• Title/Summary/Keyword: Conservative Treatments

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Stereotactic Sphenopalatine Ganglionotomy Using Radiofrequency Thermocoagulation -Case reports- (고주파열응고를 이용한 정위적 접형구개신경절절개술 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.227-230
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    • 1999
  • The sphenopalatine ganglion lies behind the middle nasal concha in the sphenopalatine foramen which connects the fossa to the nasal cavity. It has sympathetic and parasympathetic fibers as well as sensory fibers which innervate the nasal cavity, palate and nasopharynx. Current indications for blockade of the sphenopalatine ganglion include the management of migraine, cluster headache and a variety of facial neuralgias. Blockage of this ganglion can be attempted when more conservative treatments have failed. If the pain relief gained through the procedure is of short duration and the blockage needs to be repeated frequently, then radiofrequency thermocoagulation should be considered. Since the sphenopalatine ganglion lies close to the maxillary nerve, neurolytics can cause facial dysesthesia, radiofrequency thermocoagulation is the preferred method for ganglionotomy. Radiofrequency thermocoagulation of the sphenopalatine ganglion was done for 3 patients who suffered from postherpetic neuralgia, cluster headache, atypical facial pain respectively. Good results were obtained with the exception of the patient suffering from atypical facial pain. Although we were concerned about complications such as epistaxis, none were encountered. However it should be noted that caution must be exercised when repeatedly redirecting the cannula in the sphenopalatine fossa as serious bleeding and pronounced facial swelling may result.

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Rare Intractable Cervicalgia Related to Exaggerated Disc Height Distraction : Report of Two Cases and Literature Review

  • Choi, Man Kyu;Kim, Sung Bum;Lee, Jun Ho
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.530-536
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    • 2018
  • We present two cases of unexpected postoperative intractable cervicalgia due to over-sized implant insertion during simple anterior cervical decompression and fusion (ACDF) or artificial disc replacement (ADR). These patients experienced severe cervicalgia mostly related to their neck motion even after standard cervical operations. In both cases, the restored disc heights after the operations were prominently greater than the preoperative disc heights. The patients had not responded to any of the conservative treatments, and unloading of these excessively distracted segments through ultimate revision surgery led to dramatic pain relief. This report emphasizes the increase in distractional forces that takes place after a standard ACDF or ADR, as well as the importance of a proper sized implant. It also includes the reviews of other biomechanical or clinical reports dealing with this issue, thereby cautioning the surgeons not to disregard these factors, which might have an adverse effect in patients with cervicalgia even after radiographically successful cervical procedures.

Wound Infiltration in Patients with Chronic Pain after Forehead Lift Surgery -A case report- (이마주름제거술 후 발생한 만성통증의 치료경험 -증례보고-)

  • Lee, Woo Chang;Yoon, Kyung Bong;Yoon, Duck Mi;Lee, Jeong Soo
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.80-83
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    • 2008
  • Local infiltration in surgical wounds can reduce postoperative pain with very few side effects. We experienced two cases of chronic pain after forehead lift surgery. A 41-year-old male patient was suffering from a headache at the crown of the head and pain from the posterior neck. A 54-year-old female patient had pain around the forehead, worsened by psychological stress. They underwent forehead lift surgery 10 years and 8 months ago, respectively. Conservative treatments such as medication and physical therapy were not effective. After wound infiltration with 1% lidocaine more than ten times, pain significantly resolved in both patients.

A Case of Macular Edema Resulted from Branch Retinal Vein Occlusion (망막분지정맥폐쇄로 유발된 황반부종 치험 1례)

  • Kim, Ji-Hyon;Heo, Eun-Jung;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.2
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    • pp.186-195
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    • 2010
  • Objective : This study was performed to prove the effect of the oriental medical treatments like acupuncture, moxibustion, herbal medicine on macular edema resulted from branch retinal vein occlusion which could lead to terrible result like permanent visual loss at worst. Methods : The patient was treated 62 times, from July 15th, 2009 through May 12th, 2010. We used fundus photography and Dr. Hann's standard test chart for 5m to examinate the patient's eyesight. We used acupuncture, electropuncture, moxibustion and herbal medicine to treat the patient. We considered visual field, scotoma, metamorphopsia and vitreous floater to measure the effect of treatment. Results : After about 10 months of treatment, the eyesight of Rt eye was improved from 0.8 to 0.9, Lt. eye from zero to 0.3. The visual field turbidity were absolutely cleared. The scotomas in Lt. eye were reduced from 5 to 2. The metamorphopsia were improved. The vitreous floaters in Rt. eye were decreased from 5~6 to 1~2. Conclusion : These results show that the oriental medical treatment can be conservative measure to the macular edema resulted from branch retinal vein occlusion.

Prognostic Analysis of Schistosomal Rectal Cancer

  • Wang, Meng;Zhang, Yuan-Chuan;Yang, Xu-Yang;Wang, Zi-Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9271-9275
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    • 2014
  • Background: Schistosomiasis is an infectious disease that affects more than 230 million people worldwide, according to conservative estimates. Some studies published from China and Japan reported that schistosomiasis is a risk factor for colorectal cancer in Asia where the infective species is S. japonicum. Hoqwever, there have been only few reports of prognosis of patients with schistosomal rectal cancer SRC. Objectives: This study aimed to analyze differences in prognosis between SRC and non-schistosomal rectal cancer(NSRC) with current treatments. Materials and Methods: A retrospective review of 30 patients with schistosomal rectal cancer who underwent laparoscopic total mesorectal excision operation (TME) was performed. For each patient with schistosomal rectal cancer, a control group who underwent laparoscopic TME with non-schistosomal rectal cancer was matched for age, gender and tumor stage, resulting in 60 cases and controls. Results: Univariate analysis showed pathologic N stage (P=0.006) and pathologic TNM stage (P=0.047) statistically significantly correlated with disease-free survival (DFS). Pathologic N stage (P=0.014), pathologic TNM stage (P=0.002), and with/without schistosomiasis (P=0.026) were statistically significantly correlated with overall survival (OS). Schistosomiasis was the only independent prognostic factor for DFS and OS in multivariate analysis. Conclusions: The prognosis of patients with schistosomal rectal cancer is poorer than with non-schistosomal rectal cancer.

