. The PRC consists of Brodmann areas 35 and 36 (BA35, BA36). In Alzheimer's disease (AD), BA35 is the first cortical site affected by neurofibrillary tangle pathology, which is closely linked to neural injury in AD. Large anatomical variability, manifested in the form of different cortical folding and branching patterns, makes it difficult to segment the PRC in MRI scans...
October 1, 2016: NeuroImage
Pankhuri Vyas, Jingjing Sherry Wu, Amanda Zimmerman, Paul Fuchs, Elisabeth Glowatzki
Acoustic information propagates from the ear to the brain via spiral ganglion neurons that innervate hair cells in the cochlea. These afferents include unmyelinated type II fibers that constitute 5 % of the total, the majority being myelinated type I neurons. Lack of specific genetic markers of type II afferents in the cochlea has been a roadblock in studying their functional role. Unexpectedly, type II afferents were visualized by reporter proteins induced by tyrosine hydroxylase (TH)-driven Cre recombinase...
September 30, 2016: Journal of the Association for Research in Otolaryngology: JARO
K J Lee, S H Lee, M B Kim, Y H Lee
PURPOSE: We report the clinical outcome after coverage for soft-tissue defect on the medial foot and ankle with an adipofascial fold-down flap based on the posterior tibial artery perforator branch proximal to the defect. MATERIALS: Nine patients (five males and four females) with soft-tissue defects on the medial foot and ankle area underwent the procedure from March 2009 to May 2014. The average age of the patients was 54 years (range, 8-82). The pivot point of transposition of this flap is the posterior tibial artery perforator proximal to the defect...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Giovanni Salzano, Mario Turri-Zanoni, Apostolos Karligkiotis, Jacopo Zocchi, Giovanni Dell'Aversana Orabona, Luigi Califano, Paolo Battaglia, Paolo Castelnuovo
BACKGROUND: The infraorbital nerve (ION) is a terminal branch of the maxillary nerve (V2) providing sensory innervation to the malar skin. It is sometimes necessary to sacrifice the ION and its branches to obtain adequate maxillary sinus exposure for radical resection of sinonasal tumors. Consequently, patients suffer temporary or permanent paresthesia, hypoestesthia, and neuralgia of the face. We describe an innovative technique used for preservation of the ION while removing the anterior, superior, and lateral walls of the maxillary sinus through a medial endoscopic transnasal maxillectomy...
September 28, 2016: International Forum of Allergy & Rhinology
Sayed E Wahezi, Kyle Silva, Naum Shaparin, Andrew Lederman, Mohammed Emam, Nogah Haramati, Sherry A Downie
BACKGROUND: Headache (HA) is a significant cause of morbidity globally. Despite many available treatment options, HAs that are refractory to conservative management can be challenging to treat. Third occipital nerve (TON) and greater occipital nerve (GON) irritation are potential etiologic agents of primary and cervicogenic HAs that can be targeted using minimally invasive treatment options such as nerve blocks or radiofrequency ablation. However, a substantial number of patients that undergo radiofrequency ablation do not experience pain relief despite a positive diagnostic medial branch block (MBB)...
September 2016: Pain Physician
David Arsanious, Emmanuel Gage, Jonathon Koning, Mazin Sarhan, Gassan Chaiban, Mohammed Almualim, Joseph Atallah
BACKGROUND: One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. OBJECTIVES: The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease...
September 2016: Pain Physician
Natalia Lucia Rukavina Mikusic, María Inés Rosón, Silvana Lorena Della Penna, Susana Gorzalczany, Elsa Zotta, Marcelo Roberto Choi, Jorge Eduardo Toblli, Belisario Enrique Fernandez
BACKGROUND: Endothelial nitric oxide synthase (eNOS) is known to be expressed in endothelium and smooth muscle cells of arteries. The aim of this study was to investigate the expression of eNOS in intimal and medial layer of aorta from rats fed a high salt diet and its modulation by losartan and tempol. METHODS: Rats were fed during three weeks with: normal salt diet (NS, 0.4% NaCl); high salt diet (HS, 8% NaCl); NS plus tempol 1 mM (NS-T); HS plus tempol (HS-T); NS plus losartan 40mg...
