• Title/Summary/Keyword: surgical removal

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Application of dental microscope in endodontic treatment procedure. (근관치료 영역에서 치과용 미세현미경의 활용)

  • Choi, Sung Baik
    • The Journal of the Korean dental association
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    • v.55 no.8
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    • pp.542-555
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    • 2017
  • 1. Diagnosis Diagnosis of Crack, Direct pulp capping 2. Access opening Find the calcified canal orifice Removal of dentin shelf Obtaining the MB2 canal (MB2, MB3, DB2) 3. Perforation repair during endodontic treatment 4. Removal of the separated files 5. Open apex treatment 6. Void removal on CWT procedure 7. Re-endodontic treatment Removal of restorative material filled in pulp chamber Post removal Identification and removal of residual gutta-perch 8. Surgical endodontic treatment In each case will overview how to use a dental microscope.

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Renal Cell Carcinoma Extending into IVC: 2 surgical cases (하공정맥에 종양혈전을 동반한 신세포암 -수술 치험 2례-)

  • 박형주
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.390-395
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    • 1990
  • Renal cell carcinoma frequently extends into the vena cava and occasionally, even into the right atrium. We experienced 2 cases of renal cell carcinoma extending into the inferior vena cava by radical nephrectomy and complete removal of thrombi in the cava by joint approach with urologic surgeons. In the literature, improvement of survival by complete removal of tumor thrombi in the vena cava was documented and joint approach of cardiovascular surgeons and urologic surgeons result in appropriate surgical approach.

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The Treatment Result of Antituberculous Chemotherapy Followed by Surgical Excisions in Tuberculous Cervical Lymphadenitis (경부 결핵성 림프절염에서 외과적 절제수술후 항결핵제 요법시의 치료 성적)

  • Park Dong-Enn;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.192-196
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    • 2002
  • Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.

Use of an Ultrasonic Osteotome for Direct Removal of Beak-Type Ossification of Posterior Longitudinal Ligament in the Thoracic Spine

  • Kim, Chi Heon;Renaldo, Nicholas;Chung, Chun Kee;Lee, Heui Seung
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.571-577
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    • 2015
  • Direct removal of beak-type ossification of posterior longitudinal ligament at thoracic spine (T-OPLL) is a challenging surgical technique due to the potential risk of neural injury. Slipping off the cutting surface of a high-speed drill may result in entrapment in neural structures, leading to serious complications. Removal of T-OPLL with an ultrasonic osteotome, utilizing back and forth micro-motion of a blade rather than rotatory-motion of drill, may reduce such complications. We have applied the ultrasonic osteotome for posterior circumferential decompression of T-OPLL for three consecutive patients with beak-type OPLL and have described the surgical techniques and patient outcomes. The preoperative chief complaint was gait disturbance in all patients. Japanese orthopedic association scores (JOA) was used for functional assessment. Scores measured 2/11, 5/11, 2/11, and 4/11 for each patient. The ventral T-OPLL mass was exposed after posterior midline approach, laminotomy and transeversectomy. The T-OPLL mass was directly removed with an ultrasonic osteotome and instrumented segmental fixation was performed. The surgeries were uneventful. Detailed surgical techniques were presented. Gait disturbance was improved in all patients. Dural tear occurred in one patient without squeal. Postoperative JOA was 6/11, 10/11, 8/11, and 8/11 (recovery rate; 44%, 83%, 67%, and 43%) respectively at 18, 18, 10, and 1 months postoperative. T-OPLL was completely removed in all patients as confirmed with computed tomography scan. We hope that surgical difficulties in direct removal of T-OPLL might be reduced by utilizing ultrasonic osteotome.

CONSERVATIVE SURGICAL REMOVAL OF COMPOUND ODONTOMA: CASE REPORTS (복합 치아종의 보존적 외과적 적출: 증례보고)

  • Kim, Soo-Yung;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.1
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    • pp.97-102
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    • 2012
  • Odontoma is a mixed tumor formed by the overgrowth of ectodermal epithelial cells and mesodermal cells. It arises during normal tooth development and only grows to a certain level. It is not a true neoplasm and therefore it is considered as hamartomas. Odontomas are classified into compound and complex types based on morphology. Compound odontoma is commonly found in the anterior region of the maxilla, and has a radiopaque lesion that resembles small teeth. Usually, odontoma is treated by conservative surgical removal and there is little probability of recurrence. This paper describes three cases of compound odontoma diagnosed in children with 1 year of follow-up. These case reports present patients having eruption disturbance of primary and permanent teeth due to the presence of compound odontoma. In order to induce spontaneous eruption, conservative surgical removal was performed showing favorable results.

