The styloid diaphragm divides the ITF into prestyloid and retrostyloid regions and covers the high cervical ICA. Using landmarks for the exocranial portion of the lower cranial nerves is useful it identifying them and avoiding injury during approaches to the high cervical ICA, the upper cervical spine, and the ITF.
Animal models simulating acute human pulpitis are still lacking. The rat incisors present a particular situation where most of their innervation is considered to be unmyelinated and concentrated mainly in the tooth pulp. This study reports on a new model for dental pain induced by inflammatory agents applied to the tooth pulps of incisors. In different groups of rats, artificial crowns were fixed on the lower incisors, after cutting 1-2mm of their distal extremities. A volume of 7-10 microl of solutions of saline, capsaicin (1-10mg/ml) or formalin (2.5% or 5%) was injected in the crown cavity, and the nociceptive behaviour was quantitated following a devised scoring method of four scales. Intradental application of capsaicin produced nociceptive scores in the form of one plateau for 1-2h depending on the concentration used. Similar results were obtained with intradental application of formalin 2.5%. The one plateau of nociceptive scores obtained with formalin contrasts with the biphasic aspect of nociceptive behaviour described with the intradermal formalin test. This discrepancy could be attributed to a difference in the types of afferent fibres involved in each situation. Pretreatment with morphine (2 mg/kg) attenuated, in a naloxone-reversible manner, the nociceptive behaviour observed following intradental application of capsaicin. Pretreatment with meloxicam (a cyclo-oxygenase-2 inhibitor) exerted a less pronounced attenuation of the nociceptive scores when compared with morphine. These results provide evidence for the validity of the described model for the simulation of tooth pulp inflammatory pain in awake animals.
Pilonidal sinus disease is a common medical condition that accounts for almost 15% of anal suppurations with high morbidity. Its management is subject to many variations. In this study, a 25-year experience from 1984 to 2009 of treating pilonidal sinus disease is being reported. A total of 252 patients were included in the study. They were treated by phenol injection, excision and primary closure, or excision and packing. Data showed that excision with packing had the highest cure rate (85%), followed by excision and primary closure (65%), and then phenol (55%). As for the healing duration, the shortest was for excision and primary closure, followed by the phenol injection. However, excision and packing had the least recurrence rate (12%), compared to phenol and excision with primary closure 26.5% and 23%, respectively. The authors recommended excision and packing. However, hospital stay, missed days of work, recurrence rates, and the surgeon's familiarity with the techniques were important factors in the choice of treatment modality.
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