• 제목/요약/키워드: Surgical exposure

검색결과 305건 처리시간 0.023초

사대 및 전경추부의 수술적 접근법 (Surgical Approach of the Clivus and Anterior Cervical Spine)

  • 태경;이형석;박철원;김경래;백광흠;김주묵
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.172-176
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    • 1999
  • Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.

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Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

  • Chang, Hee-Yung;Park, Shin-Young;Kim, Jin-Ah;Kim, Young-Kyun;Lee, Hyo-Jung
    • Journal of Periodontal and Implant Science
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    • 제45권3호
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    • pp.82-93
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    • 2015
  • Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.

외과적 재위치술에 의한 매복된 만곡절치의 치험례 (TREATMENT OF AN IMPACTED DILACERATED INCISOR BY SURGICAL REPOITION)

  • 서윤진;이광희;라지영;안소연;김윤희;금기석;이상봉
    • 대한소아치과학회지
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    • 제39권2호
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    • pp.166-173
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    • 2012
  • 만곡치는 치관과 치근 사이의 경계부에서 굽어 있는 형태적 특징이 있다. 만곡치는 영구치열에서 3% 유병율을 나타내고 있으며 확실한 원인은 아직 정립된 바 없으나 유치의 외상으로 인한 계승 영구치의 만곡과 외상과 관계없는 치배의 특발성 발육장애가 2가지 주요 원인으로 추측되고 있다. 특히 만곡된 상악 절치는 흔히 맹출지연으로 인한 매복이 유발되며 이를 방치할 경우 정중선 불일치, 인접 치아의 이동에 의한 공간부족과 치조골 높이의 불일치가 발생된다. 본 증례는 상악 중절치의 매복을 주소로 한 8세 남아로 CT상 매복된 상태에서 치관부가 전비극에 근접하여 협측으로 위치되어 있으며 치근부에서 만곡이 관찰되어 교정적 견인을 시도하였으나 이동이 되지 않아 외과적 재위치술로 치료하여 양호한 결과를 얻었기에 보고하는 바이다.

Surgical excision of osteochondroma on mandibular condyle via preauricular approach with zygomatic arch osteotomy

  • Park, Sang-Hoon;An, Jun-Hyeong;Han, Jeong Jun;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제39권
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    • pp.32.1-32.5
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    • 2017
  • Background: Osteochondroma is a benign tumor that tends to develop in mandibular condyle and coronoid process in the craniofacial region. If tumor mass has grown from condyle into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses. Case presentation: This study reports on a case of osteochondroma on mandibular condylar head where we treated with surgical excision via preauricular approach with 3D analysis. After the local resection, there were no surgical and post-operative complications until 8-month follow-up period. Conclusions: In local excision of osteochondroma, our method is a minimally invasive method. It is a good example of osteochondroma treatment.

치아의 견인을 위한 버튼 접착시 오염이 인장강동에 미치는 영향 (TENSILE STRENGTHS OF PRE-LIGATURED BUTTON WITH SEVERAL TYPES OF CONTAMINATION IN DIRECT BONDING PROCEDURE WHICH CAN HAPPEN DURING THE SURGICAL EXPOSURE OF UNERUPTED TEETH)

