Objective : The authors study on the clinical presentations and the surgical outcomes of the tumors in the ventricular system. Methods : 15 patients with ventricular tumor were studied. The clinical presentation, radiological findings, different surgical approaches, and outcome were analyzed. Tumors were classified into three groups based on their locations in MRI : lateral, third and fourth ventricle. Surgical methods were transcortical approach in eight patients, transcallosal approach in four, median suboccipital approach in two, and subfrontal approach in one. Gross total removal was achieved in 10 patients. Subtotal resections were performed in the rest. Glasgow outcome scale was used for evaluation of the surgical outcome. Results : Main clinical presentations were chronic headache in patients with the tumor in the lateral ventricular tumor and sudden onset of headache and consciousness change in patients with the tumor in the third and fourth ventricular tumor Development of hydrocephalus was more predominant in patients with the tumors in the third ventricle. Postoperatively, good outcome [Glasgow outcome scale IV, V] were in 73%, and better results was observed in patients with the tumors in the lateral ventricular tumor. The differences of outcome according to surgical approach were not recognized, even though it was not reliable statistically. Conclusion : In ventricular tumor, postoperative outcome is not good in patients with sudden development of headache, hydrocephalus, high grade tumor. Outcome is good in patients with the tumor in the lateral ventricle relatively. There is no difference in outcome according to the approach method to the tumors. And it is necessary to be aware of various approach methods to the tumors and anatomy surrounding the ventricle for avoidance of neurological complications.
Cleft lip is one of the most common congenital deformities in craniofacial region. Despite the many reports on the outcome of various surgical techniques from individual medical centers, the evaluation of the outcome is based on the subjective observation because of lack of the objective evaluation system. Therefore, a new technique of objective and scientific evaluation for the nasal deformity of secondary cleft lip and nose deformity is critical to improve the management of the cleft patients including the decision of optimal age of operation and surgical technique as veil as evaluation of the outcome. In this study, a new method was proposed to evaluate the nasal deformity using nostril angle, distance, and area of patient images. The images were also evaluated by three expert plastic surgeons, and put into scale of 5 percentile. Measurement results were compared between the each category and the surgeon's evaluation, and coefficients of each category were statistically tested. As a result, The normalized overlap area of right and left nostrils and distance ratio between two centers of nostrils showed high coefficient with evaluations of plastic surgeons.
Kim, Jin-Tae;Nam, Ki-Chang;Hong, Hyun-Ki;Rah, Dong-Kyun;Kim, Deok-Won
The Transactions of the Korean Institute of Electrical Engineers D
/
v.54
no.8
/
pp.517-520
/
2005
Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed at quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis
Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity. Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed on quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three greatly experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis.
Adetayo, Adekunle Moses;Adetayo, Modupe Olushola;Adeyemo, Wasiu Lanre;James, Olutayo O.;Adeyemi, Michael O.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.45
no.3
/
pp.141-151
/
2019
Objectives: The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison-Randall or Millard technique based on (qualitative) parent/subject and professional assessments. Materials and Methods: This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. Results: Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison-Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison-Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. Conclusion: Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison-Randall repairs. Both Millard and Tennison-Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.
Objective : Cortical dysplasia (CD) is one of the common causes of epilepsy surgery. However, surgical outcome still remains poor, especially with frontal lobe epilepsy (FLE), despite the advancement of neuroimaging techniques and expansion of surgical indications. The aim of this study was to focus on surgical strategies in terms of extent of resection to improve surgical outcome in the cases of FLE with CD. Methods : A total of 11 patients of FLE were selected among 67 patients who were proven pathologically as CD, out of a total of 726 epilepsy surgery series since 1992. This study categorized surgical groups into three according to the extent of resection : 1) focal corticectomy, 2) regional corticectomy, and 3) partial functional lobectomy, based on the preoperative evaluation, in particular, ictal scalp EEG onset and/or intracranial recordings, and the lesions in high-resolution MRI. Surgical outcome was assessed following Engel's classification system. Results : Focal corticectomy was performed in 5 patients and regional corticectomy in another set of 5 patients. Only 1 patient underwent partial functional lobectomy. Types I and II CD were detected with the same frequency (45.45% each) and postoperative outcome was fully satisfactory (91%). Conclusion : The strategy of epilepsy surgery is to focus on the different characteristics of each individual, considering the extent of real resection, which is based on the focal ictal onset consistent with neuroimaging, especially in the practical point of view of neurosurgery.
