• Title/Summary/Keyword: Head & neck pain

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Short-Term Results of Osteochondral Autologous Transfer and Femoral Neck Osteochondroplasty for the Treatment of Osteochondral Lesions of the Femoral Head and Concomitant Femoroacetabular Impingement Syndrome: A Case Series

  • Fernando Diaz-Dilernia;Franco Astore;Martin Buttaro;Gerardo Zanotti
    • Hip & pelvis
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    • v.34 no.3
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    • pp.177-184
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    • 2022
  • This study aimed to analyse the initial results of five patients with symptomatic osteochondral lesions (OCL) and femoroacetabular impingement (FAI) who were treated successfully with osteochondral autologous transfer (OAT) and femoral neck osteochondroplasty (OCP) through surgical dislocation of the hip. Five patients with FAI and OCL of the femoral head who underwent surgery between 2015-2018 were studied retrospectively. All patients had a grade IV OCL, and the median defect size was 2 cm2 (interquartile range [IQR], 2-2). At the final follow-up, the modified Harris hip score showed a median value of 94 (IQR, 91-95) (P=0.04). Pain evaluation using the visual analogue scale showed a median value of 1 (IQR, 1-2) (P=0.04). Adequate graft union and healthy formation of the chondral surface were observed by magnetic resonance imaging. Although the procedure is demanding, the combination of OAT and femoral neck OCP appears to be an effective alternative in young patients.

Salvage Treatment of Nasopharyngeal Carcinoma (비인강암종의 구제치료)

  • Choi Jong-Ouck;Kim Yong-Hwan;Min Hun-Ki;Choi Geon;Kweon Hee-Weon
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.3-7
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    • 1996
  • Nasopharyngeal carcinoma(NPC) is a disease whose primary initial treatment is radiation. Results of radiation therapy in early stage disease is promising; however, in stage IV disease, the best reported five-year survival is only about 30%. In patients with post-radiation recurrent disease, radiation controls only a small portion of patients, as well as being associated with significant radiation injury. In this paper we discuss the use of salvage treatment modalities for post-radiation recurrence. A retrospective chart review and analysis of salvage treatment results were performed for 39 patients with recurrent post-radiation NPC and positive cervical lymph nodes during the period beginning 1985 until 1995. Mean age of these patients was 52.3$\pm$10.37 years and male: female ratio was 1.8 : 1. Twenty patients were treated with salvage treatment, and ten patients were treated by salvage chemotherapy. A total of nine patients underwent surgical salvage treatment, including neck dissection(6), transnasal laser surgery and booster radiotherapy(2), and primary surgery(1). Salvage treatment were effective in reducing patients' pain in twenty patients (51.3%) and prolonging life in nine patients(23.1%); however, recurrence of disease within six months and/or residual disease by clinical or radiologic exam was noted in all patients receiving salvage radiotherapy, chemotherapy, laser surgery with radiotherapy, and primary site surgery. In the group undergoing salvage neck dissection, three patients(50%) were disease free for at least two years. Of the different modalities, radiotherapy was associated with the best quality of life while catastrophic salvage surgery resulting in insignificant prolongation of life was associated with the poorest quality of life. We conclude that salvage surgery is the optimal choice of treatment for regional recurrence such as nodal failure, however palliative salvage therapy could be preferred in other cases with recurrent post-radiation NPC.

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A Clinical Review of Parotid Tumor (이하선 종양의 임상적 고찰)

  • Kang Gyeong-Beom;Oh Sung-Soo;Park Sung-Gil;Seel David J.;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.221-227
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    • 1997
  • The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.

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The Effect of a Exercise and Transcutaneous Electrical Nerve Stimulation in Subjects With Chronic Neck Pain (운동치료와 경피신경전기자극 치료가 만성경부 통증에 미치는 효과)

  • Byun Suk-hee;Bae Sung-Soo;Bae Ju-Han;Moon Sang-Eun;Kim Sik-Hyun
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.110-125
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    • 2003
  • The purpose of this study investigated cervicocephalic kinesthetic sensibility in patients with chronic neck pain and the effect of a exercise treatment and transcutaneous electrical nerve stimulation. Fourteen patients with a chronic neck pain participated in this study. Subjects were divided into three groups, one group had undergone medicine, another medicine and TENS, the other medicine and TENS and exercise. the result of this research were as follow 1. No significant differences were found in medicine group and medicine and TENS during 4 weeks follow-up(P>.05). 2. Head reposition errors were significant in medicine and TENS and exercise during 4 weeks follow-up(P<.05). 3. In a period of treatment time, significant differences were found in each groups(P<.05).

