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The Effect of Glossopharyngeal Nerve Block on Post-Tonsillectomy Pain of Children; Randomized Controlled Trial.

Sensory fibers of the glossopharyngeal nerve provide the tonsillar and peritonsillar areas. Thus, bilateral glossopharyngeal nerve block could alleviate post-tonsillectomy ache and enhance postoperative analgesia.The aim of this scientific trial was to guage the impact of glossopharyngeal nerve block on postoperative analgesia in kids present process adeno-tonsillectomy.Ninety ASA I-II pediatric sufferers introduced for adeno-tonsillectomy have been included on this trial.
They have been equally divided and randomly assigned to certainly one of two teams: A management group, by which kids didn’t obtain a nerve block, and a glossopharyngeal nerve block group, by which kids acquired bilateral glossopharyngeal nerve block after surgical procedure. The postoperative ache rating (FLACC rating) throughout relaxation and swallowing, the time for the primary request for rescue analgesia, the full dose consumption of pethidine rescue analgesia, and the incidence of postoperative issues have been all assessed.
Furthermore, response to gag reflex, diploma of issue in swallowing, and fogeys’ satisfaction have been recorded.Bilateral glossopharyngeal nerve block in kids introduced for adeno-tonsillectomy considerably extended the time for the primary request of rescue analgesia, in comparison with the management group, reaching 5.833 ± 2.667 hours (P < 0.0001). It additionally decreased postoperative pethidine consumption to 0.878 ± 0.387 mg/kg (P = 0.0009). Furthermore, it considerably decreased the postoperative FLACC rating assessed two, 4, six, and twelve hours after surgical procedure, throughout relaxation and swallowing (P < 0.05). The response to gag reflex and issue in swallowing have been additionally considerably decreased (P ≤ 0.0001 and 0.006, respectively).
As well as, glossopharyngeal nerve block considerably elevated mother and father’ satisfaction (P = 0.0002), with no important improve within the incidence of postoperative issues (P > 0.05).Bilateral glossopharyngeal nerve block in kids present process adeno-tonsillectomy improved the length and the standard of postoperative analgesia, decreased swallowing difficulties, and improved mother and father’ satisfaction.

A Distinctive Case of Microvascular Triple Decompression for Mixed Simultaneous Trigeminal Neuralgia, Hemifacial Spasm, and Glossopharyngeal Neuralgia Due to the Dolichoectatic Vertebrobasilar System.

Trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN) are hyperactive dysfunction syndromes (HDS) generally brought on by microvascular compression of their root entry zone. Instances of mixed HDS involving 2 or extra of those entities are extraordinarily uncommon. Though microvascular decompression is the surgical remedy of alternative, there are extra strategies which have been described as environment friendly strategies to perform vessel transposition.
To our data, we current the primary reported case of triple simultaneous HDS efficiently handled utilizing the clip-sling method to attain microvascular decompression. We talk about a number of technical pearls and pitfalls related to the usage of the sling suspension method.We report the uncommon case of a 66-yr-old male with mixed simultaneous unilateral right-sided TN, HFS, and GPN due to a dolichoectatic vertebrobasilar system compressing the exit zones of the suitable trigeminal, facial, and glossopharyngeal nerves and current a literature evaluation of mixed HDS and their totally different surgical remedies.
The Effect of Glossopharyngeal Nerve Block on Post-Tonsillectomy Pain of Children; Randomized Controlled Trial.
Symptomatic TN, HFS, and GPN have been reported eight instances within the literature with our case being the ninth. A retrosigmoid craniotomy was carried out for microvascular decompression of the brainstem with a clip-sling suspension method augmented with Teflon felt pledgets. The affected person had fast full reduction from TN, HFS, and GPN postoperatively.Microvascular decompression utilizing the clip-sling method by way of a retrosigmoid method must be thought of as a protected and efficient choice for transposition and suspension of the offending artery and decompression of the affected nerve roots in instances of mixed HDS.

Uncommon Case of Concurrent Glossopharyngeal and Trigeminal Neuralgia, in Which Glossopharyngeal Neuralgia was Probably Induced by Postoperative Modifications Following Microvascular Decompression for Trigeminal Neuralgia.

Glossopharyngeal neuralgia (GPN) and trigeminal neuralgia (TN) may end up from mechanical stimulation of the glossopharyngeal nerve (GPNv) and trigeminal nerve (TNv) by blood vessels. TN could cause extreme ache within the orofacial area, whereas GPN manifests as ache within the tongue, throat, tonsil, and ear. Though these 2 neuralgias can happen concurrently, concurrence of recurrent TN and GPN that develops postoperatively has not been beforehand described.A 68-year-old male complained of proper glossalgia and ache within the pharynx radiating to the suitable auricular space.
The affected person had beforehand undergone microvascular decompression (MVD) for proper TN. Medicine and intraoral xylocaine spray didn’t relieve the signs. An oral surgeon was unable to search out any illness associated to the glossalgia. The anesthesiologist identified that the signs may very well be from partial recurrence of the TN as a result of the affected person additionally complained of ache within the inferior alveolus.
Magnetic resonance angiography indicated that the suitable GPNv gave the impression to be compressed by the suitable posterior inferior cerebellar artery (PICA); therefore, MVD for each GPN and TN was carried out. Intraoperatively, the suitable PICA was discovered to be adherent to the GPNv due to the thickened arachnoid membrane and was subsequently indifferent. The TNv was additionally examined, however solely a Teflon ball was discovered, which was indifferent from the TNv. The GPN disappeared postoperatively, though TN persevered after the second operation.GPN may end up from adhesions between the GPNv and arachnoid membrane following earlier MVD.

Glossopharyngeal schwannoma: Scientific case report.

Schwannomas of the glossopharyngeal nerve are extraordinarily uncommon tumors of the posterior fossa. In a 100-year evaluation, a complete of 42 instances have been discovered between 1908-2008. The commonest scientific information are related to its location, the commonest being cochlear vestibule signs and signs of glossopharyngeal nerve perform. its analysis has now been facilitated by way of magnetic resonance, nevertheless, it is vitally sophisticated to outline preoperatively if the tumor originates from the ix, x or xi NC.
We current the case of a 42-year-old affected person with a syndrome of angulopentocerebellar syndrome, posterior torn (jugular) gap syndrome + anterior condyle (Collet-Sicard). The remedy used was surgical with transcondylar lateral excessive method, with monitoring of cranial nerves and trans-operative evoked potentials.
Alexander Sanchez