• Title/Summary/Keyword: surgical exposure

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Management of Eruption Disturbances of the Mandibular First Molar : A Case Report (맹출장애를 가진 하악 제1대구치의 치료 : 증례 보고)

  • Jeon, Hyunsoon;Yang, Yeonmi;Baik, Byeongju;Kim, Jaegon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.314-320
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    • 2013
  • With a prevalence rate of 0.01%, the presence of eruption disturbances of mandibular first molar has rarely been in populations. Eruption disturbances of permanent molars have been usually manifested as impaction, primary retention, and secondary retention. The treatments of eruption disturbances are carried out by: periodic observation; surgical exposure; forced eruption after surgical exposure; forced eruption with luxation; surgical repositioning; and extraction. This case report show successfully erupted mandibular first molars by various treatment methods on five patients diagnosed with impaction, primary retention, and secondary retention, respectively. Eruption disturbances of the mandibular first molar can be properly diagnosed with impaction, primary retention, and secondary retention by clinical and radiographic examination at normal eruption time of the mandibular first molar. The treatment should be done synthetically, considering eruption state of affected tooth, the relationship between the affected tooth and the adjacent or opposite tooth, the patient's age, treatment compliance, and economic state.

The necessary & method of scrotoplasty in female to male transgender (여성에서 남성으로의 성전환증에서 음낭성형술의 필요성과 방법)

  • Kim, Seok-Kwun;Moon, In-Sun;Kwon, Yong-Seok;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.437-444
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    • 2009
  • Purpose: Transgender is a disorder of gender identity, who have appropriate chromosomal, hormonal and anatomical characteristics corresponding to their sexual phenotype but feel strongly with respect to their sexual identity, that they belong to the opposite sex. There is a persistence discomfort and sense of inappropriateness about one's assigned sex in a person who has reached puberty. Transgender is a psychiatric problem, but surgical method provides more satisfactory adjustment for patients. In gender reassignment surgery for female to male transgender, mastectomy, nipple reduction, hysterectomy, oophorectomy and phalloplasty are included. And as the final operation, recommended for scrotoplasty and artificial testes insertion. So we investigated the necessity and method of scrotoplasty in the final operation of female to male transgender. Method: The authors have long term follow-up of 75 cases female to male transgender during January, 1991 to February, 2008. Among them, 13 cases were evaluated in this study. During phalloplasty, the labium major skin preserved. And this labium majoral skin flap was made for the neoscrotum. At least six months later, artificial testes were inserted in neoscrotum with local anesthesia. Middle sized (3 cm diameter) artificial testes(silicon gel or carving soft silicone implant) were used because of the limitation of the neoscrotum. We evaluated the questionnaire and interview about the postoperative satisfaction in configuration of reconstructed scrotum, and the necessity of operation, the postoperative psychosocioeconomic improvement and limitation of body exposure activities such as swimming, public bathing. Results: Based on this study, satisfaction of reconstructed scrotum after scrotoplasty was improved(92%). The necessity of scrotoplasty was in 92.3% and the postoperative psychosocioeconomic well - being improvement was 77% in answers. Less limitation of activities requiring body exposure was 54% in answers. Most of the patients were satisfied with the results of surgical operation inspite of the operative procedure had some postoperative complications. Conclusion: This study was reported that the scrotoplasty in female to male transgender is not only a conversion of external genitalia but also an improvement of psychosocial state. Most patients sincerely hope to this operation, so we improve our surgical method for more good results.

THE ERUPTION GUIDANCE OF AN IMPACTED DILACERATED MAXILLARY CENTRAL INCISOR (변위 매복된 상악 중절치의 맹출유도)

  • Kang, Keun-Young;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.550-556
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    • 2005
  • Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone by any causes. Any tooth in the dental arch can be impacted, but the teeth frequently involved in a descending order are the mandibular and maxillary third molars, the maxillary canines, the mandibular and maxillary second premolars, and the maxillary central incisors. In these teeth, impaction of maxillary incisor occurs in about 0.1-0.5% and major causes are trauma, supernumerary teeth and periapical inflammation of primary maxillary incisor. Delayed eruption of a maxillary central incisor results in midline shift, the space's being occupied by an adjacent tooth and different levels of alveolar height. Treatment options are observation, surgical intervention, surgical exposure and orthodontic traction, transplantation and extraction. These cases were about the patients with delayed eruption of maxillary central incisor. We surgically exposed impacted tooth and guided it into normal position by the orthodontic traction. At the completion of traction, the maxillary central incisor was positoned fairly within the arch and complications such as root resorption were not observed.