  • 김성오;최병재;이제호;손흥규
    • 대한소아치과학회지
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    • 제25권2호
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    • pp.400-420
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    • 1998
  • We already know that it is very difficult to obtain an "isolated field" for direct bonding during the surgical exposure of unerupted teeth. The aim of this in-vitro study is to simulate the clinical situation of forced eruption and to evaluate the tensile strengths of preligatured button with several types of contamination which can happen during the surgical exposure of unerupted teeth. Four orthodontic direct bonding systems were used. ($Ortho-One^{TM}$, $Rely-a-Bond^{(R)}$, $Ortho-Two^{TM}$, Phase $II^{(R)}$) Each material was divided into four groups(n=20) : Group 1. (Control, no contamination), Group 2. (Rinse etching agent with saline instead of water), Group 3. (Blood contamination of etched surface for 30 seconds), Group 4. (Blood contamination of primed surface for 30 seconds) 320 bovine anterior permanent teeth were divided into the above mentioned 16 groups. Enamel surface was flattened and ground under water coolant. Pre-ligatured buttons were prepared to the same form. (Cut 0.25 ligature wire 10 cm in length. Twist the ligature wire 30 times clockwise. Mark the wire 15mm and 35mm points from button. Make a loop sticking two points together and twist the loop 6 times counterclockwise.) The bonded specimens were stored at $37^{\circ}C$ saline solution for 3 days. Then the tensile strength of each sample was measured with Instron universal testing machine, crosshead speed of 0.5mm/min. The following results were obtained: 1. As compared to control groups (Group 1) of each material, Rely-a-Bond had a significantly lower mean tensile strengths than other material. (p<0.01) 2. In Group 2. of Ortho-One and Rely-a-Bond, the mean tensile strengths decreased about 7.7% and 11.1%, respectively with statistical significances. (p<0.05) 3. In Group 2. of Ortho-Two and Phase II, the mean tensile strengths did not decrease. 4. In Group 3. of Ortho-One, Rely-a-Bond, Ortho-Two, and Phase II, the mean tensile strengths decreased about 60.8%, 56.1%, 60.2%, and 46.0%, respectively with statistical significances. (p<0.01) 5. In Group 4. of Ortho-One and Rely-a-Bond, the mean tensile strengths did not decrease. 6. In Group 4. of Ortho-Two and Phase II, the mean tensile strengths were decreased about 20.95% and 22.28%, respectively with statistical significances. (p<0.01) There were formations of a hump shaped mass from bonding resin under blood contamination which disturbed direct bonding procedure. According to Reynolds, the proper bond strength for clinical manipulation should be at least 45N or about 4.5Kg.F. According to these results, it can be concluded that Ortho-One could be used during surgical exposure of unerupted teeth. In any case, blood contamination of the etched surface should be avoided, but the blood contamination of primed surface of Ortho-One may not decrease bond strength. Just 'blowing-out' is enough to remove blood from primed surface of Ortho-One. You can verify the clean surface of the primer of Ortho-One after blowing out the blood contamination.

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X-ray 저선량 피폭방지를 위한 기능성 차폐크림의 방어 효과 검증 (Verification of the Protective Effect of Functional Shielding Cream for the Prevention of X-ray Low-dose Exposure)

  • 김선칠
    • 한국방사선학회논문지
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    • 제17권4호
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    • pp.497-506
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    • 2023
  • 의료기관의 방사선 업무 종사자의 경우 환자 보호와 정확한 시술을 위해 방사선 노출이 이루어져 저선량 피폭의 문제점을 안고 있다. 저선량 방사선 피폭은 주로 Apron 영역 이외에 신체 부분에서 발생되며, 가장 많은 곳이 손 등 피부이다. 특히, 의료인의 손은 시술 중 감각과 미세한 동작을 필요로 하기에 방사선 노출영역에서는 무방비 상태로 피폭의 위험성을 안고 있다. 납장갑 등 차폐체로 문제를 해결할 수 있지만, 이는 시술 중 손의 활동성을 제안하여 사용상의 어려움이 있다. 이러한 문제점을 해결하고자 기능성 방사선 보호효과를 얻을 수 있는 차폐크림을 개발하여 납당량 0.1 mmPb와 차폐성능을 비교하였다. 차폐크림 제조과정에서 크림의 밀도를 높이기 위해 기공을 줄이는 탈포과정을 추가하여 차폐성능을 개선하였다. 따라서 황산바륨을 주 재료로 사용한 차폐크림은 납 plate보다 차폐율이 낮은 실효에너지 영역에서는 59%, 높은 실효에너지에서는 37% 정도의 차이는 보여 기능성 방사선 방어효과가 있는 것으로 나타났다. 따라서 피부에 직접 사용할 수 있는 장점으로 상시 방어효과와 수술용 장갑 착용전에 사용이 가능한 것으로 사료된다.

Chronic Heavy Metal Exposure and Gallbladder Cancer Risk in India, a Comparative Study with Japan

