• Title/Summary/Keyword: 낭종적출술

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EVALUATION ON THE DECISION AND TIMING OF CYST ENUCLEATION AFTER MARSUPIALIZATION OF LARGE SIZED CYSTIC LESION ON THE JAWS (악골내 거대 낭종 병소의 조대술 후 적출술의 시행 여부 및 적출 시기의 평가)

  • Jo, Ji-Bong;Lee, Kwang-Ho;Lee, Shi-Hyun;Kim, Bok-Ju;Kim, Chul-Hoon;Hwang, Dae-Suk;Shin, Sang-Hun;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.411-419
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    • 2009
  • Objective: The purpose of this study was to determine whether cyst enucleation would be done after marsupialization of large cystic lesion on the jaws or not, and if so, when it should be done. Patients & Methods: 12 patients with cystic lesion treated by marsupialization only and 10 patients with cystic lesion treated by marsupialization followed by enucleation were examined in this study. Postoperative clinical and radiographic examinations were performed at 1, 4, 7, 10, 13, 16, 19 months on 22 patients. Bone regeneration and reduction rate of the residual cystic cavities and bone density were evaluated with a analysis of digital panoramic radiographs. Also histological evaluation of the healing process was performed on 1 patient. Results: Uneventful healing and spontaneous bony filling of the residual cavities were observed in all cases. Postoperative radiographs showed that the size of the lesions was reduced for a few months, but the reduction rate of the residual cavity was minimized for 13~16 months after marsupialization. The bone density was increased 22.5 % after 19 months. Conclusion: This results suggest that the appropriate timing to perform enucleation would be 13~16 months after marsupialization. The state of healing process could be confirmed by histological examination and radiographic evaluation of bone density. Enucleation after marsupialization could be applied appropriately to reduce the periods of bone healing in large cystic lesion on the jaws.

A COMPARATIVE CLINICAL STUDY ON DECOMPRESSION AND ENUCLEATION TO TREAT CYSTIC LESIONS OF THE JAWS (악골내 낭종성 병소의 감압술과 적출술에 관한 임상적 연구)

  • Jung, Young-Soo;Paek, Song-Hum;Lee, Eui-Wung;Park, Hyung-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.43-48
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    • 2004
  • Purpose: Among the various surgical methods used for the effective treatment of cystic lesion in the jaws historically, decompression procedure has some of superior prognosis compare to direct enucleation. In order to propose the efficacy of decompression we performed this retrospective study to compare decompression procedure with one-stage enucleation in clinical results and prognosis. Patients and Methods: We reviewed 175 patients who had been histopathologically diagnosed cystic lesions from 1996 to 2000 in our department. Patients who had been received decompression alone or secondary enucleation after decompression were 31 cases, and enucleation alone were 144 cases. The age and sex of the patients, the area, size, and histological type of the lesions, and detailed operation and complications including recurrence were investigated. The minimal follow-up period was 2 years. Results: In 31cases of decompression, male patients were 22cases(71%) similar to male predilection(62.3%) in total 175 cases. Cystic lesions were developed evenly in all age groups totally. Decompression was mainly performed in teenagers but enucleation was used in elder decades. In decompression cases the lesions were located in mandibular posterior, maxillary posterior, mandibular anterior, and maxillary anterior in order, which had some differences in total and enucleation cases. In enucleation cases, less than 3cm in size was 77.1% but larger than 3cm was 93.5% in decompression cases. Histopathologically, dentigerous cysts(54.8%), unicystic ameloblastomas(16.1%), and odontogenic keratocysts(12.9%) were seen in decompression cases and no recurrence or metaplasia and infection was observed. On the other hand, permanent tooth loss, numbness, recurrence, and so on were accompanied after enucleation. Conclusion: Although decompression procedure has disadvantages such as many of visiting times and slow recovery of the surgical defect, decompression is the best choice of treatment for large cystic lesions of the jaws, because it prevents functional and cosmetic defect, allows bone regeneration, and makes easy secondary enucleation.

THE EVALUATION OF THE PATIENTS TAKING CBCT IN DEPARTMENT OF PEDIATRIC DENTISTRY (소아치과에서 Cone beam형 전산화단층영상을 이용한 환자의 평가)

  • Jeon, Hye-Jin;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.249-256
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    • 2012
  • Cone beam computed tomography (CBCT) has become widely available in recent years and is recognized as an important diagnostic tool for varies disease and condition of the orofacial structure. Clinician is easy to determine adequate treatment plan for pediatric patients by using CBCT. CBCT is used in Chonbuk National University Dental Hospital since 2005. This research presents clinical application of CBCT on patients visiting department of pediatric dentistry in Chonbuk National University Dental Hospital from Jan, 2005 to July, 2011. 1. Total number of patients taken CBCT is 252, and total number of area taken CBCT is 279. 2. An age group form 9 years to 12 years showing 53% was highest and percentage of 6~8 years showed 24%. 3. Chief complaints for CBCT taking are position and shape of impacted teeth (49.1%), mesiodens (19.4%), supernumerary teeth (7.9%), position and root canal shape of erupting teeth (7.2%), cyst (5.4%), inflammatory lesion (3.9%), odontoma (3.9%), tumor (2.2%), and et al. 4. Treatments are extraction (29.7%), orthodontic traction and leveling (24.0%), follow up (16.5%), refer to other professional part (11.5%), endodontic treatment (3.9%), surgical removal (2.9%), malsupialization (3.9%), enucleation (1.1%), and fail to follow up (5.0%), and et al.

Schwannoma of the Extremities (사지에 발생한 신경초종)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo;Lee, An-Hi
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.148-154
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    • 2003
  • Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

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Clinical Survey of Cesarean Section (제왕절개술에 대한 임상적 고찰)

  • Kim, Jae-Wung;Lee, Young-Gi;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.249-260
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    • 1986
  • Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows : 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent(60.2%). 3. The most common indications for cesarean section were previous cesarean section(30.2%), CPD (26.9%), Malpresentation(22.7%), and fetal distress(3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion(31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499gm was the most prevalent(39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most(97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7%. Among the causes of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin, and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased(44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbity of lower segment transverse cesarean section was the least(14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.

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Surgical Treatment of Multidrug-resistant Pulmonary Tuberculosis (다제내성 폐결핵의 수술적 치료)

  • Kim, Jin Hee;Min, Jin Hong;Park, Jun Ho;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.613-618
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    • 2005
  • Background : Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. Material and Method : A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. Results : The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. Conclusion : There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.