Tranexamic Acid in Patients Undergoing Rhinoplasty: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Rhinoplasty is one of the most popular aesthetic plastic surgeries worldwide. The effects of tranexamic acid (TXA) in patients undergoing rhinoplasty are still being studied to guide a better management. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) analyzing the effects of TXA in patients undergoing rhinoplasty. The outcomes evaluated were blood loss, postoperative edema, postoperative ecchymosis, surgery duration and surgeon satisfaction. RESULTS: Eleven studies comprising 841 patients were included. Overall, TXA reduced total blood loss regardless of dose and administration route (MD = - 39.37 mL; 95% CI = - 62.70 to - 16.05 mL; p = 0.0009; I2 = 92%), using intravenous 10 mg/kg of TXA preoperatively (MD = - 16.30 mL; 95% CI = - 29.49 to - 2.57 mL; p = 0.02; I2 = 61%) and using 1 g of oral TXA preoperatively (MD = - 61.70 mL; 95% CI = - 83.02 to - 40.39 mL; p < 0.00001; I2 = 0%). TXA also decreased edema (MD = - 0.78; 95% CI = - 1.28 to - 0.27 points; p = 0.003; I2 = 80%) and ecchymosis (MD = - 1.13; 95% CI = - 1.99 to -0.28; p = 0.01; I2 = 93%) on postoperative day one (POD 1). Surgeon satisfaction was increased (SMD = 1.55; 95% CI = 0.33 to 2.77; p = 0.01; I2 = 95%). However, there was no difference in surgery duration (SMD = - 0.26; 95% CI = - 0.56 to 0.04; p = 0.09; I2 = 36%). CONCLUSION: This study found a significant reduction in blood loss, periorbital edema and periorbital ecchymosis, along with an improvement in surgeon satisfaction. These results hold the potential to optimize the rhinoplasty management by plastic surgeons. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Endoscopic transsphenoidal endonasal surgery in pituitary adenomas / Cirugía endoscópica vía endonasal transesfenoidal en adenomas de hipófisis

The pituitary adenomas comprise the largest part of pituitary neoplasms, representing between 9 and 12% of primary brain tumors. Currently, the treatment of election is the surgical, the trans-sphenoidal endonasal path has provided a broader panoramic view, being feasible more delicate and safe procedures. The objective of this study was to describe the management of pituitary adenomas by endoscopic surgery trans-sphenoidal endonasal path. This is a study in a series of cases, with a sample of 17 patients who met the selection criteria and were attended at the José Carrasco Hospital Arteaga, Cuenca - Ecuador, period 2018 - 2019. All patients presented informed consent for the performance of the surgery and the subsequent dissemination of the results. The 53% of the population belonged to the male gender, 47% were patients between 40 and 60 years old, 65% were detected with macroadenomas, and 29% presented complications such as nasal obstruction, sphenoiditis and headache, the residual tumor stage was due 24%.Endoscopic surgery trans-sphenoidal endonasal path is a safe, minimally invasive tool, a surgical alternative with a high rate of tumor excision, better control and fewer complications, which reduces the morbidity of patients.

Los adenomas de hipófisis comprenden la mayor parte de neoplasias hipofisiarias, representando entre el 9 y 12% de los tumores cerebrales primarios. En la actualidad el tratamiento de elección es el quirúrgico, la vía endonasal transesfenoidal ha proporcionado una visión panorámica más amplia, siendo factibles procedimientos más delicados y seguros. El objetivo de este estudio fue describir el abordaje de adenomas de hipófisis mediante cirugía endoscópica vía endonasal transesfenoidal. Diseñamos un estudio de corte longitudinal, con una muestra de 17 pacientes que cumplieron con los criterios de selección y fueron atendidos en el Hospital José Carrasco Arteaga de la ciudad de Cuenca - Ecuador, periodo 2018 - 2019. Todos los pacientes presentaron consentimiento informado para la realización de la cirugía y la posterior difusión de los resultados. El 53% de la población pertenecieron al sexo masculino, 47% fueron pacientes entre 40 y 60 años, al 65% se le detectó macroadenomas, el 29% presentaron complicaciones como obstrucción nasal, esfenoiditis y cefalea, la tasa de tumor residual fue del 24%. La cirugía endoscópica vía endonasal transesfenoidal es una herramienta segura, mínimamente invasiva, una alternativa quirúrgica con una elevada tasa de exéresis tumoral, mejor control y menos complicaciones, que reduce la morbilidad de los pacientes.

