• Title/Summary/Keyword: 골 두 성형술

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A MODIFICATION OF THE MICHELET TECHNIQUE FOR SLIDING HORIZONTAL OSTEOTOMY;A CASE REPORT (MICHELET 테크닉의 변형을 이용한 이부성형술의 치험례)

  • Lee, Jin-Gew;Davis, Isaac E.;Swift, James Q.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.145-151
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    • 1994
  • 앞 턱 부위가 짧고 후방으로 위치해 있을 때 턱의 높이를 증가시키고 전방으로 돌출시키는 축조 이부성형술의 방법으로는, 매식체 삽입술, 골 절단술, 골 절제술 또는 이들을 동시에 시행하는 혼합술등이 행해져 왔다. 그러나 매식체 삽입술에서는 감염 또는 매식체의 유동성 등의 합병증의 발병이 빈발하고 매식체의 밑 부위에 골이 흡수된다든지 연조직의 변화를 예측하기 어렵다든지 하는 복잡한 문제점들이 종종 보고되고 있다. 따라서 매식체를 이용하지 않는 골 절단술이나 골 절제술만을 이용한 다양한 방법의 이부성형술이 많이 시행되고 있다. 하악골이 전후방 관계로 발육부전인 환자에게 양측 하악지 시상분할술을 시행하여 전방 이동시킨 후 앞 턱의 위치를 좀더 개선하기 위하여 $Michel{\'{e}}t$ 테크닉의 변형법을 이용한 이부성형술을 추가로 시행하였다. 이 방법의 이부성형술은 턱의 수직적, 수평적 길이를 증가시키기 위하여 하악결합면 부위에 장부와 장붓구멍 모양을 한 골 절단술을 시행하고 광범위한 연조직경을 보존하여 골편으로의 혈류 차단을 최소화하였으며 나사를 이용한 견고한 고정을 용이하게 하였다. 이 술식은 턱을 수직적으로 증가시킬 때 두 골편 사이의 공간에 골 이식을 시행할 필요가 없으며, 금속판을 이용하지 않아도 정확한 위치에 골편을 고정하기가 용이하고, 또한 고정용 나사가 향후 골형성 부위에 위치하게 된다는 장점을 경험하게 되어 이에 한 증례를 보고하는 바이다.

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THE BONE GRAFT DECLINED. IS THERE STILL A ROLE FOR IMPLANT SURGERY? (골 이식술이 환자에 의해 거부되는 경우 : 임프란트 술식이 여전히 치료방법으로서 의미를 가질 수 있는가에 관한 고찰)

  • Yang, Yun-Seok;Worthington, Philip
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.362-366
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    • 1997
  • 골의 퇴축 혹은 수술시의 절제로 인해 임플란트를 식립하기엔 불충분한 악골을 가진 환자에 있어서 골 이식술의 필요성은 오랫동안 논의 되어왔다. 골이식술은 악골의 전체 두께(full thickness)결손시 연결성(continuity)의 수복, 혹은 표면(surface)에서의 골상실시 보강(augmentation)목적으로 쓰일 수 있다. 따라서 술자들은 임플란트를 식립하기에 불충분한 악골을 가진 환자에 있어 골 이식술에 권유하게된다. 그러나, 골 이식술은 donor site 의 morbidity혹은 수술에 대한 두려운, 추가되는 비용에 대한 염려등으로 인해 환자에 의해 거부될 때가 종종 있다. 악골 결손으로 인해 골이식없이는 임플란트를 식립하기 어려운 경우에 있어서도 임플란트 술식이 여전히 해결책이 될 수 있을까? 다음의 두가지 증례를 통해 저자등은 골이식술 없이는 임플란트르 식립하기 어려운 경우에 있어서도 임플란트 술식이 여전히 치료방법으로서 의미가 있었음을 보고하는 바이다.

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Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures (제 5 수지 중수골 골절에서 평행 핀 또는 플레이트 고정술 이후 골절각 변화에 대한 비교 연구)

  • Lee, Myungchul;Shin, Hyojung;Choi, Hyungon;Kim, Jeenam;Shin, Donghyeok
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.230-238
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    • 2018
  • Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.

CLINICAL STUDY OF ORTHOGNATHIC SURGERY ON CLEFT LIP AND PALATE PATIENTS (순악구개열환자에서의 외과적 악교정술의 검토(증례보고))

  • Song, Jae-Chul;Lee, Geon-Ho;Jang, Hyun-Joong;Kim, Chin-Soo;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.317-321
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    • 1993
  • Two patients with maxillary developmental deficiency who have previously undergone cheiloplasty and palatoplasty were operated on by simultaneous two jaw surgery and maxillary advancement surgery respectively. And the following results were obtained. 1. After the operation, maxilla shifted superiorly, and then inferiorly without noticible posterior relapse. 2. Postoperative mandibular relapse to the anterior direction was evident in both cases. 3. It is highly suggested that definitive measures to enhance postoperative stability in orthognathic surgery on the cleft lip and palate patients be developed.

