The Experts below are selected from a list of 156 Experts worldwide ranked by ideXlab platform
Daniel M Prevedello - One of the best experts on this subject based on the ideXlab platform.
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endoscopic endonasal anatomical study of the cavernous sinus segment of the Ophthalmic Nerve
Laryngoscope, 2015Co-Authors: Ricardo Landini Lutaif Dolci, Ricardo L Carrau, Lamia Buohliqah, Matteo Zoli, Paulo Moacir Mesquita Filho, Paulo Roberto Lazarini, Leo Ditzel F S Filho, Daniel M PrevedelloAbstract:Objectives/Hypothesis This cadaveric study analyzes the endoscopic endonasal anatomy of the Ophthalmic division of the trigeminal Nerve (V1), from the middle fossa to its orbital entry via the superior orbital fissure. Anatomical relationships with the surrounding cranial Nerves and blood vessels are described, with emphasis on their clinical correlation during surgery in this region. Our objective was to describe the anatomical relationships of the Ophthalmic division of the trigeminal Nerve. Study Design Cadaveric study. Methods Thirty middle cranial fossae, in adult human cadaveric specimens, were dissected endonasally under direct endoscopic visualization. During the dissection, we noted the relationships of the V1 Nerve with the other trigeminal branches, as well as with the oculomotor and trochlear Nerves, the paraclival and cavernous portions of the internal carotid artery, and the superior orbital fissure (SOF). Results The V1 Nerve is the most superior trigeminal branch and runs upward and obliquely, along the middle portion of the lateral wall of the cavernous sinus. The V1 Nerve joins the oculomotor and trochlear Nerves to exit the cavernous sinus and enter the orbit through the SOF. Ten percent of the specimens displayed the trochlear Nerve running along as a mate of the V1 Nerve. The V1 Nerve borders two key triangles in the lateral wall of the cavernous sinus, and the Parkinson's and anteromedial triangles. Conclusions In this study, the V1 Nerve was a constant and reliable landmark, thus allowing the identification of the anteromedial triangle. This potential space can serve as an adequate window to access the temporal lobe. Knowledge of this anatomy is essential when planning and executing endonasal surgery in this region. Level of Evidence NA Laryngoscope, 125:1284–1290, 2015
Elisabeth M Messmer - One of the best experts on this subject based on the ideXlab platform.
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role of corneal Nerves in ocular surface homeostasis and disease
Acta Ophthalmologica, 2019Co-Authors: M Labetoulle, Christophe Baudouin, Margarita Calonge, Jesus Merayolloves, K Boboridis, Yonca A Akova, Pasquale Aragona, Gerd Geerling, Elisabeth M MessmerAbstract:Corneal Nerves are key components of the physiological system that controls ocular surface homeostasis. The cornea is primarily innervated by the Ophthalmic branch of the trigeminal Nerves (cranial Nerve V), which distend bilaterally from the pons. The nasociliary branch (afferent) of the Ophthalmic Nerve is sensory for cornea, eyelid and conjunctiva. These Nerve fibres play a role in sensing temperature, chemical and mechanical stimuli, and pain, whereas, branches of the facial Nerve (cranial Nerve VII) contain motor Nerves that control blinking and autonomic (sympathetic and a paucity of parasympathetic) fibres that stimulate tear production and secretion via feedback loops between the ocular surface, lacrimal glands and brain. Disruption of these Nerves with interruption of neural feedback loops between the ocular surface and lacrimal glands can lead to corneal diseases such as dry eye disease (DED) and neurotrophic keratopathy (NK). Inversely, hypersensitivity of the Nerve fibres and/or dysregulation of pain-controlling nervous centres may lead to neuropathic pain. Recently, medications that specifically target regeneration of corneal Nerves have started to become available - and considering the high prevalence of diseases associated with corneal Nerve dysfunction, these agents promise to fulfil a hitherto important unmet need. In this review, we explore the physiology of corneal Nerves, the pathology of corneal Nerve diseases and how these relate to neuropathic pain, NK and DED. We also discuss what novel treatments may be useful against diseases involving corneal Nerves.
Margarita Calonge - One of the best experts on this subject based on the ideXlab platform.
