scholarly journals Infraorbital Foramen and Pterygopalatine Fossa Location in Dry Skulls: Anatomical Guidelines for Local Anesthesia

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Omar Masabni ◽  
Maha Ahmad

Purpose. The aim of the study was to locate the infraorbital foramen (IOF) in relation to the infraorbital margin (IOM) for proper injections of local anesthetics in skull specimens. Another aim was to determine the depth of needle penetration into pterygopalatine fossa through the greater palatine canal (GPC). Materials and Methods. 102 skull halves were used to measure the distances between (1) IOF and IOM and (2) IOF and alveolar ridge of maxilla at second premolar. Needles were inserted and bent at a 45° angle, passing through the GPC at the level of hard palate. The depth of the tip of needle emerging out of GPC into pterygopalatine fossa was measured. Results. The mean distance between IOF and IOM was 6.46±1.57 mm on the right side and 6.74±1.72 mm on the left. The mean distance between IOF and alveolar bone process of the maxilla at second premolar was 29.07±3.58 mm on the right side and 29.39±3.78 mm on the left. The mean depth of penetration of the needle into the pterygopalatine fossa was similar on both sides. Conclusions. Proper identification of IOF and pterygopalatine fossa is of great significance during local anesthesia injections, due to their close proximity to vital anatomic structures.

2018 ◽  
Vol 17 (4) ◽  
pp. 562-566
Author(s):  
Siddharth Tewari ◽  
Chandni Gupta ◽  
Vikram Palimar ◽  
Sneha Guruprasad Kathur

Objective- The infraorbital foramen is located on the maxillary bone 1 cm under the infraorbital margin. Infra orbital nerve blocks are done in children for managing the postoperative pain which can occur after cleft lip operation and endoscopic sinus operation. Infraorbital nerve can also be damaged in cases of zygomatic complex fractures which are one of the most common facial injuries. So, this study was undertaken to analyze the anatomical variations by comparing various morphometric measurements of infraorbital foramen in dry skulls of adult South Indian population.Materials and methods- 60 dry skulls of unknown sex were used for the study. Various measurements and distance from various surgical landmarks were measured to evaluate the location of infraorbital foramen on both sides. Statistical Analysis was done for the above measurements mean and standard deviation, median, range, and mode were calculated.Results: The mean distance of infraorbital foramen from piriform aperture, lower end of alveolus of maxilla and infraorbital margin was 18.39, 27.88 and 7.09mm on the right and 17.89, 27.31 and 6.95mm on the left side. The mean vertical and horizontal diameter was 3.78 and 3.50mm on the right side and 3.48 and 3.35mm on the left side. In our study, the most common site of IOF in Indian skulls was found to be in line with the second premolar tooth (59.01%), followed by its position between the first and second premolar tooth (27.87%).Conclusion- These results will be helpful for surgeons while doing maxillofacial surgery and regional block anesthesia.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.562-566


2015 ◽  
Vol 30 (1) ◽  
pp. 24-28
Author(s):  
Neil Louis L. Apale ◽  
Joel A. Romualdez ◽  
Rodolfo E. Rivera ◽  
Joseph Benjamin M. Lu

Objective: As a guide to the clinical practice of infiltration of local anesthesia into the pterygopalatine fossa via the greater palatine canal, this study sought to determine and record the mean CT scan measurements of the following: 1) palatal mucosal thickness, 2) length and width of greater palatine canal, and 3) length and width of pterygopalatine fossa, among adult patients in a private tertiary hospital in Quezon City. Method: Study Design:            Retrospective, Descriptive Study Setting:                       Tertiary Private Hospital Participants:              Paranasal Sinus (PNS) CT Scans of 113 adult patients from January 2014 to May 2014 were reviewed and evaluated. Excluded were images with pathology that distorted the anatomy of the sinuses and surrounding structures. Results: Our study showed average CT scan measurements of 5.98 mm palatal mucosal thickness, 16.99 mm greater palatine canal length, 18.75 mm pterygopalatine fossa length, 2.37 mm greater palatine canal width, and 2.58 mm pterygopalatine fossa width. Comparison of average measurements by sex was not statistically significant. There was statistical significance when comparing the right palatal mucosal thickness of 5.86 mm with the left which was 6.11 mm, with p-value of 0.001. Comparison between the length of the right pterygopalatine fossa of 18.48 mm with the  left side at 19.01 mm, showed statistical significance with p-value of 0.01. Conclusion: As the average measurement of the mucosal palatal thickness combined with the length of the greater palatine canal was 22.97 mm, we recommend bending the needle 23 mm from the tip in a 45 degree angle, for adult patients who will undergo sinus surgery, control of posterior epistaxis, trigeminal nerve block, and minor oral cavity surgeries. Keywords: pterygopalatine fossa infiltration, greater palatine canal, greater palatine foramen, regional anesthesia blocks


2016 ◽  
Vol 6 ◽  
pp. 35 ◽  
Author(s):  
Georges Aoun ◽  
Ibrahim Nasseh ◽  
Sayde Sokhn

Aim: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF), in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 79 Lebanese adult patients (38 females and 41 males) were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically. Results: In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively. Conclusion: Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides); however, the GPC-PPF length does not significantly vary according to gender and side.


