• Title/Summary/Keyword: 안면손상

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THE PREVALENCE OF SENSORY DISTURBANCE AFTER IMPLANT SURGERY - RETROSPECTIVE SURVEY OF IMPLANT PRACTITIONERS (임플란트 식립후 하악 신경손상에 대한 후향적 연구)

  • Kwon, Tae-Geon;Kim, Shin-Yu;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.339-344
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    • 2004
  • The purpose of this study was to evaluate neurosensory disturbance associated with implant surgery performed by implant practitioner (n=47) composed of trained oral surgeon, periodontist, prosthodontist. The incidence, type and duration of sensory disorder were investigated. Anatomical factor of the patient and experience of operator were also evaluated. The result revealed high incidence of inferior alveolar nerve damage (45%) regardless of experience of implant practitioner. The sensory disturbance sustained within 6 months for 61% of cases, which revealed almost normal recovery of nerve function. Initial neurologic sign after nerve damage was not coincide with their consequence of recovery. Half of the practitioners tried surgical intervention to the implants such as removing the fixture, partial unscrewing or re-implant shorter fixture, of which trial regarded as effective measure for 53% of cases. The result indicates that the objective method of sensory nerve evaluation should be introduced to the implant practitioners and the importance of informed consent for possibility of nerve damage in mandibular implant fixation.

Conservative therapy of extensive unicystic ameloblastoma: a case report (낭종성 법랑아 세포종의 치험례: 증례 보고)

  • Hyun, Chang Lim;Song, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.246-250
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    • 2018
  • Ameloblastoma is a benign neoplasm originating from odontogenic epithelium. It is the most common neoplasm in the jaws and is characterized by aggressive behavior and local invasion. Unicystic ameloblastoma (UA) has a unilocular feature in radiologic examination and a cystic feature histologically. Decompression and marsupialization are conservative method of treatment of large UA. The purpose of decompression and marsupialization are size reduction of the mass, which makes it easy to handle at total enucleation with protection of nerve damage and facial deformity. Here we report successful conservative treatment of extensive UA using decompression and marsupialization with a review of literatures.

A Case of the Solitary Neurofibroma at the Median Nerve -Ultrastructural Study- (정중신경에 발생한 신경섬유종 치험례 -초미형태학적 관찰-)

  • Ihn, Joo-Chul;Ahn, Jong-Chul;Kim, Sae-Dong;Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.199-206
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    • 1984
  • With respect to the histogenesis of the neurofibroma, there are many controversies, since von Recklinghausen postulated that neurofibromas are mainly fibrous tumors arising from the connective tissue of the nerve sheaths. According to the recent studies through the electron microscope, the neoplastic perineurial cells are regarded as the main components of the tumor. So, the neurofibroma enucleated from the median nerve at the level of proximal arm without resulting neurologic sequale was examined through the light- and electron microscope. Ultrastructurally, this tumor is composed of the perineurial cells, fibroblasts, and collagen fibers. The predominant perineurial cells show distinct basal lamina, and contain abundant microfilaments.

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Treatment of Peripheral Facial Palsy with Skin Damage Caused by Folk Remedies Using Korean Medicine: A Case Report (민간요법으로 피부손상을 동반한 말초성 안면마비에 대한 한의치료 증례 보고)

  • Yoona, Oh;Yeonhak, Kim;Jihun, Kim;Eunseok, Kim;Byung Ryul, Lee;Gi Young, Yang
    • Korean Journal of Acupuncture
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    • v.39 no.4
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    • pp.191-198
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    • 2022
  • Peripheral facial palsy generally results from damage to the facial nerve. As facial asymmetry is observed, it accompanies not only functional problems but also psychological and social difficulties. Medical institutions treat most patients, however, there are still patients who rely on invasive methods by unqualified practitioners for fear of sequelae. This case describes a 61-year-old woman who experienced facial palsy twice. She visited our hospital with skin damage after folk patch therapy for her facial palsy. Combined Korean medicine treatment was administered during treatment period. After treatments, the symptoms of facial palsy and skin lesions improved. This case showed that Korean Medicine was efficacious in improving symptoms of facial palsy with damaged skin caused by folk patch therapy. Education and awareness of uncontrolled invasive treatments for facial palsy are needed.