  • Chhabra, Deepak;Oda, Koji;Jagannath, Palepu;Utsunomiya, Hirotoshi;Takekoshi, Susumu;Nimura, Yuji
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.187-190
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    • 2012
  • Background: High incidence of gallbladder cancer (GBC) is reported from North India, with elevated concentrations of heavy metals in water and soil. This Indo-Japan collaborative study compared presence of heavy metals in gallbladder tissues. Methods: Heavy metal concentrations were estimated in Indian GBC and cholecystitis tissues and compared with Japanese GBC and cholecystitis tissues. Spectrophotometry was done for 13 Indian gallbladder tissues (8 GBC, 5 cholecystitis) and 9 Japanese (5 GBC, 4 cholecystitis). Transmission electron microscopy (TEM) thin foil element analysis was done in 10 Indian samples (6 GBC, 4 cholecystitis). Results: Chromium, lead, arsenic and zinc were significantly high in Indian GBC compared with Japanese GBC. Chromium, lead and arsenic were significantly high in the Indian cholecystitis tissues compared to the Japanese. TEM of Indian tissues demonstrated electron dense deposits in GBC. Conclusion: Heavy metals-chromium, lead, arsenic and zinc are potential carcinogens in Indian GBC from endemic areas. This preliminary study links presence of heavy metals in gallbladder cancer tissues in endemic areas.

매복된 상악 전치부의 자가이식 치험례 (AUTOTRANSPLANTATION OF IMPACTED MAXILLARY ANTERIOR TEETH (CASE REPORTS))

  • 김주미;황보민;음종혁;서수정;김신;이애련;김주영
    • 대한소아치과학회지
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    • 제21권2호
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    • pp.561-569
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    • 1994
  • The autotransplantation procedure were performed for the cases with impacted maxillary anterior teeth, which were thought unrealistic by the treatment with surgical exposure and orthodontic traction into the arches. The results were as follow : 1. As the treatment with autotransplantation is the last resort, the case indicated should be selected cautiously by adequate case analysis. 2. In order to reduce postoperative complication, damages to periodontal ligaments and adjacent bony structures should be minimized by conservative surgical procedures. 3. After autotransplantation procedures, postoperative endodonic treatment and continuous follow-up check with clinical and radiographic examination should be followed. Although the autotransplantation procedure is not the treatment of choice in most cases, it was thought to be a good alternative in certain cases when orthodontic treatment is unrealistic with continuous study to overcome the handicaps.

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매복 상악 중절치의 교정적 처치에 관한 임상 증례 (ORTHODONTIC AND/OR PHYSIOLOGIC POSITIONING OF IMPACTED MAXILLARY CENTRAL INCISORS)

  • 임은경;최영철
    • 대한소아치과학회지
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    • 제21권2호
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    • pp.510-517
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    • 1994
  • It is a relatively common clinical experience to see a impacted maxillary central incisor. This is apparent at the dental age of about eight years and over, when the patient is in the early mixed dentition stage. The adjacent teeth may tilt toward the site of the missing tooth with resulting space closure and midline deviation. Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. Each of the current articles describing labial impactions shows at least one case with mucogingival recession or a minimal zone of attached gingiva. This report described the surgical uncovering and orthodontic-physiologic positioning methods with labially impacted maxillary central incisors. Through surgical exposure and direct bonding of lingual botton, the central incisors were brought into proper eruption path with elastic traction. The case 1 and 2 were treated with the physiologic erupting forces. The case 3 was applied with continuous orthodontic force. The case 1 and 2 resulted in good positioning, good esthetics and adequate width of keratinised gingiva. The case 3 resulted in local inflammation and inadequate width of keratinised gingiva.

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A New Technique for Conchal Cartilage Harvest

  • Kim, Joon Young;Yang, Ho Jik;Jeong, Ji Won
    • Archives of Plastic Surgery
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    • 제44권2호
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    • pp.166-169
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    • 2017
  • The goal of auricular cartilage harvest is to obtain a sufficient amount for reconstruction and to minimize the change in ear shape. The cartilage can be harvested by a posterior or anterior approach, and each method has advantages and disadvantages. The posterior approach presents the advantage of scar concealment, but there are limits to the amount of cymba cartilage that may be harvested. In contrast, the anterior approach may cause a noticeable scar. However, as cartilage is collected, the anterior approach provides a view that facilitates the preservation ear structure. In addition, it is possible to obtain a greater amount of cartilage. From January 2014 to December 2015, we harvested auricular cartilage graft material in 17 patients. To prevent the development of trapdoor scars or linear scar contracture, short incisions were made on the superior border of the cymba and cavum. Two small and narrow incisions were made, resulting in suboptimal exposure of the surgical site, which heightens the potential for damaging the cartilage when using existing tools. To minimize this, the authors used a newly invented ball-type elevator. All patients recovered without complications after surgery and reported satisfaction with the shape of the ear.