• The Korean Journal of Pain
• /
• v.22 no.3
• /
• pp.241-244
• /
• 2009

Retrobulbar hematoma can arise from orbital trauma and periorbital or intraorbital procedures, and it can result in several morbidities including vision loss. Making the immediate diagnosis and performing decompression of the retrobulbar hematoma are crucial for preventing serious morbidities such as permanent vision loss. We present here a case of temporary vision loss that was due to iatrogenic retrobulbar hematoma in a patient who received infraorbital nerve block for the treatment of trigeminal neuralgia. A 70-year-old woman with trigeminal neuralgia was treated with infraorbital nerve block. Just after the procedure she experienced acute periorbital swelling, proptosis and worsening visual acuity. Immediate orbital computed tomography was done, and this revealed a retrobulbar hematoma. The patient underwent lateral canthotomy with cantholysis and administration of dexamethasone and mannitol. Improvement of visual acuity began 3 hours after these procedures. Her visual acuity was greatly improved 12 days after admission.

• Journal of Oral Medicine and Pain
• /
• v.37 no.4
• /
• pp.243-250
• /
• 2012

Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.3
• /
• pp.278-280
• /
• 2014

A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications.

• Journal of Oral Medicine and Pain
• /
• v.44 no.3
• /
• pp.123-126
• /
• 2019

Vestibular schwannoma, also known as acoustic neuroma, is a rare benign brainstem tumor surrounding the vestibular division of the 8th cranial nerve. The presenting symptoms are hearing loss, tinnitus, and dizziness. Unabated growth can compress 5th (trigeminal nerve) and 7th (facial nerve) cranial nerve, which can cause nerve dysfunction such as orofacial pain, sensory abnormalities, or trigeminal neuralgia. We report a 51-year-old woman who presented with orofacial dysesthesia on her left side of the face with abnormal findings on 5th cranial nerve and 8th (vestibulocochlear nerve) cranial nerve examination. Brain magnetic resonance imaging scan revealed cerebellopontine angle tumor. She was referred to a neurosurgeon and diagnosed with vestibular schwannoma.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.9
• /
• pp.1228-1232
• /
• 2000

Objective : This study was undertaken to analysis gamma knife radiosurgery(GKR) effect for trigeminal neuralgia after long term follow-up. Methods : There were 11 trigeminal neuralgia patients. The authors irradiated 67-85 Gy maximally to the nerve root entry zone(NREZ) using single 4mm collimator, just 1-6mm lateral side from the junction of the trigeminal nerve and pons. For the first 3 cases, we targeted the junction between the nerve and the pons. In theses cases, the pons was irradiated 56 or 60 gray in the surface. In the later 8 cases, the isocenter is positioned more distal side so that the brain stem surface would receive less than the 20% isodose. Results : The average follow-up duration was 25 months(13-50 months). Pain relief was noticed within a week to 5 months. In 3 patients, pain was relieved completely and in other 3 patients, mark improvement was achieved(80-90%). Remaining 4 patients showed significant improvement(30-50%). There was recurrence in only one case and she complained with similar intensity of pain at the last follow-up. There was no significant complication related to GKR. Conclusion : GKR is considered effective for trigeminal neuralgia based on the long term follow-up evaluation, but more clinical experience is needed to evaluate the efficacy of GKR for trigeminal neuralgia as a primary treatment modality.

• Korean Journal of Veterinary Research
• /
• v.34 no.3
• /
• pp.583-591
• /
• 1994

This study was carried out to investigate the pathogenesis of canine herpesvirus(CHV) infection in dogs. The 17 puppies, one day old, delivered from CHV seronegative 3 dams were divided into two groups. The 13 puppies were inoculated intranasally with 1ml of CHV-KK inoculum($5{\times}10^{5.6}TCID_{50}/ml$) and 4 puppies were served as control. And then the puppies were sacrificed at 2, 4, 6 and 7 days after the treatment, and sampled nasal mucosa, trigeminal nerve, trigeminal ganglion, bone marrow, eye, brain and other major organs for the immunohistochemical examination. Distribution of CHV antigens was limited in cytoplasms and nuclei of necrotic nasal epthelia at 2 days after infection. At 4 days after infection, CHV antigens were detected in vascular walls and peripheral nerves of nasal lamina propria, reticuloendothelial cells of spleen, interstitium of kidney, leptomeningeal vascular walls and alveolar walls, At 6 and 7 days after infection, CHV antigens were detected in all of the necrotic area. CHV antigens were also detected in vascular endothelial cells of various organs and in blood leukocytes from 4 days after infection. Among the six puppies in which necrotic lesions of central nervous system were observed, CHV antigens were detected in trigeminal ganglion, trigeminal nerve and ventroposteriomedial nucleus of four puppies and in spinal trigeminal nucleus of three puppies. These results indicate that the generalized focal necrosis of all organs including brain and eyes in canine herpesvirus infection were resulted from generalized vasculitis with leukocyte-associated viremia, and also the hemonecrotizing meningoencephalitis was resulted from spreading of CHV via blood and nerve trunk.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.218-221
• /
• 2005

