• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.164-168
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• 2006

Objective : The goal of treatment for spinal cord ependymoma is complete removal without postoperative neurological deficit. The authors analyzed the surgical results and factors influencing the postoperative prognosis. Methods : Fifty-one cases of primary spinal cord ependymoma, surgically treated between 1979 and 2003, were retrospectively analyzed. The mean follow-up period was 44 months. Results : Gross total removal was achieved in 42 patients and incomplete removal in nine. The proportion of complete surgical removals was influenced by tumor location and histology. Disease progression was observed in five cases [9.8%], the mean progression free interval after surgical removal was 48 months and the 5-year progression free rate was 68%. Disease progression was found in none of the 42 cases who underwent complete removal, and in 5 of 9 cases who hadincomplete removal group [P<0.001]. Statistically significant disease-progression factors by multivariate analysis were the surgical extent of removal [P=0.012]. preoperative functional status [P=0.032] the presence of intratumoral cysts [P=0.007] and postoperative radiation therapy [P=0042]. Of those patients who underwent incomplete removal, radiation therapy was found to significantly improve the clinical result [P=0042]. Conclusion : In the surgical treatment of spinal cord ependymoma, preoperative functional status, the presence of intratumoral cysts, the extent of removal, and postoperative radiation therapy were found to be significant prognostic factors of postoperative outcome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.184-191
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• 2023

Germectomy is a surgical method most typically performed in young adults. The indications for treatment are controversial. The purpose of this review was to determine the correct indications for germectomy and to discuss the advantages and disadvantages of the procedure. We reviewed the surgical techniques (anesthetic methods, patient preparation, and flap designs) and complications. Germectomy for orthodontic purposes is a common indication for surgical removal of tooth germ among young patients. Several studies have supported removal at an earlier age to produce fewer surgical complications. Several surgical techniques have been described in the literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.464-472
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• 1994

Surgical removal of the submandibular gland via intraoral approach was performed. The surgical procedure to be used for removal of submandibular gland had been performed via extraoral approach for many centuries. Disadvantages of extraoral technique are the esthetic distress due to an external scar, residual inflammation in Wharton's duct, and neurological complications. Indications of intraoral approach are unlimited in surgical cases of submandibular gland. Advantages of intraoral approach are esthetic satisfaction due to no remaining scars, preservation of adjacent anatomical structures and preservation of lower facial contour. This paper describes the surgical technique of the submandibular gland excision through an intraoral approach and variable incision lines tried. In 7 cases, excellent results were obtained after removal of the submandibular gland through an intraoral approach.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권3호
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• pp.163-171
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• 2023

Background: Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. Methods: This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. Results: Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group) Conclusion: The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.105-111
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• 2017

Background: Dental fear is usually associated with hemodynamic changes. Fear of pain during the surgical removal of a lower impacted third molar might cause patients anxiety, thereby leading to avoidance of any future dental therapy. This study aimed to determine the effect of experiencing a surgical impacted-tooth removal on the pain perception-related anxiety and hemodynamic status. Method: Twenty-seven healthy patients aged 15-30 years (mean age, 24 years), for whom surgical removal of bilateral lower third molars was advised, were included. This prospective, randomized, controlled, split-mouth study involved operations on both sides of the mandibular arch, with a 1-month washout period in between. Blood pressure and heart rate were measured before the surgical procedure, during and after the injection, preoperatively, and postoperatively. Pain perception was evaluated using a 100-mm visual analog scale during the injection, preoperatively, and postoperatively after the numbness disappeared. Differences in the blood pressure, heart rate, and pain perception between the two appointments were analyzed using the paired t-test. For all statistical analyses, SPSS version 11.5 was used. Results: The mean pain perception values during the injection and preoperatively showed no significant differences between the two appointments (P > 0.05); however, significant differences in the blood pressure and heart rate were noted before the surgical procedure; preoperatively, the blood pressure alone showed a significant difference (P < 0.05). Conclusion: There was a significant decrease in the blood pressure and heart rate preoperatively; hence, experiencing a surgical impacted-tooth removal can reduce the subsequent preoperative anxiety in healthy patients.

