• Title/Summary/Keyword: Conservative Surgery

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The Treatment of Congenital Cutis Aplasia (선천성 피부결손증의 치험 1례)

  • Kim, Young-Ha;Cha, Gyu-Ho;Jung, Jae-Ho;Lee, Kyung-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.422-426
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    • 1992
  • One case of Congenital Cutis Aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal arterty was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of Congenital Cutis Aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.

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Sensory recovery after infraorbital nerve avulsion injury

  • Lee, Sam Yong;Kim, Seung Hyun;Hwang, Jae Ha;Kim, Kwang Seog
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.244-248
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    • 2020
  • The infraorbital nerve is a branch of the trigeminal nerve. Injury to the infraorbital nerve can be caused by trauma, including various facial fractures. Due to this nerve injury, patients complain of numbness and pain in the entire cheek, the ala of nose, and upper lip. In general, spontaneous sensory recovery is expected after decompressive surgery. If nerve transection is confirmed, however, neurorrhaphy is typically performed. Here, we present a case in which microsurgery was not performed in a patient with Sunderland grade V avulsion injury of the infraorbital nerve due to a facial bone fracture. Gradual nerve function recovery was confirmed to be possible with conservative treatment and rehabilitation alone. These findings suggest that the nerve function recovery can be expected with conservative treatment, even for severe nerve injury for which microsurgery cannot be considered.

CONSERVATIVE RESECTION OF OSTEOCHONDROMA ON MANDIBULAR CONDYLE : A CASE REPORT (하악 과두에 발생한 골연골종의 보존적 제거 1 예)

  • Nam, Jung-Woo;Kim, Jae-Young;Kim, Hak-Jin;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.257-260
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    • 2009
  • Osteochondroma is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones and extremely rare in mandibular condyle. The clinical signs and symptoms of osteochondroma of mandibular condyle may resemble those seen in patients with temporomandibular joint (TMJ) dysfunction. Condylectomy have been the first choice for treatment of osteochondroma, but it may be with some complicaitons, loss of condylar vertical height, etc. A 57 years old female patient who had an osteochondroma on left mandibular condyle visited to our clinic. We did surgically remove the mass with favorable result, so we present the case with review of literatures.

Treatment of Severe Blepharoptosis after Blow Out Fracture (안와 파열골절 후 발생한 중증 안검하수의 치료)

  • Kim, Nam-Hun;Yang, Jeong-Yeol;Moon, Jae-Won;Kim, Gyu-Bo;Cheon, Ji-Seon
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.461-464
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    • 2010
  • Purpose: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. Methods: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. Results: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. Conclusion: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

One case of surgical treatment for chylopericardium following cardiac surgery (개심술후 유미심낭 (Chylopericardium) 합병증의 수술치험 1예)

  • 김삼현
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.695-698
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    • 1986
  • Only five instances of chylopericardium following cardiac surgery have been reported in the literature previously. We encounted this complication in a patient who was operated on for secundum atrial septal defect. The patient readmitted one month after discharge because of large amount of chylous pericardial effusion. Conservative treatment of pericardiostomy drainage and parenteral hyperalimentation was continued for 3 weeks without improvement. Partial pericardiectomy and pericardiopleural window was done with success and no recurrence of chylopericardium was observed upto 3 months after surgery. We think this is the first case report of chylopericardium after open heart surgery in Korea.

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A Case Report on Conservative Treatments with Chuna manual therapy on patient who has Failed Back Surgery Syndrome owing to herniated intervertebral lumbar disc with scoliosis (측만이 동반된 요추 추간판 탈출증 수술 실패 증후군 환자에 대한 추나요법 병행치료 증례보고)

  • Ryu, Ho-sun;Kim, Mihye
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.65-73
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    • 2018
  • Objectives : To verify Korean Medicinal Combination Treatments for patients who have Failed Back Surgery Syndrome along with scoliosis Methods : We used Acupuncture, Chuna manual therapy, Pharmacoacupuncture, Herbal medication. We measured Numeral Rating Sacle(NRS), Pain-Free walking distance(PFWD) and Oswestry Disability Index(ODI) score to evaluate the treatment effects. Results : Patients' LBP & Rt.leg pain NRS, PFWD and ODI score were improved. Conclusions : Traditional Korean medicine can be effective for FBSS patients along with scoliosis.

