• Title/Summary/Keyword: Posterior Neck Pain

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Squamous cell carcinoma of the maxillary sinus mimicking periodontitis

  • Na, Ji Yeon;Kang, Joo Hyun;Choi, Seong-Ho;Jeong, Ho-Gul;Han, Sang-Sun
    • The Journal of the Korean dental association
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    • v.55 no.4
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    • pp.276-283
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    • 2017
  • Maxillary sinus squamous cell carcinoma is a relatively rare disease, comprising only 3% of malignant diseases of head and neck. As the growth rate is high and its prognosis is poor compared to others, the 5-year survival rate of maxillary sinus squamous cell carcinoma(MSSCC) is 23.4-49%. We introduce two rare clinical cases of squamous cell carcinoma originated from maxillary sinus of which symptoms include toothache and gingival swelling. On clinical examinations of both patients, deep periodontal pockets on upper right posterior teeth were detected. On panoramic images, the bony destruction of the maxillary sinus and its surrounding structures were not obvious and only alveolar bone loss was noted. It is difficult to diagnose MSSCC at an early stage due to symptoms of tooth pain and gingival swelling that are similar to that of periodontal diseases. However, if the symptoms do not improve after routine treatment of upper teeth, dentists should bear in mind of underlying malignant mass as differential diagnosis, thus early detection of the lethal disease. The aim of this study is to caution dental practitioners that malignancies have a potential to mimic periodontal diseases by introducing two cases of maxillary sinus squamous cell carcinoma presented as periodontitis.

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Giant Cell Tumor of the Cervical Spine - Case Report - (경추에 발생한 거대 세포종 - 증례 보고 -)

  • An, Ki-Chan;Chung, Kyung-Chil;Kim, Yoon-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.57-62
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    • 2006
  • Giant cell tumors are potentially malignant tumors in vertebrae, affecting frequently difficult to diagnose and are often inoperable. So it will be treated using radiation because of their high recurrence rate and the mechanical compression of spinal cord, but many surgeons described tumors of the vertebra, and the affected vertebral body can be treated using radical or near to total excision, with anteroposterior vertebral fusion or instrumentation of the spine. we report a case of giant cell tumor affecting the third cervical vertebra which caused neck pain and destroyed the vertebra body had treated using radical excison with fusion of posterior arch using instrumentation of the spine together with a literature review.

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Effectiveness of Selective Peripheral Denervation for the Treatment of Spasmodic Torticollis

  • Huh, Ryoong;Ahn, Jung-Yong;Chung, Young-Sun;Chang, Jong-Hee;Chang, Jin-Woo;Chung, Sang-Sup
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.344-349
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    • 2005
  • Objective : The Bertrand's method of selective peripheral denervation for spasmodic torticollis has already been established as being an effective and safe method. However, such effectiveness has not yet been established in Korea. The authors have performed several cases of selective denervation for the treatment of spasmodic torticollis and we hereby describe the details of the operative method to determine the effectiveness of the method. Methods : Ten patients who had the selective denervation for the spasmodic torticollis from October 1997 to December 2003, were analyzed. There were 4 rotational and 6 combined types [3 rotational plus retrocollis, 3 rotational plus laterocollis]. We performed preoperative electromyograms and neck muscle tonograms in all cases. The technique was used to involve denervation of the ipsilateral posterior paraspinal muscles. Denervation of the sternocleidomastoid muscle was performed on the contralateral side for rotational torticollis and on the ipsilateral side for laterocollis combined type. The surgery was followed by a rigorous physical therapy program. Results : The surgical results were divided into 4 groups labeled excellent, good, fair, and poor. There were 5 excellent patients who showed no detectable abnormal movements, 4 good patients who showed slight residual deviations or slight residual abnormal movements, and 1 fair patient with appreciable residual abnormal movements. Postoperative pain was well tolerated. There was no significant surgical complications. Conclusion : The study confirms that selective peripheral denervation for the treatment of spasmodic torticollis is a very useful and safe surgical technique.

