[Treatment of trigeminal neuralgia with microvascular decompression]. / Traitement de la névralgie trigéminale par décompression vasculaire microchirurgicale.

Pure microvascular decompression (MVD) can cure (that is, no pain, no medication) primary trigeminal neuralgia (TN) caused by vascular compression in 75% of patients (90% when compression is pronounced), according to a Kaplan-Meier survival study at 15 years. MRI with high resolution evidences neurovascular conflicts with good reliability. The results were found to be significantly better when the prosthesis implanted to maintain the compressive vessel away was not touching the nerve. This argues in favor of a real decompressive mechanism of the MVD procedure, rather than a conduction block. Because pure MVD generally does not produce hypoesthesia in the painful territory, MVD is the first surgical therapeutic option for patients with neuralgia resistant to anticonvulsive medications.

[Functional anatomy of the trigeminal nerve]. / Anatomie fonctionnelle du nerf trijumeau.

The cranial nerve (CN) V is a mixed nerve that consists primarily of sensory neurons. It exits the brain on the lateral surface of the pons, entering the trigeminal ganglion within a few millimeters. Three major branches emerge from the trigeminal ganglion. The first division (V1, the ophthalmic nerve) exits the cranium through the superior orbital fissure, entering the orbit to innervate the globe and skin in the area above the eye and forehead. The second division (V2, the maxillary nerve) exits through a round hole, the foramen rotundum, into a space posterior to the orbit, the pterygopalatine fossa. It then re-enters a canal running inferior to the orbit, the infraorbital canal, and exits through a small hole, the infraorbital foramen, to innervate the skin below the eye and above the mouth. The third division (V3, the mandibular nerve) exits the cranium through an oval hole, the foramen ovale. The third division also has an additional motor component, which may run in a separate fascial compartment. Most fibers travel directly to their target tissues. Sensory axons innervate skin on the lateral side of the head, the tongue, and the mucosal wall of the oral cavity. Motor fibers innervate the muscles that are attached to the mandible. Some sensory axons enter in the mandible to innervate the teeth and emerge from the mental foramen to innervate the skin of the lower jaw.

Oral mucosa: variations from normalcy, part II.

This is the second article in a 2-part series on the variations of oral mucosa. We describe the following 5 conditions that deviate from normalcy: lateral soft palate fistulas, double lip, fissured tongue, racial gingival pigmentation, and geographic tongue.

Oral mucosa: variations from normalcy, part I.

Many lesions can be identified in the oral mucosa. Some are indicative of pathologic conditions restricted to the oral cavity, whereas others are signs of systemic disorders. A third group of alterations is not severe enough to be considered pathologic; however, knowledge of this group is mandatory for a correct differential diagnosis to be established. This is the first article in a 2-part series concerning all of these pseudopathologic conditions.

Derivación lumbo-peritoneal: análisis de 18 casos y revión bibliográfica / Lumbo-peritoneal derivatons: analysis of 18 cases and bibliographic review

Se analizan 18 casos de pacientes derivados con un sistema lumbo-periotoneal (DLP) entre junio de 1991 y junio del 2000 en nuestro servicio. Siete pacientes presentaron hidrocefalia comunicante (4 post-meningiticas y 3 post-HSA), 4 fistulas de liquido cefalorraquídeo (LCR), 4 pacientes hipertensión endocraneana benigna y 2 hidrocefalía normotensiva. Catorce de los 18 casos (83,3 por ciento) resolvieron su problema con la derivación, mientras que los restantes 4 no lo hicieron y requirieron de otro tipo de sistema o tratamiento. Las complicaciones mas frecuentemente observadas fueron dolor radicular y cefaléa a la sedestación. El sistema debió ser revisado en 5 pacientes. El análisis bibligráfico muestran cifras similares a las halladas en esta serie, respecto a indices de reexploraciones y éxitos terapéuticos. En conclusión, la DLP es un metodo de derivación de LCR en las hidrocefalías comunicantes de cualquier etiología, en fístulas de LCR abiertas o cerradas y en hipertensión endocraneana benigna. Presenta indice bajo de fracasos terapéuticos, pero como contralpartida genera una relativamente alta tasa de disfunsiones y complicaciones leves, que suelen requerir reexploraciones quirúrgicas frecuentes.