Metal-Support Interactions and C1 Chemistry: Transforming Pt-CeO2 into a Highly Active and Stable Catalyst for the Conversion of Carbon Dioxide and Methane.

There is an ongoing search for materials which can accomplish the activation of two dangerous greenhouse gases like carbon dioxide and methane. In the area of C1 chemistry, the reaction between CO2 and CH4 to produce syngas (CO/H2), known as methane dry reforming (MDR), is attracting a lot of interest due to its green nature. On Pt(111), high temperatures must be used to activate the reactants, leading to a substantial deposition of carbon which makes this metal surface useless for the MDR process. In this study, we show that strong metal-support interactions present in Pt/CeO2(111) and Pt/CeO2 powders lead to systems which can bind CO2 and CH4 well at room temperature and are excellent and stable catalysts for the MDR process at moderate temperature (500 °C). The behavior of these systems was studied using a combination of in situ/operando methods (AP-XPS, XRD, and XAFS) which pointed to an active Pt-CeO2-x interface. In this interface, the oxide is far from being a passive spectator. It modifies the chemical properties of Pt, facilitating improved methane dissociation, and is directly involved in the adsorption and dissociation of CO2 making the MDR catalytic cycle possible. A comparison of the benefits gained by the use of an effective metal-oxide interface and those obtained by plain bimetallic bonding indicates that the former is much more important when optimizing the C1 chemistry associated with CO2 and CH4 conversion. The presence of elements with a different chemical nature at the metal-oxide interface opens the possibility for truly cooperative interactions in the activation of C-O and C-H bonds.

The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study.

(1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02/2019 and 12/2020. Demographic characteristics and outcomes were analysed, focusing on infections. (3) Results: Forty out of 65 patients (61.54%) suffered HAIs (surgical site infection: 52.18%, nosocomial pneumonia: 23.20%, bloodstream infection: 13% and urinary tract infection: 5.80%). Methicillin-resistant Staphylococcus aureus (MRSA) and resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were the most frequently implicated. The significant risk factors for infection were: previous radiotherapy (Odds ratio (OR): 5.42; 95% confidence interval (CI), 1.39-21.10), anaemia (OR: 8.00; 95% CI, 0.96-66.95), salvage surgery (eight out of eight patients), tracheostomy (OR: 2.86; 95% CI, 1.01-8.14), surgery duration (OR: 1.01; 95% CI, 1.00-1.02), microvascular reoperation <72 h (eight/eight) and flap loss (eight/eight). The major surgical complications were: a need to reoperate (OR: 6.89; 95% CI, 1.42-33.51), prolonged hospital admission (OR: 1.16; 95% CI, 1.06-1.27) and delay in the initiation of postoperative radiotherapy (OR: 9.07; 95% CI, 1.72-47.67). The sixth month mortality rate in patients with HAIs was 7.69% vs. 0% in patients without HAIs (p = 0.50). (4) Conclusions: HAIs were common after this type of surgery, many of them caused by resistant microorganisms. Some modifiable risk factors were identified. Infections played a role in cancer prognosis by delaying adjuvant therapy.

Breaking Simple Scaling Relations through Metal-Oxide Interactions: Understanding Room-Temperature Activation of Methane on M/CeO2 (M = Pt, Ni, or Co) Interfaces.

The clean activation of methane at low temperatures remains an eminent challenge and a field of competitive research. In particular, on late transition metal surfaces such as Pt(111) or Ni(111), higher temperatures are necessary to activate the hydrocarbon molecule, but a massive deposition of carbon makes the metal surface useless for catalytic activity. However, on very low-loaded M/CeO2 (M = Pt, Ni, or Co) surfaces, the dissociation of methane occurs at room temperature, which is unexpected considering simple linear scaling relationships. This intriguing phenomenon has been studied using a combination of experimental techniques (ambient-pressure X-ray photoelectron spectroscopy, time-resolved X-ray diffraction, and X-ray absorption spectroscopy) and density functional theory-based calculations. The experimental and theoretical studies show that the size and morphology of the supported nanoparticles together with strong metal-support interactions are behind the deviations from the scaling relations. These findings point toward a possible strategy for circumventing scaling relations, producing active and stable catalysts that can be employed for methane activation and conversion.

