• 제목/요약/키워드: 감압술

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급성 경막하 혈종에 대한 감압술 후 발생한 반대편의 천막 상, 하 급성 경막외 혈종 (Postoperative Contralateral Supra- and Infratentorial Acute Epidural Hematoma after Decompressive Surgery for an Acute Subdural Hematoma - A Case Report -)

  • 이정식;좌철수;심숙영;김강현
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.188-191
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    • 2010
  • A postoperative contralateral supra- and infratentorial epidural hematoma after decompressive surgery is an extremely rare event. We describe a 38-year-old male with a contralateral supra- and infratentorial acute epidural hematoma just after decompressive surgery for an acute subdural hematoma. A contralateral skull fracture involving a lambdoidal suture and an intraoperative brain protrusion may be warning signs. The mechanisms, along with relevant literature, are discussed.

제 2단계 견봉하 충돌증후군에서 관절경적 감압술(5년에서 12년의 장기추시관찰 결과) (Arthroscopic Decompression in Stage II Subacromial Impingement - Five to Twelve Years Follow up -)

  • 최종혁
    • Clinics in Shoulder and Elbow
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    • 제2권2호
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    • pp.99-105
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    • 1999
  • We investigated the effectiveness of arthroscopic decompression in stage Ⅱ subacromial impingement after long term follow up. Arthroscopic subacromial decompression was done in 104 consecutive patients who had stage Ⅱ sub­acromial impingement. After average of 8.4 years follow up, the final results were as following; 57 shoulders(55%) in excellent, 25(24%) in good, 16(15%) in fair and 6(6%) in poor. All parameters-pain, function, muscle strength and motion-were improved significantly(p<0.00l). Rotator cuff tear was developed in 10 shoulders after decompression. Among them, 8 shoulders had unfavorable results including two poor. In 6 failures, two had rotator cuff tear, three had recurrence of impingement with degenerative change and reflex sympathetic dystrophy was developed in one. Reoperations were done in 4 shoulders. Improvement of impingement symptoms was maintained in the most of patients(79%) after long term follow up. Arthroscopic decompression surgery was very effective means for stage Ⅱ impingement syndrome.

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회개근 개 파열과 동반된 색소 융모 결절성 활액막염 - 증례 보고 - (Pigmented Villonodular Synovitis of the Shoulder Associated with Rotator Cuff Tear - A Case Report -)

  • 하성식;홍기도;심재천;김태호;조혜제;김종현
    • Clinics in Shoulder and Elbow
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    • 제13권2호
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    • pp.275-279
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    • 2010
  • 목적: 회전근 개 파열과 동반된 색소 융모 결절성 활액막염의 치료 경험을 보고하고자 한다. 대상 및 방법: 회전근 개 파열과 동반된 색소 융모 결절성 활액막염을 가진 52세 여자 환자에 대하여 관절경하 활액막 절제술과 견봉하 감압술을 시행하였다. 결과: 수술 후 통증의 호전과 기능의 회복을 보였다. 결론: 회전근 개 파열과 동반된 색소 융모 결절성 활액막염 1예를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

관절경하 후내측 도달법을 이용한 슬와 낭종의 직접적 제거술 (Arthroscopic Direct Removal of Popliteal Cyst by Posteromedial Portal)

  • 조진호;김용훈;김동환
    • 대한관절경학회지
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    • 제9권2호
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    • pp.232-237
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    • 2005
  • 목적: 슬와낭종의 치료에 있어서 70도 관절경과 후내측 도달법을 이용한 직접적 제거술 및 관절낭 주름 제거술 술기의 유용성을 알아보고자 한다. 대상 및 방법: 2003년 1월부터 2004년 1월까지 관절경을 이용한 슬와낭종의 직접적 감압술의 방법으로 치료받은 21명, 23예를 대상으로 하였다. 연령 분포는 35세에서 78세로 평균 54세 였으며, 남자 5명, 여자 16명이었고, 우측 슬관절이 8예,좌측 슬관절이 11예,양측에 발생한 예가 4예 있었다. 수술전 슬관절내 동반 병변의 유무 파악을 위해 전예에서 MRI를 시행하였고, 술후 6개월과 1년째에 초음파 검사를 시행하여 낭종의 재발 여부를 관찰하였으며, 슬관절 통증과 낭종의 촉지 유무를 관찰하였고, 임상 평가를 위해 Rauschning and Lindgren criteria를 사용하였다. 결과: 23예중 전예에서 1년이상의 최종 추시시 방종이 촉지되지 않았으며, 초음파 검사에서 낭종이 재발한 예는 없었다. 통증 및 보행장애는 없었으며, 합병증은 1예에서 전동절삭기에 의한 후내측 구획부위의 피부손상이 있었다. 수술 후 전예에서 Rauschning and Lindgren criteria는 Grade 1 이상이었다. 결론: 70도 관절경과 후내측 도달법을 이용한 치료방법은 낭종재발의 원인이 될 것으로 사료되는 check valve 형태의 낭주름 제거가 용이하며, 슬관절 후면의 피부절개가 없어 미용상 보기 좋으며 그로 인한 합병증을 줄일 수 있으므로 슬와 낭종 치료에 효과적인 방법으로 사료된다.

