• Title/Summary/Keyword: Conservative Surgery

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Non-Surgical Management for Benign Vocal Fold Lesions (양성 성대 병변의 비수술적 치료)

  • Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.97-100
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    • 2015
  • Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.

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Natural History of Rotator Cuff Disorders (회전근 개 질환의 자연경과)

  • Oh Jeong-Hwan;Park Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.93-97
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    • 2004
  • Continued research needs to be devoted to understanding the natural history of rotator cuff tears. Recent studies have shown progression of tear, symptomatic flare-ups and irreversible change in rotator cuffs managed nonsurgically. These data allow the grouping of patients with rotator cuff tears into three categories based on risk-benefit ratios. Nonsurgical care should be maximized for patients with impingement symptoms only, with partial-thickness tears, with chronic tears, and for the elderly patients. The proper selection of candidates for nonsurgical management should lead to the high success rate quoted by multiple authors. Even though conservative treatment is necessary, early surgery should be considered for tears that are acute, small or medium, associated with shoulder loss of function, or occur in a younger patient. Prolonged nonsurgical care in these patients risks tear propagation and irreversible changes to the cuff, which may complicate rotator cuff repair.

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Conservative Management for a Highly Displaced Dens Fracture in a Two-Year-Old Child (2세 유아에서 발생한 고도 전위성 치상돌기 골절의 보존적 치료)

  • Lim, Sung Joon;Kim, Geon Jung;Kim, Yong Min
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.530-534
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    • 2021
  • Fractures of the dens (odontoid process) in children's cervical spine are rare, with very few case reports dealing with these injuries. In particular, a treatment modality has not been established for severe displaced fractures. Surgical fixation can theoretically afford early reduction and better maintenance, but it requires a very delicate and cautious procedure and results in permanent fusion of 1-2 cervical articulation. The authors chose conservative management for a displaced dens fracture in a two-year-old toddler and achieved a promising result. We report this case with a review of the relevant literature.

Comparison between Surgical and Conservative Treatments in Isolated Lateral Compartment Syndrome of the Lower Leg: A Case Report (하지 외측 구획에 국한된 구획 증후군에서 수술적 치료와 보존적 치료 간에 비교: 증례 보고)

  • Gwak, Heui-Chul;Seo, Young-Chae;Jung, Soo-Hwan;Kim, Dae-Yoo
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.3
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    • pp.136-142
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    • 2022
  • Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

Surface structure characteristics of dental implants and their potential changes following installation: a literature review

  • Pitchaya Aneksomboonpol;Basel Mahardawi;Pheeradej Na Nan;Palawat Laoharungpisit;Thongnard Kumchai;Natthamet Wongsirichat;Napapa Aimjirakul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.114-124
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    • 2023
  • Dental implants have been utilized for many years to treat individuals with missing teeth. To optimize the long-term success rate of such implants, new designs, surfaces, and materials have been analyzed. It is important for the clinician to have a background in the field of implant surface design, to be familiar with the strengths and limitations of the available options, and to be aware of the alterations in surface structure that may occur following installation. This article provides a detailed review of the structure and the surface characteristics of dental implants, the modifications of implant surface, as well as the methods of evaluating implant surface structure. Moreover, it provides information concerning the structural changes that may take place at the time of dental implant placement. It is important for clinicians to be aware of such changes to plan and execute implant procedures with the highest possible success and implant survival rates.

Endoscopic Treatment of Iatrogenic Perforation of Sigmoid Diverticulum: A Case Report of Multidisciplinary Management

  • Giacomo Emanuele Maria Rizzo;Giuseppina Ferro;Giovanna Rizzo;Giovanni Di Carlo;Alessandro Cantone;Gaetano Giuseppe Di Vita;Carmelo Sciume
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.292-296
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    • 2022
  • Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequately planned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, an iatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-the-scope clips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammation and infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. A multidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computed tomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverse event is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, to consider a conservative approach and avoid surgical treatment.

DECOMPRESSION TREATMENT FOR ODONTOGENIC CYST IN MANDIBLE USING SPECIFIC DECOMPRESSION APPLIANCE : CASE REPORT (특별히 고안된 감압술 장치를 이용한 하악의 치성 낭종의 치료: 증례보고)

