• Title/Summary/Keyword: Anatomical outcome

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A Morphological Analysis of the Facial Nerve in Korean Fetuses and Stillborn Infants

  • Lee, Won-Tae;Chung, Youn-Young;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.445-449
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    • 2006
  • Objective : The accurate anatomy of the facial nerve is essential for successful surgical outcome. The purpose of the present study is to know such information on the facial nerve from a series of specimens. Methods : This study is based on cadaveric dissection of 41 Korean fetus and stillborn infant and describes anatomical variations of the peripheral branches of the facial nerve that pose a importance in a number of neruosurgical procedure. Results : The branching patterns were classified into six types according to modified Davis classification : the frequencies of occurrence were : type I, 4.9%; type II, 24.4%; type III, 34.1%; type IV, 19.5%; type V, 12.2%; and type VI, 4.9%. Types II, III and IV together accounted for almost 80% of the specimens. Conclusion : Compared to previous adult and western stillborn fetus cadaveric studies, there was no significant difference in the percentage of the types between the subjects in the present study, similar pattern and anatomic distribution.

Registration of 3D CT Data to 2D Endoscopic Image using a Gradient Mutual Information based Viewpoint Matching for Image-Guided Medialization Laryngoplasty

  • Yim, Yeny;Wakid, Mike;Kirmizibayrak, Can;Bielamowicz, Steven;Hahn, James
    • Journal of Computing Science and Engineering
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    • v.4 no.4
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    • pp.368-387
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    • 2010
  • We propose a novel method for the registration of 3D CT scans to 2D endoscopic images during the image-guided medialization laryngoplasty. This study aims to allow the surgeon to find the precise configuration of the implant and place it into the desired location by employing accurate registration methods of the 3D CT data to intra-operative patient and interactive visualization tools for the registered images. In this study, the proposed registration methods enable the surgeon to compare the outcome of the procedure to the pre-planned shape by matching the vocal folds in the CT rendered images to the endoscopic images. The 3D image fusion provides an interactive and intuitive guidance for surgeon by visualizing a combined and correlated relationship of the multiple imaging modalities. The 3D Magic Lens helps to effectively visualize laryngeal anatomical structures by applying different transparencies and transfer functions to the region of interest. The preliminary results of the study demonstrated that the proposed method can be readily extended for image-guided surgery of real patients.

Chronic Varus Instability of the Hallux Interphalangeal Joint in College Taekwondo Athelete - A Case Report - (대학 태권도 선수의 족무지 지간 관절의 만성 내반 불안정성 - 1례 보고-)

  • Jung, Hong-Geun;Park, Sin-Hyoung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.142-145
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    • 2008
  • Forefoot injuries are common in runners or martial art athletes, but due to the anatomical stability, collateral ligament injury of the hallucal interphalangeal joint has been rarely reported. We report a college Taekwondo athlete with chronic varus instability of the hallucal interphalangeal joint due to chronic lateral collateral ligament rupture. The patient had been treated with lateral ligament reconstruction and achieved good clinical outcome.

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Combined Endovascular and Microsurgical Procedures as Complementary Approaches in the Treatment of a Single Intracranial Aneurysm

  • Lim, Yong-Cheol;Shin, Yong-Sam;Chung, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.21-25
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    • 2008
  • Objective : Both endovascular coil embolization and microsurgical clipping are now firmly established as treatment options for the management of cerebral aneurysms. Moreover, they are sometimes used as complementary approaches each other. This study retrospectively analyzed our experience with endovascular and microsurgical procedures as complementary approaches in treating a single aneurysm. Methods : Nineteen patients with intracranial aneurysm were managed with both endovascular and microsurgical treatments. All of the aneurysms were located in the anterior circulation. Eighteen patients presented with SAH, and 14 aneurysms had diameters of less than 10 mm, and five had diameters of 10-25 mm. Results : Thirteen of the 19 patients were initially treated with endovascular coil embolization, followed by microsurgical management. Of the 13 patients, 9 patients had intraprocedural complications during coil embolization (intraprocedural rupture, coil protrusion, coil migration), rebleeding with regrowth of aneurysm in two patients, residual sac in one patient, and coil compaction in one patient. Six patients who had undergone microsurgical clipping were followed by coil embolization because of a residual aneurysm sac in four patients, and regrowth in two patients. Conclusion : In intracranial aneurysms involving procedural endovascular complications or incomplete coil embolization and failed microsurgical clipping, because of anatomical and/or technical difficulties, the combined and complementary therapy with endovascular coiling and microsurgical clipping are valuable in providing the best outcome.