Derivación lumbo-peritoneal: análisis de 18 casos y revión bibliográfica / Lumbo-peritoneal derivatons: analysis of 18 cases and bibliographic review

Se analizan 18 casos de pacientes derivados con un sistema lumbo-periotoneal (DLP) entre junio de 1991 y junio del 2000 en nuestro servicio. Siete pacientes presentaron hidrocefalia comunicante (4 post-meningiticas y 3 post-HSA), 4 fistulas de liquido cefalorraquídeo (LCR), 4 pacientes hipertensión endocraneana benigna y 2 hidrocefalía normotensiva. Catorce de los 18 casos (83,3 por ciento) resolvieron su problema con la derivación, mientras que los restantes 4 no lo hicieron y requirieron de otro tipo de sistema o tratamiento. Las complicaciones mas frecuentemente observadas fueron dolor radicular y cefaléa a la sedestación. El sistema debió ser revisado en 5 pacientes. El análisis bibligráfico muestran cifras similares a las halladas en esta serie, respecto a indices de reexploraciones y éxitos terapéuticos. En conclusión, la DLP es un metodo de derivación de LCR en las hidrocefalías comunicantes de cualquier etiología, en fístulas de LCR abiertas o cerradas y en hipertensión endocraneana benigna. Presenta indice bajo de fracasos terapéuticos, pero como contralpartida genera una relativamente alta tasa de disfunsiones y complicaciones leves, que suelen requerir reexploraciones quirúrgicas frecuentes. (AU)

[Laugier-Hunziker syndrome. A clinical and anatomopathologic study. Presentation of 13 cases]. / Syndrome de Laugier-Hunziker. Etude clinique et anatomopathologique. Présentation de treize cas.

We report the clinico-pathologic characteristics of 13 cases of Laugier-Hunziker disease, consisting of the presence of oral melanotic macules associated or not to longitudinal nail pigmentation. The presence of regular acanthosis, basal pigmentation without increase in the number of melanocytes and the presence of melanophages in subepidermal connective tissue have been the most constant histopathological characteristics. The term "essential cutaneo-mucous hyperpigmentation" as synonym of Laugier-Hunziker disease is proposed.

Dark oral lesions: differential diagnosis with oral melanoma.

Oral melanoma is a neoplasm with a poor prognosis; its premature diagnosis is of foremost importance. We review here pathologic situations to be considered in the clinical differential diagnosis: tattoos, melanotic macules, Laugier's disease, melanocytic nevus, drug intake, some vascular lesions, and oral pigmented lesions associated with endocrine disorders or with different syndromes.

[Toxic epidermal necrolysis associated with lymphoproliferative syndromes. Anatomo-clinical study. Presentation of 2 cases]. / Nécrolyse épidermique toxique associée à des syndromes lymphoprolifératifs. Etude anatomo-clinique. Présentation de deux cas.

Two cases of Toxic Epidermal Necrolysis, with a previous history of drugs intake, and associated to a lymphoma and to a chronic lymphoid leukemia, are presented. The oral lesions are described and the clinical and pathological particularities of the cases are commented. The rule of the drugs and of the neoplastic diseases in the aetiology of these cases is discussed. In conclusion, we emphasize the N.E.T. as an entity of stomatological interest.

[Oral herpes virus infection in immunodepressed patients: presentation of 2 cases. Review of the literature]. / Infección oral por herpes virus en pacientes inmunodeprimidos: presentación de 2 casos. Revisión de la literatura.

Two cases of herpetic intraoral infection, in inmunodepressed patients, are presented. We emphasize its diagnosis and therapeutical aspects. A bibliographic review is done.