September 22, 2016: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
A J Fairburn, E Busschers, A R S Barr
BACKGROUND: Suspensory ligament branch (SLB) desmopathy is a common cause of lameness and an important cause of lost training in the Thoroughbred racing industry. Studies have assessed the significance of insertional injuries of the SLB on the careers of flat racehorses and established the prevalence of subclinical ultrasonographic abnormalities of the SLB in this population but there is little work looking at SLB injury in National Hunt racehorses. OBJECTIVES: To investigate the prevalence of subclinical ultrasonographic abnormalities of the SLB in National Hunt racehorses with no clinical signs or history of SLB injury and establish the cross sectional area (CSA) of the suspensory ligament branches (SLBs) in this population...
September 23, 2016: Equine Veterinary Journal
S Parikh, E Dawe, C Lee, T Whitehead-Clarke, C Smith, S Bendall
Introduction Pseudoaneurysm formation following ankle arthroscopy is a rare but potentially catastrophic complication. The placement of anterior ankle portals carries inherent risk to the superficial and deep peroneal nerves, as well as to the dorsalis pedis artery. Anatomical variations in the dorsalis pedis and the presence of branches at the joint line may increase the risk of vascular injury and pseudoaneurysm formation during arthroscopy. There is limited anatomical evidence available regarding the branches of the dorsalis pedis artery, which occur at the point at which they cross the ankle joint...
September 23, 2016: Annals of the Royal College of Surgeons of England
Ines E Tinhofer, Chieh-Han J Tzou, Dominik Duscher, Michael S Pollhammer, Wolfgang J Weninger, Georg M Huemer, Manfred Schmidt
BACKGROUND: Fasciocutaneous flaps supplied by discrete perforator arteries can be raised in numerous parts of the human body and are routinely used in plastic surgery. The aim of this anatomical investigation was to provide a description of the vascular supply of the medial upper arm, to localize and measure the perforator arteries and to define potential perforator flap dimensions in pendency of individual anatomical conditions. MATERIAL AND METHODS: A total of 20 upper limbs from 11 fresh cadavers were examined...
September 16, 2016: Microsurgery
Yamini Soundara Rajan, Senthil Kumar Sampath Kumar
INTRODUCTION: The Bicipital Groove (BG) is an indentation between the lesser and greater tubercles of the proximal part of the humerus. It conveys biceps tendon, its synovial sheath and ascending branch of anterior circumflex humeral artery. The knowledge of the morphometry is important for the understanding of the functional aspect of the shoulder region. AIM: To study the morphometry of bicipital groove of humerus in south Indian population. MATERIALS AND METHODS: In the present study, 100 adult humeri (50 right and 50 left) were examined...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
P Vaněk, Ondřej Bradáč, P de Lacy, R Konopková, J Lacman, V Beneš
There are numerous indications for stabilization using instrumentation of the upper cervical spine. This area is comprised of sophisticated anatomy. There is no study describing bony and vascular anomalies of this area in the middle European population. The main aim of this study was to investigate prevalence of any vertebral artery (VA) variations and osseous anomalies in the region of the craniocervical junction in a large sample of Czech patients based on three-dimensional computed tomographic angiography (3D CTA)...
September 13, 2016: Neurosurgical Review
Wael Mohamed Mohamed Moussa, Wael Khedr
OBJECTIVES: Percutaneous radiofrequency denervation of the medial dorsal branch is often used in chronic low back pain of intervertebral facet etiology, which is sometimes difficult to perform and recurrence of pain often ensues. We theorized that shifting the target of RF coagulation to the facet joint capsule would provide an easier target and a longer-lived pain relieving response. PATIENTS AND METHODS: A prospective randomized controlled trial where 120 patients diagnosed with CLBP of a confirmed facet origin were randomly divided into three equal groups, the first was submitted to percutaneous radiofrequency coagulation of the facet joint capsule, the second underwent percuataneous denervation of the medial dorsal branch and the third did not receive radiofrequency lesioning...
November 2016: Clinical Neurology and Neurosurgery
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