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Correlation Between the Lateral Flexion Postural Habit of the Neck and Sense of Position (경부의 외측굴곡 자세습관과 위치감각과의 관계)

  • Kim, Young-Min
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.2
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    • pp.1-9
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    • 2011
  • Background: Injury or pain in the neck can affect proprioception. People who have a reduced proprioception are easily exposed to induce injury or pain. The aim of this study was to examine the reduced proprioception among people who had lateral flexion postural habit of neck in a sitting position. Methods: Twenty subjects with lateral flexion postural habit were compared with a matched control group. Relocation errors in 30 degree rotation to the right were measured three times with and without visual information randomly. Results: Relocation errors were higher in the lateral flexion postural group than the control group with (p<.01) and without (p<.005) the visual information. Visual information didn't affect the cervical relocation errors in the abnormal and control groups. Repetition is increased the relocation errors with (p<.01) and without (p<.001) visual information. Conclusions: The results support the hypothesis that subjects with lateral flexion postural habit have incorrect perception of their head position. It is necessary to realize the possibility of injury or pain found among people with lateral flexion postural habit.

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Dental hygienists work-related musculoskeletal symptoms and factor analysis (치과위생사의 직무관련 근골격계 자각증상과 요인분석)

  • Park, Sae-Rom;Shim, Youn-Soo;Jung, Sang-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.4
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    • pp.685-693
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    • 2012
  • Objectives : This research was conducted to find the subjective symptoms of musculoskeletal system for main jobs and job posture. Methods : A survey was conducted from September 15, 2011 to October 7, 2011 and 357 dental hygienists were responded. The survey was consisted of the working environment and medical equipments, psycho-social characteristics, health habits and education, job posture, subjective symptoms of musculoskeletal system pain, and so on. Results : In the survey on the frequency of job posture of dental hygienists by jobs, said they cast down or tilt their head by 15 degrees or more or twist or bend their back. The result of the analysis on the subjective symptoms of musculoskeletal system by main job showed that they experienced a pain in neck, shoulder, and back, although the order differed. The order of subjective symptoms of musculoskeletal system for casting down or turning head by 15 degrees or more, twisting or bending back, having shoulders not parallel to the ground, sitting at the end of a chair, and supporting the whole body with one leg or pressing on a pedal for treatment was from the shoulders to the neck to the back. The order of subjective symptoms of musculoskeletal system for having arms too far from the body or hunching for treatment and bending wrists inward or outward for treatment was from the shoulders to the back to the neck. Conclusions : Due to the characteristics of the job which requires one to have a proper view of a patient's oral cavity, most of the postures included casting down of head or bending of back. Therefore a development of new postures is needed to replace the existing job postures which pressure the musculoskeletal system. And shift rotation can be used as a preventive measure.

Clinical Features Related to Occlusion and Head and Neck Posture in Patients with Internal Derangement of Temporomandibular Joint (악관절내장환자에서 교합관계와 두경부자세의 임상적 양상에 관한 연구)

  • 정호인;한경수;이규미
    • Journal of Oral Medicine and Pain
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    • v.23 no.2
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    • pp.127-141
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    • 1998
  • This study was performed to investigate the clinical features of internal derangement of temporomandibular joint. For this study, 117 patients with temporomandibular disorders and 81 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the control group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, maximal mouth opening range, and affected side were recorded clinically. Head and shouldeer posture was measured in a groundplate on which square diagram of five centimeters each had been drawn, and cephalograph was also taken for measurement of head and neck posture. Sonopak of Biopak system (Bioresearch inc., USA) was used to record joint vibration for evaluation of internal healthy status of temporomandibular joint. The data collected were analyzed by SAS statistical program. The results of this study were as follows : 1. Frequency of left side chewing subjects was higher in patients than in control group, but there was no difference in distribution of subjects by Angle's classification. Other types was prvalent in patients whereas group function was more in control group for lateral guidance pattern. 2. As to lateral guidance pattern by clinical diagnosis, patients with internal derangement and/or degenerative joint disease showed higher frequency was consistent with the result by Sonopak impression. 3. There was no difference for shoulder height between the two groups, however, tilting of head and backward extension of cervical spine was more frequent in control group. 4. Acromion was positioned more anteriorly in patients with internal derangement and/or degenerative joint disease than in control group and angle between eye and tragus was larger in patients. Patients with degenerative joint disease showed more flexed head posture than control group did in cephalometric profile. 5. Maximal mouth opening range in patients with internal derangement was the least in all subgroups in patients classified by Sonopak impression.