Supported Molybdenum Carbide Nanoparticles as Hot Hydrogen Reservoirs for Catalytic Applications.

Transition metal carbides have been long proposed as replacements for expensive Pt-group transition metals as heterogeneous catalysts for hydrogenation reactions, featuring similar or superior activities and selectivities. Combining experimental observations and theoretical calculations, we show that the hydrogenating capabilities of molybdenum carbide can be further improved by nanostructuring, as seen on MoCy nanoclusters anchored on an inert Au(111) support, revealing a more prominent role of Mo active sites in the easier H2 adsorption, dissociation, H adatom diffusion, and elongated chemisorbed H2 Kubas moieties formation when compared to the bulk δ-MoC(001) surface, thus explaining the observed stronger H2 interaction and the larger formation of CHx species, making these systems ideal to catalyze hydrogenation reactions.

Boosting the activity of transition metal carbides towards methane activation by nanostructuring.

The interaction of methane with pristine surfaces of bulk MoC and Mo2C is known to be weak. In contrast, a series of X-ray photoelectron spectroscopy (XPS) experiments, combined with thermal desorption mass spectroscopy (TDS), for MoCy (y = 0.5-1.3) nanoparticles supported on Au(111)-which is completely inert towards CH4-show that these systems adsorb and dissociate CH4 at room temperature and low CH4 partial pressure. This industrially-relevant finding has been further investigated with accurate density functional theory (DFT) based calculations on a variety of MoCy supported model systems. The DFT calculations reveal that the MoCy/Au(111) systems can feature low C-H bond scission energy barriers, smaller than the CH4 adsorption energy. Our theoretical results for bulk surfaces of Mo2C and MoC show that a simple Brønsted-Evans-Polanyi (BEP) relationship holds for C-H bond scission on these systems. However, this is not the case for methane activation on the MoCy nanoparticles as a consequence of their unique electronic and chemical properties. The discovery that supported molybdenum carbide nanoparticles are able to activate methane at room temperature paves the road towards the design of a new family of active carbide catalysts for methane activation and valorisation, with important implications in climate change mitigation and carbon cycle closure.

Room Temperature Methane Capture and Activation by Ni Clusters Supported on TiC(001): Effects of Metal-Carbide Interactions on the Cleavage of the C-H Bond.

Methane is an extremely stable molecule, a major component of natural gas, and also one of the most potent greenhouse gases contributing to global warming. Consequently, the capture and activation of methane is a challenging and intensively studied topic. A major research goal is to find systems that can activate methane, even at low temperatures. Here, combining ultrahigh vacuum catalytic experiments, X-ray photoemission spectra, and accurate density functional theory (DFT) based calculations, we show that small Ni clusters dispersed on the (001) surface of TiC are able to capture and dissociate methane at room temperature. Our DFT calculations reveal that two-dimensional Ni clusters are responsible for this chemical transformation, confirming that the lability of the supported clusters appears to be a critical aspect in the strong adsorption of methane. A small energy barrier of 0.18 eV is predicted for CH4 dissociation into adsorbed methyl and atomic hydrogen species. In addition, the calculated reaction free energy profile at 300 K and 1 atm of CH4 shows no effective energy barriers in the system. Comparison with other reported systems which activate methane at room temperature, including oxide and zeolite-based materials, indicates that a different chemistry takes place on our metal/carbide system. The discovery of a carbide-based surface able to activate methane at low temperatures paves the road for the design of new types of catalysts which can efficiently convert this hydrocarbon into other added-value chemicals, with implications in climate change mitigation.

Direct Conversion of Methane to Methanol on Ni-Ceria Surfaces: Metal-Support Interactions and Water-Enabled Catalytic Conversion by Site Blocking.

The transformation of methane into methanol or higher alcohols at moderate temperature and pressure conditions is of great environmental interest and remains a challenge despite many efforts. Extended surfaces of metallic nickel are inactive for a direct CH4 → CH3OH conversion. This experimental and computational study provides clear evidence that low Ni loadings on a CeO2(111) support can perform a direct catalytic cycle for the generation of methanol at low temperature using oxygen and water as reactants, with a higher selectivity than ever reported for ceria-based catalysts. On the basis of ambient pressure X-ray photoemission spectroscopy and density functional theory calculations, we demonstrate that water plays a crucial role in blocking catalyst sites where methyl species could fully decompose, an essential factor for diminishing the production of CO and CO2, and in generating sites on which methoxy species and ultimately methanol can form. In addition to water-site blocking, one needs the effects of metal-support interactions to bind and activate methane and water. These findings should be considered when designing metal/oxide catalysts for converting methane to value-added chemicals and fuels.

