• Title/Summary/Keyword: 안면부 통증

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Linear Accelerator Radiosurgery for Trigeminal Neuralgia: Case Report (선형가속기를 이용한 삼차신경통의 정위적 방사선수술: 증례보고)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.144-148
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    • 2006
  • Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

The Patterns of Mandibular Movement in Relation to Maxillofacial Skeletal Structure (악안면부 골격구조에 따른 하악 개구운동 양상)

  • Kim, Byung-Gook;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.25 no.3
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    • pp.293-303
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    • 2000
  • 앵글씨 분류에 따른 최대개구시 하악의 수직 변위에 대한 차이를 확인하고, 수직 하악운동에 영향을 주는 골격요소를 확인하기 위하여, 측두하악관절 및 저작계 이상에 대한 증상 및 병력이 없으며 발치 및 교정치료의 경험이 없는 광주지역 대학에 재학중인 학생들을 대상으로, 앵글씨 구치부 관계에 근거하여 1급군(남:30명, 여:49명), 2급군(남:18명, 여:24명)과 3급군(남:18명, 여:33명)으로 분류하여 총 172명(연령 범주:20-30세)의 학생을 선택하였다. 전남대학교 병원 구강내과에서 사용하는 계측용자를 이용하여 최대 개구시 상하악 중절치 절단면간의 거리를 측정하였다. 대상자들의 진단모형을 만들어 상하악궁 길이와 폭경를 측정하였다. 대상자들에 대한 두부 규격방사선 사진을 촬영, 작도하고 방사선학적 지표를 계측, 비교분석하였다. 앵글씨 분류 1급군, 2급군 그리고 3급군 절치간 최대개구량은 3급군이 가장 컸으며 모든 군에서 남자가 여자보다 컸다. 구치간 최대개구량은 앵글씨 분류 1급군, 2급군 그리고 3급군에서 각 군간의 유의한 차이는 없었으나, 모든 군에서 남자가 더 컸다. 앵글씨 분류 1급군과 2급군의 하악운동에서 총 하악골 길이, 하악지 길이, 하악 하연부 길이 그리고 상악궁 폭경이 변수로 나타났으며, 상하악궁 길이와는 역상관관계를 나타내었다. 앵글씨 분류 3급군의 하악운동에서 상하악궁 길이와 안면 부길이가 1급군과 2급군과는 다른 중요한 변수로 나타났으며, 상악궁의 폭경과는 역상관관계를 나타내었다. 이상의 결과로 보아 앵글씨 분류 각 군에서 하악개구운동은 안면 골격구조의 영향을 받으며, 각 군간에 영향을 주는 안면 골격 요소들은 차이가 있었다. 따라서 이러한 골격적 요소들은 개구량 개선을 위한 진단과 치료시 고려되어야 할 것으로 사료된다.

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Pain Threshold & Taste Threshold Variations across the Menstrual Cycle (월경주기에 따른 동통역치 및 미각역치의 변화)

  • Byun, Young-Hee;Koo, Sun-Ju;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.253-260
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    • 2001
  • 이 연구의 목적은 월경주기에 따른 동통역치와 미각역치의 변화를 평가하고자 하는 것이다. 안면부에 동통성 질환이 없고 정상 월경 주기를 가진 건강한 20대 여성 11명이 이 연구에 참여하였다. 2회의 연속적인 월경주기 동안, 월경기(menstrual phase), 여포기(follicular phase), 황체기(luteal phase)의 세 시기에서 압력통각역치, 전기미각역치, NaCl 미각역치를 각각 측정하였다. 각 역치를 월경주기의 시기별로 비교 분석하여 다음과 같은 결과를 얻었다. 압력통각역치와 전기미각역치는 월경주기의 시기에 따라 유의한 차이를 나타내었고, 황체기에서 월경기에서와 비교하여 통계적으로 유의하게 높은 역치를 나타내었다. NaCl 미각역치는 월경주기에서 통계적으로 유의한 변화를 나타내지 않았다.

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Alcohol Neurolysis of the Celiac Plexus of Upper Abdominal Pain Relief (상복부(上腹部) 통증완화(痛症緩和)를 위한 복강신경총차단(腹腔神經叢遮斷))

  • Kim, Inn-Se
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.164-170
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    • 1988
  • Neurolysis of the celiac plexus is performed to relieve intractable pain caused by carcinoma of the stomach, liver and pancreas, and upper abdominal metastasis of tumors having more distant origins. It is also occasionally effective in controlling the pain of chronic pancreatitis. Alcohol celiac plexus blocks were done in 22 patients of whom 18 had intractable upper abdominal pain from cancer and 4 had pain from chronic pancreatitis. In most cases, an initial diagnostic block with 0.2 percent bupivacaine was followed by the therapeuntic block performed by injecting 50ml of 60 percent ethyl alcohol. Good to excellent pain relief occurred in 86 percent of patients. Duration of pain relief was from 4 months to 7 months in 55 percent of patients. Complications and side effects were infrequently seen but did include a 16 percent decrease of mean systolic arterial pressure and 16 cases of facial flushing. This block is remarkably safe as well as effective for the relief of upper abdominal pain from cancer origin.