The purpose of this study was to examine the effect of smoking on the clinical, radiographic outcome of surgical peridontal therapy. The outcome of periodontal surgery was evaluated in 51 systemically healthy subjects that had received maintenance care. The study subject consisted of 26 smokers and 25 non-smokers. The average age of smoking patients was 51 years old and non-smoking patients was 48 years old. Changes of probing pocket depth(PPD) and radiographic bone height, and number of missing teeth compared between smokers and non-smokers during maintenance period after surgical therapy. The clinical parameters were less favorable in the smoking group compared with non-smoking group. The number and percentage of missing teeth were greater in smokers(21.6%) than non-smokers(l2.4%), especially in molars. The mean presurgery PPD was similar in smokers and non-smokers, molars and premolars, but significantly decreased at least 2 years after surgery. The mean PPD reduction was significantly greater in non-smokers than smokers. Both in the smoking and non-smoking group, the mean PPD reduction was significantly greater in premolars than molars. The radiographical evaluation was also less favorable in the smoking group than non-smoking group. The radiographic evaluation of bone height in smokers showed bone loss. On the contrary, bone height of non-smokers showed bone gain during the period of maintenance. But there was no significant difference between molars and premolars. The clinical and radiographic outcomes of the smoking group was less favorable than those of the non-smoking group. Therefore , smoking seems to influence on the clinical and radiographic outcomes of surgical periodontal therapy.
Objective : The authors investigate appropriate evaluation and surgical methods in treatment of the cerebral paragonimiasis accompanying epilepsy. Methods : Thirteen patients with the cerebral paragonimiasis accompanying epilepsy were included for this study. Preoperative evaluation methods included history taking, skin and serologic tests for Paragonimus westermani, neurologic examinations, computerized tomography, magnetic resonance imaging, amytal test, PET or SPECT, and video-EEG monitoring with depth and subdural grid electrodes. Seizure outcome was evaluated according to Engel's classification. Results : Surgical methods were temporal lobectomy including lesions in six, lesionectomy in five, and temporal lobectomy plus lesionectomy in two. Postoperative neurological complications were not noticed, and seizure outcomes were class I in 12 patients [92%], class II in one [8%]. Conclusion : In patients with a cerebral paragonimiasis accompanying epilepsy, further evaluation methods must be done to define the epileptogenic zone, and complete resection of the epileptogenic zone with different surgical methods should be performed for seizure control.
Objective : The purpose of this study was to evaluate the efficacy and safety of the surgical treatment for lumbar spinal stenosis in elderly patients. Methods : The authors reviewed the medical records of 49 patients older than 65 years of age with lumbar spinal stenosis who underwent surgical treatment from January 2002 to December 2004 in our institute. Results : Average age of patients was 70 years old [32 women, 17 men]. Twenty-four patients had chronic medical disorders. All patients were operated under the general anesthesia of these, 29 patients underwent decompressive laminectomy and decompressive laminectomy with instrumentation and fusion in 20 patients. The mean operation time was 193.5 minutes, mean estimated blood loss was 378cc and mean postoperative hospital stay length was 15.3 days. The mean follow-up duration was 11.9 months. The evaluation of outcome was assessed by Macnab classification. At first month after operation, the outcome showed excellent in 7 [14.3%]. good in 35 [71.4%], fair in 5 [10.2%], and poor in 2 [4.1%]. And at 6 months after operation, 17 patients were lost in follow-up, the outcome showed excellent in 4 [12.5%], good in 25 [78.1%], fair in 3 [9.4%], and no poor cases. There was no significant difference between outcome of laminectomy alone and that of laminectomy with fusion. Six patients [12.2%] experienced postoperative complications which included wound infection [3], nerve root injury [1], disc herniation [1], and reoperation due to insufficient decompression [1]. There were no deaths related to operation. Conclusion : We conclude that the surgical treatment for lumbar spinal stenosis in elderly patients can provide good results with acceptable morbidity when carefully selected. In addition, decision on lumbar spinal fusion should not be against solely on advanced age.
Kim, Seong-Ki;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
Archives of Plastic Surgery
/
v.37
no.3
/
pp.245-249
/
2010
Purpose: High-pressure injection injury is caused by accidental injection of the high-pressure injection devices in industry. The initial benign appearance of the wound fools patients into delays in an adequate treatment. And it can result in disastrous outcomes such as necrosis and amputation. To avoid the poor prognosis, the injuries require a prompt surgical intervention. The purpose of this article is to recognize the poor outcome of the highpressure injection injury and to introduce an adequate treatment in need. Methods: We have 4 cases of the high-pressure injection injuries in the hand from April, 2005 to March, 2009. Average age is 39 years (30 - 49 years old), 2 cases are the palm of dominant hand, 1 case is the thumb of dominant hand, and 1 case is the palm of non-dominant hand, respectively. We followed up these patients for 20 months on average. In 3 cases, the immediate, aggressive surgical intervention was carried out, but the other one was delayed in early adequate treatment. The wounds were covered by local advancement flap, anterolateral thigh free flap, conservative treatment with antibiotics and dressing. Results: No pathogens after culture were found nor any findings of fracture in imaging study. Conservative treatment, local advancement flap and anterolateral thigh free flap for the open wound resulted in a desirable aesthetic outcome. In a long-term follow up, functional capability of the patient was also satisfactory. Conclusion: Upon initial evaluation, most high-pressure injection injuries present as innocuous wounds with very few symptoms and result in delaying the proper management. And the majority of high-pressure injection injuries will produce significant morbidity to the hand, amputation. And the initial aggressive surgical debridement was needed to prevent the poor outcome. The key to success in treating high-pressure injection injuries of the hand is the prompt aggressive surgical intervention.
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