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TREATMENT OF IMPACTED MAXILLARY CENTRAL INCISORS USING ORTHODONTIC TRACTIONS (매복된 상악 중절치의 교정적 처치를 통한 치험례)

  • Kim, Nam-Hyuk;Kim, Seong-Oh;Song, Je-Seon;Son, Heung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.109-116
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    • 2010
  • Impaction is defined as a cessation of the eruption of a tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by an ectopic position of the tooth. The reasons for impaction of the maxillary central incisor are supernumerary tooth, odontoma, ectopic position of tooth germ, dilacerated tooth and so force. Impacted tooth cause space loss due to proximal movement of adjacent tooth, malocclusion, root resorption of adjacent tooth, cyst formation, so careful observation and early detection is important and exact treatment should be applied to prevent these results. The treatment options of impacted tooth include induction an eruption through extraction of deciduous tooth or surgical exposure, reposition of impacted tooth by surgical method or orthodontic treatment. Orthodontic traction is recommended when an eruption does not happen after removal of barrier or surgical exposure, when eruption path is too transpositioned to be corrected spontaneously so eruption does not expected. In these cases, traction of impacted maxillary central incisor was carried out using orthodontic method with closed eruption technique and it showed good clinical results so we report these cases.

MAGNETIC RESONANCE IMAGING AND HISTOPATHOLOGIC CORRELATIONS OF FOCAL LESIONS INDUCED BY LASER (레이저 조사후 자기공명영상과 조직학적 소견의 상호일치도)

  • 이정구;정필상;정필섭;조정석;김상준
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.194-199
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    • 1996
  • Laser therapy is becoming an accepted procedure for tissue coagulation and ablation and is especially useful in treating tumors. The laser energy is applied to the tissue of interest through various delivery systems which are introduced percutaneously, via blood vessels, through body openings, or during surgical exposure of the tissue. One of the major obstacles to effective application of lasers has been the lack of reliable method to determine the extent of tissue involvement in real time. Several methods have been proposed for monitoring the tissue response and controlling the laser in real time during laser therapy. Among them, magnetic resonance imaging(MRI) has been introduced to monitor laser-tissue interactions because laser irradiation induces changes not only in the thermal motions of the hydrogen protons within the tissue but also in the distribution and mobility of water and lipids. The buttocks of New Zealand rabbits were treated by KTP and $CO_2$laser(power : 10 watts, exposure time:10 seconds). m images were taken at immediately after lasering, 1 week later, 2 weeks later, and at the same time, tissues were harvested for histopathologic study. We analyzed MR images and histopathologic findigs of laser-treated tissues. The MR images taken immediately after laser treatment showed 3 layer pattern and which was correlated with histopathologic changes. We suggest MRI may become a useful monitoring tools for laser-tissue interaction.

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Surgical Experience of Pulsed Dye Laser Using Laryngeal Mask Airway Under General Anesthesia in Glottal Papillomatosis Patient who Had Previously Failed to Undergo Surgery Under General Anesthesia Due to Impossible Laryngeal Exposure (전신 마취하 후두 노출이 되지 않았던 후두 유두종 환자에 대하여 시도한 후두 마스크 전신 마취하 Pulsed Dye Laser 수술 치험 1예)

  • Chung, Hyun-Pil;Park, Jun-Hee;Kim, Won-Sik;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.54-57
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    • 2008
  • Non-visualization of larynx is one of the reasons for failure of vocal fold surgery. Many otorhinolaryngologists may have a trouble in choice of alternative treatment if they experience this situation. The laryngeal mask airway could be alternative approach for this situation. We report a glottal papillomatous patient who was treated by pulsed dye laser via laryngeal mask airway after failure of vocal fold surgery via endotracheal intubation. The patient was a 73-year-old man. Laryngoscopy revealed a severe diffuse papillomatous lesion on right true vocal cord, anterior commissure, and partial left true vocal cord. The patient was refered for difficult laryngeal exposure during laryngomicrosurgey under general endotracheal anesthesia.

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Treatment of Carcinoma in Situ of Glottis by KTP Fiberoptic Laryngeal Laser Surgery Under Local Anesthesia (국소 마취 하 굴곡 내시경 후두 레이저 수술로 치료한 성문 제자리 암종 1례)

  • Lee, Yun Ji;Lee, Eunsang;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.53-56
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    • 2019
  • The optimal treatments of carcinoma in situ of glottis include radiotherapy, laser surgery and vertical partial laryngectomy. Conventional surgical treatments need general anesthesia and radiotherapy has several complications. Recently, the effectiveness of 532 nm potassium titanyl phosphate (KTP) laser has been proven and widely used in vocal fold diseases even some cases of vocal fold dysplasia. A patient with difficult laryngeal exposure underwent fiberoptic laryngeal laser surgery using KTP laser under local anesthesia, showed improved voice outcome and the glottic lesion was removed successfully without local recurrence and regional metastasis 18 months after surgery.

