• Title/Summary/Keyword: Cervical approach

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Computerized Tomographic Measurements of Morphometric Parameters of the C2 for the Feasibility of Laminar Screw Fixation in Korean Population

  • Kim, Young-June;Rhee, Woo-Tack;Lee, Sang-Bok;You, Seung-Hoon;Lee, Sang-Youl
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.15-18
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    • 2008
  • Objective : C2 laminar screw fixation is considered as an excellent alternative to Magerl's transfacetal approach or Harms construct for the atlantoaxial stabilization. However, to our knowledge, there is no report on the feasibility of the new approach to Korean population. We investigated morphometric parameters of the dorsal arch of the C2 to provide the quantitative data for the feasibility of laminar screw fixation. Methods : One-hundred-and-two patients' cervical computed tomography had been reconstructed and investigated on the anatomical parameters related with C2 laminar screw placement. Sixty patients were male and forty-two patients were female. Measurements included the laminar thickness and slope, spino-laminar angle, and maximal screw length. Results : Ages ranged from 20 to 81 and the mean age was 48.4. Mean laminar thickness was 5.7 mm (${\pm}1.0$) (5.8 mm in male and 5.4 mm in female). Fifty-one patients (50%) had a laminar thickness smaller than 5.5 mm at least unilaterally, therefore the patients were considered as inappropriate candidates for the laminar screw fixation in the smaller side of the laminae. Mean value of maximal length of screw was 33.3 mm (34.3 mm in male and 31.9 mm in female). Mean spino-laminar angle was $43.2^{\circ}$ and mean slope angle was $32.9^{\circ}$. Conclusion : Half of patients had inappropriate laminar profiles to accommodate a 3.5 mm screw in at least one side of the axis. The three-dimensional computed tomography reconstruction is mandatory for the preoperative assessment for the feasibility of the C2 lamina.

Management of Descending Necrotizing Mediastinitis with Thoracoscopy (흉강경을 이용한 하행 괴사성 종격동염의 치료)

  • Lee, Sung-Ho;Sun, Kyung;Kim, Kwang-Taik
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.161-165
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    • 2002
  • Descending necrotizing mediastinitis is a life-threatening infection originating in the head or the neck and descends into the mediastinum. Even in the era of antibiotics, mortality rate has been reported to be 25 ∼ 40%. Prompt diagnosis and treatment is mandatory for delayed diagnosis and inappropriate drainage of the mediastinum are the main causes of high mortality Surgical management ranges from cervical drainage to routin thoracotomy:however, the optimal management still needs to be defined particularly in respect to effective mediastinal drainage. Although posterolateral thoracotomy incision has been considered as a standard approach, potential disadvantages including postoperative pain, risk of wound complication and delayed recovery remain to be concerned. Thoracoscopic approach is an attractive treatment modality as it can provide an excellent exposure with minimal incision and can complete drainage from the mediastinum and the neck in one-staged manner We describe here two cases of descending necrotizing mediastinitis successfully managed by thoracoscopic drainage.

Exploring Reproductive Health Education Needs in Infertile Women in Iran: A Qualitative Study

  • Khakbazan, Zohreh;Maasoumi, Raziyeh;Rakhshaee, Zahra;Nedjat, Saharnaz
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.353-361
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    • 2020
  • Objectives: An inadequate understanding of infertility can affect individuals' self-efficacy and ability to perform self-care; thus, reproductive health education is an important part of infertility treatment. The present qualitative study aimed to explore the experiences and educational needs of infertile women with regard to reproductive health. Methods: In this qualitative study, we utilized a content analysis approach. Purposive sampling was performed to ensure maximum diversity. In total, 23 individual interviews were conducted with 20 Iranian women with infertility and 3 key informants between July 2018 and February 2019 in northern Iran. Data were collected through in-depth, semi-structured interviews. Data analysis was performed using a conventional content analysis approach. Results: Reproductive health education needs were identified by analyzing interview data from 4 main categories: familiarity with the fertility process and preparation for pregnancy, recognition of infertility and expectations around seeking treatment, recognition of preventive actions associated with reproductive health, and correction of false beliefs. Recognizing the causes of infertility and understanding the different approaches to infertility treatment are among the most important educational needs of infertile women. The potential for neglect of health-related issues due to concerns about fertility and the maternal experience necessitates education about preventive measures for cervical cancer, breast cancer, and sexually transmitted infections. Correcting misconceptions, including those related to contraceptives and traditional medicine, can also help promote reproductive health. Conclusions: In infertile women, the educational needs associated with reproductive health are multifaceted. Satisfying these needs can help achieve optimal treatment results and promote reproductive health.

