• Title/Summary/Keyword: Iatrogenic

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Surgical Resection of Neurogenic Heterotopic Ossification around Hip Joint in Stroke Patients: A Safety and Outcome Report

  • Jae-Young Beom;WengKong Low;Kyung-Soon Park;Taek-Rim Yoon;Chan Young Lee;Hyeongmin Song
    • Hip & pelvis
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    • v.35 no.4
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    • pp.268-276
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    • 2023
  • Purpose: Resection remains the most reliable treatment for established heterotopic ossification, despite questions regarding its effectiveness due to the potential for complications. This study evaluated the clinical outcomes and complications of neurogenic heterotopic ossification (NHO) resection in stroke patients' ankylosed hips. Materials and Methods: We retrospectively analyzed nine hip NHO resections performed on seven patients from 2010 to 2018. The pre- and postoperative range of motion of the operated hip were compared. Analysis of postoperative complications, including infection, recurrence, iatrogenic fracture, and neurovascular injury was performed. Results: The mean operative time was 132.78±21.08 minutes, with a mean hemoglobin drop of 3.06±0.82 g/dL within the first postoperative week. The mean duration of postoperative follow-up was 52.08±28.72 months for all patients. Postoperative range of motion showed improvement from preoperative. Flexion and external rotation (mean, 58.89±30.60° and 16.67±18.03°, respectively) showed the greatest gain of motion of the operated hip joint. Postoperative infections resolved in two cases through surgical debridement, and one case required conversion to total hip arthroplasty due to instability. There were no recurrences, iatrogenic fractures, or neurovascular injuries. Conclusion: Resection is a beneficial intervention for restoring the functional range of motion of the hip in order to improve the quality of life for patients with NHO and neurological disorders. We recommend performance of a minimal resection to achieve a targeted functional arc of motion in order to minimize the risk of postoperative complications.

Two Cases of Subcutaneous Emphysema and Pneumomediastinum caused by Oral Trauma (구강외상 후 발생된 피하기종과 기종격동 2예)

  • Kim Chul-Ho;Mo Jung Yun
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.58-62
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    • 2004
  • Spontaneous rupture of the pulmonary alveoli after a sudden increase intra-alveolar pressure is a common cause of pneumomediastinum, which is usually seen in healthy young men. Other common causes are traumatic and iatrogenic rupture of the airway and esophagus; however, pneumomediastinum following cervicofacial emphysema is much rarer and is occasionally found after dental surgical procedures, head and neck surgery, or accidental trauma. We present two cases of pneumomediastinum following cervicofacial subcutaneous emphysema after oral trauma. They constitute an uncommon clinical entity, So its radiologic appearance, clinical presentation, and diagnosis are described.

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In Situ Rescue Bypass for Iatrogenic Avulsion of Parent Artery during Clipping Large Pericallosal Artery Aneurysm

  • Park, Jae-Chan;Kang, Dong-Hun
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.68-70
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    • 2009
  • A case of large aneurysm arising from the distal end of an azygous A2 segment is presented. Multiple clip application inadvertently tore the aneurysmal neck, resulting in near avulsion of a right pericallosal artery origin. After an unsuccessful attempt to repair the avulsion, it was treated by occlusion of the origin of the pericallosal artery and an A4-A4 anterior cerebral artery in situ bypass without neurological deficits. The surgical technique and previous reports onside-to-side in situ bypass are discussed.

Supraorbital Keyhole Approach for Intracranial Aneurysms : Transitioning from Concerns to Confidence

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.4-13
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    • 2020
  • For surgical minimalism to reduce iatrogenic traumatization, a supraorbital keyhole approach has already been successfully applied to treat many unruptured anterior circulation aneurysms. However, using this minimal approach also raises several technical concerns due to the small cranial opening and cosmetic impact of a facial incision. Yet, such technical limitations can be overcome by using favorable surgical indications, slender surgical instruments, and optimized surgical techniques, while excellent cosmetic outcomes can be achieved using a short skin incision located <1 cm from the supraorbital margin, reconstruction of any bone defects around the bone flap, and meticulous wound closure. Thus, given such reassuring surgical results, in terms of the clipping status, neurological effects, and cosmetic outcomes, any concerns can be transitioned into confidence.

Cause of Metatarsalgia (중족통의 원인)

  • Gwak, Heui Chul;Ha, Dong Jun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.3
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    • pp.79-82
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    • 2017
  • Metatarsalgia is one of the most common causes of patients complaining of pain in their feet. This pain is the plantar forefoot, including the second to fourth metatarsal heads and arises from either mechanical or iatrogenic causes. On the other hand, it is frequently accompanied by a deformity of the toes as well as of the first and fifth rays. The pain has a variety of causes, and sometimes the cause is difficult to distinguish. The variability of possible causative factors necessitates an individualized approach to treatment. To determine these causes, this paper presents an overview of the gait mechanics, plantar pressure, and the classification according to the etiology.