Solitary Keratoacanthoma at the Recipient Site of a Full-Thickness Skin Graft: A Case Report and Review of the Literature

  • Jeong Ho Kim;Sang-Hoon Lee;Seung-Phil Hong;Jiye Kim;Sug Won Kim
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.59-62
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    • 2023
  • A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

Non-neoplastic Myelopathies Mimicking Intramedullary Spinal Cord Tumors : Retrospective Analysis of 8 Surgically Proven Cases (척수내 종양과 감별을 요하는 비종양성 척수증 : 수술로 확진된 8례의 후향적 분석)

  • Kim, Ki-Jeong;Chung, Chun-Kee;Sim, Ki-Bum;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.891-898
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    • 2000
  • Objective : It is difficult to differentiate intramedullary spinal cord tumors preoperatively from non-neoplastic pathologies in patients presenting as non-compressive myelopathies in magnetic resonance imaging(MRI). In this report, the authors reviewed nonneoplastic intramedullary spinal cord lesions preoperatively diagnosed as tumors and discussed their clinical and radiological characteristics and usefulness of surgical intervention. Methods : From January, 1985 to January, 1999, authors experienced eight non-neoplastic pathologies mimicking intramedullary spinal cord tumors and analysed their medical records, radiological findings and histopathological specimens retrospectively. Results : There were five males and three females and the duration of symptoms were from two to 20 months(mean, 9.8 months). The location of lesions were four cervical, one cervicothoracic and three thoracic. All patients manifested sensory abnormality, seven motor weakness, and six bladder symptom. All cases had swollen spinal cords and increased signal intensities in spin-echo sequences. Six cases showed contrast enhancement : four cases were focal and two diffuse. Under the impression of intramedullary tumors, the patients were operated upon. Final diagnoses on the base of clinical and pathologic finding were : three subacute necrotizing myelopathies, two multiple scleroses, two myelopathy of unknown etiology. One case showed no gross abnormality in surgical field in spite of adequate exposure of the lesion, so biopsy was not performed. In that case, postoperative MRI revealed spontaneous resolution of the lesion. Conclusion : MRI is invaluable diagnostic tool in screening myelopathies. However, its high sensitivity and lack of specificity make difficulty in preoperative differential diagnosis of non-compressive myelopathies. Although no surgical morbidity occurred in our series, we sometimes failed to confirm definite diagnosis even with biopsy. In such a circumstance, long-term follow up is needed.

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Clinical study of diagnosis and treatment of bisphosphonate-related osteonecrosis of the jaws (비스포스포네이트 관련 악골괴사의 진단 및 치료에 대한 임상적 연구)

  • Kim, Kyung-Wook;Kim, Beom-Jin;Lee, Chung-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.54-61
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    • 2011
  • Introduction: Bisphosphonates is used widely for the treatment of the Paget's disease, multiple myeloma, bone metastases of malignant tumors with the prevention of pain and their pathological fracture. However, it was recently suggested that bisphosphonates related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate use. Materials and Methods: Twenty-four individuals, who were referred to the Department of Oral and Maxillofacial surgery, Dankook University Dental Hospital, were selected from those who had exposed bone associated with bisphosphonates from January, 2005 to December, 2009 according to the criteria of American Association of Oral and Maxillofacial Surgeons (AAOMS) for BRONJ. The patients group consisted of 7 males and 17 females between the age of 46 to 78 years (average 61.8 years). Each patient had panoramic imaging, computed tomography (CT), whole body bone scanning performed for a diagnosis and biopsy sampling from the necrotizing tissue. C-terminal cross-linking telopeptide of type I collagen (CTX) level of patients who had undergone surgical intervention was measured 7 days before surgery. Results: The main cause of bone exposure was post-extraction (15), chronic periodontitis (4), persistent irritation of the denture (3). Twenty people had undergone BRONJ treatment for two to eight months except for 4 people who had to maintain the bisphosphonates treatment to prevent a metastasis and bone trabecular pain with medical treatment. When the bisphosphonate treatment was suspended at least for 3 months and followed up according to the AAOMS protocols, the exposed necrotizing bones were found to be covered by soft tissue. Conclusion: Prevention therapy, interruption of bisphophonates for at least 3 months and cooperation with the physician for conservative treatment are the essential for treating BRONJ patient with high risk factors. The CTX level of BRONJ patients should be checked before undergoing surgical intervention. Surgical treatments should be delayed in the case of a CTX level <150 pg/mL.