Eagle's syndrome: a case report

  • Moon, Chang-Sig;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Yun, Sun-Ung;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.43-47
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    • 2014
  • Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.

Is the Loop Electrosurgical Excision Procedure Necessary for Minor Cervical Cytological Abnormalities?

  • Aksan-Desteli, Guldeniz;Gursu, Turkan;Baykal, Cem Murat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.305-308
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    • 2014
  • Background: To investigate the indications of loop electrosurgical excision procedure (LEEP) and its overtreatment rates for the see and treat and three step strategies in cases of atypical squamous cells of undetermined cytology (ASC-US) and low grade intraepithelial neoplasia (LGSIL) cytology. Materials and Methods: We retrospectively analyzed colposcopy directed biopsy (CDB) and LEEP results of 176 paients with ASC-US or LGSIL cytologies who underwent colposcopic examination. Results: Initial cytologies were ASCUS in 120 women and LGSIL in 56. According to the see and treat approach immediate LEEP was performed for38 women. Among the remaining 138 women, LEEP was performed for 32 whose CDB results revealed CIN2/3 lesions. In the see and treat group the recognition of CIN2/3 was found to be 39.4%. The overtreatment rate was 60% as compared to 25% in the three step group. In CDB group detection of CIN 2 or greater lesions increased with 3 or more biopsies. Conclusions: In patients with ASC-US/LGSIL cytologies CDB should be performed before LEEP to prevent overtreatment, with attention to all suspected areas and more than 2 biopsies taken.

Unusual Location of Esophageal Diverticulum (비전형적인 위치에 발생한 상부 식도 게실)

  • Kim, Tae-Hoo;Heo, Chul-Young;Kim, Beom-Gyu;Kim, Yong-Bok;Park, Il-Seok
    • Korean Journal of Bronchoesophagology
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    • v.15 no.2
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    • pp.87-91
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    • 2009
  • Esophageal diverticulum is a rare entity, the true incidence of which is unknown, mainly because there are usually no clinical symptoms. Most esophageal diverticulum are found incidentally during an endoscopic or radiologic examination. Their classification is based on anatomical location; namely, upper third(Zenker or pharyngoesophageal), middle third(thoracic), or lower third(epiphrenic). Here we report a 52-years-old female presenting with dysphagia and regurgitation. Esophagogram showed esophageal diveticulum at lower cervical esophagus. Its positional aspect, it is different from Zenker's diveticulum. Treatment is surgical via an endoscopic or external approach. In view of the patient's age and anatomical location, various surgical approaches were considered as a therapeutic option for the management. This paper presents our experience in the management of esophageal diverticulum which was unusual location and stapled open resection without sternotomy.

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Removal of Intradural-Extramedullary Spinal Cord Tumors with Unilateral Limited Laminectomy

  • Sim, Jong-Eun;Noh, Seung-Jin;Song, Young-Jin;Kim, Hyung-Dong
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.232-236
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    • 2008
  • Total laminectomy for the removal of intradural-extramedullary spinal cord tumors has been used widely, but postoperative complications often develop, such as kyphosis, spinal instability, and persistent back pain. In this study, we evaluated seven patients with intradural-extramedullary spinal cord tumors with respect to the value of unilateral limited laminectomy. Our cases included six schwannomas, and one meningioma. The cervical region was involved in four cases, the thoracolumbar region in two cases, and the lumbar region in one case. The rationale for choosing a unilateral approach is to preserve musculoligamentous attachments and posterior bony elements as much as possible. The patients were mobilized on the third postoperative day and preoperative neurological symptoms were recovered within a few weeks. We did not observe any complication relating to unilateral limited laminectomy and at follow-up evaluation (at 3 and 12 months postoperatively), none of the patients showed spinal deformity or spinal instability. We think that the unilateral limited laminectomy is a safe and efficient technique for the treatment of intradural-extramedullary spinal cord tumors. We suggest that this technique is one of the best treatments for these tumors.