In†Situ Investigation of Methane Dry Reforming on Metal/Ceria(111) Surfaces: Metal-Support Interactions and C-H Bond Activation at Low Temperature.

Studies with a series of metal/ceria(111) (metal=Co, Ni, Cu; ceria=CeO2 ) surfaces indicate that metal-oxide interactions can play a very important role for the activation of methane and its reforming with CO2 at relatively low temperatures (600-700 K). Among the systems examined, Co/CeO2 (111) exhibits the best performance and Cu/CeO2 (111) has negligible activity. Experiments using ambient pressure X-ray photoelectron spectroscopy indicate that methane dissociates on Co/CeO2 (111) at temperatures as low as 300 K-generating CHx and COx species on the catalyst surface. The results of density functional calculations show a reduction in the methane activation barrier from 1.07 eV on Co(0001) to 0.87 eV on Co2+ /CeO2 (111), and to only 0.05 eV on Co0 /CeO2-x (111). At 700 K, under methane dry reforming conditions, CO2 dissociates on the oxide surface and a catalytic cycle is established without coke deposition. A significant part of the CHx formed on the Co0 /CeO2-x (111) catalyst recombines to yield ethane or ethylene.

Corneal transparency after cross-linking for keratoconus: 1-year follow-up.

PURPOSE: To evaluate the changes in corneal transparency and thickness measured objectively using Pentacam Scheimpflug (Oculus Optikgeräte GmbH) corneal tomography (densitometry) after corneal cross-linking (CXL). METHODS: Twenty-two eyes from 15 patients with keratoconus underwent CXL. Corneal thickness and curvature as well as lens and corneal densitometry were measured at baseline and 1, 3, 6, and 12 months after CXL with Pentacam. RESULTS: Immediately after CXL, central corneal thickness significantly decreased (-40 µm) and corneal densitometry increased significantly. At 6-month follow-up, densitometry values were reduced and seemed to stabilize at a higher value than baseline. No statistically significant differences were noted (mean difference at 12 months: +30%). Changes in corneal densitometry were detected with the Pentacam even when clinical haze did not increase beyond grade 1 during follow-up. CONCLUSIONS: Corneal CXL is associated with a transient reduction in central corneal thickness, which recovered to baseline after 12 months. During the same time period, corneal densitometry experienced a transient increase that recovered to baseline values after 3 months. Changes in compactness of the corneal tissue after CXL may have an impact in corneal power not due to curvature changes, but to refractive index changes as a result of hydration changes. Pentacam is a useful objective method to monitor corneal transparency after CXL.

[Optimization of creatinine measurement for laboratory estimation of glomerular filtration rate]. / Optimización de la creatinina al estimar la tasa de filtración glomerular en el laboratorio.

OBJECTIVE: to analyze the optimization of serum creatinine in the laboratory reports of the estimation of glomerular filtration rate (GFR) in groups of patients who were overweight, obese, hypertensive, or had participated in SOHDI diabetes self-help groups. We also looked at how much the patients had learned about their disease, stress control, diet and exercise, as all the problems have increased risk of kidney disease. METHODS: The serum creatinine results in the Family Medicine Unit No. 34, IMSS, at Jalisco, was analyzed in a transverse study, from January to December of 2008. GFR was estimated with the Cockcroft-Gault formulary. Statistical analysis with multivariate logistic regression analyses was performed. RESULTS: the sample was 8331 patients: 23.5 % with GFR < 60 mL/min/1.73 m(2), and 9.1 % with serum creatinine > 1.5 mg/dL. Associated factors were age < 19 years, woman age 19 to 59 years, and SOHDI. CONCLUSIONS: the study suggested that participating in SOHDI groups, and being women are protective factors for dimunution of GFR. The people < 19 years had lesser GFR.

Visual quality after monovision correction by laser in situ keratomileusis in presbyopic patients.