Iatrogenic Duodenal Obstruction due to Acupuncture Therapy Trauma

  • Chung, Jae Hun;Lee, Si-Hak
    • Journal of Trauma and Injury
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    • v.34 no.1
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    • pp.70-74
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    • 2021
  • There are many possible causes of duodenal obstruction, such as congenital anomalies and various acquired conditions associated with space-occupying lesions. However, hemorrhage or retroperitoneal hematoma is a rare cause of duodenal obstruction. Here, we report the case of a 55-year-old man who developed duodenal obstruction due to a large retroperitoneal hematoma after acupuncture therapy. The patient experienced abdominal discomfort along with vomiting and nausea. Considering the size of the hematoma, emergency surgery could have been performed, but conservative treatment was continued because the patient's vital signs were stable. With spontaneous resolution of the hematoma, the symptoms of duodenal obstruction improved. The patient was eventually discharged without any complications associated with the hematoma. Our findings suggest that even when a hematoma is large, a conservative approach can be maintained until improvement of the symptoms of duodenal obstruction if the vital signs of the patient remain stable.

The Voice Change after Conservative Laryngeal Surgery (조기 후두암 환자에서 보전적 후두수술 후 음성 변화)

  • Lee, Yoon-Se;Park, Jung-Je;Choi, Seung-Ho;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.2
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    • pp.128-132
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    • 2004
  • Objectives : The total laryngectomy for laryngeal cancer has made patients be afraid of voice loss. Early staged glottic or supraglottic cancer can be treated with conservative laryngeal surgery which preserve voice, though which was not normal voice comparing before. Voice analysis is used to evaluates objectively the quality of the voice in pre- and postoperation, 4 different types of conservative laryngeal surgery : laser cordectomy, supracticoid partial laryngectomy, vertical partial laryngectomy, and supralottic laryngectomy. Materials and Methods : The patients who received conservative laryngeal surgery(laser cordectomy : 23 cases, vertical partial laryngecotmy : 9cases, supracriocoid partial laryngectomy : 6cases, supraglottic laryngectomy : 8cases) from 1995 to 2001 in the Asan medical center. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum comfortable phonation time and subglottic pressure were used as parameters for voice analysis. Results : The patients who received laser cordectomy(shimmer : 5.26${\pm}$1.12%, jitter : 3.33${\pm}$0.42%, NHR : 0.47${\pm}$0.02, MPT : 9.32${\pm}$3.59sec) and supraglottic laryngectomy(shimmer : 4.39${\pm}$1.03%, jitter : 1.49${\pm}$0.14%, NHR : 0.51${\pm}$0.06, MPT : 8.9${\pm}$0.59sec) showed better results than other two procedures, but differed from normal value. Especially the patients who received supracricoid partial laryngectomy(shimmer : 9.23${\pm}$1.56%, jitter : 5.81${\pm}$1.23%, NHR : 5.89${\pm}$1.13, MPT : 6.3${\pm}$1.18sec, MFR : 632${\pm}$89ml/sec) had poorer quality of voice but presented fast functional recovery time, and the subjective symptom was improved as time goes by slowly. Conclusion : The appropriate conservative laryngeal surgery for each cancers and stage can preserve the acceptable voice for patients. Supracricoid partial laryngectomy for T1b glottic cancer can be used for acceptable voice despite its poor voice analysis.

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Interoperative Radiotherapy of Seventy-two Cases of Early Breast Cancer Patients During Breast-conserving Surgery

  • Zhou, Shi-Fu;Shi, Wei-Feng;Meng, Dong;Sun, Chun-Lei;Jin, Jian-Rong;Zhao, Yu-Tian
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1131-1135
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    • 2012
  • Objective: To evaluate interoperative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications, cosmetic outcome and recurrence events. Methods: From June 2007 to Dec 2011, 143 early breast cancer patients received breast conservative surgery. Seventy-two (study group) received interoperative radiotherapy, compared with 71 patients (control group) given routine radiotherapy. Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up. Results: The average wound healing time was 13~22 d in the study group and 9~14 d in the control group. In the study group, 2 patients developed lyponecrosis, 16 patients showed wound edema while no such side effects were found in the control group. No infection or hematomas were found in either group. In the study group (59 cases), overall cosmetic outcome in 53 patients was graded as excellent or good, and in 6 as fair or poor. Meanwhile in the control group (56 cases), 42 patients were graded as excellent or good, and 14 as fair or poor (P=0.032). After a follow-up from 3 to 54 months (median: 32 months), two patients (2.78%) in study group developed local relapses, one of them (1.39%) died, 2 patients (2.78%) developed bone metastases. In control group, one patient (1.41%) developed local relapse, 2 patients (2.82%) developed bone metastases, and no one died. Conclusion: Intraoperative radiotherapy is safe and reliable with good cosmetic outcome.