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Induction of Local and General Analgesia by Electroacupuncture in Dogs (개에 있어서 침술에 의한 국소 및 전신마취에 관한 연구)

  • 남치주;서강문
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.244-253
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    • 1997
  • This study was performed to evaluate the possibility of inducing analgesia by electroacupuncture stimulation at single acupoint or combined acupoints and to examine the analgesic effects following the combination of premedication and electroacupunrture analgesia(EA). Analgesia was induced by EA with the current of 1-4 volts and the frequency of 10-45 Hz to the acupoints Uown to be related to analgesia on the head/necIL axial part thoracic and pelvic limb. In Yi Feng acupoint of head/neck part pain responses were not disappeared after electroacupunrture stimulation to the head/necIL thoracic limbo thoraxl abdomen, loin, rear and pelvic limb. Pain responses were remained after EA of Tian Men-Tian Ping and Shen Yu arupoints of axial park whereas hypoalgesia was observed after EA of Tian Ping-Bai Hui acupoint in all parts of body. There was no analgesic effects after EA stimulation of the brachial plexus and Wai Kuan acupoint, whereas after EA stimulation of San Yang Lo, pain responses were disappeared in headfnecll, thoracic limb and pelvic limbo and in the other parts of body hypoalgesia was shown. In EA stimulation of Tsu San Li acupoint pain responses were disappeared in pelvic limb and in San Yin Chiao acupoint pain responses were disappeared in head/necIL thoracic and pelvic limb, and hypoalgesia was shown in abdomen. On the combination of San Yang Lo Pli Men) and San Yin Chiao (Pu Yan6 acupoints, pain response in heauneck was decreased in 5 minutes, whereas analgesia in thoracic and pelvic limb was induced after 20-30 minutes and in abdomen was noted after 50 minutes. The more frequrncy was increased, the more rapid analgesic e11%t was induced. The analgesic effects wert not good in laparotomy under EA at the combination of San Yang Lo (Xi Men) and San Yin Chiao (Pu Yang) arufoints. Enteroanastomosis could not be continued under acrpromazine, xylazine and diazepam with EA. However, under EA followed by tiletaminetzolazepam, the operation could be completed without additional anesthesia and the analgesic effects were good. There were no changes in clinical signs, hematological and serological values after combination of the premeditation of tiletamine+zolaEepam and EA. It is considered that EA alone is not suitable for the main surgery, but the combination method of EA and sedatives can be utilized in practice.

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Canalicular Adenoma of the Parotid Gland (이하선에 발생한 소관 선종)

  • Shin Dong-Woo;Chung Woung-Youn;Shim Jeong-Yun;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.269-274
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    • 1997
  • Parotid canalicular adenoma is a benign neoplasm that is predominantly composed of branching and interconnecting cords of single or double rows of columnar epithelium in a very loose stroma. There has been considerable confusion in the literature concerning the terminology of canalicular adenoma. However, thesedays it has been newly-recognized as a discrete entity of the monomorphic adenoma group. Canalicular adenoma has a remarkable predilection for occurrence in the minor salivary glands such as the upper lip, in contrast with basal cell adenoma that occurs predominantly in major salivary glands such as the parotid gland. We have experienced a case of canalicular adenoma of the parotid gland in a 65-year-old woman. The patient had a palpable mass on the preauricular area for the last 15 years and recently noticed a mild pain and discomfort on the mass. Neck ultrasonography showed a low echogenic mass of 1.0cm in diameter in the right parotid gland and a neck CT scan showed a well-enhanced rectangular-shaped mass. A superficial parotidectomy was performed for the lesion and the final pathologic diagnosis turned out to be 'multifocal canalicular adenoma'.

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A Case Report on Chronic Tension-type Headache Improved by Korean Medicine with Chuna Manual Therapy (추나요법을 병행한 한방치료로 호전된 만성 긴장성 두통 치험 1례)

  • Won, Je-Hoon;Ahn, Hee-Duk;Woo, Chang-Hoon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.105-111
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    • 2013
  • Objectives : The purpose of this study is to evaluate the Korean medical treatment for chronic tension-type headache, especially chuna manual therapy on cervical vertebrae. Methods : One patient was treated with acupuncture, herbal medication and chuna manual therapy on cervical vertebrae. To evaluate the pain of head and neck, visual analog scale(VAS) was measured. Results : After treatment for 1 week, the pain of head and neck was declined from VAS 10 to VAS 3. Conclusions : Korean medical treatment including acupuncture, herbal medication and cervical chuna manual therapy is effective for chronic tension-type headache. But further studies are required to prove the effectiveness of chuna manual therapy on cevical vertebrae.

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