Anomalies of the common carotid artery: A rare complication of radical neck dissection

Anatomical variants of the common carotid artery are rarely reported. Two different congenital anomalies of the common carotid artery, encountered during radical neck dissection, are documented and their surgical significance discussed.     

Spontaneous dissection of the internal carotid artery manifesting as pain in an endodontically treated molar

BACKGROUND: Dental pain is a common occurrence, whereas spontaneous dissection of an internal carotid artery is rare. CASE DESCRIPTION: The authors describe a patient who experienced a spontaneous dissection of an internal carotid artery that manifested initially as dental pain in an endodontically treated molar. CLINICAL IMPLICATIONS: It is important for dental practitioners to be familiar with unusual causes of dental pain. In this case in which the cause of dental pain was uncommon, the authors referred the patient appropriately, thus avoiding potentially serious complications.     

Injury to the long thoracic nerve as a complication of neck dissection: a case report

Injury to nerves by dissection of the neck is well recognised. A case report of injury to the long thoracic nerve follows, which has not been previously described.     

High division of the accessory nerve: a rare anatomical variation as a possible pitfall during neck dissection surgery.

A rare clinical variant found during neck dissection surgery is reported in which the spinal accessory nerve divided at a high level in the neck, before entering the sternocleidomastoid muscle. This case documents the need for meticulous technique in identification and dissection of the spinal accessory nerve in order to reduce the risk of postoperative morbidity.     

Infiltrative local anesthesia with articaine is equally as effective as inferior alveolar nerve block with lidocaine for the removal of erupted molars

Aim

The aim of this study is to assess the efficacy of 4% articaine with 1:100,000 adrenaline given as buccal and lingual infiltration in adult patients undergoing erupted mandibular first and second molar teeth extraction versus inferior alveolar nerve block technique using 2% lignocaine with 1:80,000 adrenaline.

Materials and methods

A total of 100 patients undergoing extraction of mandibular posterior teeth were divided into two equally matched groups for the study, out of which 50 patients were given 4% articaine with 1:100,000 adrenaline as buccal and lingual infiltration and 50 patients were given 2% lignocaine with 1:80,000 adrenaline using classic direct inferior alveolar nerve block with lingual and buccal nerve block. Efficacy of anesthesia was determined using a numeric analog scale (NAS) ranging from 0 indicating no pain to 10 indicating the worst pain imaginable. The NAS was taken by a different operator to avoid bias.

Results

The pain scores in both groups were analyzed using the Mann–Whitney U test, and a p value of 0.338 was obtained which is not statistically significant. Hence, no significant difference in the pain score was established between both groups. The adverse effects of both the local anesthetics if any were noted.

Conclusion

From this study, we concluded that the use of 4% articaine with 1:100,000 adrenaline is as effective as inferior alveolar nerve block with lignocaine but without the risk of attendant adverse effects of inferior alveolar nerve block technique.