PURPOSE: To evaluate visual quality after laser in situ keratomileusis (LASIK) performed to achieve monovision in presbyopic patients. SETTING: Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, Granada, and Clínica Novovisión, Madrid, Spain. DESIGN: Cohort study. METHODS: Laser in situ keratomileusis was performed with the Allegretto Wave Eye-Q 400 Hz laser. The dominant eye was corrected for far vision and the nondominant eye for near vision by targeting -1.25 diopters of myopia. The F-CAT algorithm was programmed targeting a postsurgical corneal asphericity of -0.80 in the dominant eye and -1.00 in the nondominant eye. Visual acuity, contrast sensitivity function, ocular aberrations, stereoacuity, the scattering index, and the visual-discrimination capacity were analyzed preoperatively and 3 months postoperatively. RESULTS: The study enrolled 25 patients (50 eyes) with a mean age of 49.3 years ± 4.5 (SD). Postoperatively, more than 90% of patients had a binocular uncorrected distance and near visual acuity of 0.0 logMAR or better, although the contrast sensitivity function diminished, especially in the nondominant eye and with binocular vision. Stereoacuity was significantly worse in all patients (P<.001). The visual discrimination capacity declined in nondominant eyes and under binocular conditions (P<.005); no significant changes occurred in dominant eyes (P=.614). In all eyes, the mean objective scatter index value increased postoperatively, but not significantly (P>.05). CONCLUSIONS: Monovision correction by LASIK improved functional near vision in presbyopic patients. Although visual acuity was good for far vision, contrast sensitivity and stereoacuity diminished significantly.

Keratoconus-integrated characterization considering anterior corneal aberrations, internal astigmatism, and corneal biomechanics.

PURPOSE: To evaluate the clinical features of keratoconus taking into consideration anterior corneal aberrations, internal astigmatism, and corneal biomechanical properties and to define a new grading system based on visual limitation. SETTING: Vissum Corporation, Alicante, Spain. DESIGN: Retrospective case series. METHODS: This multicenter study comprised consecutive keratoconic eyes with no previous ocular surgery or active ocular disease. Visual, refractive, corneal topography, and pachymetry outcomes were analyzed. Internal astigmatism was calculated by vectorial analysis. Corneal aberrations and corneal biomechanics characterized by the Ocular Response Analyzer were evaluated in some eyes. Correlations between clinical data and a linear multiple regression analysis for characterizing the relationship between visual limitation and objective clinical data were performed. RESULTS: This study comprised 776 eyes of 507 patients (age range 11 to 79 years) The mean keratometry (K) correlated significantly with logMAR corrected distance visual acuity (CDVA) (r = 0.591, P<.01), internal astigmatism (r = 0.497, P<.01), corneal asphericity (r = -0.647, P<.01), and several corneal higher-order aberrometric coefficients (r≥0.603, P<.01). Significant correlations were found between some corneal aberrometric parameters and CDVA (r≥0.444, P<.01). Multiple regression analysis showed that CDVA was significantly correlated with the mean K, intraocular pressure, corneal resistance factor, and spherical equivalent (r(2) = 0.69, P<.01). There were significant differences in mean K, internal astigmatism, and corneal higher-order aberrations between 4 groups differentiated by visual limitation (P<.01). CONCLUSION: The visual limitation in keratoconus could be explained by different alterations that occur in these corneas and allowed development of a new grading system for this condition.

Degrees of tolerance in post-traumatic orbital volume correction: the role of prefabricated mesh.

PURPOSE: To identify factors influencing the volumetric correction of orbital fractures, and evaluate the use of prefabricated titanium mesh in their repair. MATERIALS AND METHODS: We included patients with unilateral orbital fractures and floor or medial-wall defects, subsequently reconstructed with titanium mesh, and subject to adequate follow-up with multislice, digitalized computed tomography (CT) images. Medical records were reviewed, and demographics, operative details, and postoperative course were recorded as prognostic variables. Moreover, orbital volume, apex-to-globe distance, and orbital rim area were measured using postoperative CT. Univariate analysis and a multiple-regression model were used to identify associated factors. RESULTS: A total of 32 patients fulfilled the inclusion criteria. Postoperative clinical evaluation and CT images were obtained in a mean +/- SD of 12.3 +/- 7.2 months after surgery. Clinically, 20 patients were considered normal (63%), and 12 manifested some ocular dystopia (37%). On postoperative CT, the mesh was in good position in 44% of cases, and in an insufficient position in 56% of cases. There was a significant difference between fractured and normal orbits in relation to orbital volume and apex-globe distance. Clinical evaluation significantly correlated with CT mesh placement, but there was no correlation between clinical evaluation and any of the variables measured on CT. The most important factors influencing postoperative orbital volume correction were type of fracture, affected walls, and use of prefabricated mesh. CONCLUSION: Volumetric and lineal symmetry between fractured and normal orbits are very difficult to achieve. In this study, postoperative CT measurements did not correlate with subjective clinical assessment. The clinical-radiological disagreement may be explained by measurement accuracy problems, clinical bias, or normal differences between orbits. The most important identified modifiable factor was the use of prefabricated mesh.