A Case Report of Langerhans Cell Histiocytosis of Frontal Area (전두부에 발생한 랑게르한스세포 조직구증의 치험례)

  • Yang, Hae Won;Kang, Min Gu;Chang, Choong Hyun
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.37-39
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    • 2009
  • Purpose: Langerhans cell histiocytosis is a heterogenous group of Langerhans cell proliferative disorders and includes eosinophilic granuloma, Letterer-Siwe diseases, and Hand-Schuller Christian disease. We report a case of eosinophilic granuloma on frontal area. Methods: A 17-year-old male presented with swelling and tenderness on Lt. frontal and periorbital area. CT and MRI showed a $33{\times}25mm$ sized mass that involved Lt. frontal calvarium, frontotemporal meninges, and orbital roof. Results: Total excision of the mass and adjacent soft tissue, calvarium, and orbital roof was performed. Orbital roof defect was reconstructed with absorbable plate and calvarial defect was done with outer cortex of temporal bone flap. The histology revealed proliferation of histiocytes and eosinophils. Immunologically, these histiocytic cells expressed S-100 protein and CD1a. The patient is currently taking conservative treatment. Conclusion: The severity of these disease and their prognosis and treatments are various. For unifocal cranial Langerhans cell histiocytosis, complete excision is the treatment of choice. We report this case with review of literature.

The Effect of Botulinum Toxin on an Iatrogenic Sialo-Cutaneous Fistula

  • Hong, Seung Eun;Kwon, Jung Woo;Kang, So Ra;Park, Bo Young
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.237-239
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    • 2016
  • A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula.

Complications in the Recipient Sites of Autologous Rib Cartilage Grafts for Microtia (소이증에서 자가늑연골 이식수혜부의 합병증)

  • Kim, Suk Wha;Ahn, Seung Hyun
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.703-708
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    • 2008
  • Purpose: Microtia is a congenital anomaly resulting from abnormal development of the branchial apparatus. Although significant modification and improvement of operative procedures for the reconstruction of the auricle with a natural appearance have been reported, postoperative complications, such as infection, flap necrosis and deformity, still remain serious problems in patients. Many studies with long-term results have focused mainly on operative procedures for an acceptable auricular shape without consideration of possible complications. Methods: We conducted a retrospective study on postoperative complications at the recipient sites of 183 patients who underwent auricular reconstruction with autologous rib cartilage grafts from November 1987 to January 2007 at the Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital. Patients were analyzed in terms of the kinds and incidences of complications, and their treatment options. Results: Postoperative complications included wound dehiscence, flap necrosis, infection, hypertrophic scar, auricular deformity and absorption of rib cartilage grafts. The complications occurred in 47 patients with a complication rate of 25.7%. Fourteen patients were successfully managed with conservative treatment. However, surgical treatment was required in 51 reoperations(33 patients) of total 329 operations. Conclusion: Postoperative complications at the recipient sites of autologous rib cartilage grafts occurred with relatively high incidences and required long-term treatments and multiple surgeries. The results of this study may provide information on the causes and proper management of postoperative complications as well as safe procedures for the reconstruction of the auricle.

A Case of Recurrent Intracranial Hypotension after Successful Epidural Blood Patch (경막외강 혈액첩포 시술로 두통이 호전된 후 반복적으로 발생한 두개내 저압증 1예)

  • Lee, Kee-Ra;Choi, Sung-Min;Lee, Seung-Han;Park, Man-Seok;Kim, Byeong-Chae;Kim, Myeong-Kyu;Cho, Ki-Hyun
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.190-192
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    • 2006
  • Intracranial hypotension is a benign disorder characterized by orthostatic headache. It is caused by CSF leakage, therefore its treatment of choice has been epidural blood patch when initial conservative treatments were not effective. We would like to report a 26-year-old patient with recurrent orthostatic intracranial hypotension in spite of the successful epidural blood patch several times. Her headache was caused by myelography 8 month ago. Cisternography showed a CSF leakage at the level of L1 vertebral body. Headache was resolved completely after epidural blood patch and then recurred 3 times several months after blood patch. Now, she is free from headache for 5 months after last blood patch.

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Integrated Medicine Therapy for a Patient with Tuberculous Spondylitis: a Case Report (결핵성 척추염에 대한 한·양방 병행치료 1례)

  • Lee, Jung Hee;Lee, Yun Kyu;Lim, Seong Chul;Lee, Hyun Jong;Kim, Jae Soo
    • Journal of Acupuncture Research
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    • v.32 no.3
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    • pp.221-227
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    • 2015
  • Objectives : The purpose of this study is to report the clinical effects of Integrated Medicine Therapy on Tuberculous Spondylitis. Methods : The patient was diagnosed with Tuberculous Spondylitis by MRI. Despite taking antituberculous drugs for one month the back pain remained. As a result the patient was hospitalized shortly thereafter in our hospital, and was treated with acupuncture, pharmacopuncture, and herbal medication during the admission period. The clinical effects of these treatments are measured by the verbal rating scale(VRS), the range of motion(ROM) and the Korean oswestry disability index(KODI). Results : VRS is changed from 10 to 3.5, limited lumbar ROM recovered, KODI changed from 85.71 to 28.57. Conclusions : These results suggest that integrated medicine therapy may be effective for tuberculous spondylitis.