Typical West Nile virus paralysis is characterized by muscle weakness, decreased tone, and loss of deep tendon reflexes attributed to destruction of anterior horn cells. Two cases in which deep tendon reflexes were initially preserved in the presence of profound and persistent muscle weakness are presented here. In both cases, deep tendon reflexes were later severely attenuated or lost, while weakness of the involved muscles remained profound and unchanged. Both patients showed good motor recovery at 6 months. Initial preservation of deep tendon reflexes in the presence of persistent muscle weakness indicates that in the early stages of disease, the muscle weakness in these two cases was not caused by destruction of anterior horn cells. Pathology involving anterior horns preceding AHC destruction could potentially disrupt upper motor neuron pathways to anterior horn cells, causing weakness with initial preserved deep tendon reflexes.

Objective: This study aims to evaluate endoscopic foraminotomy through the iliac window, using three-dimensionally (3D) printing guide based on the preoperative plan, in cadaveric dogs. Methods: Trans-iliac foraminotomies were performed on each side of five canine cadavers using and individualized 3D printing guide. The intervertebral foramen (IVF) area was divided into entrance, middle, and exit zones and the trajectory angle was calculated from the computed tomography data. Results: Trans-iliac foraminotomy with an endoscope through the iliac hole using a 3D printed guide provide good visual access to the L7-S1 region. The variations in IVF in three zones were not significantly different after surgery. The angle of deviation of the guide was not significantly different caudally or ventrally after surgery. The mean trajectory angle after surgery was 14.06 ± 4.61°caudally and 13.07 ± 6.79° ventrally. Conclusions and Relevance: Our results suggest that surgical site were directly visualized during foraminotomy by the lateral approach through the spinal endoscope. However, other procedure including corpectomy and discectomy were not performed in this study.

Objective: This study aims to evaluate endoscopic foraminotomy through the iliac window, using three-dimensionally (3D) printing guide based on the preoperative plan, in cadaveric dogs. Methods: Trans-iliac foraminotomies were performed on each side of five canine cadavers using and individualized 3D printing guide. The intervertebral foramen (IVF) area was divided into entrance, middle, and exit zones and the trajectory angle was calculated from the computed tomography data. Results: Trans-iliac foraminotomy with an endoscope through the iliac hole using a 3D printed guide provide good visual access to the L7-S1 region. The variations in IVF in three zones were not significantly different after surgery. The angle of deviation of the guide was not significantly different caudally or ventrally after surgery. The mean trajectory angle after surgery was 14.06 ± 4.61°caudally and 13.07 ± 6.79° ventrally. Conclusions and Relevance: Our results suggest that surgical site were directly visualized during foraminotomy by the lateral approach through the spinal endoscope. However, other procedure including corpectomy and discectomy were not performed in this study.

Objective: This study aims to evaluate endoscopic foraminotomy through the iliac window, using three-dimensionally (3D) printing guide based on the preoperative plan, in cadaveric dogs. Methods: Trans-iliac foraminotomies were performed on each side of five canine cadavers using and individualized 3D printing guide. The intervertebral foramen (IVF) area was divided into entrance, middle, and exit zones and the trajectory angle was calculated from the computed tomography data. Results: Trans-iliac foraminotomy with an endoscope through the iliac hole using a 3D printed guide provide good visual access to the L7-S1 region. The variations in IVF in three zones were not significantly different after surgery. The angle of deviation of the guide was not significantly different caudally or ventrally after surgery. The mean trajectory angle after surgery was 14.06 ± 4.61°caudally and 13.07 ± 6.79° ventrally. Conclusions and Relevance: Our results suggest that surgical site were directly visualized during foraminotomy by the lateral approach through the spinal endoscope. However, other procedure including corpectomy and discectomy were not performed in this study.

Objective: This study aims to evaluate endoscopic foraminotomy through the iliac window, using three-dimensionally (3D) printing guide based on the preoperative plan, in cadaveric dogs. Methods: Trans-iliac foraminotomies were performed on each side of five canine cadavers using and individualized 3D printing guide. The intervertebral foramen (IVF) area was divided into entrance, middle, and exit zones and the trajectory angle was calculated from the computed tomography data. Results: Trans-iliac foraminotomy with an endoscope through the iliac hole using a 3D printed guide provide good visual access to the L7-S1 region. The variations in IVF in three zones were not significantly different after surgery. The angle of deviation of the guide was not significantly different caudally or ventrally after surgery. The mean trajectory angle after surgery was 14.06 ± 4.61°caudally and 13.07 ± 6.79° ventrally. Conclusions and Relevance: Our results suggest that surgical site were directly visualized during foraminotomy by the lateral approach through the spinal endoscope. However, other procedure including corpectomy and discectomy were not performed in this study.

BACKGROUND: Tunneled transposition of the facial artery myomucosal (FAMM) island flap on the lingual side of the mandible has been reported for intraoral as well as oropharyngeal reconstruction. This modified technique overcomes the limitations of short range and dentition and further confirms the flexibility of the flap. This paper presents a case of reconstructing secondary soft palatal defect due to flap necrosis following two-flap palatoplasty in irradiated patient with lingually transposed facial artery myomucosal island flap. CASE PRESENTATION: The authors successfully reconstructed secondary soft palatal defect due to flap necrosis following two-flap palatoplasty in an irradiated 59-year-old female patient with tunnelized-facial artery myomucosal island flap (t-FAMMIF). CONCLUSIONS: Islanding and tunneling modification extends the versatility of the FAMM flap in the reconstruction of soft palatal defects post tumor excision and even after radiation, giving a great range of rotation and eliminating the need for revision in a second stage procedure. The authors thus highly recommend this versatile flap for the reconstruction of small and medium-sized oral defects.
Arteries* ; Dentition ; Female ; Humans ; Mandible ; Middle Aged ; Necrosis* ; Pliability