• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.195-199
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• 2013

Pseudoaneurysms are rare complications of orgthognathic surgery, trauma or other surgical procedures in the head and neck regions. Surgical approach is a routine procedure of bleeding control. However, bleeding control using angiography and embolization can also be an excellent method. We experienced pseudoaneurysm of the inferior alveolar artery occurring after surgical curettage of cystic lesion. The 33-year-old man who underwent surgical curettage of keratocystic odontogenic tumor was presented with severe bleeding in the right mandible ramal inner surface 14 days after the surgical curettage. After hemostasis with vaseline gauze packing and pressure, bleeding temporarily stopped. However, bleeding started after 14 days and soon it has been continued. Finally, the patient was diagnosed as pseudoaneurysm of the inferior alveolar artery from the enhanced-computed tomography images, and angiographic embolization was performed successfully. We report a rare case of pseudoaneurysm of the inferior alveolar artery after benign tumor curettage and review of the previewer's literature.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.500-508
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• 2021

Background: The major limitation of arteriovenous graft access is the high incidence of thrombotic occlusion. This study investigated the outcomes of our salvage strategy for thrombosed hemodialysis arteriovenous grafts (including surgical thrombectomy with balloon angioplasty) and evaluated the efficacy of intragraft curettage. Methods: Salvage operations were performed for 290 thrombotic occluded arteriovenous grafts with clinical stenotic lesions from 2010 to 2018. Of these, 117 grafts received surgical thrombectomy and balloon angioplasty from 2010 to 2012 (group A), and 173 grafts received surgical thrombectomy and balloon angioplasty, with an additional salvage procedure using a curette and a graft thrombectomy catheter, from 2013 to 2018 (group B). Outcomes were described in terms of post-intervention primary patency and secondary patency rates. Results: The post-intervention primary patency rates in groups A and B were 44.2% and 66.1% at 6 months and 23.0% and 38.3% at 12 months, respectively (p=0.003). The post-intervention secondary patency rates were 87.6% and 92.6% at 6 months and 79.7% and 85.0% at 12 months, respectively (p=0.623). Multivariate Cox regression analysis demonstrated that intragraft curettage was a positive predictor of post-intervention primary patency (hazard ratio, 0.700; 95% confidence interval, 0.519-0.943; p=0.019). Conclusion: Surgical thrombectomy and balloon angioplasty showed acceptable outcomes concerning post-intervention primary and secondary patency rates. Additionally, intragraft curettage may offer better patency to salvage thrombotic occluded arteriovenous grafts with intragraft stenosis.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.71-78
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• 2004

Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.81-93
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• 1999

Non-surgical therapy is still an important technique in periodontal treatment. In this study, scaling and root planing(SRP) with or without concomitant subgingival curettage were compared clinically and microbiologically. 14 moderate adult periodontitis patients were included in this study. After 2 weeks from screening visit, with split mouth design, one quadrant was treated by SRP, and the opposite side was treated by SRP with subgingival curettage. Clinical measurement and microbiological analysis was taken at baseline, 1 month, 3 month post-treatment. Clinical parameters used in this study was probing depth, gingival recession, gingival index, bleeding on probing, plaque index, tooth mobility(Periotest Value). Microbiological analysis consisted of determination of the percentages of 4 bacterial groups according to morphologic type with phase-contrast microscope and measuring Black-pigmented Bacteroides after anaerobic culture. 1. There were significant changes in probing depth and gingival recession at 1 month(P<0.05), and these changes remained through 3 month. However, no significant differences were observed between two groups(P<0.05). 2. There were also significant reductions in gingival index and bleeding on probing at 1 month(P<0.05),and these reduced levels were maintained through 3 month with no significant differences between two groups(P<0.05). 3. In both groups, motile bacteria decreased significantly at 1 months(P<0.05), but increased nearly to baseline level at 3 month. 4. The percentages of Black-pigmented Bacteroides, in both groups, decreased significantly at 1 month(P<0.05), and in the subgingival curettage group, significant more reductions were observed than in the root planing group(P<0.05). At 3 month, significant reduction was found in subgingival curettage group only(P<0.05). According to these results, we surmised that concomitant subgingival curettage and root planing give some advantageous effect on bacterial recolonization.

• Journal of Korean society of Dental Hygiene
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• v.15 no.6
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• pp.941-946
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• 2015

Objectives: Since World Health Organization reclassified the odontogenic keratocyst as a keratocystic odontogenic tumor(KCOT) in 2005, management of KCOT remains controversial. The purpose of the this study is to present a current concept of the treatment of the KCOT. Methods: Recent articles were focused on the method of the surgical therapy and the recurrence rate of KCOT. Results: The treatment modality is divided into conservative treatment-such as simple enucleation with or without curettage or marsupialization-and aggressive treatment including peripheral ostectomy, chemical curettage with Carnoy's solution, and resection. Conclusions: Keratocystic odontogenic tumors have higher recurrence rates than other odontogenic lesions; thus, the selected type of treatment is very important.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.192-196
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• 2002

Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.134-138
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• 2007

Brodie abscess is a localized form of subacute or chronic osteomyelitis which is common in children but may also occur in adulthood. When Brodie abscess is located in the posterior metaphysis of the proximal tibia, open biopsy and curettage have a difficulty in approach to the lesion and can cause neurovascular injury or soft tissue contamination. We report a case wherein a novel surgical technique was used to treat a Brodie abscess in the posterior proximal tibial metaphysis in 48 year-old-male with endoscopic-assisted curettage by commercial anterior cruciate ligament targeting device(Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). Two portals were created toward the abscess site and, through each portal interchangeably, the granulation tissue and sclerotic bone could be excised. We believe that endoscopic-assisted curettage presents safe technique, decreased morbidity, accurate assessment of the extent of the abscess and possible improvement in long-term outcomes.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.138-145
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• 2009

Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

• Imaging Science in Dentistry
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• v.42 no.1
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• pp.35-39
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• 2012

A 9-year-old girl visited our hospital, complaining of a rapid-growing and rigid swelling on the left posterior mandibular area. Panoramic radiograph showed a moderately defined multilocular honeycomb appearance involving the left mandibular body. CT scan revealed an expansile, multilocular osteolytic lesion and multiple fluid levels within cystic spaces. Bone scan demonstrated increased radiotracer uptake and angiography showed a highly vascularized lesion. The lesion was suspected as aneurysmal bone cyst (ABC) and preoperative embolization was performed, which minimize the extent of operation and the surgical complication. The lesion was treated by surgical curettage and lateral decortication with repositioning. No additional treatment such as a surgical reconstruction or bone graft was needed. Early diagnosis of ABC is very important and appropriate treatment should be performed considering several factors such as age, surgical complication, and possibility of recurrence.

• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.40-46
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• 2013

Benign intraosseous osteolytic lesions of the glenoid are very rare. The present study reports on three cases of symptomatic intraosseous osteolytic lesions of the glenoid in which surgical interventions were made. Of the three, two cases presented with intraosseous ganglion and one case with fibrous dysplasia. In all the cases, the lesion was located at the posteroinferior portion of the glenoid, and it seems to be related to posterior shoulder pain. If intraosseous osteolytic lesions have symptoms or the risk for chondral defects or cortical breakage, surgical intervention is needed and bone curettage with or without bone grafting will be a useful treatment option.