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A Case of Abductor Type Spasmodic Dysphonia Treated with $Botox^{circledR}$ Injection to Posterior Cricoarytenoid muscle (후윤상피열근에 $Botox^{circledR}$ 주사로 치유된 외전형 연축성 발성장애 1례)

  • 서장수;송시연;배창훈;정옥란
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.86-86
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    • 1996
  • 연축성 발성장애(spasmodic dysphonia)는 아직까지 그 원인을 정확히 밝혀내지 못하고 있는 만성적인 발성장애로 과거에는 경직성 발성장애(spastic dysphonia)로 불리던 질환이다. 연축성 발성장애는 두 종류 즉, 내전형(adductor)과 외전형(abductor)으로 나누어지며 이중 내전형이 대부분이다. 외전형 연축성 발성장애는 발성도중에 성대가 갑자기 불수의적으로 외전되면서 음성이 중단되므로 원활히 대화하기가 힘든 질환이다. 이러한 질환은 국소적 근긴장이상(fecal dystonia)의 일종이다. 현재까지 연축성 발성장애의 치료법으로 사용되고 있는 것으로는 언어치료, botulium 독소주입술, 편측반회후두신경절 단술, 반회후두신경분쇄술, 상후두신경절단술, 갑상연골성형술, implantable stimulator 등이 있다. 연축성 발성장애 환자에 $Botox^{circledR}$ 주입에 관한 보고는 주로 내전형에 대해서만 보고되고 있으며 외전형에 대하여 보고된 예는 매우 적다. (중략)

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Debridement or Tuberoplasty for Massive Rotator Cuff Tear (광범위 회전근 개 파열에 대한 변연절제술 및 결절성형술)

  • Cho, Nam-Su;Oh, Hyun-Sup;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.146-152
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    • 2010
  • Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods: We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than $90^{\circ}$ on flexion and abduction.

Transcatheter Removal of Bone Cement Embolism in the Right Atrium after Percutaneous Vertebroplasty: The Embolus Broke in Half and Migrated to the Right Pulmonary Artery Intraoperatively (경피적 척추성형 후 발생한 우심방 내 골 시멘트 색전의 도관경유제거술: 시술 중 두 동강나 우폐동맥으로 이동한 색전)

  • Sunhyang Lee;Jae Woo Yeon;Jin-Tae Kwon;Hyuk Jung Kim;Suk Ki Jang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.1011-1017
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    • 2021
  • Bone cement embolism often occurs during percutaneous vertebroplasty. Bone cement pulmonary arterial embolism generally requires no treatment because of the small size and asymptomatic manifestation. Intracardiac bone cement embolisms are rare but associated with a risk of severe complications. Intracardiac bone cement embolisms are mainly removed through open heart surgery. To the best of our knowledge, only three cases of intracardiac bone cement embolisms removed with interventions have been reported. Here, we report another case of successful transcatheter retrieval of a 6-cm-long cement embolism in the right atrium after percutaneous vertebroplasty. The embolus broke in half and migrated to the right pulmonary artery intraoperatively. Using two snares and a filter retrieval device, we advanced from opposite directions. Further, we gently grasped and pulled the fragments of the right pulmonary artery and aligned them in a linear fashion directly into the sheath for uneventful removal.

Recurrent ossifying and cemento-ossifying fibroma of the jaws;report of 2 cases (재발된 골섬유종과 백악질골섬유종)

  • Ryu, Sun-Youl;Oh, Hee-Kyun;Kim, Geon-Jung;Yun, Young-Su;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.297-308
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    • 1989
  • These are two case reports of recurrent ossifying and cemento-ossifying fibroma in a year or 5 months following conservative treatment. Ossifying fibroma or cemento-ossifying is a relatively uncommon benign fibro-osseous tumor of the jaws, and is generally believed to originate from periodontal ligaments. In recent, it is not demanded more differentiation of ossifying, cementifying and cemento-ossifying fibroma due to the thought that these lesions represent a spectrum of the same disease process rather than separate entities. The tumor commonly presents as an asymptomatic mass lesion and is usually well-circumscribed clinically so that conservative surgical excision has been the treatment of choice, but on occasion extended surgical procedures may become necessary, especially for those tumors which demonstrate rapid expansions and are poorly encapsulated (either initially or when recurrent) and when tumor growth is progressed aggressively or recurrent. En-bloc resection of mandible with iliac bone and inferior alveolar nerve graft was performed in case 1, recurrent cemento-ossifying fibroma of 32-year old male patient, and extended surgical enucleation of mass including normal marginal bone was done in case 2, recurrent ossifying fibroma of 72-year old female patient. By follow-up check of the patients, we obtained good result without any sings of recurrence.

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TWO CASES OF MASSIVE CRANIOFACIAL FIBROUS DYSPLASIA (광범위한 두개안면부 섬유성골이형성증의 치험 2례)

  • Kim, Jong-Ryoul;Chung, Gi-Deon;Kim, Hong-Sik;Kim, Ki-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.61-68
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    • 1996
  • In Fibrous dysplasia(FD) of the jaws, the majority of cases can await the cessation of growth before surgical intervention, and it seems prudent to delay surgery whenever possible until growth has ceased. In craniofacial FD, however, the dangers of dystopia, dystopia and loss of vision may require early surgery to prevent or control cranio-orbital complications. Delaying surgery in those circumstances may be significantly detrimental to such patients. Conservative surgical management of FD is widely practised and we advocate an extension to this conservative treatment by combining surgical recontouring with appropriate osteotomies if indicated, to achieve an optimal esthetic and functional results in craniofacial FD. One case will be presented to illustrate the feasiblility of such combined treatment, to report the uneventful healing of osteotomies in the FD of the jaws, and to demonstrate the use of titanium miniplate fixation in dysplastic bone. The other case had expansile disease of the left facial and fronto-temporal bones and osteolytic change left mandible. This patient complained of severe spontaneous bleeding of left mandibular premolar area and it was suspected as central hemangioma of the left mandible and craniofacial FD. Angiogram disclosed generalized dilation of the external carotid artery and its branches, especially terminal branches of the left facial and inferior alveolar arteries. But no specific abnormalities, such as A-V shunt, venous lake, or early venous drainage, was seen. So it was diagnosed craniofacial FD with hypercellularity and generalized bony recontouring was performed via coronal and transoral approaches.

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