Ovarian blood vessel occlusion as a surgical sterilization method in rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A new surgical technique to treat corneal perforations using amniotic membrane and surgical adhesive

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Endoscopic approach for a laryngeal neoplasm in a dog

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients

The authors investigate the complications of transnasal transsphenoidal endoscopic surgery in the treatment of 301 patients with pituitary adenomas. A retrospective analysis of complications in 301 patients submitted to transsphenoidal transnasal endoscopic surgery at the General Hospital of Fortaleza, Brazil between January 1998 and December 2009. The complications were divided in two groups: anatomical (oronasofacial, sphenoid sinus, intrasellar, suprasellar and parasellar) and endocrinological complications (anterior and posterior pituitary dysfunctions). We observed a total of 81 complications (26.9%) in our series. Anatomical complications occurred in 8.97% (27 cases): 8 CSF postoperative leaks (2.6%), 6 cases (1.9%) of delayed nasal bleeding, 5 cases (1.6%) of sphenoidal sinusitis, 3 cases (0.9%) of carotid artery lesion, 2 cases of meningitis (0.6%) and one case (0.3%) of each of the uncommon following complications: intrasella-suprasella hematoma, pontine hematoma and chiasmaplexy. Endocrinological complications occurred in 17.9% (54 cases): additional postoperative anterior lobe insufficiency in 35 cases (11.6%), and postoperative diabetes insipidus in 19 cases (6.3%). In our series, 3 cases of deaths (not directly related to the procedure) were also observed. Endoscopic transsphenoidal surgery represents an effective option for the treatment of patients with pituitary tumor. Complications still occur and must be reduced as much as possible. Successful endoscopic pituitary surgery requires extensive training in the use of an endoscope and careful planning of the surgery. Additional improvement can be expected with greater experience and new technical developments.

Can cone-beam computed tomography superimposition help orthodontists better understand relapse in surgical patients?

This case report describes the interdisciplinary treatment of a 19-year-old Brazilian man with a Class I malocclusion, a hyperdivergent profile, an anterior open bite, and signs of temporomandibular joint internal derangement. The treatment plan included evaluation with a temporomandibular joint specialist and a rheumatologist, orthodontic appliances, and maxillomandibular surgical advancement with counterclockwise rotation. Cone-beam computed tomography images were taken before and after surgery at different times and superimposed at the cranial base to assess the changes after orthognathic surgery and to monitor quantitatively the internal derangement of the temporomandibular joints and surgical relapse. Our protocol can improve the orthodontist's understanding of surgical instability, demonstrate the clinical value of cone-beam computed tomography analysis beyond the multiplanar reconstruction, and guide patient management for the best outcome possible.

Electroencephalographic Responses to a Noxious Surgical Stimulus in Mules, Horses, and Ponies

The aim of this study was to investigate the electroencephalographic (EEG) response of equidae to a castration stimulus. Study 1 included 11 mules (2 1/2-8 years; 230-315 kg) and 11 horses (1 1/2-3 1/2 years; 315-480 kg); study 2 included four ponies (15-17 months; 176-229 kg). They were castrated under halothane anesthesia after acepromazine premedication (IV [study 1] and intramuscular [study 2]) and thiopental anesthetic induction. Animals were castrated using a semiclosed technique (study 1) and a closed technique (study 2). Raw EEG data were analyzed and the EEG variables, median frequency (F50), total power (Ptot), and spectral edge frequency (F95), were derived using standard techniques at skin incision (skin) and emasculation (emasc) time points. Baseline values of F50, Ptot, and F95 for each animal were used to calculate percentage change from baseline at skin incision and emasculation. Differences were observed in Ptot and F50 data between hemispheres in horses but not mules (study 1) and in one pony (study 2). A response to castration (>10% change relative to baseline) was observed in eight horses (73% of animals) and four mules (36% of animals) for F50 and nine horses (82%) and four mules (36%) for Ptot. No changes in F95 data were observed in any animal in study 1. Responses to castration were observed in three ponies (75% of animals) for F50, one pony (25%) for F95, and all ponies for Ptot Alteration of acepromazine administration and castration technique produced a protocol that identified changes in EEG frequency and power in response to castration. (c) 2014 Elsevier Inc. All rights reserved.

Balanced anesthesia with sevoflurane does not alter redox status in patients undergoing surgical procedures

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

PREDICTABLE INTERPROXIMAL TISSUE REMOVAL WITH A SURGICAL STENT

The correction of diastemas in the anterior region with composite resin is considered to be practical and conservative. Harmony between the restorative material and the periodontium is necessary to achieve satisfactory functional and esthetic results. Whenever excessive gingiva occurs in the interproximal region, removal is necessary to avoid excessively contoured restorations. A predictable technique is described to conservatively remove interproximal tissue in situations in which crown lengthening is required to treat bilateral diastemas. A surgical template based on the diagnostically waxed cast was produced to serve as a reference during periodontal surgery.

