• Title/Summary/Keyword: Anterior approach

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Ankle Arthrodesis (족관절 유합술)

  • Lee, Jun Young;Park, Sang-Ha
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.147-152
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    • 2014
  • Ankle arthrodesis has been used as standard treatment of ankle arthritis unresponsive to conservative treatment. Transfibular approach was used for ankles with severe deformities and minimally invasive arthroscopic ankle arthrodesis was used for patients with mild deformities. Anterior approach may be used when lateral approach couldn't be performed. Tibiotalocalcaneal arthrodesis is standard treatment for coexisting ankle and subtalar arthritis, and modified Blair arthrodesis can be used if the talus body resection is necessary in severe talar necrosis. In serious infection of ankle arthritis, arthrodesis can be performed as staged operation. In cases with low bone density and severe deformities, Charcot arthropathy should be considered.

L1-2 Disc Herniations : Clinical Characteristics and Surgical Results

  • Lee, Sang-Ho;Choi, Seok-Min
    • Journal of Korean Neurosurgical Society
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    • v.38 no.3
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    • pp.196-201
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    • 2005
  • Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

Extended Application of Endoscopic Repair for Frontal Sinus Fractures (전두동 골절에서 내시경적 치료의 확대 적용)

  • Jeong, Jae-Yeon;Lim, So-Young;Pyon, Jai-Kyong;Bang, Sa-Ik;Oh, Kap-Sung;Mun, Goo-Hyun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.613-618
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    • 2010
  • Purpose: The coronal approach for repair of frontal sinus fractures is associated with significant adverse sequelae including a long scar, alopecia, paresthesias, and, uncommonly, facial nerve injury. To minimize these complications, an endoscopic approach for repair of frontal sinus fractures was developed. The authors now present the results of an endoscopy-assisted approach for the treatment of frontal sinus fractures. Methods: From 2002 to 2009, five patients with frontal sinus fracture underwent endoscopic repair. Two slit incisions were placed in the scalp, and one or two stab incisions directly over the fractures were placed in the forehead. After subperiosteal dissection, fracture segments were reduced under direct vision and fixed with microplates or fibrin glue. Results: All patients had good cosmetic results and remained free of sinus complaints. There were no perioperative complications reported. Conclusion: Endoscopic repair of frontal sinus fractures is an efficacious technique that significantly reduces patient morbidity. A relatively wide range of anterior table fractures can be reduced using an endoscope. In cases of complicated comminuted fractures, fibrin glue helps to achieve satisfactory endoscopic reduction. Endoscopic repair is an alternative treatment for various anterior table fractures of the frontal sinus.

Implant-assisted removable partial denture in a maxillary edentulous patient: A case report (상악 무치악 환자에서 전방부 임플란트 지지 고정성 보철물을 이용한 임플란트 보조 국소의치 수복 증례)

  • Kang, Hyun-Mo;Kim, Jee-Hwan;Kim, Jae-Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.442-452
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    • 2022
  • Implant-assisted removable partial denture (IAPRD) can be considered as a simple and cost-effective treatment approach for an edentulous patient with anatomical or financial limitations. Recently, it was reported that the application of IARPD with implant supported fixed prostheses covered by the National Health Insurance Service (NHIS) were increasing. This case report describes the treatment of maxillary fully edentulous patient with anterior four-implant-supported fixed prosthesis and distal extension IARPD. This treatment approach may be advantageous over maxillary implant overdentures in some circumstances. The patient was satisfied with improved function and esthetics in the anterior area and financial benefit from the NHIS. Further long-term clinical studies are needed to establish clinical validity of the treatment approach described in this case report.

SHADE ANALYSIS OF ANTERIOR TEETH USING DIGITAL SHADE ANALYSIS SYSTEM (Digital Shade Analysis System을 이용한 전치부의 색조 특성에 관한 연구)

  • Kim Hee-Eun;Cho In-Ho;Lim Ju-Hwan;Lim Hun-Song
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.5
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    • pp.565-581
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    • 2003
  • Statement of problem : A scientific examination and understanding of overall aspects of the natural dentition is the first step involved in making a satisfactory selection in the shade of an aesthetic prosthesis. Proper natural shade selection of the prosthetic restoration that is in harmony with the remaining dentition is as important aesthetically, as harmony of form and function in the anterior dentition. Clinically, the most commonly applied method of shade selection has been visual, but because of the subjective nature inherent to this method, shade selection results are variable and can be influenced by such factors as the technician, the type of shade guide used, and the type and intensity of the lighting. Purpose : The purpose of this study was to develop a more objective and scientific approach to examining and understanding the shade of teeth, which has in turn lead to the development of a number of shade analysis devices that present a more objective method of shade analysis. Material and Method : In this study, the shades of healthy anterior teeth were examined and analyzed using the recently developed digital shade analysis of the $ShadeScan^{TM}$ System. The study examined 80 individuals in their twenties, 40 males and 40 females, presenting 6 healthy, unrestored maxillary anterior teeth. Tooth brushing and oral prophylaxis were performed prior to evaluation. The ShadeScan handpiece was used to acquire images of the 6 maxillary anterior teeth. These images were analyzed using the Vita/Classical mode of the $ShadeScan^{TM}$ Software, and shade maps of each tooth were acquired and divided into cervical, middle, and incisal thirds. The shade distribution of each third, left and right symmetry, and gender differences were investigated and analyzed. Results : The results of the study are as follows : 1. An overwhelming majority of the examined teeth were found to possess shades belong to Group A, with the greatest variations occurring at the middle and cervical thirds of the maxillary central and lateral incisors, in both male and female subjects. 2. Canines of both male and female subjects showed left and right symmetry with uniform shade distribution of A4 and C4, while the lateral and central incisors showed left-right symmetry of the incisal 1/3 with a uniform shade distribution of A2 and A3 shades 3. No significant differences in shade distribution were seen between genders in maxillary canines, whereas maxillary central and lateral incisors showed differences at the middle and cervical thirds between male and female subjects The results of this study show that with the exception of maxillary canines, maxillary anterior teeth display a diverse shade distribution as well as gender differences. Conclusion : Clinically, when making a shade selection using the existing shade guide, one must consider the fact that even a single tooth consists of a variety of shades. The results of this study show that when selecting a shade from a number of groups is difficult, shades from A group are the most consistent with the natural shade or maxillary anterior teeth.

