• Title/Summary/Keyword: Surgery, technique

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L-Shaped Columellar Strut in East Asian Nasal Tip Plasty

  • Dhong, Eun-Sang;Kim, Yeon-Jun;Suh, Man Koon
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.616-620
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    • 2013
  • Background Nasal tip support is an essential consideration for rhinoplasty in East Asians. There are many techniques to improve tip projection, and among them, the columellar strut is the most popular technique. However, the conventional design is less supportive for rotating the tip. The amount of harvestable septal cartilage is relatively small in East Asians. For an optimal outcome, we propose an L-shaped design for applying the columellar strut. Methods To evaluate the anthropometric outcomes, the change in nasal tip projection and the columella-labial angle were analyzed by comparing preoperative and postoperative photographs. The anthropometric study group consisted of 25 patients who underwent the same operative technique of an L-shaped strut graft using septal cartilage and were followed up for more than 9 months. Results There were statistically significant differences between the preoperative and postoperative values in the nasal tip projection ratio and columella-labial angle. We did not observe any complications directly related to the L-shaped columellar strut in the anthropometric study group. Conclusions The L-shaped columellar strut has advantages not only in the controlling of tip projection and rotation, but in that it needs a smaller amount of cartilage compared to the conventional septal extension graft. It can therefore be an alternative technique for nasal tip plasty when there is an insufficient amount of harvestable septal cartilage.

Pigmented Villonodular Synovitis of the Ankle and Subtalar Joint Treated by Surgical Excision and Ligament Reconstructions: A Case Report

  • Shin, Jae-Hyuk;Lee, Byung Hoon;Kim, Gab-Lae;Kim, Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.192-195
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    • 2016
  • Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

Novel approach to the maxillary sinusitis after sinus graft

  • Hong, Sung ok;Shim, Gyu-Jo;Kwon, Yong-Dae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.18.1-18.4
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    • 2017
  • Background: Postoperative infection occurs when bone graft material is dislodged into the maxillary sinus cavity and most of the patients are often uncomfortable with the drainage and irrigation procedures to eradicate the infection. In this case report, we share a technique in treating patients with such condition. Material and methods: A 47-year-old patient was referred after sinus elevation using the crestal socket osteotome, bone graft, and implant insertion at a local clinic. Clinical and radiographic findings confirmed the diagnosis of right maxillary sinusitis. A surgical and medical treatment regimen was applied. Results: By using this technique for irrigation, we were able to achieve successful results, and the patient was satisfied due to less discomfort during the irrigation process. Conclusion: This method is a patient-friendly technique for sinus irrigation. It is not only limited to sinus grafted patients, but also maxillary sinusitis patients in any other type of odontogenic infection.

Application of Hand Towel Drape over Dingman Mouth Gag

  • Choi, Kyeong Beom;Park, Myong Chul
    • Archives of Craniofacial Surgery
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    • v.16 no.1
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    • pp.29-30
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    • 2015
  • In cleft palate surgery, the environment is especially critical when suturing. Encum-bered, obstructive space in the environment can hinder a suture while using the Dingman mouth gag. We introduced a novel but simple draping technique. A simple hand towel is placed over the gag. A hole is cut out in the middle according to each patient's mouth. After making the hole, the hand towel is soaked in water and gently squeezed. Then the towel is properly placed over the Dingman mouth gag. Dripping water on the hand towel during the suture helps keep it in place. Using this draping technique, we cut 14 minutes of operation time compared to the average operation time of the past 2 years. There were several disadvantages in previous draping method. First, long suture material may easily get caught. Second, the operation field can easily be contaminated. Third, focusing on the operation becomes difficult due to the obstruction. This draping technique can compensate for the disadvantages of the previous Dingman mouth gag.

Soft tissue reconstruction in wide Tessier number 3 cleft using the straight-line advanced release technique

  • Kim, Gyeong Hoe;Baek, Rong Min;Kim, Baek Kyu
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.255-259
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    • 2019
  • Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods

  • Al-Zajrawee, Mustafa Zahi;Aljodah, Mohammed Abd-Alhussein;Hassan, Qays Ahmed
    • Archives of Plastic Surgery
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    • v.46 no.2
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    • pp.114-121
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    • 2019
  • Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle. Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a modification of the Millard and Manchester techniques. Patients with a very wide cleft lip and protruded or rotated premaxilla were excluded from this study. We analyzed 30 normal children for a comparison with our patients in terms of anthropometric measurements. Results By the end of the follow-up period (between 9 and 19 months), all our patients had obtained a full central segment with adequate white roll in the central segment and a deep gingivolabial sulcus, and we obtained nearly normal anthropometric measurements in comparison with age-matched normal children. Conclusions We recommend this modified technique for the treatment of bilateral cleft lip deformity.

The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.