This report describes a case of dizziness in a patient with trigeminal neuralgia that was caused by a vestibular schwannoma. A 60-year-old man with a history of pain on his left cheek, chin, molar and tongue for 5 months was diagnosed as suffering with trigeminal neuralgia of the left mandibular nerve, and this was caused by a left vestibular schwannoma. The diagnosis of the tumor was confirmed with magnetic resonance imaging (MRI), and so gamma knife surgery was performed 1 month later. At that time, the patient had been referred to the pain clinic due to allodynia on the tongue and gingival, and hypesthesia was also present on the left half of the face. Trigeminal nerve block with dehydrogenated alcohol and stellate ganglion block with 1% mepivacaine were performed and oral medication with diphenylhydantoin was started. The symptoms were alleviated after nerve block and oral medication. Dizziness, blurred vision and ataxia then developed from the 13th hospital day. We considered the symptoms as a side effect of diphenylhydantoin and we reduced the dose of diphenylhydantoin. However, the symptoms grew worse. Another brain MRI showed a slight increase of the tumor size and a mass effect with displacement of the adjacent organs, and hydrocephalus was also noted. This case shows the importance of considering the secondary symptoms that are due to brain tumor while treating trigeminal neuralgia. The changes of the brain tumors should also be considered along with the presence of new side effects.

• The korean journal of orthodontics
• /
• v.49 no.5
• /
• pp.326-337
• /
• 2019

Objective: The objective of this study was to develop new parameters based on the foramina of the trigeminal nerve and to compare them with the conventional cephalometric parameters in different facial skeletal types. Methods: Cone-beam computed tomography (CBCT) scans and cephalograms from 147 adult patients (57 males and 90 females; mean age, 26.1 years) were categorized as Class I ($1^{\circ}$ < ANB < $3^{\circ}$), Class II (ANB > $5^{\circ}$), and Class III (ANB < $-1^{\circ}$). Seven foramina in the craniofacial area-foramen rotundum (Rot), foramen ovale (Ov), infraorbital foramen, greater palatine foramen, incisive foramen (IF), mandibular foramen (MDF), and mental foramen (MTF)-were identified in the CBCT images. Various linear, angular, and ratio parameters were compared between the groups by using the foramina, and the relationship between the new parameters and the conventional cephalometric parameters was assessed. Results: The distances between the foramina in the cranial base did not differ among the three groups. However, the Rot-IF length was shorter in female Class III patients, while the Ov-MTF length, MDF-MTF length, and Ov-MDF length were shorter in Class II patients than in Class III patients of both sexes. The MDF-MTF/FH plane angle was larger in Class II patients than in Class III patients of both sexes. Most parameters showed moderate to high correlations, but the Ov-MDF-MTF angle showed a relatively low correlation with the gonial angle. Conclusions: The foramina of the trigeminal nerve can be used to supplement assessments based on the conventional skeletal landmarks on CBCT images.

• Archives of Craniofacial Surgery
• /
• v.19 no.3
• /
• pp.231-234
• /
• 2018

A schwannoma is a benign tumor that develops from Schwann cells. It is known to occur more frequently in women than men, and about one third of schwannoma cases occur in the head and neck area. It is also known to originate mainly in the auditory nerve. However, it is rarely associated with the trigeminal nerve, and especially, schwannomas related to the infraorbital nerve are very rare. we report a rare case of a schwannoma involving the infraorbital branch of the trigeminal nerve in a 45-year old male adult. The patient underwent physical examination and magnetic resonance imaging. The mass was approached through subciliary approach that is familiar to the plastic surgeon and completely resected. Histopathological findings showed pointed to a benign schwannoma. Infraorbital nerve schwannoma is difficult to distinguish from other diseases by means of clinical symptoms, physical findings, or imaging. In spite of its rarity, infraorbital nerve schwannoma may be considered a possible diagnosis in the case of mass on cheek. Assessment by computed tomography or magnetic resonance imaging is necessary for proper diagnosis. About the surgical approach, excision through the subciliary approach should be considered rather than the direct transfacial approach in view of stability, cosmetic effects, and familiarity.

• The Journal of the Korean dental association
• /
• v.10 no.4
• /
• pp.233-236
• /
• 1972

The authors have effectively treated a case of true trigeminal neuralgia involving the 3rd branch of the 5th cranial nerve by mandibular nerve block with alcohol and Dilantin administration, and reached following results. 1. Alcohol injection has a definite value as the primary treatment of trigeminal neuralgia. 2. It is not yet to be clarified whether the effects of alcohol injection and Dilantin therapy reveal synergism. 3. Phenobarital was given as an adjuvant of Dilantin, but its effect on the painful paroxysms is questionable.