  • Kim, Kyoung-Soo;Kim, Jin-Cheol;Oh, Hae-Soo;Choi, Bin;Kil, Yong-Kab;Hong, Yong-Jae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.182-186
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    • 2007
  • A cyst is a pathologic lesion characterized by a cavity filled with fluid, celluar products, air, or a combination of these. Dentigerous cysts were formed around the crown of unerupted teeth. The reduced enamel epithelium persists around the crown after it has formed. Proliferation of the epithelium in a fluid-filled sac may be induced by osmotic pressure. In the first decade the most frequent location is the premolar site. In each subsequent decade the largest number of cysts are in the mandibular third molar site, with the second most frequent site being the maxillary canine. The treatment of odontogenic cyst can be mostly classified into three types of cyst enucleation, marsupialization and decompression. We should consider age of patient, anatomic structure, location and size for choosing a treatment method. Advantage of cyst enucleation is fast healing, but a injury of a surrounding structure is highly. Marsupialization is conservative treatment that can reduce the damage of a adjacent structure, but it is only limited at superficial lesion. Decompression also is conservative treatment, but it has the difficulty of the oral hygiene and the troublesome of the lavage. We present the possibility that reduces the defect of decompression and cures the lesion efficiently. We report a male patient with the dentigerous cyst developed at left mandibular third molar in this study. We used the decompression for a treatment and created special appliance to treat the lesion efficiently. We report a case of the cyst treatment that is association with efficiency of decompression appliance.

HERPES ZOSTER OF ORAL AND MAXILLOFACIAL AREA : CASES REPORT (구강 악안면 영역에 발생한 대상 포진 환자의 치험례)

  • Kim, Il-Kyu;Choi, Jin-Ho;Jeong, Sung-Rok;Oh, Seong-Seob;Oh, Nam-Sik;Kim, Eui-Seong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.3
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    • pp.313-317
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    • 2000
  • Return of facial nerve function is important in patients with facial nerve paralysis by trauma. Sometimes, delay in diagnosis of facial nerve paralysis make recovery of facial nerve function difficult. Traumatic facial palsy mostly occur after temporal bone fracture in unilateral. Temporal bone fracture after head trauma are divided into the three group; longitudinal fracture, transverse fracture and mixed fracture. The most common symptoms are hearing impairment, bloody otorrhea, loss of consciousness and facial nerve paralysis. The early care of temporal bone fracture involves facial nerve paralysis. And there has been many discussion and study in the treatment of the immediate or delayed facial palsy ; examply, surgical approach, time and methods. We have managed a patient with unilateral facial nerve paralysis after longitudinal temporal bone fracture in mastoid process and conservative facial nerve decompression was performed. We have obtained good result and report this case with review of literatures.

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Clinical Analysis of Chylous Ascites after Surgery for Gastric Cancer (위암수술 후 발생한 유미성 복수증의 임상적 고찰)

  • Hong Jeong Hun;Min Byung Wook;Lee Gyung Bum;Mok Young Jae
    • Journal of Gastric Cancer
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    • v.2 no.1
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    • pp.20-25
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    • 2002
  • Purpose: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity due to trauma or to an obstruction on the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. It is frequently reported after retroperitoneal dissections and results in high morbidity and mortality. However, there have been few report of such a complication following a radical gastrectomy. Therefore, we review the clinical analysis and treatment of chylous ascites based on our experience. Materials and Methods: From July 1992 to June 2001, we treated 13 cases of chylous ascites after operations for gastric cancer. We reviewed medical charts of those patients retrospectively. Results: The incidence of chylous ascites after operations for gastric cancer was $0.83\%$ (13/1552). The mean time from ingestion of a meal after the operation to the development of symptoms was 2 days (range: $1\∼6$ days). Conservative treatment by fasting, total parenteral nutrition (TPN), and repeated paracentesis was successful in all patients. The mean time from diagnosis to complete resolution was 25 days (range: $2\∼105$ days). Conclusion: Chylous ascites should be considered in any patient with a typical milky color of drainage who has recently undergone radical gastrectomy. Treatment with fasting, TPN, and repeated paracentesis usually is successful.

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FIBROSIS THAT OCURRED AFTER CONSERVATIVE THERAPY OF LARGE ODONTOGENIC KERATOCYST (광범위한 치성각화낭종의 보존적 치료후 발생한 섬유증)

  • Kwon, Taek-Kyun;Byun, June-Ho;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.162-164
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    • 2004
  • Odontogenic keratocysts are developmental odontogenic cysts which derived from rests of dental laminas and often found in posterior area of mandible. Because this lesion has tendency of frequent recurrence, treatment of choice is often radical removal of the lesion. Sometimes in case of large cysts, however, conservative therapy like marsupialization is often selected in treatment plan. A 39-years old woman referred to our department for evaluation of large radiolucent lesion that occupies the areas from mandible angle to upper part of ramus and condyle. In cytology, the lesion was identified as odontogenic keratocyst. Marsupialization was our treatment of choice, and the result was so favorable. 2 years later, there was small radiolucent lesion on upper part of mandibular ramus on panoramic view. It was suspected as recurred lesion, and excisional biopsy was done. On biopsy result, it was not a cystic lesion but fibrosis.