• Title/Summary/Keyword: Iliac bone

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Conservative surgical treatment for ameloblastoma: a report of three cases

  • Kim, Se-Won;Jee, Yu-Jin;Lee, Deok-Won;Kim, Hyung Kyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.5
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    • pp.242-247
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    • 2018
  • Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.

Mandibularl Reconstruction with Various Methods Including Iliac and Fibular Osteocutaneous free Flaps (유리 피판술을 포함한 다양한 방법의 하악골의 재건술)

  • Kim, In Chul;Minn, Kyoung Won;Kim, Chin Whan;Park, Chul Gyoo;Lee, Yoonho;Kim, Suk Wha;Kwon, Sung Tack;Kim, Ji Hyuk;Lee, Min Goo
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.6-14
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    • 2000
  • Reconstruction of the composite mandibular defect resulting from ablative resection of tumor involved jaw has been challenging task to the plastic surgeon. A wide variety of different techniques were used with limited success until the advent of microsurgery. The high success rate of microsurgical procedures has allowed for significant improvement in both functional and aesthetic results. A variety of free flap donor sites have been used successfully for mandibular reconstruction. Between April of 1991 and August of 1998, 20 mandibular reconstructions were performed for oncologic defects. 4 patients underwent mandibular reconstruction with pectoralis major flap, 3 patients with free nonvascularized bone graft, 1 patient with metal plate. 12 patients underwent microvascular mandibular reconstruction(8: fibula, 4: ilium). The type of free flap was determined by the requirements of the defect. Satisfactory aesthetic and functional results were achieved in all cases without significant complications. So microvascular mandibular reconstruction should be considered as primary choice in all mandibular defect without hesitation.

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A Case of Tuberculous Spondylitis Combined with Schwannoma of Spinal Cord - A Case Report - (척수 신경초종을 동반한 결핵성 척추염 1례 - 증례보고 -)

  • Park, Jong Hoon;Kim, Kyu Hong;Lee, Woon Gi;Choi, Jeong Hoon;Lee, In Chang;Bae, Sang Do
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1241-1244
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    • 2001
  • The authors report a very rare case of tuberculous spondylitis combined with a schwannoma of spinal cord. A 39- year-old man was admitted because of paraparesis(G1/G2). MRI showed severe cord compression at two different levels. One was by the bulged soft tissue and subligamentous abscess extending from T7 to T9 and the other was by an intradural extramedullary cord tumor at the level of T1-2. At first operation, T8 corpectomy and T7-9 plate fixation with autogenous iliac bone graft were performed. After then, Paraparesis was improved(G2/G3) postoperatively. The second operation underwent two weeks later. The tumor was totally removed and shortly after second operation, paraparesis was markedly improved(G3/G4). Histological diagnosis were tuberculous spondylitis and schwannoma, respectively. The authors reviewed this case where good surgical outcome was obtained by two stage operation.

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A CASE REPORT OF TREATMENT OF RECURRENT GRANULAR-TYPE AMELOBLASTOMA (하악골에 발생한 재발성 법랑아 세포종의 치험례)

  • Yoon, Kyu-Ho;Rho, Young-Seo;Park, Seong-Won;Shin, Myoung-Sang;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.179-185
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    • 1994
  • The Ameloblastoma is a true neoplasm of enamel organ-type tissue histopathologically. Ameloblastoma is recognized as a benign tumor, but its clinical behavior is locally invasive. Therefore treatment of choice is surgical resection rather than conservative enucleation. This is a case report about En-bloc excision of granular ameloblastoma arising from dentigerous cyst in the right mandibular angle area of 50-year male patient. He visited local clinic with chief complaint of facial swelling on the right mandibular angle area. Surgical removal was performed by cyst enucleation and En-bloc excision with preservation of inferior border of mandible. After 1 year, iliac bone graft was done and hyperbaric oxygen therapy was applied. We obtained a good result of bony regeneration without any sign of recurrence.

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TREATMENT OF BASAL CELL NEVUS SYNDROME WITH ENUCLEATION FOLLOWING MARSUPIALIZATION : A CASE REPORT (다발성 악골의 치성 각화낭을 동반한조대술 후 적출술을 이용한 기저세포모반증후군의 치험례)

  • Park, Chul-Min;Kim, Hak-Kyun;Kim, Su-Gwan;Lee, Kye-Joon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.485-489
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    • 2008
  • Basal cell nevus syndrome is a hereditary disease of an autosomal dominant trait with variable conditions such as basal cell carcinomas of the skin, deformity of rib, fusion of vertebrae, mental retardation, hypertelorism, and multiple odontogenic keratocysts. A 32 years old man with pus discharge from fistula on the vestibule of left upper 1st molar visited to Chosun University Dental Hospital. Radiographic evaluation revealed multiple maxillary and mandibular cysts that had multilocular radiolucency on left mandibular body area, thining of inferior border of left border of ramus and well defined unilocular radiolucency above right upper 1st and 2nd molar and from left upper 1st premolar to 2nd molar. In chest PA view, he had a forked rib in the left 4th rib and in skull PA view the calcification of falx cerebri was observed. There was not any skin lesion. After the preliminary evaluation, the patient was diagnosed with basal cell nevus syndrome and he underwent marsupialization for decreasing the size of cystic lesion and came to hospital for dressing 3days a week. As time goes by, the size of lesion decreased. So, one and half year after marsupialization, he underwent cyst enucleation and iliac bone graft for the mandibular lesion and buccal fat pad grafts for the maxillary lesions. After the surgery, the patient experienced normal healing without any complications and he is on long-term follow-up.

