Facial Reanimation Utilizing Combined Orthodromic Temporalis Muscle Flap and End-to-Side Cross-Face Nerve Grafts

Individuals with facial paralysis of 6 months or more without evidence of clinical or electromyographic improvement have been successfully reanimated utilizing an orthodromic temporalis transfer in conjunction with end-to-side cross-face nerve grafts. The temporalis muscle insertion is released from the coronoid process of the mandible and sutured to a fascia lata graft that is secured distally to the commissure and paralyzed hemilip. The orthodromic transfer of the temporalis muscle overcomes the concave temporal deformity and zygomatic fullness produced by the turning down of the central third of the muscle (Gillies procedure) while yielding stronger muscle contraction and a more symmetric smile. The muscle flap is combined with cross-face sural nerve grafts utilizing end-to-side neurorrhaphies to import myelinated motor fibers to the paralyzed muscles of facial expression in the midface and perioral region. Cross-face nerve grafting provides the potential for true spontaneous facial motion. We feel that the synergy created by the combination of techniques can perhaps produce a more symmetrical and synchronized smile than either procedure in isolation.Nineteen patients underwent an orthodromic temporalis muscle flap in conjunction with cross-face (buccal-buccal with end-to-side neurorrhaphy) nerve grafts. To evaluate the symmetry of the smile, we measured the length of the two hemilips (normal and affected) using the CorelDRAW X3 software. Measurements were obtained in the pre- and postoperative period and compared for symmetry.There was significant improvement in smile symmetry in 89.5 % of patients.Orthodromic temporalis muscle transfer in conjunction with cross face nerve grafts creates a synergistic effect frequently producing an aesthetic, symmetric smile.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.spinger.com/00266.

THE RETINAL TARGETS OF CENTRIFUGAL NEURONS AND THE RETINAL NEURONS PROJECTING TO THE ACCESSORY OPTIC-SYSTEM

In birds, neurons of the isthmo-optic nucleus (ION), as well as ''ectopic'' neurons, send axons to the retina, where they synapse on cells in the inner nuclear layer (INL). Previous work has shown that centrifugal axons can be divided into two anatomically distinct types depending on their mode of termination: either ''convergent'' or ''divergent'' (Ramon y Cajal, 1889; Maturana and Frenk, 1965). We show that cytochrome-oxidase histochemistry specifically labels ''convergent'' centrifugal axons and target neurons which appear to be amacrine cells, as well as three ''types'' of ganglion cells: two types found in the INL (displaced ganglion cells) and one in the ganglion cell layer. Labeled target amacrine cells have distinct darkly labeled ''nests'' of boutons enveloping the somas, are associated with labeled centrifugal fibers, and are confined to central retina. Lesions of the isthmo-optic tract abolish the cytochrome-oxidase labeling in the centrifugal axons and in the target amacrine cells but not in the ganglion cells. Cytochromeoxidase-labeled ganglion cells in the INL are large; one type is oval and similar to the classical displaced ganglion cells of Dogiel, which have been reported to receive centrifugal input; the other type is rounder. Rhodamine beads injected into the accessory optic system results in retrograde label in both types of cells, showing that two distinct types of displaced ganglion cells project to the accessory optic system in chickens. The ganglion cells in the ganglion cell layer that label for cytochrome oxidase also project to the accessory optic system. These have proximal dendrites that ramify in the outer inner plexiform layer. Neither the target amacrine cells nor either of the displaced ganglion cells are immunoreactive for the inhibitory transmitter gamma aminobutyric acid. At least some of the target amacrine cells may, however, be cholinoceptive: we found that the antibody to the alpha-7 subunit of the nicotinic ACh receptor labels a population of cells in the INL that are similar in location, size, and the presence of labeled bouton-like structures to those we find labeled with cytochrome oxidase. This antibody also labels neurons in the ION proper but not ectopic cells. In conclusion, it appears that cytochrome oxidase may be a marker for ''convergent'' centrifugal axons and at least one of their target cells in the INL.

Origin and function of short-latency inputs to the neural substrates underlying the acoustic startle reflex

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

Long-Term Spinal Ventral Root Reimplantation, but not Bone Marrow Mononuclear Cell Treatment, Positively Influences Ultrastructural Synapse Recovery and Motor Axonal Regrowth

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

Contribution of magnetic resonance in acute spinal cord trauma - case report

Acute spinal cord trauma is a common injury that occurs frequently in small animals. In order to acertain a prognosis of the lesion generated in the spinal cord, it is necessary to perform a complete neurological and physical examination, aided by complementary images. Magnetic resonance imaging may be advantageous over other types of images, because it can determine with greater definition the structural damage to the nervous tissue. The objective of this report was to demonstrate the contribution of magnetic resonance imaging in a case of acute spinal cord trauma in a dog.

Avaliação da funcionalidade de atletas de basquete sobre rodas com lesão medular na perspectiva da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF)

Introduction: Spinal cord injury occurs due to interuption in nerve stimuli and could caused from traumatic and non-traumatic illnes. After spinal cord, there are problems in personal life activities affecting ou modifying personal life and provoking impacts in his own life. International Classification of Functioning, Disability and Healthy (ICF) consider and analyse more than the illness ou injury and include informations about functionality in differents domains as activities, participation and enviroment. Objective: The aim of this study is to evaluate functionality wheelchair athlets with spinal cord injury using ICF. Metodology: For this research, it was evaluated 60 athlets with spinal cord injury who were practicing wheelchair basqketball, using the Checklist corresponding to the main ICF categories and othes Identity Protocol with personal datas, lesion time, lesion level and functional classification from bwheelchair basketball. Results: In analyses, we identify in quartis data, that in Body Fucntion, median was 56,67% from all athlets with light and moderate qualifications; In Body Strutucture, the median was 60% for light qualifications; in Activities and Participation, this median corresponded to 91% and in Enviroment Factors, 51,67% feel that this enviroment was facilitator... (Complete abstract click electronic access below)

Espondilomielopatia cervical caudal em cães: diagnóstico por imagem

The Caudal Cervical Spondylomyelopathy, also known as “Wobbler syndrome” is a neurological disorder that affects mainly breeds of large and giant size, especially Doberman pinsher and Great danes. Its aetiology is multifactorial and leads to a narrowing of the spinal canal by morphological and positional caudal cervical vertebrae (C5, C6 and C7), causing compression of the spinal cord and nerve roots. The clinical signs presented by the affected animals are progressive ataxia of hindlimbs and, later, the forelimbs, sometimes progressing to tetraparesis. Neck pain may be present. The diagnosis is made through the association of clinical signs and diagnostic imaging such as radiography, myelography, computed tomography and magnetic resonance imaging. According to the classification of the lesion obtained by imaging examinations, the conservative or surgical treatment is established and the prognosis is variable in accordance with the degree of affection of the spinal cord

Structure, histochemistry and seasonal variations of the male reproductive accessory glands in the Pallas

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

Comparative analysis of the male reproductive accessory glands of bat species from the five Brazilian subfamilies of the family Phyllostomidae (Chiroptera)

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

Efeitos da administração subaracnoidea em punção única, de cetamina S(+) a 5%, sem conservantes, sobre a medula espinal e as meninges de coelhos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)