A Case Report of Injection Laryngoplasty Who have Difficulty in Neck Extension Using, an I-Gel Laryngeal Mask Airway (경부 신전이 불가한 성대 마비 환자에서 I-Gel$^{TM}$ 후두마스크를 이용한 전신 마취하 성대주입술 증례)

  • Jo, Kwang-Hee;Jung, Chan-Min;Jang, Chul-Ho;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.96-98
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    • 2014
  • Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

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Modern Interpretation on Kinesiology of Yangsaeng-Doinbub Presented in [Jebyungwonhuron·Huhrobyungjehu] - Dealing with Knee Joint, Nuchal Area and Upper Extremity (「제병원후론(諸病源候論)·허로병제후(虛勞病諸候)」에서 제시된 양생방도인법과 현대 운동치료의 비교 연구 - 슬관절과 경부/상지부 중심으로)

  • Kim, Tae Yoon;Kim, Soon Joong
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.1
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    • pp.63-77
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    • 2016
  • Objectives The objective of this study is to interpretate Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu] in a modern kinesiologic approach. Methods Based on the interpretation of [Jebyungwonhuron Huhrobyungjehu] and implementation of its kinesiology, this study presents similar kinesiologies and their purposed, with the reference to various documents on modern kinesiology. Results 1) Exercises in Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu], which are similar to resistance exercise, can be used for isometric exercise of knee joint extensor and cervical extensor. 2) Exercises in Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu], which are similar to stretching exercise, has its purpose to stretch semitendinosus m., semimembranous m., gastrocnemius m., quadriceps femoris m., upper trapezius m., levator scapulae m., serratus m., and splenius capitis m. 3) Exercises in Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu], which are similar to active exercise, can be used for strengthen quadriceps femoris m.. 4) Yangsaeng-Doinibub also describes breathing methods, which help normalization of breathing exercised and increase the efficiency of spine and joint exercises. Conclusions The modern interpretation on kinesiology of Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu] leads to a conclusion that Yangsaeng-Doinbub consists of various exercises for knee joint, neck and upper extremity.

The Effects of Stretching and Isometric Exercise for Chronic Neck Pain Patient in Strength and Pain (스트레칭과 등척성 운동이 만성 경부통증환자의 근력과 통증에 미치는 영향)

  • Lee, Han-Suk;Yoo, Ji-Hun
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.3
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    • pp.329-337
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    • 2012
  • Purpose : The purpose of this study was to assess more effective exercise prescription for the people with chronic neck pain by comparing stretching exercise and isometric exercise about strength and pain. Method : The research design of the study was that 20 young adults with mild neck disability (5-14 out of 50 in Neck Disability Index) were randomized into 2 groups and underwent stretching exercise(10 peoples) and isometric exercise(10 peoples) at 3 times a week for 5weeks. Measures of pain scale (Visual Analog Scale) and Muscle strength of deep neck flexor (Pressure Biofeedback) were assessed before and after intervention. The pre and post exercise results were compared using paired t-test and the effectiveness of intervention of two groups were compared using Independent t test. Results : The results of this study were that pain reduction was seen after stretching and isometric exercise and significantly difference. There was significantly improvement of cervical flexor strength after stretching and isometric exercise. But, there was no significant difference between stretching and isometric exercise groups. Conclusion : The stretching and isometric exercise for chronic neck pain patients may use according to preference of patient because the effects of treatment was same. Further studies are needed to analyzed psycho social factors, cost effects, group approach.