The Clinical Study of the Supracondylar Fracture of the Femur (대퇴골 과상부 골절 및 치료에 대한 임상적 고찰)

  • Ahn, Jong-Chul;Kim, Se-Dong;Ahn, Myun-Whan;Seo, Jae-Sung;Lee, Dong-Chul;Lee, Young-Joo
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.197-211
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    • 1993
  • Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So complications of the supracondyle fractures including joint stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989, Dec. To 1992, Jan. The results were as follows : 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification. 4 cases were type A, 4 in type B, 12 in type C (10 in type $C_2$&$C_3$). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in conservative treatment and 67% in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.

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THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.117-127
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    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

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Effects of enucleation and chemotherapy in advanced intraocular and intraorbital retinoblastoma with or without radiotherapy (진행된 안구내 및 안와내 망막모세포종에서 안구적출술과 항암화학치료 및 방사선조사 유무에 따른 효과)

  • Lee, Jae Min;Lee, Hyun Dong;Hah, Jeong Ok
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.84-88
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    • 2008
  • Purpose : Radiotherapy is effective in local treatment for retinoblastoma. However, asymmetric facial hypoplasia after radiation is a serious late effect. This study was performed to investigate the effects of enucleation and chemotherapy with or without radiotherapy in advanced intraocular and intraorbital retinoblastoma. Methods : Between 1985 October and 2006 December, the records of thirty five patients who were diagnosed as retinoblastoma at Yeungnam University Hospital were reviewed. Advanced intraocular and intraorbital retinoblastoma patients classified as Reese-Ellsworth group III, IV, and V and Grabowski- Abramson class II were selected for the study. Results : Eighteen patients were enrolled in this study. All patients were enucleated and had received chemotherapy. Nine patients received radiotherapy and nine patients didn't receive radiotherapy. Tumor cells were found on resection margin of optic nerve in five of nine patients who received radiotherapy, but none of nine who didn't receive radiotherapy. Chemotherapy included vincristine, adriamycin, cyclophosphamide, VM-26, cisplatin before 2001, and vincristine, etoposide, and carboplatin after 2001. There were no recurrences or metastases in nine patients who didn't receive radiotherapy. But two of nine patients who received radiotherapy had metastases to brain. However, all survivors who received radiotherapy had significant facial asymmetry. Conclusion : In advanced intraocular and intraorbital retinoblastoma without tumor cell on resection margin of optic nerve, enucleation and chemotherapy without local radiotherapy appears to be safe for long-term survival. However, in those with tumor cells on resection margin of optic nerve, enucleation and chemotherapy with local radiotherapy seems to be necessary to improve survival.

Determination of Appropriate Exposure Angles for the Reverse Water's View using a Head Phantom (두부 팬텀을 이용한 Reverse Water's View에 관한 적절한 촬영 각도 분석)

  • Lee, Min-Su;Lee, Keun-Ohk;Choi, Jae-Ho;Jung, Jae-Hong
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.187-195
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    • 2017
  • Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.

New maxillary anterior ridge classification according to ideal implant restorative position determined by CAT (전산화단층영상을 이용한 이상적 임플란트 수복 위치에 따른 상악 전치부 치조제의 새로운 분류)

  • Park, Young-Sang;Cho, Sang-Choon;Kim, Kyoung-Nam;Kim, Kwang-Mahn;Choi, Seong-Ho;Moon, Hong-Seok;Lee, Yong-Keun
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.385-396
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    • 2007
  • This study proposed a new classification system for maxillary anterior alveolar ridge deformities based on CAT-scan implant simulation as a useful concept in order to more precisely predict treatment outcomes and the necessity for ridge augmentation prior to implant placement. The results indicate that a high number of cases in the maxillary anterior area would require augmentation procedures in order to achieve ideal implant placement and restoration.

Nerve Injuries after the Operations of Orbital Blow-out Fracture (안와골절 수술 후 발생한 신경손상)

  • Choi, Jae Il;Lee, Seong Pyo;Ji, So Young;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.28-32
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    • 2010
  • Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.