Clinical Evaluation of Mediastinal Tumors and Cysts - 50 cases report - (종격동 종양 및 낭종의 임상적 고찰: 50례 보고)

  • 오창근
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.245-252
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    • 1991
  • For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors and cysts, 50 patients with mediastinal tumors and cysts treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January, 1978 to Mach, 1990 were reviewed. The results of this cases analysis were as follows; 1. of all 50 mediastinal tumors and cysts, 27 patients were male and 23 patients were female. There was no sex preference. The age distribution was from 10 months to 84 years, and mean age was 37 years old, and no age preference. 2. Subjective symptoms were as follows : Dyspnea[54%], Chest pain[44%], Coughing [34%] Fever[16%] and General malaise[12%]. Objective signs were as follows: Decreased breathing sound[46%], Pleural effusion and hemothorax[32%], Palpable neck mass[24%] and SVC syndrome[14%]. But, there were no definitive symptoms in 5 cases[10%]. 3. The most frequently encountered tumors were teratodermoid tumors[26%] followed by lymphomas[22%], thymomas[12%] and benign cysts[8%] in decreasing order of frequency. 4. Based on the subdivision of the mediastinum, 44% of the tumors were in the anterior mediastinum, 24% in the middle mediastinum, 18% in the superior mediastinum and 14% in the posterior mediastinum. 5. The malignant tumors were 25 cases[50%]. 6. The successful removal was possible in all the benign mediastinal tumors and cysts. In malignant cases, the surgical removal had been 12 cases and inoperable cases were treated to radiation and chemotherapy. 7. Postoperative complications were bleeding, wound infection, pneumothorax and vocal cord paralysis. The recurrence was 3 cases. 8. The most frequent mediastinal tumor in the west is neurogenic tumor but is teratoma in Korea.

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Osteochondroma at the Cervicothoracic Junction (경흉추 이행부에 발생한 골연골종)

  • Park, Yung;Ha, Joong Won;Kie, Jeong Hae;Hong, Seung-Pyo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.562-566
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    • 2019
  • Osteochondroma is a common benign bone tumor, but relatively rare in the spine. Spinal osteochondroma originates mainly from the posterior column and sometimes invades the spinal canal causing cord compression and myelopathy. A 36-year-old man was admitted to the authors' institution with a two-year history of neck pain. A radiology examination revealed osteochondroma, arising from the left superior articular process of the T1 vertebra with significant central canal narrowing. Most cases of the spinal osteochondroma originate in the cervical vertebra, but there are few reports of an origin of the cervicothoracic junction. This paper reports a case of osteochondroma at the cervicothoracic junction with a review of the relevant literature.

The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.33-39
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    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

The Prevalence Study of TMD and the Associated Factors in Korean Malocclusion Patients (한국인 부정교합자의 측두하악장애(TMD) 유병율과 그 기여요인에 관한 연구)

  • Kim, Myung-Hee;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.523-538
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    • 1997
  • In order to investigate TMD prevalence in malocclusion patients and to study its relationship with occlusal factors, 205 malocclusion patients (M67, F138, 6Y1M-46Y8M) were examined. The following examinations were carried out, Questionnaire personal history, TMD symptoms, and the associated factors Clinical examination : TMJ sound and maximum mouth opening Orthopantomogram : condyle abnormalities, length of Co'-Inc' and Co'-Go', ratio Co'- Inc'/ Co'-Go', and depth of antegonial notch Transcranial view limitation of anterior movement of condyle Model Angle classification, overjet, overbite, midline discrepancy, missing of posterior teeth, posterior crossbite, attrition of palatal cusp of maxillary molars, crowding/spacing The results could be summarized as follows, 1. The prevalence of TMD showed that Helkimo Anamestic Inder(Ai) 0 was $46.8\%$, Ai I was $22.0\%$, Ai II was $31.2\%$ and subjective symptoms increased with aging (p<0.001) and were frequent in females (p<0.05). 2. Flattening ($4.4\%$) was the most frequent condyle abnormality on Orthopantomogram, and $8.3\%$ of subjects showed some abnormalities on Orthopantomogram. 3. The cases with neck and shoulder pain (p<0.001), clenching, lip biting (p<0.01), and headache (p<0.05) showed higher scores of Ai. 4. Angle class II showed high frequency of condylar abnormalities on Orthopantomogram, and subjects whose palatal cusp of maxillary molars had been attrided had the tendency to show high hi scores (p<0.05). The other occlusal factors had nothing to do with the symptoms of TMD. 5. In the cases that 1)the value of Co'-Inc', Co'-Go' or Co'-Inc'/Co'-Go' were low or 2)the differences of Co'-Go' or Co'-Inc'/Co'-Go' between the right and the left were large, condylar abnormalities were frequently obserbed on Orthopantomogram.

