• Title/Summary/Keyword: conservative therapy

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Conservative treatment modalities for patients with temporomandibular joint(TMJ) disorders (임상가를 위한 특집 1 - 턱관절장애의 보존적 치료)

  • Kim, Cheul
    • The Journal of the Korean dental association
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    • v.51 no.2
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    • pp.74-83
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    • 2013
  • In the management of temporomandibular joint(TMJ) disorders, dental practioner should conduct the reversible, conservative, and inexpensive treatment modalities prior to the irreversible and invasive treatment. That is to say, behavioral, pharmacologic, and physical therapy should be conducted firstly, and then the occlusal appliance therapy could be considered. If patients do not react to these conservative treatments, we have to consider surgical treatments. If the accurate diagnosis is confirmed by intimate history taking, clinical and imaging examinations, we can rehabilitate the normal TMJ function and relieve the clinical symptoms with only conservative treatments in most TMJ disorder cases.

Clinical Analysis of Stereotactic Aspiration and Conservative Management in Spontaneous Thalamic Hematoma (자발성 시상부 출혈에서 뇌정위적 흡인술 및 보존적 치료의 임상분석)

  • Nam, Cheon Hyun;Kang, Jae Kyu;Doh, Jong Oung;Lee, Chun Dae
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.156-162
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    • 2001
  • Objective : The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. Methods : The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows : age & sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. Results : The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows : good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age & sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. Conclusion : Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.

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Conservative Treatment with Occlusal Appliance for Temporomandibular Disorder Patients with Rheumatoid Arthritis

  • Kim, Young-Ae;Kim, Kyung-Hee;Ok, Soo-Min;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.41 no.4
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    • pp.169-179
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    • 2016
  • Purpose: This study is designed to analyse etiology and bone pattern at the first visit using cone-beam computed tomography (CBCT) and to evaluate the treatment outcome of conservative treatment in temporomandibular disorder (TMD) patients with rheumatoid arthritis (RA). Methods: One hundred condyles in 50 subjects with RA were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Dental Hospital, diagnosed as TMD. Condylar bone changes were classified by normal, erosive bony change, proliferative bony change and combined group (erosive bony change+proliferative bony change). They were treated conservatively with physical therapy, medication, behavioral therapy and/or occlusal stabilizing splint therapy. After 3 months on average, patients were re-evaluated with regards to subjective symptoms and the clinical findings were investigated. Results: TMD patients with RA have behavioral contributing factors such as parafunctional habit. The results that analyse bone pattern at the first visit using CBCT proliferative bony changes group (32.6%) were more common than erosive bony changes group (15.2%). In comparison between unilateral and bilateral bony change in temporomandibular joint, the ratio showed no significant differences. After 3 months of conservative treatments, pain, noise, limitation of motion (LOM) were markedly improved regardless of occlusal splint therapy. However only LOM was significantly improved through occlusal splint therapy during 3 months. Conclusions: TMD patients with RA had similar behavioral contributing factors and characteristics of CBCT images shown in general TMD patients and also similar response to conservative treatment so it is difficult to differentiate. Therefore when TMD patients show symptoms corresponding to clinical diagnostic criteria of RA at the first visit, serological testing should be conducted and through this, early diagnosis and treatment of RA should be initiated.

Conservative Surgery of Hypopharyngeal Cancer and Intraoperative Radiation Therapy of Neck Recurrence (하인두암의 보존적 수술과 경부 재발의 술중방사선치료 치험 1예)

  • Cho, Woo-Sung;Kim, Yang-Soo;Kim, Moo-Pil;Baek, Seung-Kuk;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.181-184
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    • 2007
  • Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.

A Review of Lumbar Herniated Intervertebral Disc (요추 추간판 탈출증에 대한 고찰)

  • Kim, Hyoung-Su;Kim, Eun-Young;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.125-137
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    • 2006
  • Purpose : The purpose of the study was to examine lumbar pain through literature reviews about herniated intervertebral disc (HIVD). Methods : Diagnosis was made by patient's history, physical examination, simple radiography, myelography, spinal computerized tomography, electromyography, somatosensory evoked potential, etc. Results : There are two treatment modalities, one is conservative and the other is operative. About 90% of patients with HIVD have been recovered only by conservative treatment and therapeutic exercise was the most effective one among these conservative treatments. Conclusion : We consider HIVD can be treated with therapeutic exercise which can correct muscular imbalance and facet joint problems and make the degenerative process of intervertebral disc slower.

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Study on Temporomandibular Disorder Patients with Conservative Treatment (보존적 치료를 이용한 TMD 환자에 관한 연구)

  • Ko, Myung-Yun;Kim, Jin-Hwa;Heo, Jun-Young;Ok, Soo-Min;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.77-86
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    • 2013
  • In order to evaluate the effect of conservative treatment for Temporomandibular Disorders(TMD), 137 patients were subjected at the Department of Oral Medicine, Pusan National University Dental Hospital from June 2012 to Sept. 2012. They were treated conservatively with behavioral therapy, physical therapy, medication and occlusal stabilizing splint therapy. Subjective symptoms and clinical findings were investigated to evaluate and compare the patients' status after 3 months treatment. The results were as follows; 1. Pain, Noise, LOM(Limitation of motion) and MCO(Maximum comfortable opening) measurements of TMD were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender and chronicity. 3. Conservative treatment including stabilization splint produced better results than physical therapy with medication. 4. After 3 months of treatment, pain and LOM were significantly improved in the MD(Muscle disorder) group. Pain, LOM and noise were significantly improved in the DD(Disc displacements) group. In the OA(Osteoarthritis) group, pain, noise, LOM and MCO were significantly improved.

