• Title/Summary/Keyword: Surgery, technique

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A CEPHALOMETRIC AND PANORAMIC ANALYSIS OF THE CHANGES OF THE CONDYLAR POSITION AFTER ORTHOGNATHIC SURGERY (하악전돌증 환자의 악교정 수술후 하악과두의 위치변화에 대한 연구)

  • Kang, Young-Ki;Kim, Jong-Ryoul;Yang, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.4
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    • pp.411-419
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    • 2000
  • Purpose: This study was aimed at analysis of the changes in the condyle position in subjects with mandibular setback osteotomies Method: Twenty patients were evaluated retrospectively for their changes in the condyle position who underwent surgical mandibular setback using bilateral sagittal split osteotomies with a manual condyle repositioning technique and rigid fixation. The cephalometric and panoramic analysis was performed preoperatively, 1 week, 6 months, and 1 year postoperatively. And postoperative noise, temporomandibular joint pain, and mouth opening were clinically examined 2 months, 4 months, 6 months, 8 months, 10 months, and 12 months postoperatively. Result: The condyles rotated posteriorly and laterally immediately after surgery, and they returned to the preoperative position during follow-up period but it is not significant. The statistical analysis (Paired t-test) showed no significant effects in postsurgical stability. The changes in the condyle position didn't have a significant harmful influence on temporomandibular joint disorder. Conclusion: A careful surgical mandibular setback using manual condyle repositioning and fixation technique will move condyle minimally and that will decrease the relapse and temporomandibular joint disorder.

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Surgical Management of Edentulous Atrophic Mandible Fractures in the Elderly

  • Chee, Nam Seok;Park, Seong June;Son, Min Ho;Lee, Eoy Jung;Lee, Soo Woon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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    • pp.207-213
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    • 2014
  • Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

Postoperative Systemic Dissemination of Injected Elemental Mercury

  • Kang, Suk-Hyung;Park, Seung-Won;Moon, Kyung-Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.245-247
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    • 2011
  • There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

IMPLANT REHABILITATION IN THE UNFAVORABLE ALVEOLAR RIDGE (불량한 치조제에서의 임플랜트 시술증례)

  • Park, Jae-Bum;Ahn, Sang-Hun;Cheung, Soo-Il;Jo, Byung-Woan;Ahn, Jae-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.1
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    • pp.35-44
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    • 1997
  • The most critical factor in determining which type of implant to be used would be the available bone of the patient. Usually a minimum of 5mm in the bone width and 8mm in the bone height is necessary to ensure primary implant stability and maintain the integrity of bone contact surface. Placement of implant is limited by the several anatomic strutures such as maxillary sinus, floor of the nose, inferior alveolar neurovascular bundle and nasopalatine foramen, etc. When severe resorption of alveolar ridge is encountered, implant placement would be a problematic procedure. A number of techniques to improve the poor anatomic situations have been proposed. This article reports 4 cases of patients using surgical procedures such as blade implant technique, cortical split technique in the anterior maxillary area, sinus lifting and lateral repositioning of inferior alveolar nerve, We treated dental implant candidates with unfavorable alveolar ridge utilizing various surgical techniques, resulted in successful rehabilitation of edentulous ridge.

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Modified Extracorporeal Reduction of the Mandibular Condylar Neck Fracture

  • Kim, Min-Keun;Kwon, Kwang-Jun;Kim, Seong-Gon;Park, Young-Wook;Kim, Jwa-Young;Kweon, Hae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.1
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    • pp.30-36
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    • 2014
  • There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

Unilateral intraoral vertical ramus osteotomy and sagittal split ramus osteotomy for the treatment of asymmetric mandibles