Clinical Evaluation between Mandibulotomy and Mandible Sparing Approaches in Oropharyngeal Cancer Operation and Reconstruction (구인두암의 절제 및 재건수술에서 하악골 절개 접근법과 하악골 보존 접근법의 임상적 비교)

  • Kim, Jeong Tae;Lee, Jung Woo;Jo, Dong In;Lee, Hae Min
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.152-158
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    • 2008
  • Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.

Clinical and Radiologic Assessment for Anterior Cervical Interbody Fusion with Synthetic Cages

  • Shin, Seung-Ho;Lee, Woo-Jong;Eun, Jong-Pil;Choi, Ha-Young;Lee, Jung-Chung
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.105-110
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    • 2007
  • Objective : This purpose of this study was to determine the clinical efficiency and applicability, and to analyze the radiologic findings of the anterior cervical approach using two synthetic cages for interbody fusion. Methods : A total of 41 patients with cervical diseases underwent anterior discectomy and interbody fusion with the PEEK $Solis^{TM}$ cage in 21 patients and the carbon composite $Osta-Pek^{TM}$ cage in 20 patients. Outcome assessment was done using Odom's criteria. Radiological assessment was performed with respect to subsidence, bony fusion and lordosis. The mean follow-up period was 13 months. Results : There were 34 [92.9%] successful cases. The average height of the disc space 12 months after surgery compared the height just after surgery was decreased over 3mm in 4 cases, indicating severe subsidence. The use of these synthetic cages have provided the increase in postoperative cervical lordosis. Conclusion : There were no significant differences between the $Solis^{TM}$ and $Osta-Pek^{TM}$ cages on clinical and radiologic outcomes. Both $Solis^{TM}$ and $Osta-Pek^{TM}$ cages showed low subsidences and complications associated with hardware with good clinical outcomes, high fusion rates, restored disc heights, and restored cervical lordosis.

Conservative approach for anterior crown-root fractured teeth: forced eruption (상악 전치부 치관-치근 파절 증례에서의 보존적 접근법: 교정적 정출술)

  • Kim, Ji-Eun;Choi, Sung-Hyeon;Chang, Hoon-Sang;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.1
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    • pp.48-54
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    • 2020
  • In the case of crown-root fracture due to traumatic injury in anterior tooth and the fracture margin is located subgingivally, forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. Forced eruption is one of the easiest orthodontic approaches that can have an acceptable outcome and prognosis, and has a low incidence of relapse. However, using heavy forces or very fast movements can also cause tissue damage or ankylosis. The following case reports present forced eruption as treatment option of crown fracture in maxillary anterior teeth.

Treatment and retention of relapsed anterior open-bite with low tongue posture and tongue-tie: A 10-year follow-up

  • Seo, Yu-Jin;Kim, Su-Jung;Munkhshur, Janchivdorj;Chung, Kyu-Rhim;Ngan, Peter;Kim, Seong-Hun
    • The korean journal of orthodontics
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    • v.44 no.4
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    • pp.203-216
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    • 2014
  • The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer.

Removal of an intraosseous hemangioma of the frontal bone through an anterior hairline incision: a case report

  • Myung-Good Kim;Jeong-Ho Ryu;Dong Min Lee;Tae-Seo Park;Ji-An Choi;Keun-Cheol Lee;Song-Hee Han
    • Archives of Craniofacial Surgery
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    • v.24 no.4
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    • pp.189-192
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    • 2023
  • An intraosseous hemangioma of the frontal bone is typically removed via a coronal incision. This procedure, while effective, can be lengthy and may result in complications such as a prominent scar and hair loss. An alternative approach involves a direct incision in the forehead, which leaves a less noticeable scar and allows a quicker recovery. However, in this specific case, the patient declined both coronal surgery and surgery through a direct forehead incision due to cosmetic concerns. Therefore, we proposed an anterior hairline incision. A 35-year-old woman presented with a firm, non-mobile, palpable mass on her right forehead. Preoperative non-contrast computed tomography revealed a heterogeneous osteolytic lesion. We performed an excisional biopsy through the anterior hairline. Postoperative non-contrast computed tomography was conducted 2 and 6 months after surgery. The wound was clean and free of complications, and there was no local recurrence. Partial resection can reduce scarring for patients who are concerned about cosmetic outcomes. However, the potential for recurrence remains a significant concern. We present this case of an anterior hairline incision for a hemangioma located in the forehead, evaluated using serial computed tomography for both preoperative and postoperative imaging.