Central Giant Cell Granuloma in Pediatric Maxilla: Surgical Management

Central giant cell granuloma (CGCG) is an intraosseous lesion consisting of fibrous cellular tissue that contains multiple foci of hemorrhage, multinucleated giant cells, and occasional trabeculae of woven bone. An 8-year-old boy presented himself complaining of a painless swelling in the left maxilla that had started 1 year. Computed tomography (CT) scan confirmed a poorly defined multilocular radiolucent lesion in the left maxilla crossing the midline. The patient underwent enucleation through an intraoral approach of the lesion. The biopsy revealed multinucleated giant cells in a fibrous stroma. A CT was taken approximately 1 year postoperatively. There was no clinical or radiographic evidence of recurrence. Therefore, surgical treatment of CGCG can be performed, trying to preserve the surrounding anatomic structures, which can be maintained in case the lesion does not show an aggressive clinical behavior, avoiding large surgical defects which are undesirable in children.

Probabilistic ictal EEG sources and temporal lobe epilepsy surgical outcome

Objective - For patients with medication refractory medial temporal lobe epilepsy (MTLE), surgery offers the hope of a cure. However, up to 30% of patients with MTLE continue to experience disabling seizures after surgery. The reasons why some patients do not achieve seizure freedom are poorly understood. A promising theory suggests that epileptogenic networks are broadly distributed in surgically refractory MTLE, involving regions beyond the medial temporal lobe. In this retrospective study, we aimed to investigate the distribution of epileptogenic networks in MTLE using Bayesian distributed EEG source analysis from preoperative ictal onset recordings. This analysis has the advantage of generating maps of source probability, which can be subjected to voxel-based statistical analyses.Methods - We compared 10 patients who achieved post-surgical seizure freedom with 10 patients who continued experiencing seizures after surgery. Voxel-based Wilcoxon tests were employed with correction for multiple comparisons.Results - We observed that ictal EEG source intensities were significantly more likely to occur in lateral temporal and posterior medial temporal regions in patients with continued seizures post-surgery.Conclusions - Our findings support the theory of broader spatial distribution of epileptogenic networks at seizure onset in patients with surgically refractory MTLE.

Alternative approach to the management of postoperative pain after pediatric surgical procedures

This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. Background: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. Case description: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. Conclusion: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. Clinical significance: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children.

Innovation in pediatric surgery: the use of ultrasonic CVD tips: case report

The non-eruption of teeth due to highly keratinized gingival mucosa is a frequent event in the pediatric dentistry, which harms the oral aesthetics and function. A surgical excision of the involved area is indicated, exposing the non-erupted tooth. This procedure involves anesthesia and cutting instruments that may increase the fear and anxiety in young patients. The use of new technologies has avoided these instruments and has promoted more comfort to the patients. This study presents clinical cases in which gingivectomy was performed using the innovative method with an ultrasound-activated CVD tip. It was concluded that this method presented effectiveness, promoted more comfort, and less fear to the patients, making its use a viable alternative to pediatric surgery.

Intraoral approach for treatment of displaced condylar fractures: case report

Dislocated subcondylar fractures often require open reduction and internal fixation. This treatment modality results in better anatomy, early function, and facilitated physical therapy. Ideal stable fixation is obtained by use of two miniplates to control the tension zone in the sigmoid notch area and stabilize the posterior border region or, if there is not enough space, one stronger plate. That is most frequently achieved through extraoral approaches. Recently new instruments have facilitated the use of an intraoral approach, which is used usually with the aid of an endoscope. However, it is possible to perform the procedure without the endoscope if proper instruments and clinical mirrors for checking the posterior border reduction and fixation are used. A case of reduction and fixation of a medially dislocated condylar fracture is presented and discussed.

A utilização do enxerto ósseo autógeno para tratamento de lesão de furca grau II

Destruction of bone and periodontal ligament as a result of periodontal disease can lead to anatomical defects in the furcation area. Treatment of these lesions is a major challenge to the clinician. Periodontal instruments have limited access to this area and plaque and calculus removal from root surfaces are extremely difficult. For proper treatment planning a number of factors must be taken into consideration to achieve immediate and long term success. Surgical therapy associated with bone grafts may be a viable option in the treatment of class II furcation defects, aiming to restore lost tissues. The aim of this paper is to report a clinical case where a simplified surgical approach with the use of autogenous graft was used to treat a class II furcation defect Twelve months after the surgery, an increase in clinical attachment level and pocket depth reduction resulted in a complete closure of the furcation lesion.