• 제목/요약/키워드: conservative operation

검색결과 256건 처리시간 0.022초

말초성 안면마비에서 중두개와 접근법에 의한 안면신경 감압술 : 3례 보고 (Facial Nerve Decompression via Middle Fossa Approach : Report of Three Cases)

  • 조준;박성호;김재영
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.479-485
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    • 2001
  • Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

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Ileal Fecaloma Presenting with Small Bowel Obstruction

  • Yoo, Ha Yeong;Park, Hye Won;Chang, Seong-Hwan;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권3호
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    • pp.193-196
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    • 2015
  • A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

대퇴골두 무혈성 괴사 감압술 시술 후 발생한 고관절 통증 환자의 치험 1례 (A Case Report on a Patient of Pain after Core Decompression Surgery on Avascular Necrosis of Femur Head Treated with Korean Medicine Treatments)

  • 조성우
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.55-65
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    • 2019
  • Objectives : The aim of this study was to report the improvements in pain that a woman experienced after receiving Korean medicine treatments for the pain associated with core decompression surgery due to avascular necrosis (AVN) of both femur heads. Methods : The patient was diagnosed as having AVN in both femur heads and underwent core decompression surgery. After operation, she had pain on her right inguinal region and her range of motion (ROM) was restricted. She was treated with Korean medicine including, herbal medicine, acupuncture, Chuna Manual Therapy and bee venom acupuncture (BV). This study was measured by using the Visual Analogue Scale (VAS) and the ROM scale. Results : After conservative treatment, the patient's pain was reduced and ROM was increased. Daily living quality had improved. Conclusions : In this case, Korean conservative medicine therapy with Chuna Manual Therapy had a positive effect on the symptoms after core decompression surgery due to avascular necrosis of the femur head.

하악 과두에 발생한 골연골종의 보존적 제거 1 예 (CONSERVATIVE RESECTION OF OSTEOCHONDROMA ON MANDIBULAR CONDYLE : A CASE REPORT)

  • 남정우;김재영;김학진;김형준;차인호;남웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권4호
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    • pp.257-260
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    • 2009
  • Osteochondroma is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones and extremely rare in mandibular condyle. The clinical signs and symptoms of osteochondroma of mandibular condyle may resemble those seen in patients with temporomandibular joint (TMJ) dysfunction. Condylectomy have been the first choice for treatment of osteochondroma, but it may be with some complicaitons, loss of condylar vertical height, etc. A 57 years old female patient who had an osteochondroma on left mandibular condyle visited to our clinic. We did surgically remove the mass with favorable result, so we present the case with review of literatures.

Traditional and minimally invasive access cavities in endodontics: a literature review

  • Ioanna Kapetanaki;Fotis Dimopoulos ;Christos Gogos
    • Restorative Dentistry and Endodontics
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    • 제46권3호
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    • pp.46.1-46.9
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    • 2021
  • The aim of this review was to evaluate the effects of different access cavity designs on endodontic treatment and tooth prognosis. Two independent reviewers conducted an unrestricted search of the relevant literature contained in the following electronic databases: PubMed, Science Direct, Scopus, Web of Science, and OpenGrey. The electronic search was supplemented by a manual search during the same time period. The reference lists of the articles that advanced to second-round screening were hand-searched to identify additional potential articles. Experts were also contacted in an effort to learn about possible unpublished or ongoing studies. The benefits of minimally invasive access (MIA) cavities are not yet fully supported by research data. There is no evidence that this approach can replace the traditional approach of straight-line access cavities. Guided endodontics is a new method for teeth with pulp canal calcification and apical infection, but there have been no cost-benefit investigations or time studies to verify these personal opinions. Although the purpose of MIA cavities is to reflect clinicians' interest in retaining a greater amount of the dental substance, traditional cavities are the safer method for effective instrument operation and the prevention of iatrogenic complications.