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Analysis of Current Perception Threshold(CPT) Change after Dental Surgery using Neurometer (치과 수술 후 뉴로미터를 이용한 전류인지역치의 변화의 분석)

  • Park, Jin-Hyung;Ryu, Ji-Won;Ahn, Jong-Mo;Ok, Soo-Min;Yoon, Chang-Lyuk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.293-298
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    • 2010
  • The goal of this study is to contribute to the clinical application by making a quantitative nerve current perception threshold(CPT) examination for the evaluation of numbness that could be occurred after dental surgery, Measurement of CPTs at each different frequencies(2000 Hz, 250 Hz, and 5 Hz) were performed to trigeminal nerve main branch(mandibular division) of 29 patients with dental surgery on mandibular area and 25 normal subjects. There were significant differences in CPTs between patient group and control group.(p<0.05) But, there were no significant between patient male and female in both patient and control group except 2000 Hz was significantly high in the control female.

Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Case Report; Tetanus, Differential Diagnosis with Trismus (개구장애 환자에서의 감별진단, 파상풍 환자의 증례보고)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.117-121
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    • 2011
  • Tetanus is fatal neurological disease caused by Clostridium tetani on contaminated wound that is characterised by muscle spasm, muscle pain, and autonomic dysfuction. C. tetani exist on contaminated wound frequently that developed clinical tetanus under low oxygen condition. Tetanus have four symptomatic form: generalized, localized, cephalic, and neonatal. The incubation period is about 7 days and mortality is high. The commonest presenting symptom is trismus and other is stiffness of neck and back(opisthotonos), muscle spasm, dysphagia, facial pain, risus sardonicus. Trismus is primary presenting symptom in 50~75% of the cases and this have high possibility of initial visit to dental office. This case report of a patient who visit in our department with trismus as chief complaint.

Comparison of absolute and relative thermal QST thresholds In the orofacial region of the young Korean women (젊은 한국 여성의 구강안면영역에서 절대적 온도역치와 상대적 온도역치간의 비교)

  • Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.367-372
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    • 2013
  • To diagnose sensory nerve damage, patient values for thermal stimuli as quantitative sensory test (QST) can be compared with the values of the general population (absolute reference data) or to values measured at contralateral unaffected side (relative reference data). It is well know that relative reference data are more sensitive for detecting sensory abnormality than absolute reference data. However it is still lack of the studies for comparisons between relative and absolute data. This study aimed to evaluate the validity of relative reference data and compare the sensitivities of the two approaches in the orofacial region. In 19 young Korean women as normal subjects, quantitative somatosensory thermotest were done in the forehead, cheek, mentum, lower lip and tongue tip bilaterally. After we get the standard deviations (SD) of average reference data and relative reference data, the ratios SD absolute data/SD relative data were calculated. Our study showed that relative reference data for side to side comparisons in the same patient have the high ratios than the absolute reference data, i.e. the side to side comparisons with relative reference data exhibit gain in sensitivity in assessment of sensory abnormality.

Early Diagnosis of Burkitt Lymphoma on the Mandible: A Case Report (하악골에서 발생한 Burkitt 림프종의 조기발견과 진단)

  • Kim, Miae;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.4
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    • pp.452-460
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    • 2016
  • Burkitt lymphoma (BL) is an aggressive form of non-Hodgkin's B-cell lymphoma found primarily in the pediatric population. In the oral cavity, this tumor can grow rapidly and often brings about facial swelling or development of an exophytic mass involving the jaws. A 5-year-old boy was referred for swelling and pain in the left mandibular area. The patient showed diffuse swelling on the left side of the mandible and firm-moderate tenderness upon palpation. An intraoral examination showed moderate mobility and sensitivity to percussion on the left primary first and second molars, without severe caries. A radiographic examination revealed complete loss of the lamina dura on the left primary second molar and permanent first molar. There was a radiolucent osteolytic lesion and destruction of the cortical bone of the left mandibular body. Based on the clinical, radiographic, and immunohistochemical findings, the patient was diagnosed with BL, and was referred to a pediatrician for systemic evaluation and intensive chemotherapy. Even before the completion of chemotherapy, the swelling resolved and the displaced teeth were relocated to a normal position. This patient showed a good prognosis due to prompt diagnosis and intensive chemotherapy. Early diagnosis and referral for treatment can prevent the development of BL.

Non Hodgkin lymphoma in the maxillary sinus mimicking dental abscess: a case report (치성 농양과 유사한 상악동에 발생한 비호지킨 림프종의 증례 보고)

  • Song, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.2
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    • pp.130-134
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    • 2016
  • Malignant lymphomas are neoplasms with diffuse proliferation of neoplastic lymphocytes and their precursor cells. Diffuse large B-cell lymphoma, which is a subtype of non-Hodgkin's lymphomas, rarely occurs in the head and neck area and is especially rare in the maxillary sinus. We report a case of a 76-year-old female patient who was referred to the oral and maxillofacial surgery office for evaluation of a dental abscess as a clinical diagnosis. Laboratory tests revealed no signs of inflammation or infection; therefore, incisional biopsy was performed. The final diagnosis was diffuse large B-cell lymphoma in the maxillary sinus. Here we describe this case with a review of relevant literature.