Effectiveness of dexamethasone injection in the pterygomandibular space before and after lower third molar surgery

  • Sitthisongkhram, Kalaya;Niyomtham, Nattisa;Chaiyasamut, Teeranut;Pairuchvej, Verasak;KC, Kumar;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.313-323
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    • 2020
  • Background: Previous studies have investigated the effects of dexamethasone injections into the pterygomandibular space and compared them to those of controls; however, the effects of dexamethasone injections before and after lower third molar surgery on postoperative complications have not been studied. This research investigated the postoperative sequelae of dexamethasone injections before and after surgery into the pterygomandibular space. The aim of this study was to evaluate the effects of preoperative and postoperative injections of 4 mg of dexamethasone into the pterygomandibular space on postoperative pain, facial swelling, and the restriction of mouth opening following lower third molar surgical removal. Methods: Twenty-seven participants with bilateral symmetrical lower impacted third molars were included in this study. Each participant was randomly allocated to one of two groups. Group A received injections of 1 ml dexamethasone (4 mg/mL) and 1 mL placebo into the pterygomandibular space before and after surgery, respectively. Group B received the same doses of placebo before surgery and dexamethasone after surgery. Results: A significant restriction of mouth opening on the second postoperative day was observed in both groups. Nonetheless, the postoperative restriction of mouth opening, facial swelling, postoperative pain, and analgesic consumption after lower third molar surgical removal were not significantly different in the two groups. Conclusions: Regardless of the time of administration, dexamethasone injections into the pterygomandibular space resulted in satisfactory control of the postoperative sequelae of the mandibular third molar surgical removal.

Tailored Surgical Approaches for Benign Craniovertebral Junction Tumors

  • Jung, Seung-Hoon;Jung, Shin;Moon, Kyung-Sub;Park, Hyun-Woong;Kang, Sam-Suk
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.139-144
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    • 2010
  • Objective : We report our surgical experience in the treatment of 16 consecutive patients with benign craniovertebral junction (CVJ) tumor, observed from 2003 to 2008 at our department. Methods : We had treated 6 foramen magnum meningiomas, 6 cervicomedullary hemangioblastomas, 1 accessory nerve schwannoma, 1 hypoglossal nerve schwannoma, 1 C2 root schwannoma, and 1 cavernous hemangioma. Clinical results were evaluated by Karnofsky Performance Scale (KPS) and all patients underwent preoperative neuroradiological evaluation with computed tomography (CT) and magnetic resonance image (MRI). Angiography was performed in 15 patients and preoperative embolization was done in 2 patients. Results : Five far-lateral, 1 supracondylar and 10 midline suboccipital approaches were performed. Gross total removal was achieved in 15 cases (94%) and subtotal removal in 1 patient (6%). None of the patients required occipitocervical fusion. Radiological follow-up showed no recurrence in cases totally removed. Postoperative decrease of KPS scores was recorded in only 1 patient. The treatment of cervicomedullary solid hemangioblastoma presented particular issues : by preoperative embolization, we removed tumor totally without an excessive bleeding or brainstem injury. In one of foramen magnum meningioma, we carried out subtotal removal due to hard tumor consistency and encasement of neurovascular structures. Conclusion : The choice of surgical approaches and the extent of bone resection should be defined according to the location and size of individual tumors. Moreover, we emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon in tailoring the technique and providing the required exposure for different lesions, without unnecessary surgical steps.

Preoperative arterial embolization of heterotopic ossification around the hip joint

  • Kim, Jin Hyeok;Park, Chankue;Son, Seung Min;Shin, Won Chul;Jang, Joo Yeon;Jeong, Hee Seok;Lee, In Sook;Moon, Tae Young
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.130-134
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    • 2018
  • Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

Comparative efficacy of bromelain and aceclofenac in limiting post-operative inflammatory sequelae in surgical removal of lower impacted third molar: a randomized controlled, triple blind clinical trial

  • Gupta, Aishwarya Ashok;Kambala, Rajanikanth;Bhola, Nitin;Jadhav, Anendd
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.29-37
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    • 2022
  • Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

Treatment of Subungual Glomus Tumor (손톱밑에 발생한 사구종의 치료)

  • Lee, Kwang-Hyun;Yang, Mun-Seung
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.244-248
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    • 1995
  • Glomus tumor is uncommon tumor with an incidence of about 1% in soft tissue tumors and the single most common location is the subungual region of the finger. Many reports have emphasized that glomus tumors were difficult to diagnose and that the result of surgical removal was good, but nail deformity has received little attention. Most of authors removed the entire nail or partially splitted the nail to exposure the nail bed and tumor. Nobody reported whether nail deformity after operation was present or not. But, an abnormal nail is both a cosmetic and a functional problem in that catches on objects. In this study, our attention was postoperative nail deformity as well as the results of surgical removal. Seven patients(eight cases) who were diagnosed as a subungal glomus tumor in the hand were treated by surgical excision without removal of the nail and followed over twenty two months. And then we report on our experience with 8 cases of subungual glomus tumor which were successfully treated by complete excision without nail deformity.

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