The Effects of P-A Mobilization on The Cervical Range of Motion and Pain for Patients with Chronic Neck Pain (만성 경부 통증환자에 대한 후-전방 가동기법이 경부 가동범위와 통증에 미치는 영향)

  • Park, Ki-Byoung;Gong, Won-Tae;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.519-535
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    • 2005
  • The main purpose of this study is to evaluate the effects of manual therapies which are Posterior Anterior Central Vertebral Pressure (PACVP) and Posterior Anterior Unilateral Vertebral Pressure(PAUVP} in patients having a chronic pain in the neck. This study focused on sixty patients having a chronic pain in the neck from 19 years old and 65years old. There are 33 females and 27 males each. This study randomize two groups from all subjects that have been mentioned above. Group 1 received a cervical spine manual therapy, Group 2 received a conservative physical therapy. Each therapy was held for 3 times a week, totally, 6 times for two weeks. The tape was used to measure cervical range of motion(ROM) in six areas-flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation. 100mm Visual Analogue Scale(100mm VAS) was used to measure the subjective pain level. All measurements of each patient were measured at pre-treatment and 2 weeks post-treatment. The results of this study would be summarized as follow: 1. The manual treatment group has much more recovery than that of conservative physical therapy group in terms of the degree of the ROM improvement showing a significant difference between two groups(p<0.05) 2. The manual treatment group has more recovery than that of the conservative physical therapy group in the improvement of pain(p<0.05).

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Efficacy of conservative treatment of perianal abscesses in children and predictors for therapeutic failure

  • Boenicke, Lars;Doerner, Johannes;Wirth, Stefan;Zirngibl, Hubert;Langenbach, Mike Ralf
    • Clinical and Experimental Pediatrics
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    • v.63 no.7
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    • pp.272-277
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    • 2020
  • Background: The optimal management of perianal abscess in children is controversial. Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001-2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary surgery group). Conservative treatment was initiated in 49 patients (primary conservative group) but was stopped because of inefficiency in 25 patients, who were referred for surgery after a median 7.03 days (range, 2 to 16 days). The other 24 patients (48%) initially achieved complete remission after conservative treatment, but 10 were readmitted after a median 34 months (range, 3 to 145 months) with recurrent disease. There were no significant differences in permanent success after conservative treatment between infants (10 of 29, 34%) and older children (4 of 20 [20%], P=0.122). Overall, conservative treatment alone was effective in only 14 of 113 patients. Recurrence after surgery occurred in 16 patients (25%) in the primary surgery group and 11 patients (22%) in the primary conservative group (P=0.75). Univariate analysis of predictors for conservative treatment failure revealed inflammatory values (C-reactive protein and white blood count, P=0.017) and abscess size (P=0.001) as significant parameters, whereas multivariate analysis demonstrated that only abscess size (odds ratio, 3.37; P=0.023) was significant. Conclusion: Conservative treatment of perianal abscess is permanently efficient in only a minority of children but is not associated with a higher recurrence rate after subsequent surgery. Abscess size is a predictor for therapy failure.

Clinical study on 3 cases of HIVD, patients recommended to a operation (수술권유받은 요추추간판탈출증(腰椎椎間板脫出症) 환자 3례에 대한 임상적 고찰)

  • Kim, Jae-Young;Lee, Hyun
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.53-58
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    • 2006
  • Objectives: The object of this study is to report a clinical effect regarding the conservative treatment of the patients who were diagnosed as the herniated intervertebral lumbar disc(HIVD). Methods: The patients were treated by the oriental medical conservative treatment (Acupuncture, Moxibustion, oriental medicine, and Chu-na therapy). Result of conclusions: 1) Oriental medicine conservative treatment proved its effectiveness during the treatment of HIVD, patients. Especially, Chu-na therapy was superior on pain relive. 2) Treatment of HIVD, took less than 3 months in most cases except protruded or extruded disc. 3) In case of seniors who cannot have a surgical operation because of organ and muscle wickness, the oriental treatment was effective in terms of strengthening muscle and organs.

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The Case Report of Conservative Treatment on Failed Back Surgery Syndrome (요추 추간판 탈출증 수술 실패 증후군 환자레 대한 보존적 치료 치험 1례)

  • Hong, Soon-Sung;Jin, Eun-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.163-172
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    • 2009
  • Objectives : The purpose of this study is to evaluate the conservative treatment for FBSS patient. Method : We used Acupuncture, Beevenom, CHUNA manual therapy, Herbal medication, for this patient. And we measured of VNRS and ODI score to evaluate the conservative treatment effects. Result : Patient's LBP & Rt.leg pain VNRS and ODI score were decreased.

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