2001 ◽  
Vol 40 (04) ◽  
pp. 107-110 ◽  
Author(s):  
B. Roßmüller ◽  
S. Alalp ◽  
S. Fischer ◽  
S. Dresel ◽  
K. Hahn ◽  
...  

SummaryFor assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimer-captosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256,300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Ctsdors x Ctsventr]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PFgeom and the PFdors was 1.5 ± 1.4%. A difference > 5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PFdors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differntial renal function in orthotopic kidneys, so that in these cases the anterior view is not necesssary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality.


2017 ◽  
Vol 30 (1) ◽  
pp. 71-93
Author(s):  
Gustav Muller

In this article an attempt is made to put forward a convincing case for giving substantive content to the right of access to adequate housing and looks towards relevant international law elaborations on the meaning of this right as contained in the International Convention on Economic, Social and Cultural Rights (ICESCR). It does so while being aware of the Constitutional Court’s prior rejection of an international law-based minimum core interpretation of the right and opting, instead, for the so-called model of reasonableness breview. Given that the court has so expressly taken and stuck to this stance, it is argued in the article that an international law-based substantive interpretation of the right is possible – given that South Africa has recently ratified the ICESCR – and that it is preferable given the shortfalls of the model of reasonableness review. The article further highlights what difference the preferred reading of section 26(1) would make as to how courts ‘interpret’ reasonableness, that is, how courts review compliance with section 26 at present if ‘adequate’ housing is understood as having security of tenure and access to basic municipal services; is affordable, habitable and accessible; is located in close proximity to social facilities; and is culturally adequate.


2019 ◽  
Vol 8 ◽  
pp. 1218
Author(s):  
Ebrahim Khalil BaniHabib ◽  
Ali Mostafai ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ghadir Mohammdi

Background: Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma. Materials and Methods: In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group was received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group was received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared at before the intervention (t1), one month (t2), and two months (t3) after the intervention. Results: The mean decrease in intraocular pressure for the right eye at three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The patients in the intervention group expressed more satisfaction than the patients in the placebo group (P≤0.001). Conclusion: Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming of timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.[GMJ.2019;In press:e1218]


1989 ◽  
Vol 257 (3) ◽  
pp. C528-C536 ◽  
Author(s):  
B. D. Uhal ◽  
S. R. Rannels ◽  
D. E. Rannels

Type II pneumocytes were isolated by either Percoll density gradient centrifugation or by immunoglobulin G (IgG) panning from the lungs of normal rats and the right lung of rats subjected to left pneumonectomy. Cells were studied at 7- (pnx-7) and 15- (pnx-15) days postoperative, times during and after, respectively, rapid compensatory growth of the right lung. Acridine orange staining permitted resolution of type II cells from contaminants on the basis of high red fluorescence (greater than 590 nm). Simultaneous measurement of forward-angle light scatter (FALS) suggested a shift of pnx-7 cells toward greater size, which was reversed in pnx-15 cells. By Percoll gradient isolation, approximately 15% of pnx-7 cells analyzed were above the mean FALS of control cells. In contrast, approximately 30% of the pnx-7 cells isolated by IgG panning were above the mean FALS of corresponding control cells. Biochemical analyses of pnx-7 cells separated by cell sorting into "high FALS" and "low FALS" subgroups revealed that high FALS type II cells contained 50% more protein (P less than 0.05) and 140% more RNA (P less than 0.01) than low FALS cells, with no significant change in cellular DNA content. These data are consistent with previous studies of type II cells isolated from the lungs of pneumonectomized animals and confirm the presence of hypertrophic cells in these preparations. They provide a foundation from which to design further flow cytometric studies of the role of hypertrophic type II pneumocytes in compensatory lung growth.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Velarie Ansu ◽  
Stephanie Dickinson ◽  
Alyce Fly

