• Title/Summary/Keyword: Anterior approach

Search Result 466, Processing Time 0.02 seconds

The endoscopic transnasal approach to the lesions of the craniocervical junction: two case reports

  • Baraa Dabboucy;Wissem Lahiani;Damien Bresson;Nouman Aldahak
    • Journal of Yeungnam Medical Science
    • /
    • v.40 no.1
    • /
    • pp.96-101
    • /
    • 2023
  • The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the traditional transoral approach because the complications associated with the latter are avoided or minimized. Here, we present two challenging cases of CVJ pathologies. The first case involved os odontoideum associated with anterior displacement of the occipitocervical junction where the EEA was used, followed by C0-C1-C2 fusion using a posterior approach to decompress the CVJ, and was complicated by rhinorrhea and Candida albicans meningitis. The second case involved basilar invagination with syringomyelia previously treated using a posterior approach, where aggravation of neuropathic symptoms required combined treatment with EEA and occipitocervical fusion of C0-C2-C3-C4, with the postoperative course challenged by operative site infection requiring drainage with debridement and antibiotic therapy. The EEA is an alternative approach for accessing the CVJ in well-selected patients. Knowledge of EEA complications is crucial for the optimal care of patients.

The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
    • /
    • v.13 no.2
    • /
    • pp.293-298
    • /
    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Revision Anterior Cruciate Ligamnet Reconstruction (전방 십자 인대 재재건술)

  • Ahn, Jin-Hwan;Lee, Sang-Hak
    • Journal of the Korean Arthroscopy Society
    • /
    • v.9 no.2
    • /
    • pp.115-122
    • /
    • 2005
  • With the increasing number of primary ACL reconstructions, revision surgery has become more frequent. Despite arthroscopic technique and treatment advancements, the current methods of reconstruction are far from perfect that a significant number of patients have an unsatisfactory. This article discusses the multiple mechanisms of failure of primary intra-articular ACL reconstruction and provides the orthopaedic surgeon with a systematic approach to the evaluation and treatment of failed ACL reconstructions.

  • PDF

Gunshot Injury to the Anterior Arch of Atlas

  • Park, Jun-Hee;Kim, Hyeung-Sun;Kim, Seok-Won;Do, Nam-Yong
    • Journal of Korean Neurosurgical Society
    • /
    • v.51 no.3
    • /
    • pp.164-166
    • /
    • 2012
  • Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.

Orthodontic-prosthodontic interdisciplinary treatment for a patient with multiple missing posterior teeth and unilateral scissors bite (다수의 구치 상실과 편측성 가위교합을 갖는 환자의 보철 교정 협진 치료)

  • An, Kiyong
    • The Journal of the Korean dental association
    • /
    • v.53 no.11
    • /
    • pp.844-854
    • /
    • 2015
  • This clinical report describes an orthodontic-prosthodontic interdisciplinary treatment for a patient with multiple missing teeth and unilateral scissors bite. A 47-year-old female presented with multiple missing posterior teeth, anterior large overjet, deep bite, and posterior scissors bite on the right premolar area. Periodontal therapy was performed and followed by orthodontic treatment. The maxillary anterior teeth were initially aligned, then two implants were placed for the left mandibular molars to increase occlusal vertical dimension. The scissors bite between the right maxillary and mandibular premolars were corrected using the miniscrews as an anchorage. Other implants were placed for the right maxillary and mandibular molars after the occlusal planes and occlusal relationship were harmonized. The patient adapted well to altered vertical dimension without any specific problems including peri-implant marginal bone loss. Interdisciplinary approach resolve the complex orthodontic-prosthodontic problems and concluded in successful results.

Humeral Avulsion of the Glenohumeral Joint Capsule - Case Report - (상완골 부착 부위에서 파열된 견관절 낭(증례 보고))

  • Lee Young-Soo;Baek Joon-Sik;Shin Dong-Rae
    • Clinics in Shoulder and Elbow
    • /
    • v.2 no.2
    • /
    • pp.199-203
    • /
    • 1999
  • It is well known that the essential pathology in traumatic anterior dislocation of the shoulder is the avulsion of the glenohumeral ligament complex from the glenoid rim, However, there were some reports that the avulsion can occur from the humeral attachment site. We have experienced a 42-year-old man who had complained of persistent shoul­der pain after traffic accident and showed the instability on physical examination. The MR arthrogram and arthro­scopic surgery revealed the avulsion of glenohumeral ligament from the humeral attachment site. We repaired the lesion using the suture anchor through the anterior axillary approach and had a good result after 1 year.

  • PDF

Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
    • /
    • v.32 no.12
    • /
    • pp.1127-1130
    • /
    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

  • PDF

Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review

  • Nazim Sifi;Ryad Bouguenna
    • Journal of Trauma and Injury
    • /
    • v.37 no.2
    • /
    • pp.161-165
    • /
    • 2024
  • Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

Supraorbital Keyhole Approach for Intracranial Aneurysms : Transitioning from Concerns to Confidence

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
    • /
    • v.63 no.1
    • /
    • pp.4-13
    • /
    • 2020
  • For surgical minimalism to reduce iatrogenic traumatization, a supraorbital keyhole approach has already been successfully applied to treat many unruptured anterior circulation aneurysms. However, using this minimal approach also raises several technical concerns due to the small cranial opening and cosmetic impact of a facial incision. Yet, such technical limitations can be overcome by using favorable surgical indications, slender surgical instruments, and optimized surgical techniques, while excellent cosmetic outcomes can be achieved using a short skin incision located <1 cm from the supraorbital margin, reconstruction of any bone defects around the bone flap, and meticulous wound closure. Thus, given such reassuring surgical results, in terms of the clipping status, neurological effects, and cosmetic outcomes, any concerns can be transitioned into confidence.

Frontal Sinus Mucocele with Massive Skull Destruction

  • Choi, Hwan-Young;Lee, Hyung-Jin;Yang, Ji-Ho;Lee, Il-Woo
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.4
    • /
    • pp.285-288
    • /
    • 2006
  • A 63-year-old female complained of left frontal headache and swelling for several months. Physical examination revealed left supraorbital soft, nontender, nonpulsatile mass without bruit. The left eye was displaced downward with respect to the normal right globe. Based on the clinical and radiological findings, the patient was diagnosed as a mucocele arising from the left frontal sinus. The patient underwent a transcranial approach through coronal incision. In this patient, large portions of the anterior and posterior frontal sinus walls were destroyed in association with epidural spread, so we performed cranialization of the frontal sinus and removed the mucosal wall with the aid of a microscope. With a brief review we present a patient with mucocele of the frontal sinus extending into the intracranial and intraorbital region, which was successfully treated by a transcranial approach.