• 제목/요약/키워드: Extirpation

검색결과 89건 처리시간 0.24초

혈행화된 부분층 두개골피판을 이용한 상악골 종양 적출 환자에서의 안와하벽 재건술 증례 (Inferior Orbital Wall Reconstruction with Vascularized Partial Thickness Calvarial Bone Flap in Three Cases of Maxillary Tumor)

  • 신상호;이윤정;김준식;김남균;이경석
    • 대한두개안면성형외과학회지
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    • 제10권1호
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    • pp.49-54
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    • 2009
  • 상악골 악성종양의 경우 적출 후 골편들을 이식해 상악동 전체를 재건하는 경우는 재발이 많아 잘 시행하지 않는다. 이러한 이유로 안와하연의 재건을 통해 안구 및 안면윤곽만을 재건하는데, 저자들이 시행한 혈행화된 부분 두께의 골이식(vascularized split thickeness calvarium)은 술기방법에 있어 골피판이 혈관경에서 쉽게 분리되는 성질이 있어 시행에 주의가 필요하고 혈관경을 포함한 temporalis muscle이 부피감을 주므로 미용상 불리한 점이 있는 반면에 골편의 높은 생존율이 보장된다는 장점과 공여부의 합병증이 적다는 장점을 가진다. 또한 술후 복시 현상이나 안구함몰이 관찰되지 않았다는 점이 합리적인 술기임을 지지해준다. 따라서 측두동맥 및 정맥을 혈관경으로 하는 혈행화된 두정골 부분층 이식술은 안와하벽을 재건하는데 있어 안전하게 시행가능 한 술기였음을 보고하는 바이다.

Clinical Analysis of Lobular Keloid after Ear Piercing

  • Kim, Hyung Do;Chu, Sung Chul;Hwang, So Min;Sun, Hook;Hwang, Min Kyu;Kim, Min Wook;Lee, Jong Seo
    • 대한두개안면성형외과학회지
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    • 제17권1호
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    • pp.5-8
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    • 2016
  • Background: Lobular keloid appears to be a consequence of hypertrophic inflammation secondary to ear piercings performed under unsterile conditions. We wish to understand the pathogenesis of lobular keloids and report operative outcomes with a literature review. Methods: A retrospective review identified 40 cases of lobular keloids between January, 2005 and December, 2010. Patient records were reviewed for preclinical factors such as presence of inflammation after ear piercing prior to keloid development, surgical management, and histopathologic correlation to recurrence. Results: The operation had been performed by surgical core extirpation or simple excision, postoperative lobular compression, and scar ointments. Perivascular infiltration was noted in intra- and extra-keloid tissue in 70% of patients. The postoperative recurrence rate was 10%, and most of the patients satisfied with treatment outcomes. Conclusion: Histological perivascular inflammation is a prominent feature of lobular keloids. Proper surgical treatment, adjuvant treatments, and persistent follow-up observation were sufficient in maintaining a relatively low rates of recurrence.

구강 내 접근과 하악하 절개를 통한 몰입성 하마종의 수술적 치료 (Surgical Treatment of a Plunging Ranula using the Intraoral and Submandibular Approach)

  • 김정홍;은석찬;백롱민
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.111-115
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    • 2010
  • Purpose: A plunging ranula is relatively uncommon and represents a mucus escape reaction occurring from a disruption of the sublingual salivary gland. It is a common condition found in young adults, even though the reported age range is 2 - 61 years. We report our experience of a complete excision of a plunging ranula via the intraoral and submandibular approach. Methods: A 23-year-old man had a large protruding mass in the right submandibular area. Initially, the protruding mass appeared bilaterally but the left side disappeared spontaneously. The MRI findings revealed a homogenous fluid attenuation mass in the submandibular space, suggesting a ranula. The sublingual gland was extirpated through the intraoral approach and the ranula excised totally via the submandibular approach. Results: The patient had an uneventful postoperative course without infection, paralysis and tongue sensory changes, etc. The pathology findings were characteristic of a pseudocyst without a lining epithelium or endothelium but with a vascular fibro-conective tissue wall filled with mucinous fluid. No recurrence was observed on the submandibular area during the 8 month follow-up period. Conclusion: The combined intraoral approach and submandibular approach is an effective and highly recommended method for sublingual gland extirpation and complete excision of a plunging ranula.