하악골에 발생한 법랑아세포종의 임상통계학적 분석 (The Clinico-Statisitical Analysis of Ameloblastoma of Mandible)

  • 유경환;김수관;문성용;오지수;이정훈;김진하
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권6호
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    • pp.551-557
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    • 2010
  • Purpose: In this study, we evaluated the relation between surgical methods and reccurrence rate by investigating clinical, radiological aspects and histopathological patterns of 26 patients who were diagnosed with amelobalstoma. Patients and Methods: In this study, we retrospectively investigated 26 patients who were diagnosed with ameloblastoma and treated at the Department of Oral and Maxillofacial Surgery of Chosun University Dental Hospital from January 2000 to December 2008. Results: The patients comprised 12 males (46.1%) and 14 females (53.9%), and their ages ranged from 10 to 69 years (average, 37.3 years). All cases presented a mandibular location, and in particular, 13 cases (50%) demonstrated an occurrence in the mandibular body. Clinically, 8 cases (30.8%) presented no symptoms, and the most prevalent chief complaint was swelling in 13 cases (50%). Radiographically, a unilocular type appeared in 14 cases (53.8%), and a multilocular type was observed in 10 cases (38.5%). Histopathologically, there were 8 follicular types (30.8%) and 7 plexiform types (26.9%). Conservative treatment was performed in 5 cases (19.2%), and radical treatment was performed in 21 cases (80.8%). The follow-up period ranged from 1 to 10 years. The total recurrence rate was 15.4%, and the mean duration of recurrence was 6.7 years. Three of the 5 cases (60%) that received conservative treatment demonstrated a recurrence, as compared to 1 of the 21 cases (4.8%) that underwent radical treatment. Conclusion: The radical treatment was more effective than the conservative treatment for recurrence prevention. We should consider a continuous follow-up check after operation.

지간 신경종에서 보존적 치료의 임상적 결과 (Clinical Results of Conservative Treatment for Interdigital Neuroma)

  • 이진우;최윤락;한수봉
    • 대한족부족관절학회지
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    • 제8권1호
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    • pp.58-63
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    • 2004
  • Purpose: The purpose of this study is to evaluate the effectiveness of low-dose gabapentin for interdigital neuroma. Metrials and Methods: Between April 2000 and June 2003, 32 patients (39 feet) with interdigital neuroma were treated with using low-dose gabapentin. Two of the 32 patients were male, and thirty were female, and the average age was 47.4 years. The follow-up was 6 to 44months (mean 15.1 months). All cases were diagnosed by physical examination and ultrasonography or MRI. Low-dose gabapentin (300-600 mg) was prescribed and shoe modification was recommended. The patients were evaluated through questionnaire. Results: Neuroma was found in twenty one cases at the third intermetatarsal space, and thirteen at the second intermetatarsal space. The sensitivity of ultrasonography was 96% and that of MRI was 79%. Overall satisfaction was rated as excellent or good by 18 cases (57%). Average pain relief ratio was 50.3%, and in 14 cases, more than 80% of pain relief was noted. Nine (28%) of 32 patients showed they had no activity restrictions, such as daily activities or work, whereas 8 (25%) had mild restrictions and 15 (47%) had major restrictions. Twelve of 15 patient with major restrictions had been treated operatively (neurectomy; 10 cases, decompression; 2 cases). One case had gastrointestinal problem. Conclusion: Low-dose gabapentin for interdigital neuroma was one of the effective conservative treatments. The operation may be preserved for patient with the persist symptoms, nevertheless the conservative treatments and use of low-dose gabapentin.

