RESUMO
Four groups were studied to look at effects of synthetic materials on the pial vasculature. Using Sprague-Dawley rats, an open pial window approach was used in which there was a control group, a hydroxyapatite cement group mixed with sodium phosphate, a methylmethacrylate slow-set, and a methylmethacrylate fast-set group. There were 10 animals with 20 vessels studied within each group. The permeability leakage outside the vessel was evaluated to determine the vascular albumin leakage, and the number of rolling and adherent leukocytes was studied within each group. It was seen that the control group was significantly different compared with the fast-set methylmethacrylate group during a 2-hour period in regard to the percentage leakage, as well as a number of rolling and adherent leukocytes. This is one of the first studies to demonstrate the effects of synthetic craniofacial materials on the underlying pial vasculature.
Assuntos
Materiais Biocompatíveis/farmacologia , Substitutos Ósseos/farmacologia , Circulação Cerebrovascular/efeitos dos fármacos , Animais , Permeabilidade Capilar/efeitos dos fármacos , Adesão Celular/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Craniotomia , Durapatita/farmacologia , Extravasamento de Materiais Terapêuticos e Diagnósticos/fisiopatologia , Feminino , Fluoresceína-5-Isotiocianato , Corantes Fluorescentes , Leucócitos/efeitos dos fármacos , Metilmetacrilato/farmacologia , Microcirculação/efeitos dos fármacos , Microscopia de Fluorescência , Modelos Animais , Fosfatos/farmacologia , Pia-Máter/irrigação sanguínea , Ratos , Ratos Sprague-Dawley , Albumina Sérica/efeitos dos fármacosRESUMO
OBJECT: The goal of this paper is to present a critical review of the endoscopic procedures currently in use for the treatment of carpal tunnel syndrome. Endoscopic techniques and outcomes are discussed. METHODS: An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. In many studies in which open and endoscopic techniques were compared, it was reported that patients in the the latter group experienced significantly less pain and returned to work and activities of daily living earlier. CONCLUSIONS: Success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures.
Assuntos
Síndrome do Túnel Carpal/cirurgia , Endoscopia , Absenteísmo , Atividades Cotidianas , Emprego , Endoscopia/efeitos adversos , Endoscopia/métodos , Traumatismos da Mão/etiologia , Humanos , Complicações Intraoperatórias , Ligamentos Articulares/cirurgia , Nervo Mediano/lesões , Nervo Mediano/fisiopatologia , Dor Pós-Operatória/prevenção & controle , Parestesia/etiologia , Distrofia Simpática Reflexa/etiologia , Traumatismos dos Tendões/etiologia , Fatores de Tempo , Falha de Tratamento , Resultado do Tratamento , Nervo Ulnar/lesões , Nervo Ulnar/fisiopatologia , Indenização aos TrabalhadoresRESUMO
An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. All studies in which open and endoscopic techniques were compared reported that patients in the latter group experienced significantly less pain and returned to work and activities of daily living earlier. The reported success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures. Endoscopic techniques and outcomes are discussed.