  • Lee, Jee-Ho;Park, Tae-Jun;Jeon, Ju-Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.2
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    • pp.102-108
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    • 2015
  • In surgery for facial asymmetry, mandibles can be classified into two types, rotational and translational, according to the required mandibular movements for surgery. During surgery for rotational mandibular asymmetry, a bilateral sagittal split ramus osteotomy (BSSRO) may cause a large bone gap between the proximal and distal segments as well as condylar displacement, resulting in a relapse of the temporomandibular joint disorder, especially in severe cases. The intraoral vertical ramus osteotomy has an advantage, in this respect, because it causes less rotational displacement of the proximal segment on the deviated side and even displaced or rotated condylar segments may return to their original physiologic position. Unilateral intraoral vertical ramus osteotomy (UIVRO) on the short side combined with contralateral SSRO was devised as an alternative technique to resolve the spatial problems caused by conventional SSRO in cases of severe rotational asymmetry. A series of three cases were treated with the previously suggested protocol and the follow-up period was analyzed. In serial cases, UIVRO combined with contralateral SSRO may avoid mediolateral flaring of the bone segments and condylar dislocation, and result in improved condition of the temporomandibular joint. UIVRO combined with contralateral SSRO is expected to be a useful technique for the treatment of rotational mandibular asymmetry.

Free Semitendinosus Tendon Graft in Re-ruptured Achilles Tendon (반건상근 건을 이용한 아킬레스건 재파열의 치료)

  • Ji, Jong-Hoon;Kim, Weon-Yoo;Kim, Young-Yel;Lee, Yeun-Soo;Yoon, Jong-Seoung
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.259-263
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    • 2006
  • The acute Achilles tendon rupture usually occurs to the people who participate in sports-related activities between 30 and 40 years of age. Recently surgical repair is the standard treatment in acute Achilles tendon rupture. After the Achilles tendon rupture in the left ankle, a 30-years old young man had been suffered from re-rupturing within three months after the primary repair. 2 years later, right-side Achilles tendon was reruptured after primary repair consequently. In the revision surgery, we performed V-Y advancement of the gastrocnemius-soleus fascia and reinforcement of the semitendinosus tendon. None of the English-literature was reported about using the semitendinosus tendon in revision surgery of the Achilles tendon retear previously. Therefore, we report this case and surgical technique because of the simple technique and the excellent results.

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Lateral Osteotomy with Sawing Technique in Open Rhinoplasty (개방 코성형술에서 톱을 이용한 외절골술)

  • Kim, Youn-Hwan;Lee, Hak-Sung;Naidu, Shenthilkumar;Kim, Jeong-Tae
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.499-530
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    • 2010
  • Purpose: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. Methods: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. Results: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. Conclusion: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

Reattachment of amputated auricle using postauricular subcutaneous pocket (귓바퀴 뒤 포켓을 이용한 절단된 외이의 재접합)

  • Jang, Ju Yun;Kang, Dong Hee;Lee, Chi Ho;Oh, Sang Ah
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.660-662
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    • 2009
  • Purpose: There are several modalities to reattach the amputated auricle. Microvascular replantation can achieve the best outcome, but technically difficult. Conventional composite graft is technically easy, but uniformly unsuccessful. Our successful experience of reattachment using postauricular subcutaneous pocket is presented. Methods: The amputated tissue was placed in its anatomical position with buried sutures. The amputated part is dermabraded to remove the epidermis and outer layer of dermis(Fig. 1, Center, left). Postauricular skin flap was then raised and the reattached dermabraded ear was buried beneath the flap(Fig. 1, Center, right). Two weeks after the original surgery, the buried ear was removed from its pocket (Fig. 1, Below, left). Results: The ear was reepithelialized spontaneously in 7 days. At 3 months, the reattached ear has satisfactory appearance without contour deformity(Fig. 1, Below, right). Conclusion: This technique provides increase in contact surface between the amputated segment and the surrounding tissues which supply blood, serum, oxygen and nutrients, maximizing the probability of "take". Minimally injured dermis can be healed from spontaneous reepithelialization and provides minimal contour deformity. We have used this non-microsurgical technique with very satisfying outcome.