• Journal of Korean Neurosurgical Society
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• 제39권3호
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• pp.171-175
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• 2006

Objective : In the present study, we evaluate visual outcomes after surgical removal of craniopharyngiomas and analyze the factors that are considered to affect visual outcomes. Methods : This study includes 30 patients with craniopharyngioma, who underwent surgery in this clinic during the last 10 years. The changes of visual function [visual acuity and field] of the patients were assessed preoperatively and postoperatively, and paired data of this change were compared. Also, the factors that influence on this change were analysed. Results : Among the 21 patients complaining of decreased vision before the operation, 8 patients were improved [38.0%], and 7 patients were worse [33.3%]. However, Four out of 9 patients without any preoperative visual symptoms developed worse vision after the operation [44.4%]. The average duration of symptom was 17.2 months in the improved group and 23.6 months in the aggravated group. The tumors recurred in only 5 patients after the gross total resection : Four of them showed the aggravation of visual function after surgical removal and 1 had improvement. Conclusion : After removal of craniopharyngiomas, the overall rate of vision improvement, no change and aggravation are 26.6%, 36.7% and 36.7%, respectively. Aggravation of postoperative visual function is higher in males, children and patients with a longer duration of symptom and the tumor recurres more frequently in patients who complained of worsened vision after surgical removal.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.167-170
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• 1994

The surgical removal of the wisdom teeth is obligate when forceps extraction fails or when the wisdom teeth are impacted. The surgical removal of impacted maxillary third molars is a commonly performed procedure usually associated with few complications & little morbidity. The most frequent complications are tooth root fracture, maxillary tuberosity fracture, tooth displacement into the maxillary sinus & oroantral fistula formation. A rarely reported complication is the displacement of a tooth into the infratemporal fossa. The method of prevention of this complication is by the placement of either a finger or periosteal elevator posterior to the tooth during extraction. To remove the displaced upper third molar is very difficult & has many complications, e.g., persistent bleeding & nerve damage. When the wisdom teeth is displaced, it is initially necessary to gain access to bone by developing a mucoperiosteal path of delivery is developed by additional bone removal or, preferably planned sectioning of the tooth. There are many approaching techniques to remove the displaced upper third molar. This following report describes the surgical technique of displaced upper third molar in the pterygopalatine fassa by the midpalatal ＆transpharyngeal approach.

• 여성건강간호학회지
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• 제24권2호
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• pp.163-173
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• 2018

Purpose: To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. Methods: With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. Results: The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were $1.57{\pm}0.51$, $0.37{\pm}0.64$, $3.62{\pm}0.67$, and $4.00{\pm}0.45$, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. Conclusion: In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권3호
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• pp.103-106
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• 2018

Objectives: The goal of the study was to investigate the clinical effects of amoxicillin-clavulanic acid (500+125 mg) with metronidazole 400 mg administered three times daily (Group I) versus azithromycin 500 mg administered once daily and with metronidazole 400 mg three times daily (Group II) for the prevention of postoperative infection following mandibular third molar surgical removal. Materials and Methods: The study design was a single-center prospective study. Patients who reported to the Department of Oral and Maxillofacial Surgery between February 2015 and January 2017 for removal of mandibular third molar were screened, and 108 patients were chosen. One surgeon carried out all procedures. Patients were prescribed antibiotics until the two groups contained a similar number of cases. Results: Our data showed that Group II had fewer incidences of surgical site infection, but with no statistical significance. Conclusion: Although both treatments are used routinely after removal of the mandibular third molar, neither is significantly better than the other.

• 한국임상수의학회지
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• 제22권4호
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• pp.309-313
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• 2005

본 연구는 심장사상충 감염견에 있어서 flexible alligator forceps(FAF)을 이용한 외과적 치료법의 효능을 평가하기 위해 실시되었다. FAF를 이용한 외과적 치료를 위해 평균 연령 $5.3\pm3.0\;(mean{\pm}S.D.)$ 년, 평균 체중 $9.3\pm6.5(mean{\pm}S.D.)kg$인 20마리의 심장사상충 감염견을 실험에 사용하였다 그 중 수컷 10마리, 암컷 10마리였다. 성충 제거를 위한 외과적 치료를 isoflurane호흡 마취 하에 FAF완 투시기를 이용하여 실시하였다 FAF를 이용한 외과적 치료방법의 평가를 위해 제거율과 수술시간을 측정하였고 제거 부위를 확인하였다 제거되지 알고 남아 있을 수 있는 성충 확인을 위해 항원 ELISA kit검사와 부검을 실시하였다. 제거율은 심장사상충이 완전히 제거된 15마리를 포함 전체 심장사상충의 $91.4\%$ 였고 수술에 걸린 평균 시간은 $30.0\pm7.6(mean{\pm}S.E.)$이었다. 또한 심장사상충은 우심실, 주폐동맥, 우폐동맥, 그리고 좌폐동맥에서 제거되었다 결론적으로, FAF를 이용한 외과적 치료법은 높은 제거율, 짧은 수술 시간, 그리고 다양한 제거부위와 같은 장점을 보이는 효과적이 방법이며 심장사상충 감염견에서 적용될 수 있는 좋은 치료법으로 사료된다.