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role of corneal Nerves in ocular surface homeostasis and disease
Acta Ophthalmologica, 2019Co-Authors: M Labetoulle, Christophe Baudouin, Margarita Calonge, Jesus Merayolloves, K Boboridis, Yonca A Akova, Pasquale Aragona, Gerd Geerling, Elisabeth M MessmerAbstract:Corneal Nerves are key components of the physiological system that controls ocular surface homeostasis. The cornea is primarily innervated by the Ophthalmic branch of the trigeminal Nerves (cranial Nerve V), which distend bilaterally from the pons. The nasociliary branch (afferent) of the Ophthalmic Nerve is sensory for cornea, eyelid and conjunctiva. These Nerve fibres play a role in sensing temperature, chemical and mechanical stimuli, and pain, whereas, branches of the facial Nerve (cranial Nerve VII) contain motor Nerves that control blinking and autonomic (sympathetic and a paucity of parasympathetic) fibres that stimulate tear production and secretion via feedback loops between the ocular surface, lacrimal glands and brain. Disruption of these Nerves with interruption of neural feedback loops between the ocular surface and lacrimal glands can lead to corneal diseases such as dry eye disease (DED) and neurotrophic keratopathy (NK). Inversely, hypersensitivity of the Nerve fibres and/or dysregulation of pain-controlling nervous centres may lead to neuropathic pain. Recently, medications that specifically target regeneration of corneal Nerves have started to become available - and considering the high prevalence of diseases associated with corneal Nerve dysfunction, these agents promise to fulfil a hitherto important unmet need. In this review, we explore the physiology of corneal Nerves, the pathology of corneal Nerve diseases and how these relate to neuropathic pain, NK and DED. We also discuss what novel treatments may be useful against diseases involving corneal Nerves.
Sue S Yom - One of the best experts on this subject based on the ideXlab platform.
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delineation of radiation therapy target volumes for cutaneous malignancies involving the Ophthalmic Nerve cranial Nerve v 1 pathway
Practical radiation oncology, 2016Co-Authors: Mekhail Anwar, Christine M Glastonbury, Ivan H Elsayed, Sue S YomAbstract:Abstract Purpose The Ophthalmic Nerve (cranial Nerve V-1) runs in close proximity to the globe, optic Nerve, chiasm, and brain. The purpose of this study was to provide contouring guidance using computed tomography (CT)-identifiable landmarks, based on an analysis of skin cancer patients with V-1 invasion. Methods and materials Radiation oncology planning CT scans were analyzed for landmarks to guide V-1 target delineation from the skin surface to the trigeminal ganglion. Axial and coronal magnetic resonance imaging (MRI) sequences were fused with the planning CT to confirm soft-tissue findings and identify enhancement related to perineural spread. CT/MRI-based anatomic landmarks were catalogued and described on an atlas. Results Soft-tissue and bony landmarks were confirmed as consistently identifiable on CT with assistance from fused MRI. A reference atlas was developed that shows the entirety of the V-1 pathway on consecutive CT slices. Conclusions Initial delineation of the V-1 pathway can be accomplished using CT-visualized landmarks confirmed on fused MRI. This CT/MRI atlas will assist radiation oncologists in delineation of the V-1 pathway.
Roberto Delfini - One of the best experts on this subject based on the ideXlab platform.
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blood supply to the intracavernous cranial Nerves comparison of the endoscopic and microsurgical perspectives
Neurosurgery, 2008Co-Authors: Elena Davella, Manfred Tschabitscher, Antonio Santoro, Roberto DelfiniAbstract:OBJECTIVE: To provide a comparative description of the endoscopic and microsurgical anatomic features of the blood supply to the cranial Nerves in the lateral wall of the cavernous sinus. METHODS: Twenty-four cavernous sinuses were dissected in 12 adult cadaveric heads. Endoscopic observations were made with 0- and 45-degree, 4-mm rod-lens endoscopes. The lateral wall of the cavernous sinus was exposed through an endonasal transsphenoidal approach. The microsurgical observations were performed with a surgical microscope with possible magnification ranging from 4x to 40x through a lateral transcranial approach. Neurovascular relationships in the lateral wall of the cavernous sinus were noted, and the endoscopic and microsurgical perspectives were compared. RESULTS: The neurovascular relationships in the lateral wall of the cavernous sinus that are visible by the endonasal transsphenoidal approach but not visible by the transcranial microsurgical approach are as follows: between the oculomotor Nerve and the tentorial artery, between the distal segment of the trochlear Nerve and the tentorial artery, between the Ophthalmic Nerve and the inferolateral trunk, and between the abducens Nerve and the inferolateral trunk. The neurovascular relationships visible by the transcranial microsurgical approach but not visible by the transsphenoidal endoscopic approach are as follows: between the oculomotor Nerve and the superoproximal artery, when present, and between the proximal segment of the trochlear Nerve and the superoproximal artery. CONCLUSION: Incorporating the endoscopic and microsurgical perspectives ensures a better understanding of the neurovascular relationships in the cavernous sinus lateral wall. This information could be relevant for preservation of the blood supply to the Nerves during surgery in or around the cavernous sinus.