[Lichen planus of the oral mucosa in the clinical course of chronic active hepatitis. Presentation of two cases]. / Liquen plano de la mucosa oral en el curso clínico de hepatitis crónica activa. Presentación de dos casos.

Two cases of oral lichen planus associated with chronic active hepatitis are presented. One of them it was also associated with achrosclerosis. A review of the literature is done, and it is suggested the possibility that oral lichen planus play a role of diagnostic importance in hepatic pathology.

[Dental caries in 2 families with tuberous sclerosis]. / Puits dentaires dans deux familles avec sclérose tubéreuse.

Four cases of tuberous sclerosis in two families are presented. We studied the oral manifestations of the disease and we suggest that dental pits should be taken as clinical markers for diagnosis in oligosymptomatic cases. We found that feature in all patients affected by tuberous sclerosis.

[Radioprotective effect of ascorbic acid on oral structures in patients with cancer of the head and neck]. / Efecto radioprotector del acido ascorbico sobre estructuras orales en pacientes con cancer de cabeza y cuello.

It is considered the radioprotective effect of ascorbic acid in patients with head and neck cancer. It is observed a reduction of yatrogenic effects over oral structures secondary to radiotherapy. It is recommended the oral administration of ascorbic acid in this type of patients.

[Oral manifestations in tuberous sclerosis. Report of 3 cases]. / Manifestaciones orales en esclerosis tuberosa. Presentación de tres casos.

We present three cases of Tuberous Sclerosis, studying its oral manifestations and suggesting that dental pits are clinical markers of diagnostic interest in the paucisymptomatic forms of the syndrome.

[Detection of human papillomavirus antigens in papillomatous lesions of the palate]. / Detección de antigenos de Papilomavirus humano (HPV) en lesiones papilomatosas del paladar.

The presence of human papillomavirus antigen was studied in palate papillomas and in verruca vulgaris located in the palate using the Peroxidase-Antiperoxidase immunohistochemical methods. The antigens were detected only in the nuclei of cells of the stratum granulosum and stratum corneum in some cases of verruca vulgaris but not in any case of palate papillomas.

Enfermedades profisionales del pulmon: utilidad de la biopsia pulmonar perbronquial en su diagnostico. / Pulmonary occupational diseases:usefulness of the perbronchial pulmonar biopsy in its diagnosis

Las exigencias medicas y legales para sentar el diagnostico de neumonoconiosis son puestas en consideracion, haciendo hincapie en la conveniencia legal y en la necesidad medica de sustentarlo con la certificacion histologica. La biopsia perbronquial con pinza flexible y utilizando material rigido, es un procedimiento sencillo, economico y con pocas complicaciones, que permite la certificacion histologica de afecciones con expresion fundamental a nivel de parenquima pulmonar, como la neumonoconiosis. Se presentan los resultados de la biopsia pulmonar en 25 pacientes sospechosos por sus antecedentes laborales y/o sus cuadros radiologicos de padecer una neumonoconiosis

Enfermedades profisionales del pulmon: utilidad de la biopsia pulmonar perbronquial en su diagnostico. / Pulmonary occupational diseases:usefulness of the perbronchial pulmonar biopsy in its diagnosis

Las exigencias medicas y legales para sentar el diagnostico de neumonoconiosis son puestas en consideracion, haciendo hincapie en la conveniencia legal y en la necesidad medica de sustentarlo con la certificacion histologica. La biopsia perbronquial con pinza flexible y utilizando material rigido, es un procedimiento sencillo, economico y con pocas complicaciones, que permite la certificacion histologica de afecciones con expresion fundamental a nivel de parenquima pulmonar, como la neumonoconiosis. Se presentan los resultados de la biopsia pulmonar en 25 pacientes sospechosos por sus antecedentes laborales y/o sus cuadros radiologicos de padecer una neumonoconiosis