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미세혈관감압술에도 지속된 삼차신경통의 고주파 열응고술을 이용한 치험 -증례 보고- (Radiofrequency Thermocoagulation for Trigeminal Neuralgia Sustained Following Microvascular Decompression -A case report-)

  • 김해규;강동희;김기엽;백승완;김인세
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.302-306
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    • 1998
  • The authors report the result achieved in the treatment of trigeminal neuralgia patient, especially V2 involved patient, using radiofrequency (RF) thermocoagulation of Gasserian ganglion. A 62-year old female patient had severe burning pain on right cheek usually initiating from upper molar teeth area for 10 years. She was treated with microvascular decompression operation 10 years ago. However, there was no pain relief by operation. She wanted non-surgical treatment. Therefore, we recommended RF thermocoagulation therapy. After 2 times of RF thermocoagulation, there was excellent pain relief without complications. And, for 6months follow-up, there were no pain, and no evidences of complication and recurrence.

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소아에서 발생한 S상 결장 염전증 1예 (A Case of Sigmoid Volvulus in a Child)

  • 이동한;위주희;박현석;김해영;박재홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제13권2호
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    • pp.199-203
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    • 2010
  • 본 증례는 1년 전부터 갑작스럽게 복부팽만과 복통이 반복하다 내원 10일 전부터 심한 복통과 복부팽만, 구토가 발생하여 내원한 9세 남자 환자이다. 복부 X-선 촬영과 바륨 관장 등의 검사로 S상 결장 염전증을 진단하고 내시경적 염전 정복과 감압술 시도하였으나 실패하였다. 수술 시야에서 심하게 확장되고 비정상적으로 긴 S상 결장과 굵은 혈관이 포함된 결장간막이 관찰되었고 S상 결장의 원위부 및 근위부에서 좁아진 부위를 확인하여 이 부분을 포함한 S상 결장 절제술을 시행하였다. 이후 환자는 5년 동안의 추적관찰에서 증상의 재발이 없었다.

안와골파열골절 정복술 후 지속되는 안구함몰 환자에서 정상측 안구의 안구 감압술의 치험례 (Correction of Persistent Enophthalmos after Surgical Repair of Blow Out Fracture Using Orbital Decompression Technique of Contralateral Eye)

  • 이준호;박원용;남현재;김용하
    • 대한두개안면성형외과학회지
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    • 제9권2호
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    • pp.101-104
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    • 2008
  • Purpose: Diplopia and cosmetically unacceptable enophthalmos are the major complications of blow out fracture. Prolapse of orbital tissue into the sinuses, enlarged orbital volume, atrophy of orbital fat and loss of support of orbital walls play a role in the pathogenesis of enophthalmos. To correct post-traumatic enophthalmos, freeing of incarcerated orbital contents combined with reduction of bony orbital volume and reconstruction of suspensory support of globe is necessary. But remained enophthalmos after surgical treatment is difficult to correct completely. In this case, the authors performed implant insertion for affected orbit and endoscopic orbital decompression for unaffected orbit for correction of late enophthalmos. Method: We reviewed a girl patient with right inferomedial orbital wall blow out fracture, right zygoma fracture treated at our hospital for correction of enophthalmos. An 18-year-old female had sustained posttraumatic enopthalmos. Two surgical management was performed for correction blow out fracture at the other hospital. But residual diplopia, enophthalmos, cheek drooping were found. And then she transferred to our hospital. She had severe enophthalmos(5 mm) also had diplopia and extraocular muscle limitation. We performed operation for correction of enophthalmos. After operation, she showed minimal improvement of diplopia and enophthalmos(3 mm). The authors make plan for operation for correction enophthalmos due to cosmetical improvement. Implant insertion was performed for affected orbit. For unaffected orbit, nasoendoscopic medial orbital wall decompression was proceeded. Result: Correction of enophthalmos was found after operation and was maintained for nine years follow-up. Patient expressed satisfaction for the result. Conclusion: To correct persistant enophthalmos, we could have satisfactory result with orbital wall reconstruction on affected eye and decompression on unaffected eye.