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교도소에서 의뢰된 급성 하악 지치 주위염의 보존적 감염관리: 증례보고 (Conservative infection control on acute pericoronitis in mandibular third molar patients referred from the prison)

  • 이천의;유재하;최병호;설성한;김하랑;모동엽;김종배
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권1호
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    • pp.57-61
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    • 2010
  • In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

눈썹거상술 후 발생한 만성 통증에 대한 수술적 치험례 1례 (A Case Report of Surgical Treatment for Relief of Intractable Pain Developed after Browlift Surgery)

  • 이강우;강상윤;양원용
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.81-84
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    • 2011
  • Purpose: Nerve injury is one of the complication which can develop after brow lift. Peripheral nerve ending which is stretched from supraorbital nerve and supratrochlear nerve can be injured and symptoms such as pain, dysesthesia may appear. Usually, developed pain disappeared spontaneously and does not go on chronic way. We experienced a case that a patient complained chronic pain after brow lift which was not controlled by conservative management such as medications, local nerve block and report a successful surgical treatment of chronic pain after brow lift. Methods: A 24-year-old male who received brow lift with hairline incision at local hospital was admitted for chronic pain at the right forehead. The pain was continued for 3 months even though fixed thread was removed. Local nerve block at trigger point with mixed 1 mL 2% lidocaine and 1 mL Triamcinolone acetonide was done and oral medications, Gabapentine and carbamazepine, were also applied but there was no difference in the degree of pain. Therefore the operation was performed so that careful dissection was carried out at right supraorbital neurovascular bundle and adhered supraorbital nerve was released from surrounding tissues and covered with silastic sheet to prevent adhesion. Results: The pain was gradually relieved for a week. The patient was discharged without complications. No evidence of recurrence has been observed for 2 years. Conclusion: The pain developed after brow lift was engaged with nerve injury and sometimes remains chronically. Many kinds of conservative management to treat this complication such as medications, local nerve block have been reported and usually been used. But there are some chronic cases that conservative treatment do not work. In sum, we report 1 case of successful surgical treatment for relief of intractable pain developed after brow lift surgery.

실험적 백서 치근단 병소에서의 면역글로불린 분포에 관한 면역조직화학적 연구 (AN IMMUNOHISTOCHEMICAL STUDY ON THE IMMUNOGLOBULINS OF EXPERIMENTALLY INDUCED RAT PERIAPICAL LESIONS)

  • 부정선;임성삼
    • Restorative Dentistry and Endodontics
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    • 제15권2호
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    • pp.58-76
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    • 1990
  • This study was designed to elucidate the distribution of the immunoglobulins in the experimentally induced rat periapical lesions. The pulp exposure was performed in 80 molars from 40 rats and the animals were sacrificed at 15, 30, 60 and 90 days after the operation and examined and radiographed. Of the 80 samples, 56 samples were routinely sectioned ($4-6{\mu}$ in thickness) and stained with Hematoxylin-Eosin for the light microscopic examination and 50 samples were stained with toluidin blue for mast cells and 50 samples were stained using the Avidin-Biotin horseradish peroxidase for detecting the presence of Ig A, Ig E, Ig M and Ig G containing cells. The following results were obtained : 1. The periapical lesions could be observed in all of 80 teeth by radiogragh (100%) and the periapical lesions were detected in 50 samples of 51 samples by light microscopy (98%). The size of lesions increased with time lapse both by radiograph and by light microscopy(p<0.05). 2. Of the 50 samples, 19 samples were diagnosed as periapical abscesses, 18 as periapical granulomas, 10 as fibrous scar tissues and 3 cysts. 3. After pulp exposure, periapical granulomas were developed mostly in the 15 day group, with time lapse periapical abscesses and fibrous scar tissues increased. 4. In the 50 periapical lesions, the numbers of Ig G containing cell (57.2%) were prominent and the percentage of Ig A, Ig E and Ig M containing cells were 16.4%, 14.7% and 11.8% respectively. The numbers of all classes of immunoglobulin containing cell were highest in the periapical granulomas and lowest in the cysts(p<0.05). 5. The number of the mast cell and immunoglobulin containing cells decreased generally with time lapse after the pulp exposure and Ig A, Ig E, Ig M and Ig G containing cells and mast cells had the high correlation one another(>0.6).

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