Afferent Pupillary Defect (Marcus Gunn Pupil): Definition and Clinical Significance An afferent pupillary defect (APD), also known as a Marcus Gunn pupil, is an important clinical sign that indicates damage to the optic nerve or severe retinal disease. It is most commonly identified during the swinging flashlight test and reflects an abnormal afferent (sensory) visual […]
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TMJ Degeneration: Molecular Mechanisms and Clinical Implications Degenerative disease of the temporomandibular joint (TMJ) is a complex, multifactorial process involving mechanical overload, inflammation, and biochemical degradation of joint tissues. At the molecular level, enzymatic breakdown of extracellular matrix components and cytokine-mediated inflammation play central roles in the progression of TMJ degeneration. Understanding these mechanisms is
The Steiner analysis is a cephalometric analysis useful in evaluating the degree of maxillary and mandibular incisor protrusion relative to the surrounding skeletal structures. The position of the maxillary and mandibular incisors is related to Nasion-A point (N-A) and Nasion-B point (N-B) lines using both angular and linear measurements.
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Neuropathic Pain: Mechanisms, Clinical Features, and Diagnostic Patterns Neuropathic pain is a complex pain condition that arises from injury or dysfunction of the peripheral or central nervous system. Unlike nociceptive pain, which is proportional to tissue injury, neuropathic pain is often described by patients as severe, disproportionate, spontaneous, continuous, or lingering, even in the absence
Dermal Grafts in TMJ Discectomy: Clinical Outcomes and Limitations The use of dermal interpositional grafts following temporomandibular joint (TMJ) discectomy has been proposed as a method to improve joint function, reduce pain, and prevent degenerative changes after disc removal. However, current clinical evidence suggests that dermal graft placement offers limited advantages over discectomy alone. Understanding
Rinne Test A Rinne test involves evaluating a subject’s ability to hear a vibrating tuning fork when it is held next to the ear and when it is placed on the mastoid process. Normally, air conduction is greater than bone conduction. A positive Rinne test exhibits diminished hearing acuity through air and somewhat heightened hearing
Cartilagenous lacerations should be approximated to reconstruct anatomy and prevent chronic chondritic inflammation. Interrupted sutures may promote cartilage margin overlap; the use of figure of eight sutures prevents overlap of lacerated cartilage margins. Cartilage has a limited vascurlar supply, originating from overlying soft tissue; therfore extensive debridement of overlying soft tissue should be discourage. If
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Karapandzic Flap In most instances of reconstructing one-half to two-thirds of the lower lip, the Karapandzic flap provides a good functional and esthetic result. The Karapandzic flap re-approximates the orbicularis oris muscle providing for adequate sphincter function of the lips. In addition, since the sensory and motor nerves are preserved, the flap allows for a
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Metastatic Disease In adults, metastases to the jaws most commonly originate from primary carcinomas of the breast in women and of the lung in men. Other common primary sites in decreasing order of frequency are the prostate, gastrointestinal tract, kidney, colon, and rectum. SCC Treatment of the N0 neck with elective neck dissection is indicated
Trigeminal neuralgia is characterized by paroxysmal, lacinating pain in the distribution of one or more of the divisions of the 5th nerve in a woman in the 6th or 7th decade of life. Pain of trigeminal neuralgia is usually provoked by trivial stimulation of the involved dermatome. Traumatic trigeminal neuralgia occurs in a younger population
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