• Title/Summary/Keyword: Office-based surgery

Search Result 45, Processing Time 0.027 seconds

Office-Based EMG-Guided Botox Injection to Cricopharyngeus Muscle in ENT Clinic (근전도유도하 윤상인두근 보톡스 주입 술의 유용성)

  • Kim, Hyun-Sung;Chung, Eun-Jae;Rho, Young-Soo;Park, Dong-Sik
    • Korean Journal of Bronchoesophagology
    • /
    • v.19 no.1
    • /
    • pp.19-24
    • /
    • 2013
  • Objective The objective was to evaluate changes in swallow safety and dietary status after the transcutaneous injection of botulinum toxin into the upper esophageal sphincter in a series of outpatients with dysphagia. Methods Patients who were at risk for aspiration and who had an unsuccessful trial of swallowing therapy were admitted to the study. All patients showed significant pooling of fluids in the pyriform sinus. All patients were treated in the office; none had previous esophageal dilatation. The upper border of the cricoid cartilage was identified using standard electromyogram procedures and botulinum toxin was injected. Outcomes were assessed using the penetration-aspiration scale, NIH swallowiwng safety score, patients' short-term and long-term subjective impressions of their ability to swallow, and change in dietary status. Results Ten patients underwent an instrumental evaluation of swallowing function. Of the 10 patients, 9 showed an overall improvement in their ability to take an oral diet safely. The penetration-aspiration scale, NIH swallowiwng safety score, patients' short-term and long-term subjective impressions of their ability to swallow, and change in dietary status were significantly improved after office-based botox injection. Conclusion Office-based EMG guided botox injection to the cricopharyngeus muscle is a simple, safe, and effective tool for dysphagia patients. Injection of Botox in the office should be considered when the dysphagia pattern is aspiration after swallow.

  • PDF

Technical Review of How to Determine the Exact Location of Needle Tip During Office-Based Injection Augmentation of the Vocal Folds Via Cricothyroid Approach (외래에서 시행하는 경윤상갑상막 접근 성대주입술 중 주입 위치를 정확하게 파악하는 방법에 관한 기술적 고찰)

  • Park, Sung Joon;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.29 no.2
    • /
    • pp.70-75
    • /
    • 2018
  • The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

Association of the number of remaining teeth with kidney function in community-dwelling healthy older adults: a cross-sectional study

  • Yui Nanba;Yuhei Matsuda;Satsuki Watanabe;Mayu Takeda;Takafumi Abe;Kazumichi Tominaga;Minoru Isomura;Takahiro Kanno
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.49 no.5
    • /
    • pp.243-251
    • /
    • 2023
  • Objectives: Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function. Materials and Methods: We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m2 and creatinine levels, mg/dL). Results: The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=-0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function. Conclusion: This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

Use of office-based ultrasonography for soft tissue lesions : A report of 3 cases with literature review (안면부 연조직 진단에서 외래기반 초음파의 사용 : 증례 보고(3례) 및 문헌 고찰)

  • Kim, Jae-Young;Kim, Min-Kyu;Lee, Sung-Hwa;Kim, Hyung Jun;Nam, Woong
    • The Journal of the Korean dental association
    • /
    • v.53 no.2
    • /
    • pp.143-152
    • /
    • 2015
  • Ultrasonography is relatively inexpensive, non-invasive imaging tool and provides real-time imaging. In addition, the images can be obtained repeatedly. But it is not widely used by dentists because it is hard to interpret and technique sensitive. Above all, ultrasonography cannot be used for hard tissue diagnosis. However, ultrasonography can be applied for diagnosis of infection, soft tissue tumor and inflammatory muscle diseases which are commonly found in dental outpatients. Generally, it shows well-defined border, hypoechoic and homogenous structure in case of benign tumor. Malignant tumor appears relatively irregular margin and heterogenous structure. Cyst represents relatively echo-free features compared with benign tumor. Although the general characteristics of abscess are similar with benign tumor, we can observe an increased vascularity and different clinical features. The purpose of this report is to present 3 cases of US images using office-based ultrasonography with their features and discuss the role of office-based ultrasound in dentistry for diagnosis of soft tissue lesions with literature review.

Quality Assessment of Hypertension Management of Office-based Physicians in Korea (우리 나라 개원의 고혈압 관리의 질 평가)

  • Cho, Hong-Jun;Lee, Sang-Il
    • Quality Improvement in Health Care
    • /
    • v.4 no.1
    • /
    • pp.36-49
    • /
    • 1997
  • Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.

  • PDF

Update on Angiolytic Laser Laryngeal Surgery (혈관용해 레이저를 이용한 후두미세수술 최신 지견)

  • Kang, Min Seok;Lim, Jae-Yol
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.32 no.2
    • /
    • pp.51-55
    • /
    • 2021
  • There are several lasers available for office-based or suspension microlaryngoscopy laser procedures in the treatment of laryngeal diseases. Each has advantages and disadvantages given the depth of penetration per unit of power, absorption in water, spectral absorption characteristics, mode of delivery, safety, and cost. It is important to note that while the proper selection of indication of treatment based on a laser wavelength is critical, of equal importance is selecting the appropriate power setting, focal length (or spot size), and time of exposure. The photoangiolytic lasers precisely target hemoglobin within the microcirculation of the highly vascularized tissue and may have better hemostatic effects and preservation of surrounding normal tissue than the CO2 laser. Although the choice of laser is purely theoretical and cannot be accurately concluded which parameters of laser (wattage and pulse width) were best to use, photoangiolytic laser surgery is safe and effective for specific laryngeal lesions. In this review, indications for photoangiolytic laser procedures for various laryngeal diseases, laser settings and surgical techniques for specific laryngeal lesions including sulcus vocalis, laryngeal dysplasia, and recurrent respiratory papillomatosis will be introduced. Pros and cons of in-office laser surgery using photoangiolytic laser and flexible CO2 laser will also be addressed.

Benefits of Palliative Office-Based Hyaluronic Acid Injection Laryngoplasty in Cancer-Related Unilateral Vocal Cord Paralysis Patients (악성 종양 관련 일측성 성대 마비 환자에서 고식적 Hyaluronic Acid 성대 주입 성형술의 유용성)

  • Kim, Go-Woon;Park, Young-Hak;Joo, Young-Hoon;Kim, Sang-Yeon;Shim, Mi-Ran;Hwang, Yeon-Sin;Sun, Dong-Il
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.29 no.1
    • /
    • pp.30-36
    • /
    • 2018
  • Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.