Cranial surgery

No. Bleeding (and increased intracranial pressure) could be exacerbated with cranial trauma, recent cranial surgery (within 6 months), or subarachnoid hemorrhage. 

Warren DT, Bowen-Roberts T, Ou C, Purdy R, Steinbok P. Safety and efficacy of continuous morphine infusions following pediatric cranial surgery in a surgical ward setting. Childs Nerv Syst 2010 26 1535 1. 

Advances N. A. Lassen and D. H. Ingvar Clinical Relevance of Cerebral Blood Flow Measurements. — G. W. Taylor and J. S. P. Lumley Extra-Cranial Surgery for Cerebrovascular Disease. — J. Retif Intrathecal Injection of a Neurolytic Solution for the Relief of Intractable Pain. 

Neomycin is principally used topically for skin, eye and ear infections and, by some, to reduce the bacterial load in the colon in preparation for bowel surgery, or in hepatic failure. Enough absorption can occur from both oral and topical use to cause eighth cranial nerve damage, especially if there is renal impairment. 

A 73-year-old woman was given a Nadbath Rehman block behind the left pinna to provide motor blockade of cranial nerve VII, before retrobulbar block for cataract surgery. Several minutes later she complained of a metallic taste in her mouth. After surgery she had altered taste sensation on the anterior left side of the tongue, with recovery a day later. 

Because SCLC has the propensity to disseminate early on in the disease, surgery is not usually indicated. SCLC is radiosensitive, and radiotherapy is used in combination with chemotherapy in patients with limited disease. Prophylactic cranial irradiation is used in select patients to reduce the risk of CNS metastases. Combination chemotherapy will prolong the survival of most patients with SCLC. Patients with limited disease are more likely to have a complete response to chemotherapy and longer survival than those who have extensive disease at the time of diagnosis. The most widely used chemotherapy regimens for SCLC include cisplatin or carboplatin plus etoposide. Despite very high response rates to chemotherapy, most patients with SCLC eventually have disease progression and die from this disease. 

Injection of a local anesthetic into or around individual peripheral nerves or nerve plexuses produces even greater areas of anesthesia than do the techniques described above. Blockade of mixed peripheral nerves and nerve plexuses also usually anesthetizes somatic motor nerves, producing skeletal muscle relaxation, which is essential for some surgical procedures. The areas of sensory and motor block usually start several centimeters distal to the site of injection. Brachial plexus blocks are particularly useful for procedures on the upper extremity and shoulder. Intercostal nerve blocks are effective for anesthesia and relaxation of the anterior abdominal wall. Cervical plexus block is appropriate for surgery of the neck. Sciatic and femoral nerve blocks are useful for surgery distal to the knee. Other useful nerve blocks prior to surgical procedures include blocks of individual nerves at the wrist and at the ankle, blocks of individual nerves such as the median or ulnar at the elbow, and blocks of sensory cranial nerves. 

Fig. 1.65a-c. CT in appendicitis. A 13-year-old girl treated with antibiotics for pelvic pain and fever, a US shows a non-specific cystic mass (M) cranial to the uterus (U). No flow was observed on color Doppler study. b,c CT clearly demonstrates the close relationship between the mass (A) and the enlarged appendix (arrow) with an appendicolith (arrowhead). An appendiceal abscess was demonstrated at surgery. B, Bladder A, abscess... 

Albo, D., Long, C., Jhala, N. et al., 1996. Modulation of cranial bone healing with heparin-hke dextran derivatives. Journal of Craniofacial Surgery 7 19-22. 

Dupoirieux, L., Pourquier, D., Picot, MC., Neves, M. 2001. Comparative study of three different membranes for guided bone regeneration of rat cranial defects. International Journal of Oral Maxillofacial Surgery 30 58-62. 

Synthetic materials based on hydroxyapatite are used as implants in ear, nose and throat surgery, facial and cranial rebuilding and in fracture healing. Dental uses include crowns, tooth capping, dentures and tooth implants [27,28,33]. 

Snyderman C, Zimmer LA, Kassam A (2004) Sources of registration error with image guidance systems during endoscopic anterior cranial base surgery. Otolaryngol Head Neck Surg 131 145-149... 

Kockro RA and Hwang PY, Virtual temporal bone An interactive 3-dimensional learning aid for cranial base surgery. Neurosurgery, vol. 64 5, pp. 216-229,2009. 

In the head and neck area, otolaryngologists treat infectious diseases, trauma, and tumors (such as those arising in the aerodigestive tract, thyroid, and salivary glands). They may perform plastic and reconstructive surgery. Cranial nerve disorders (such as facial paralysis) also represent an area of focus for some otorhinolaryngologists. 

Levels of RBP have been measured in patients with infections of various kinds (Arroyave and Calcano, 1979), with bum injury (of between 2 and 37% of the body surface area) (Moody, 1982), and with stress arising from multiple traumas, cranial-cerebral lesions, or surgery (Kasper et al., 1975). Low RBP levels were found in all of these conditions. The RBP levels returned toward or to normal following recovery from infection or from the bum injury. 

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