Delayed Iatrogenic Diaphragmatic Hernia after Left Lower Lobectomy

  • Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.456-459
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    • 2017
  • A 66-year-old patient undergoing regular follow-up at Samsung Medical Center after left lower lobectomy visited the emergency department around 9 months postoperatively because of nausea and vomiting after routine esophagogastroduodenoscopy at a local clinic. Abdominal computed tomography showed the stomach herniating into the left thoracic cavity. We explored the pleural cavity via video-assisted thoracic surgery (VATS). Adhesiolysis around the herniated stomach and laparotomic reduction under video assistance were successfully performed. The diaphragmatic defect was repaired via VATS. The postoperative course was uneventful, and he was discharged with resolved digestive tract symptoms.

Iatrogenic subcutaneous cervicofacial emphysema with pneumomediastinum after class V restoration

  • Lee, Sang-Woon;Huh, Yoon-Hyuk;Cha, Min-Sang
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.1
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    • pp.49-52
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    • 2017
  • Subcutaneous facial emphysema after dental treatment is an uncommon complication caused by the invasion of high-pressure air; in severe cases, it can spread to the neck, mediastinum, and thorax, resulting in cervical emphysema, pneumomediastinum, and pneumothorax. The present case showed subcutaneous cervicofacial emphysema with pneumomediastinum after class V restoration. The patient was fully recovered after eight days of conservative treatment. The cause of this case was the penetration of high-pressure air through the gingival sulcus, which had a weakened gingival attachment. This case indicated that dentists should be careful to prevent subcutaneous emphysema during common dental treatments using a high-speed hand piece and gingival retraction cord.

Management of Anterior Glottic Web with Laser Vaporization and Endolaryngeal Silastic Keel Insertion (성대 전연부 격막에 대한 레이저 치료 및 후두경하 실라스틱 Keel 삽입술의 효과)

  • 최종욱;주형로;정광윤
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.5 no.1
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    • pp.64-68
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    • 1994
  • Anterior glottic webs shorten the free margins of the vocal cords and prevent air flow at their locations, thereby changing the potential vibratory characteristics of the vocal system. They are now more often iatrogenic from endolaryngeal surgical procedures, complications of intubation, chronic inflammation or due to penetrating and blunt trauma to the larynx. A wide range of treatment procedures are now available but the solution to acquiring a "normal" voice has remained elusive due to reflectory stenosis and scar formation. We present our recent experiences with glottic web in nine cases using KTP-532 laser vaporization and endolaryngeal silastic keel insertion technique. Postoperative speech assessment in our cases showed significant improvement in voice quality of 7 of 9 cases studied(77.8%), and no specific problems were not seen.

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A Case of NRRL(Non-Recurrent Recurrent Laryngeal Nerve) in a Patient with the Parathyroid Adenoma (부갑상선 선종 수술시 관찰된 비회귀성 반회후두신경 (Non-Recurrent Recurrent Laryngeal Nerve) 1례)

  • 한수진;임재열;박헌이;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.2
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    • pp.188-191
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    • 2000
  • In thyroid and parathyroid surgery, damage to the recurrent laryngeal nerve(RLN) is the most common iatrogenic cause of vocal cord paralysis. Identification and preservation of the BLNs and meticulous technique can siginificantly decrease the incidence of this complication. We experienced one case of NRRLN in a patient with the parathyroid adenoma. During the dissection, there was no branch to be considered as RLN in tracheoesophageal groove. While searching for the RLN, We found a white structure coursing horizontally at the level of cricoid cartilage directly arising from the vagus nerve in the carotid sheath. That structure was nonrecurrent recurrent laryngeal nerve(NRRLN) and NRRLNs are exceedingly rare. Awareness of the possibility of NRRLN will prevent the surgeon from accidentally severing one if it is encountered during surgery.

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Minocycline as a treatment of dog with calcinosis cutis

  • Jang, Hye-Jin;Kang, Min-Hee;Sur, Jung-Hyang;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.53 no.4
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    • pp.253-256
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    • 2013
  • An 8-year-old, castrated male, Schnauzer dog was presented for evaluation of gradually worsening erythematous papules. Physical examination revealed multiple erythematous papules having a firm, gritty texture located in bilateral ears, dorsal midline, perianal and inguinal area. Skin biopsy revealed aberrant structure, characterized by atrophic epidermal-dermal layer structure with granular materials which was presumed as calcinosis cutis secondary to iatrognic hyperadrenocotricism. By initiating minocycline for 14 days, there was reduction in size, number of calcium deposit with remarkably decreased erythema. This case report presents the clinical trial of minocycline as a potential agent in treating dogs with calcinosis cutis.