ABSTRACT
Operation on the carotid arteries (CA) prevent strokes in patients with occlusions and stenoses of these arteries. We have worked out the measures for preventing perioperative strokes. During interventions on the CA, iatrogenic injuries to the cranial nerves (CN) are paid little attention. 1186 patients underwent 1362 operations. There were 26 lethal outcomes and 38 strokes. 146 (0.7%) cases of CN injuries were documented. Of these, there were 2 (0.1%) injuries to the accessory nerve, 14 (1%) to the glossopharyngeal nerve, 28 (2%) to the hypoglossal nerve, 46 (3.4%) injuries to vagal nerve branches, and 56 (4.2%) to facial nerve branches. In 42 patients, neuropathies acquired the 'permanent' character. We describe the symptomatology of injuries to different CN pairs consequent on carotid operations and the algorithm of their diagnosis. CN injuries deteriorate the results of operations and decrease quality of life of the patients. Early diagnosis and correction of the sequelae of iatrogenic injuries to the CN is a reserve for the refinement of the results of operations on the CA.
Subject(s)
Carotid Artery Diseases/surgery , Cranial Nerve Injuries/etiology , Iatrogenic Disease , Intraoperative Complications , Accessory Nerve Injuries , Adult , Aged , Aged, 80 and over , Algorithms , Blinking , Cranial Nerve Injuries/diagnosis , Facial Nerve Injuries , Female , Glossopharyngeal Nerve Injuries , Humans , Hypoglossal Nerve Injuries , Male , Middle Aged , Vagus Nerve InjuriesABSTRACT
Physiotherapy including laser exposure was used in the treatment of 243 patients aged 13-34 years with abnormal occlusion. The results indicate that laser exposure effectively relieved pain after fixation and activation of permanent orthodontic devices, treated gingivitis before and during orthodontic treatment, prevented exacerbations of periodontitis, and accelerated eruption of retained teeth.
Subject(s)
Laser Therapy , Malocclusion/rehabilitation , Orthodontic Appliances , Physical Therapy Modalities/instrumentation , Adolescent , Adult , Combined Modality Therapy , Evaluation Studies as Topic , Female , Humans , Male , Malocclusion/complications , Malocclusion/therapy , Physical Therapy Modalities/methods , Time Factors , Toothache/etiology , Toothache/rehabilitationABSTRACT
The efficacy of emergency surgical interventions on the carotid and vertebral arteries in patients with acute disorders of cerebral circulation is discussed. An organizational structure of rendering aid is suggested, which unites emergency ambulance service, neurology, and vascular surgery in one therapeutic institution. A clinical classification of the severity of acute cerebral ischemia and the optimal terms for operations were elaborated. In a group of 21 patients who underwent emergency operations 14 showed excellent and good clinical results.
