• 제목/요약/키워드: Obturator

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조대술을 이용한 함치성 낭종의 치료 (CASE OF DENTIGEROUS CYSTS TREATED BY MARSUPIALIZATION)

  • 박성진;이광희;김대업
    • 대한소아치과학회지
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    • 제30권3호
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    • pp.459-464
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    • 2003
  • 함치성 낭종이란 퇴축법랑상피와 법랑질 표면 사이에 체액이 축적되어 치관이 내강의 안쪽에 있으며 치근은 바깥쪽에 위치하는 매복치 치관을 둘러싸는 치원성 낭을 의미한다. 함치성 낭종의 치료법으로는 적출술, 조대술, 감압술 및 외과적 절제술이 있다. 본 증례는 하악 제2유구치의 만기잔존을 주소로 내원한 환아들을 검사하였다. 두 환아에서 해당 제2유구치의 협측부에서 팽융을 관찰하였다. 두 환아, 모두 방사선사진상 하악 제2소구치의 치관을 포함한 단방성의 방사선투과상이 보였으며 조직검사 결과 함치성 낭종으로 진단되었다. 본 증례에서 발치와를 통한 조대술을 시술하였다. 제2유구치를 발거하고 바세린 거즈로 발치와를 보호한 후 익일에 보격장치를 겸한 obturator를 장착해 주었다. 시술 후 매복된 영구치는 정상 맹출속도보다 빠르게 맹출하는 양상을 보이고 있다.

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상악골 절제술을 시행한 완전 무치악 환자에서 폐쇄장치를 이용한 보철 수복 증례 (Prosthetic rehabilitation of a fully edentulous patient after maxillectomy: A case report)

  • 윤정훈;김종진;백진;차현석;이주희
    • 대한치과보철학회지
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    • 제55권1호
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    • pp.88-93
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    • 2017
  • 수술로 인한 상악골 결손 환자는 저작, 발음, 연하의 기능적 손상과 안모 변형으로 인한 어려움을 겪게 된다. 보철 치료의 목적은 폐쇄 장치를 통해 가능한 한 정상적인 기능과 안모를 회복하는 것이다. 이러한 목표는 재건에 대한 보철과 의사와 외과 의사의 술 전 의사소통을 통해 성취할 수 있다. 본 증례에서는 우측 상악동에 편평상피암 진단을 받은 환자에서 수술 전 치과 검진을 통해 보철적 재건에 대한 계획을 수립하였다. 상악골 절제술 4개월 후 수술용 폐쇄장치, 이행 폐쇄장치를 거쳐 최종 폐쇄장치를 제작하였다. 이를 통해 환자는 저작, 발음, 연하, 안모의 만족스러운 개선을 얻었기에 보고하고자 한다.

개에서 내폐쇄근 변위술을 이용한 회음탈장 정복 3예 (The Use of Internal Obturator Transposition for Perineal Herniorrhaphy in Three Dogs)

  • 윤헌영;강명곤;정순욱
    • 한국임상수의학회지
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    • 제26권6호
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    • pp.632-636
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    • 2009
  • 회음부 팽대 병력을 보이는 세 마리 개가 건국대학교 부속 동물병원과 한강 동물병원에 내원하였다. 회음부 팽대 외에 다른 증상이 없었으며 신체 검사에서 두 마리는 환납성 한 마리는 비 환납성임을 확인 하였다. 일반 방사선 사진에서 골반강 또는 복강 내 장기가 탈장 낭 내에 없음을 확인하였다. 회음 탈장의 교정을 위해 내폐쇄근 변위 탈장 봉합술 실시 하였다. 한 마리에서 수술 후 지방을 함유하고 있는 대측 탈장이 확인되었다. 수술 후 정기 점진은 수의사의 신체 검사 혹은 보호자와의 전화 통화를 통해 실시 되었으며 세 마리 모두에서 수술과 관련한 좌골 신경 손상, 직장 탈출, 수술 부위 열개, 회음 탈장 재발과 같은 합병 증상이 없음을 확인하였다.

Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases

  • Salvatori, Pietro;Mincione, Antonio;Rizzi, Lucio;Costantini, Fabrizio;Bianchi, Alessandro;Grecchi, Emma;Garagiola, Umberto;Grecchi, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제39권
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    • pp.13.1-13.8
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    • 2017
  • Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

Modified Urethral Graciloplasty Cross-Innervated by the Pudendal Nerve for Postprostatectomy Urinary Incontinence: Cadaveric Simulation Surgery and a Clinical Case Report