Angiographic embolization for hemorrhage control after dental implantation

  • Hwang, Hee-Don;Kim, Jin-Wook;Kim, Yong-Sun;Kang, Dong-Hun;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.27-30
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    • 2013
  • Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.

COMPREHENSIVE TREATMENT OF OBSTRUCTIVE SLEEP APNEA - THE ROLE OF DEPARTMENT OF DENTISTRY IN SLEEP CLINIC (폐쇄성 수면 무호흡증에 대한 포괄적 치료 - 수면 클리닉에서 치과의 역할)

  • Kwon, Tae-Geon;Cho, Yong-Won;Ahn, Byung-Hoon;Hwang, Sang-Hee;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.150-156
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    • 2004
  • The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree & site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.

Vertebral Artery Injury during Anterior Cervical Spine Surgery : Report of Two Cases (전방경추수술중 추골동맥 손상 : 2예 보고)

  • Lee, Dong Girl;Rhim, Seung Chul;Roh, Sung Woo;Im, Su Bin;Kwon, Yang;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.231-238
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    • 2001
  • Vertebral artery injury is a rare complication of anterior cervical approach. We report two patients who suffered injury to vertebral artery during anterior cervical spine surgery. The mechanism of injury, their operative management, and the subsequent outcome were assessed and relevant literatures reviewed. The awareness of the possibility of vertebral artery injury is most important to prevent and it's occurrence is best avoided by a thorough understanding of the anatomical relationships of the artery, the spinal canal, and the vertebral body and careful use of surgical instruments.

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Preservation of Facial Nerve Function Repaired by Using Fibrin Glue-Coated Collagen Fleece for a Totally Transected Facial Nerve during Vestibular Schwannoma Surgery

  • Choi, Kyung-Sik;Kim, Min-Su;Jang, Sung-Ho;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.208-211
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    • 2014
  • Recently, the increasing rates of facial nerve preservation after vestibular schwannoma (VS) surgery have been achieved. However, the management of a partially or completely damaged facial nerve remains an important issue. The authors report a patient who was had a good recovery after a facial nerve reconstruction using fibrin glue-coated collagen fleece for a totally transected facial nerve during VS surgery. And, we verifed the anatomical preservation and functional outcome of the facial nerve with postoperative diffusion tensor (DT) imaging facial nerve tractography, electroneurography (ENoG) and House-Brackmann (HB) grade. DT imaging tractography at the 3rd postoperative day revealed preservation of facial nerve. And facial nerve degeneration ratio was 94.1% at 7th postoperative day ENoG. At postoperative 3 months and 1 year follow-up examination with DT imaging facial nerve tractography and ENoG, good results for facial nerve function were observed.

Clinical Review in Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과)

  • Lee, Ju-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.111-114
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    • 2009
  • Double-bundle anterior cruciate ligament reconstruction (DBACLR) has been developed to produce better clinical outcomes in traditional single-bundle reconstruction, which showed considerable rate of dissatisfaction in restoration of stability and function of the anterior cruciate ligament deficient knee. There is plenty of evidence that DBACLR has theoretical advantages in anatomical, biomechanical, biological, kinematical, and possibly clinical standpoint compared with traditional one but still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the substantial advantages of DBACLR. The purpose of this article is to review the clinical outcomes of double-bundle technique and to address controversy exists over the usefulness of this technique.

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Accessory penis: A rare method of peno-urethral separation of sexual function and voiding following successful complex hypospadias reconstruction with a free ileum flap

  • Elia, Rossella;Pafitanis, Georgios;Ciudad, Pedro;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.381-385
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    • 2019
  • Hypospadias is a congenital malformation of the male genitalia. The reconstructive objectives are to obtain voiding with laminar flow and satisfactory sexual function. Several urethroplasty techniques have been described, but for perineal or revisional cases no single technique has shown robust success. In this study, we describe the expanded use of intestinal flaps for urethral reconstruction and report a peculiar request from a patient to undergo peno-urethral separation after successful hypospadias repair with a free ileum flap. A 51-year-old male patient with perineal hypospadias underwent several urethral reconstructive procedures with poor outcomes. A free ileum flap was attempted as a substitute for the urethra. Following successful reconstruction, separation of the neo-urethra (ileum) from the penile body was performed to address the patient's sexual expectations. A free ileum flap proved to be a reliable urethral substitute in perineal hypospadias reconstruction, with a successful outcome. The peno-urethral separation with the creation of an "accessory penis," however peculiar, optimized the results in terms of both sexual and urinary function. Anatomical restoration of the urethra and patient-reported expectations are the key to successful hypospadias reconstructive procedures. Sexual function outcomes and the patient's perception of success should not be underestimated, even when urinary function has been restored.