Visual performance after LASIK for a Q-optimized and a standard ablation algorithm.

We test visual performance after LASIK (laser in situ keratomileusis) for a Q-optimized ablation algorithm and one based on the Munnerlyn formula. The visual functions tested include aberrometry, monocular and binocular contrast sensitivity function (CSF), and a discrimination test under low-illumination conditions. This test is useful to quantify night-vision disturbances. A total of 102 patients took part in the experiments, and visual data were taken before (with best correction) and after LASIK. Results show a deterioration in aberrometry, CSF, binocular summation, and discrimination index for the two algorithms tested, although this deterioration is significantly lower for the Q-optimized algorithm.

Effect of LASIK and contact lens corneal refractive therapy on higher order aberrations and contrast sensitivity function.

PURPOSE: Corneal and total higher order eye aberrations and their effects on visual function were compared in two groups subjected to different emmetropization techniques-refractive surgery (LASIK) and corneal refractive therapy (CRT). METHODS: Twenty eyes of 11 patients and 22 eyes of 13 patients were examined in the CRT and LASIK groups, respectively. Mesopic contrast sensitivity function (CSF) was studied monocularly and binocularly in the two groups of patients undergoing CRT and LASIK who had approximately the same mean refractive error. Corneal asphericity and corneal and total aberrations were calculated, and the differences were analyzed between groups. Visual acuity, corneal and total ocular aberrations, corneal asphericity, and mesopic CSF were determined before and 3 months after treatment. RESULTS: In both groups, corneal and total higher order aberrations increased after treatment, and the change in some Zernike coefficients was significant. Mesopic CSF diminished after treatment under monocular as well as binocular conditions, with the greatest decline being found in the CRT group under binocular conditions. Corneal asphericity also increased significantly in both groups, which was more accentuated in the CRT group. CONCLUSIONS: Both emmetropization techniques increased higher order ocular aberrations, implying a decline in the mesopic CSF. The increase in aberrations and the consequent deterioration in visual function was more marked in the CRT group.

Traumatic neuroma of the inferior alveolar nerve: A case report

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Traumatic neuromas are rare entities which characteristically arise subsequently to surgery and are usually accompanied by pain, typically neuralgic. We present an unusual case of an intraosseous traumatic neuroma of the inferior alveolar nerve following tooth extraction. A 56-year-old man consulted for paresthesias and hyperesthesia in the left mandibular region following extraction of the left mandibular third molar (#38). The panoramic radiograph revealed a radiolucent lesion in the inferior alveolar nerve canal, and CT demonstrated the existence of a mass withinthe canal, producing widening of the same. Nerve-sparing excisional biopsy was performed. Histopathology andimmunohistochemistry were consistent with traumatic neuroma of the left inferior alveolar nerve. After 3 years of follow-up, the patient is asymptomatic and there are no signs of recurrence (AU)

Traumatic neuroma of the inferior alveolar nerve: a case report.

Traumatic neuromas are rare entities which characteristically arise subsequently to surgery and are usually accompanied by pain, typically neuralgic. We present an unusual case of an intraosseous traumatic neuroma of the inferior alveolar nerve following tooth extraction. A 56-year-old man consulted for paresthesias and hyperesthesia in the left mandibular region following extraction of the left mandibular third molar (#38). The panoramic radiograph revealed a radiolucent lesion in the inferior alveolar nerve canal, and CT demonstrated the existence of a mass within the canal, producing widening of the same. Nerve-sparing excisional biopsy was performed. Histopathology and immunohistochemistry were consistent with traumatic neuroma of the left inferior alveolar nerve. After 3 years of follow-up, the patient is asymptomatic and there are no signs of recurrence.