  • Hisashi Sakuma;Masaki Yazawa;Makoto Hikosaka;Yumiko Uchikawa-Tani;Masayoshi Takayama;Kazuo Kishi
    • Archives of Plastic Surgery
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    • 제50권6호
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    • pp.578-585
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    • 2023
  • An artificial sphincter implanted in the bulbous urethra to treat severe postprostatectomy urinary incontinence is effective, but embedding-associated complications can occur. We assessed the feasibility, efficacy, and safety of urethral graciloplasty cross-innervated by the pudendal nerve. A simulation surgery on three male fresh cadavers was performed. Both ends of the gracilis muscle were isolated only on its vascular pedicle with proximal end of the obturator nerve severed and transferred to the perineum. We examined whether the gracilis muscle could be wrapped around the bulbous urethra and whether the obturator nerve was long enough to suture with the pudendal nerve. In addition, surgery was performed on a 71-year-old male patient with severe urinary incontinence. The postoperative 12-month outcomes were assessed using a 24-hour pad test and urodynamic study. In all cadaveric simulations, the gracilis muscles could be wrapped around the bulbous urethra in a γ-loop configuration. The length of the obturator nerve was sufficient for neurorrhaphy with the pudendal nerve. In the clinical case, the postoperative course was uneventful. The mean maximum urethral closure pressure and functional profile length increased from 40.7 to 70 cm H2O and from 40.1 to 45.3 mm, respectively. Although urinary incontinence was not completely cured, the patient was able to maintain urinary continence at night. Urethral graciloplasty cross-innervated by the pudendal nerve is effective in raising the urethral pressure and reducing urinary incontinence.

Anatomical Observation on Components Related to Foot Gworeum Meridian Muscle in Human

  • Park, Kyoung-Sik
    • 대한한의학회지
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    • 제32권3호
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    • pp.1-9
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    • 2011
  • Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

Acquired palatal defect의 보철적 수복

  • 하일수
    • 대한치과보철학회:학술대회논문집
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    • 대한치과보철학회 1992년도 춘계학술대회
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    • pp.10-11
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    • 1992
  • 상악골이 부분적으로 결손된 환자의 증가와, 수술 후 수명의 연장으로 좀 더 확실한 보철물이 요구되고 있다. 본 증례에서는 종양으로 인해 상악골의 Leoisection을 시행한 2명의 환자에 대하여 obturator를 제작, 창착하여 발표, 심미, 기능 및 심리적인 개선이 이루어졌다. 그러나 악골 자체의 부분의 소실로 외치의 지지 및 유지등에 한계성이 있으므로, 장래의 Hemimaxillectomy가 시행된 악궁에 대한 의치의 설계에 관한 더 많은 연구가 진행되어야 하겠다.

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30대 성인의 골반, 척추 및 견갑대 정렬의 패턴 분석 - Full Spine AP X-ray 분석에 따른 - (The Study on Static Alignment Classification based on the Full Spine AP X-ray of Adults aged 30-39)

  • 박지현;홍서영
    • 한방재활의학과학회지
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    • 제20권2호
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    • pp.89-99
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    • 2010
  • Objectives : This study was designed to analyze the pattern of asymmetrical alignment. Methods : This study was carried out with the data from comprehensive medical testing. 91 subjects aged 30-39 were evaluated by full spine AP X-ray. For pelvis, innominate measurement(IM), off centering measurement(OCM), ilium shadow measurement(ISM), major axis of obturator foramen(MaF), minor axis of obturator foramen(MiF) were analyzed. Spinal curvature and height of shoulder girdle were analyzed. Results : 1. In pelvis, It. posterior-inferior and it. inflare combination pattern was 38 cases(42.8%). 2. In spinal curvature, "reverse S" curve was 45 cases(49.4%) and "reverse C" curve was 30 cases(33%). 3. In shoulder girdle, It. superior pattern was 42 cases(46.1 %) and It. superior pattern was 39 cases(42.9%). 4. In whole body analysis, It. posterior-inferior and It. inflare pelvis, "reverse S" spinal curvature and It. superior shoulder girdle combination patten was 11 cases(12.1 %). This pattern is similar to Kendall's right handedness pattern and Zink's common compensatory pattern. Conclusions : Results from this investigation showed asymmetrical alignment in 30-39 years-old adults. This results are expected to contribute to classifying the alignment pattern in clinic and systemic treatment.

상악 전치부에서의 큰 팽창성 낭종과 연관된 다수 영구치의 맹출 유도: 증례 보고 (Eruption Guidance of Multiple Permanent Teeth Associated with Expansive Large Cyst in Maxillary Anterior Region: Two Case Reports)

  • 손혜지;이제식
    • 대한소아치과학회지
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    • 제50권1호
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    • pp.121-130
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    • 2023
  • 소아들에게서 커다란 치성낭은 주위 해부학적 구조물뿐만 아니라 발육 중인 영구치의 변위를 일으키게 되는데 이러한 경우 적출술이나 조대술이 치료법으로 사용되어 진다. 이 증례는 상악에서 발생한 커다란 낭종으로 인해 3개 이상의 영구치와 더불어 상악동 기저부의 거상이 함께 발생한 5세 남자 환자, 10세 남자 환자 2가지 증례를 보고하고 있다. 두 증례 모두에서 합병증을 최소화하기 위해 조대술이 선택되었으며 조대술 후 맹출 유도를 위한 맞춤 제작 아크릴 폐쇄 장치(obturator), 개창술(window opening), 교정적 견인을 점진적으로 시행하여 양호한 예후를 보였기에 이를 보고하는 바이다.