두개저 결손의 미세수술적 재건술 (Microvascular Reconstruction of the Cranial Base Defects)

  • 민경원;김인철;이민구
    • Archives of Reconstructive Microsurgery
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    • 제8권1호
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    • pp.71-76
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    • 1999
  • Until recently, the cranial base tumors were deemed unresectable due to the inability to diagnose the extent of the involvement accurately and to approach and excise the tumor safely. With refinements in CT and NMR scanning and development of craniofacial techniques, reconstruction becomes absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, the free tissue transfer was a useful alternative because it can provide large amount of well-vascularized tissues and reliable separation of intracranial space from bacterial flora of the upper airway. The microvascular free tissue transfer was used in 9 patients at our center to reconstruct the cranial base defects. Of these, 8 were free rectus muscle flaps, and 1 was free latissimua dorsi muscle flap. There were 1 case of partial flap loss and 1 case of postoperative wound infection. The large, complex defects were successfully reconstructed by one stage operation and the functional and aesthetic results were satisfactory with acceptable complication rates.

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EDTA의 근관세척효과(根管洗滌效果)에 관(關)한 주사전자현미경적(走査電子顯微鏡的) 연구(硏究) (A SCANNING ELECTRON MICROSCOPIC STUDY ON THE EFFECT OF EDTA AS A CANAL IRRIGANT)

  • 이명종;김영해
    • Restorative Dentistry and Endodontics
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    • 제9권1호
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    • pp.107-114
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    • 1983
  • The purpose of this study was to observe the effect of cleansing action of irrigation solutions which was 3% $H_2O_2$ and 5% NaOCl, and 15% EDTA solution on the root canal wall. After treatment with the irrigant, each sample was dehydrated, and coated with 200~250${\circ}$A of gold, and observations were made with the use of scanning electron microscope. The results were as follows: 1. In the root canal walls irrigated with 3% $H_2O_2$ and 5% NaOCl solution without instrumentation after extirpation through barbed broach, the predentin of root canal wall was found scarely affected, and the wall was shown retaining network structure and fibrous organic matters. 2. When 15% EDTA was applied as irrigants for 60, 90 and 120 seconds after instrumentation, there was no signigicant difference of the cleansing effect of the elapsed times which were 90 and 120 seconds on the root canal wall, but in the applied time which was 120 seconds, the canal wall was the cleanest. Therefore it was thought that the most suitable application time of 15% EDTA as the irigants was 120 seconds.

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골결손을 동반한 비구개관 낭종의 치험례 (A Clinical Experience of Nasopalatine Duct Cyst with Bony Defect)

  • 김영진;서제원;전영준;김성식
    • Archives of Plastic Surgery
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    • 제32권2호
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    • pp.255-258
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    • 2005
  • The nasopalatine duct cyst, known as the incisive canal cyst, is the most common nonodontogenic cyst in the maxillofacial area. It is believed to arise from epithelial remnants of the embryonic nasopalatine duct. Nasopalatine duct cysts are most often detected in patients between forties and sixties. The trauma, bacterial infection, or mucous retention has been suggested as etiological factors. The cysts often present as asymptomatic swelling of the palate but can present with painful swelling or drainage. Radiologic findings include a well demarcated cystic structure in a round, ovoid or heart shape presenting with a well-defined bone defect in the anterior midline of the palate between and posterior to the central incisors. Most of them are less than 2cm in size. On MRI, the cyst is identified as a high-intensity, well-marginated lesion, which indicates that it contains proteinaceous material. We experienced a case of a 61-year-old female patient who had a $2.3{\times}2.6{\times}1.7cm$ sized nasopalatine duct cyst. The bony defect after a surgical extirpation was restored with hydroxyapatite. So we report a good results with some reviews of the literatures.

