Ocular complications after posterior superior alveolar nerve block: a case of trochlear nerve palsy.

Many intraoperative complications occurring during third molar surgery are described in the literature. Unilateral trochlear nerve palsy secondary to dental anaesthesia is a rare complication. We report the case of a 36-year-old healthy man, ASA I classification, requiring upper third molar extraction. Articaine 1:200,000 epinephrine for right posterior superior alveolar (PSA) nerve block was administered locally in the mucobuccal fold above the upper third molar. A few minutes after PSA nerve block the patient experienced double-vision. The patient was subsequently visited by an ophthalmologist and the condition was diagnosed as transient unilateral vertical diplopia due to temporary paralysis of the superior oblique muscle as a result of the anaesthetic solution involving the IV cranial nerve. The authors report this unusual case and discuss the possible anatomical pathways that might explain this rare phenomenon.

[Determination of plasma fibronectin (Fn) levels. Comparison between normal subjects and patients with various pathological conditions]. / Determinazione dei livelli di fibronettina (Fn) plasmatica. Confronto tra soggetti normali e pazienti con vari tipi di patologia.

Fibronectin is a glycoprotein secreted by connective tissue cells into their environment and into the blood. Plasma fibronectin in circulation exhibits some important interactions with other proteins in several diseases. We have detected plasma fibronectin levels in 187 normal subjects and in 126 patients. The mean value of this glycoprotein was strongly influenced by age but not by sex. 99 cancer patients showed lightly lower fibronectin levels than in normal controls. On the contrary, 25 chronic hepatic failure patients had higher values than normal controls. The mean level of plasma fibronectin in 20 hemodialyzed patients and in 7 plasmocytoma patients did not offer from what we detected in normal controls.