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C7 Fracture as a Complication of C7 Dome-Like Laminectomy : Impact on Clinical and Radiological Outcomes and Evaluation of the Risk Factors

  • Yang, Seung Heon;Kim, Chi Heon;Lee, Chang Hyun;Ko, Young San;Won, Youngil;Chung, Chun Kee
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.575-584
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    • 2021
  • Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

Two Cases of Iatrogenic Pneumothorax after Intra-Muscular Stimulation (IMS) Therapy (근육 내 자극 요법 후 발생한 의인성 기흉 2예)

  • Son, Jun Gwang;Oh, In Jae;Jeong, Jong Pil;Kim, Soo Ok;Ju, Jin Yung;Lim, Jung Hwan;Cho, Gye Jung;Chae, Dong Ryeol;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.444-448
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    • 2007
  • Recently, intra-Muscular Stimulation (IMS) therapy is being increasingly used for musculoskeletal pain. This procedure is generally regarded as a safe procedure for the general public. Some cases of iatrogenic pneumothorax caused by acupuncture have been reported in the medical literature. However, a case of an IMS therapy associated pneumothorax has not reported. We experienced two cases of iatrogenic pneumothorax after IMS therapy. A 62 year-old man received IMS therapy on the right shoulder due to posterior neck pain. After IMS therapy, acute dyspnea and chest discomfort developed. The other patient was a 74 year-old woman who also received IMS therapy. This patient experienced a nonproductive cough and acute dyspnea after the treatment. As the popularity of this form of alternative medicine increases, we might expect to see more cases of iatrogenic pneumothorax. Physicians should be aware of the adverse events associated with IMS therapy.

An Analysis of Swimming Injuries and Their Rehabilitation (근육 골격계의 질환 및 재활분석(수영선수를 중심으로))

  • Kim, Kwi-Baek;Ji, Jin-Gu;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.32 no.4
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    • pp.325-330
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    • 2022
  • While swimming is a very popular competitive sports activity, swimming injuries are unique due to the repetitive nature of the swimming stroke and demanding training programs that can result in upper limb overuse. Therefore, the primary objective of this review was to analyze swimmers' injury areas, injury types by stroke type, and swimming rehabilitation, as well as to discuss safety management for improving swimming performance. In this study, the injuries incurred in swimming events were discussed in the order of upper limb injuries (neck, shoulder, arm, and wrist), lower limb injuries (knee and ankle), and waist injuries. An analysis by stroke type found that shoulder injuries occurred most often with freestyle, backstroke, and butterfly strokes, followed by rotator cuff injury, impingement syndrome, and SLAP (superior labral tear from anterior to posterior) lesions. Knee injuries were associated with the breaststroke, whereas spinal cord injuries occurred with the breaststroke and butterfly stroke. Finally, back injuries were associated with the butterfly stroke. During the freestyle stroke, the shoulder undergoes repetitive overhead movement; hence, shoulder and musculoskeletal pain are the most common and well-documented complaints of swimmers. For safety management, coaches and instructors must ensure that athletes do sufficient warm-up and cool-down exercises to avoid injuries. In case of an injury, they should be familiar with first aid measures so that secondary damage can be prevented with its quick application. In addition, coaches and instructors need to be trained in injury prevention and treatment so that they can provide appropriate rehabilitation treatment for athletes. Although swimming-related injuries cannot be completely eliminated, to reduce them to a minimum, leaders need the knowledge to apply scientific and systematic training principles and methods individualized for each athlete.