기저핵부 뇌실질내 출혈에 대한 수술후 뇌농양으로 오인한 다형성 교아세포종 (Glioblastoma Misdiagnosed as Brain Abscess after Surgical Evacuation of Spontaneous Basal Ganglia Hemorrhage)

  • 정진환;김재민;백광흠;박용욱;김충현;오석전
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.384-388
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    • 2001
  • A 51-year-old woman presented with sudden severe headache, vomiting, and right hemiparesis at first admission. Computed tomography(CT) scans revealed an hemorrhagic density at left basal ganglia. Preoperative cerebral angiography showed no vascular lesion. Under the diagnosis of hypertensive intracerebral hemorrhage(ICH), total extirpation of hematoma was done. The postoperative neurological condition improved gradually and discharged without any neurological sequelae. Two months later, she revisited with headache, vomiting and progressive right hemiparesis. CT scans at second admission showed an irregular rim enhanced mass with central low density with surrounding edema at the initial bleeding area. Repeated craniotomy was performed and the mass was partially removed. The histopathological diagnosis of the specimen was confirmed as glioblastoma. The authors report a glioblastoma, which occurred at initial ICH site and regarded as a brain abscess with literature review.

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만삭 크기 거대 난소 낭종의 복강경 적출술 (Laparoscopic Extirpation of the Term Sized Huge Ovarian Cyst)

  • 고민환;주현철;권오진;김정숙
    • Journal of Yeungnam Medical Science
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    • 제21권1호
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    • pp.108-113
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    • 2004
  • A 23 years old single nulligravida woman underwent laparoscopic removal of a huge cystic adnexal mass that occupied her entire abdomen, giving the appearance of a full term pregnancy. After anesthesia, a vertical infra-umbilical incision, 1 cm long, was made and a telescope was introduced through the port to determine the status of the intra-abdomen and the surface contour of the mass. A needle tipped with a laparoscopic suction apparatus was inserted into the cyst through the infra-umbilical port, directly under the mass. Subsequently, 3,200 ml of cystic fluid was aspirated without spillage. A huge cyst, reaching to the level of the xyphoid process was effectively excised through the operative laparoscopy after prelaparoscopic drainage. Operation time was 140 minutes and hospital stay was 2 days. There were no complications during hospital stay and after discharge. It seems the size of the cyst is not a criteria for the contraindication of laparoscopic surgery.

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Spontaneous Ligamentum Flavum Hematoma in the Rigid Thoracic Spine : A Case Report and Review of the Literature

  • Lee, Hyun-Woo;Song, Joon-Ho;Chang, In-Bok;Choi, Hyun-Chul
    • Journal of Korean Neurosurgical Society
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    • 제44권1호
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    • pp.47-51
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    • 2008
  • Ligamentum flavum hematoma is a rare condition. Twenty cases including present case have been reported in English-language literature. Among them, only one case reported in pure thoracic spine. A 72-year-old man presented with thoracic myelopathy without precedent cause. Magnetic resonance images revealed a posterior semicircular mass which was located in T7 and T8 level compressing the spinal cord dorsally. T7-8 total laminectomy and extirpation of the mass was performed. One month later following surgery, the patient fully recovered to normal state. Pathologic result was confirmed as ligamentum flavum hematoma. Ligamentum flavum hematoma of rigid thoracic spine is a very rare disease entity. Most reported cases were confined to mobile cervical and lumbar spine. Surgeons should be aware that there seems to be another different pathogenesis other than previously reported cases of mobile cervical and lumbar spine.

골연골종으로 인한 과두절제 후 하악지 수직 골절단술 및 bone sliding을 통한 즉시 재건: 증례보고 (IMMEDIATE RECONSTRUCTION USING VERTICAL RAMUS OSTEOTOMY AND BONE SLIDNG AFTER CONDYLECTOMY DUE TO OSTEOCHONDROMA: A CASE REPORT)

  • 장지영;오제경;차두원;백상흠
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권3호
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    • pp.233-240
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    • 2007
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.