급성뇌경색증에 동반된 악성 뇌부종 환자에 있어서 뇌경막확장성형술을 통한 두개골 감압술의 효용성 (The Effectiveness of Decompressive Craniectomy with Dural Augmentation in Malignant Cerebral Infarction)

  • 손성호;김수영;정영균;조봉수;박혁;이동열
    • Journal of Korean Neurosurgical Society
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    • 제30권9호
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    • pp.1072-1078
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    • 2001
  • Objectives : There is continuing controversy about the benefits of decompressive craniectomy in massive cerebral edema following space occupying hemispheric cerebral infarction. The aims of this study are to determine the effectiveness and to confirm the life-saving nature of decompressive craniectomy with dural augmentation for massive cerebral infarction. Patients and Methods : We present twelve patients with medically uncontrollable hemispheric cerebral infarction. All were treated with extensive craniectomy and duroplasty without resection of necrotic tissue. We evaluated various characteristics(size of hemispheric infarction, Glasgow Coma Scale, volume of low density and midline shift in CT) at three different periods(preoperative, immediate postoperative and 3-4weeks after operation) and evaluated effectiveness of hemicraniectomy for massive cerebral edema after large hemispheric infarction. Results : All patients have survived from surgery. Nine patients with nondominant hemispheric infarction showed significant functional recovery with minimal assistance, and remaining two patients with dominant hemispheric infarction and one patient with nondominant hemispheric infarction have functionally dependent. The volume of low density and midline shift in CT were significantly reduced after decompressive craniectomy. Conclusions : Our results indicate that decompressive craniectomy with dural augmentation without resection of necrotic tissue for massive cerebral hemispheric infarction not only reduce the mortality and infarction size but also significantly improve the outcome, especially for nondominant hemispheric infarction.

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회전근개 관절내 부분 파열 환자의 관절경적 처치(변연 절제술 단독과 견봉하 감압술 병용시와의 비교) (Arthroscopic Treatment for Articular Side Partial- Thickness Tears of the Rotator Cuff - Comparison Between Simple Debridement and Additional Acromioplasty -)

  • 문영래;윤태현;박준광;오서진
    • Clinics in Shoulder and Elbow
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    • 제2권2호
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    • pp.120-125
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    • 1999
  • Objectives : To evaluate the effects of arthroscopic acromioplasty and debridement for partial thickness articular side rotator cuff tears, Method: We divided 97 patients into 2 groups according to treatment protocol, with both groups having confirmed intra-articular partial tears of the rotator cuff. In group Ⅰ, we debrided the frayed and fibrotic cuff margin while in group II, we performed subacromial decompression in addition to debridement. After the surgery we checked all the patients with the modified UCLA shoulder rating scale. Results: The follow-up observation 12 months after surgery revealed that 44 patients in group I were rated as excellent in 32 cases, good in 10 cases, fair in 1 case, and poor in one case, while 53 patients in group II, were rated as excellent in 38 cases, good in 17 cases, and fair in 2 cases. Twenty-four month after surgery we observed that patients in group I were rated as excellent in 23 cases, good in 16 cases, fair in 4 cases, and poor in 1 case, while patients in group II were rated as excellent in 34 cases, good in 17 cases, and fair in 6 cases. Conclusion: The use of acromioplasty on partial thickness tears of rotator cuff, even in the cases of intra-articular nature, is preferable to the procedure performed without it.

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악골 내 치성 낭종의 감압술 전 후의 임상 및 조직학적 비교 연구 (COMPARISON OF CLINICO-HISTOPATHOLOGIC FINDINGS BEFORE AND AFTER DECOMPRESSION OF ODONTOGENIC CYST IN THE JAW)

  • 김영현;이의웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권2호
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    • pp.150-160
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    • 2005
  • Background: For normalization of displaced anatomical structure by large cyst, two-step procedure (decompression and enucleation afterward) has been recommended. However, the histological transformation after cystotomy for decompression was shown frequently in secondary enucleation. Therefore, analyses about effects and histological changes after decompression have been necessary. Methods: 48 cases diagnosed as large odontogenic cyst in the jaw and treated by decompression and secondary enucleation were retrospectively analyzed in clinical, rediographical, and histological aspects. Results: In dentigerous cyst, decompression was much useful. Impacted permanent teeth were erupted and reduction rate was higher than that of odontogenic keratocyst (OKC) and apical periodontal cyst. In OKC, among the 29 cases, 11 cases showed no-keratosis, proliferation and rete-ridge elongation after decompression. 4 cases showed no-keratosis, only. 7 cases showed orthokeratosis and rete-ridge elongation and 6 cases showed reteridge elongation, only. 1 case had no change. And the recurrence rate for OKCs was 10.3%. For all odontogenic cysts in this study, dysplasia was not found in cystic lining after decompression. Conclusions: This study implied that decompression for large odontogenic cyst was useful treatment modality because it was conservative treatment and recurrence rate was low although long treatment period was required.