Abstract Objectives To determine which digit and hand have the highest and lowest skin carotenoid scores, to compare inter-and-intra-hand variability of digits, and to determine if results are consistent with another subject. Methods Two subjects’ first(F1), second(F2), third(F3) and fifth(F5) digits on both hands were measured for skin carotenoids with a Veggie Meter, for 3 times on each of 18 days over a 37-day period. Data were subjected to ANOVA in a factorial treatment design to determine main effects for hand (2 levels), digits (4), and days (18) along with interactions. Differences between digits were determined by Tukey's post hoc test. Results There were significant hand x digit, hand x day, digit x day, and hand x digit x day interactions and significant simple main effects for hand, digit, and day (all P < 0.001). Mean square errors were 143.67 and 195.62 for subject A and B, respectively, which were smaller than mean squares for all main effects and interactions. The mean scores ± SD for F1, F2, F3, and F5 digits for the right vs left hands for subject A were F1:357.13 ± 45.97 vs 363.74 ± 46.94, F2:403.17 ± 44.77 vs. 353.20 ± 44.13, F3:406.76 ± 43.10 vs. 357.11 ± 45.13, and F5:374.95 ± 53.00 vs. 377.90 ± 47.38. For subject B, the mean scores ± SD for digits for the right vs left hands were F1:294.72 ± 61.63 vs 280.71 ± 52.48, F2:285.85 ± 66.92 vs 252.67 ± 67.56, F3:268.56 ± 57.03 vs 283.22 ± 45.87, and F5:288.18 ± 34.46 vs 307.54 ± 40.04. The digits on the right hand of both subjects had higher carotenoid scores than those on the left hands, even though subjects had different dominant hands. Subject A had higher skin carotenoid scores on the F3 and F2 digits for the right hand and F5 on the left hand. Subject B had higher skin carotenoid scores on F5 (right) and F1 (left) digits. Conclusions The variability due to hand, digit, and day were all greater than that of the 3 replicates within the digit-day for both volunteers. This indicates that data were not completely random across the readings when remeasuring the same finger. Different fingers displayed higher carotenoid scores for each volunteer. There is a need to conduct a larger study with more subjects and a range of skin tones to determine whether the reliability of measurements among digits of both hands is similar across the population. Funding Sources Indiana University.


Author(s):  
Mehrdad Rafiepourgatabi ◽  
Alistair Woodward ◽  
Jennifer A. Salmond ◽  
Kim Natasha Dirks

Children walking to school are at a high risk of exposure to air pollution compared with other modes because of the time they spend in close proximity to traffic during their commute. The aim of this study is to investigate the effect of a walker’s route choice on their exposure to ultrafine particles (UFP) on the walk to school. During morning commutes over a period of three weeks, exposure to UFP was measured along three routes: two routes were alongside both sides of a busy arterial road with significantly higher levels of traffic on one side compared to the other, and the third route passed through quiet streets (the background route). The results indicate that the mean exposure for the pedestrian walking along the background route was half the exposure experienced on the other two routes. Walkers on the trafficked side were exposed to elevated concentrations (>100,000 pt/cc) 2.5 times longer than the low-trafficked side. However, the duration of the elevated exposure for the background route was close to zero. Public health officials and urban planners may use the results of this study to promote healthier walking routes to schools, especially those planned as part of organized commutes.


Author(s):  
Dhaval Gohil ◽  
Nasser Mohammed ◽  
Anita Mahadevan ◽  
Nupur Pruthi

Abstract Objective To compare the histopathology of patent and nonpatent microvascular anastomosis using rat femoral artery end-to-end anastomosis model. Materials and Methods In 15 Sprague–Dawley rats, end-to-end anastomosis was performed on the right femoral artery. The classical method was used in four cases and one-way up method in 11 cases. The animals were sacrificed after 2 weeks and the anastomosis was subjected to histopathology. The pathological changes in patent and nonpatent cases were compared. Results The immediate patency rate and delayed patency (after 2 weeks) rate was 86.7% and 66.7%, respectively. The mean follow-up was 3 months. At sacrifice, 5/15 anastomosis were not patent. Marked subintimal thickening was noted in ⅘ (80%) of the nonpatent group, which was absent in the patent group. Severe loss or fibrosis of tunica media and marked adventitial inflammation were noted in all nonpatent cases (5/5, 100%). As much as ⅘ of the nonpatent cases had poor or indeterminate apposition; in contrast, good apposition was seen in 6/10 (60%) of the patent group. The mean clamp time and mean suturing time were significantly longer in the nonpatent group (69.2 minutes and 53.8 minutes, respectively) as compared with the patent group (48.8 minutes and 31.8 minutes, respectively). A single case that was initially nonpatent was found to have recanalized at 6 months. Conclusion Minimal intimal injury and reaction, minimal thinning of tunica media, mild-to-moderate adventitial changes, good apposition, and equidistant sutures were associated with a successful microvascular anastomosis. Short duration of vessel clamping time and suturing comes with experience and dedicated practice in a skills laboratory.


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