Effectiveness Evaluation of Scanogram Using Longbone Detector (Longbone 검출기를 이용한 Scanogram의 유효성 평가)

  • Jang, Su-han;Heo, Ji-eun
    • Journal of radiological science and technology
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    • v.43 no.4
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    • pp.235-242
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    • 2020
  • Scanogram is that combine several practical images into one image to observation. So it is an important consideration in many clinical situation such as iliac measurement, leg alignment measurement and Scoliosis. Currently, scanogram examinations are mainly conducted for children and elderly patients. In this study, in order to apply the longbone detector to children or elderly patients who are difficult to cooperate with, we compared the longbone detector from D equipment with the G equipment discovery 656 Puls equipment in reproducibility of images, distribution of irradiation dose, scattering dose, irradiation time and image acquisition time. D equipment took more than twice as much time as G equipment. The scattered dose generated about 50% more G equipment than D equipment. In the whole spine scanogram and the measurement length of the lower leg, D equipment was also measured longer than G equipment. However, both methods did not show much difference from the CT scanogram, so there was no problem in measurement. The height of the thyroid radiation dose of G equipment was produced more radiation than D equipment. However, the longbone detector deviated from the x-ray center line relative to the tube rotation method, and was measured lower by the directionality of the measuring instrument, so that the error could not be corrected. In the conclusion of study, using the longbone detector is excellent for applying to children or elderly patients to reduce scattering dose. However, using CR may be useful to normal patients. Because, the image quality may deteriorate due to an imbalance of dose difference in thickness depending on the body part. So, it is useful to using a compensation filter or tube rotation method when we take a whole spine scanogram.

Facial Reconstruction Using Groin Dermo-Fat Free Flap in Romberg's Disease: Case Report (Romberg병 소아에서 서혜부 진피-지방 유리피판을 이용한 안면부 재건례)

  • Lee, Yoon Jung;Kim, Jun Sik;Kim, Nam Gyun;Lee, Kyung Suk
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.43-47
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    • 2011
  • Purpose: Romberg's disease manifests as progressive hemifacial atrophy of the skin, soft tissue and bone, which usually begins in the first or second decade of life. When present, atrophy may originate from the cutaneous stigmata and may become so sharply delimited by the midline. Methods: A 10-year-old girl, who had suffered from right mandibular area atrophy for 3 years, visited us and was diagnosed with Romberg's disease. The depressed lesion of the face was augmented successfully using a deepithelialized groin free flap. The superficial circumflex iliac vessels were used as the donor pedicle and the facial artery and vein were used as the recipient vessels. Results: After surgery, the flap survived well and she was satisfied with the result. Although there are various methods of facial augmentation using free flaps, this flap has some advantages. First, there is a considerable amount of fat tissue components for augmentation. Second, flap elevation with thinning is possible. Third, the donor site can be hidden. Conclusion: The groin dermo-fat free flap is a good method for the facial augmentation of Romberg's disease.

One Stage Correction of the Severe Secondary Cleft Lip Nasal Deformities in Foreigners (외국인에서 발생한 심각한 이차 입술갈림코변형에 대한 한 단계 수술)

  • Kim, Seok-Kwun;Kim, Ju-Chan;Park, Su-Sung;Lee, Keun-Cheol
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.102-106
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    • 2011
  • Purpose: It is accepted universally that correction of the cleft lip nasal deformity requires multiple stages of surgery. Following primary lip repair in infancy or early childhood, secondary surgery to improve the deformity of the lip and nose is frequently necessary. A suitable surgical procedure to correct the accompanying deformity, such as cleft palate and alveolus, must be carried out at an appropriate age. In developing countries, it is common for patients with cleft lip nasal deformity to present severe secondary deformities in adolescence, because of poor follow-up and inappropriate surgery. Methods: The first patient was a 12 year old Mongolian boy. He presented prominent lip scar, short lip, wide columella, asymmetric nostril, palatal fistula, cleft alveolus, and velopharyngeal incompetence. He underwent cheilorhinoplasty, transpositional flap, alveoloplasty by iliac bone graft, and sphincter pharyngoplasty. On follow-up, a bilateral maxillary hypoplasia and a class III malocclusion developed. He underwent LeFort I osteotomy and maxillary advancement at the age of 16 years. The second patient was an 18 year old Eastern Russian girl. She presented with a deviated nose, right alar base depression, short lip, protrusion on vermilion, large palatal fistula, and severe VPI due to short palate. She underwent the combined procedure of cheilorhinoplasty, corrective rhinoplasty, tongue flap for palatal fistula, and superiorly based pharyngeal flap. And the tongue flap was detached at postoperative 3 weeks. Results: The overall results have been extremely pleasing and satisfactory to patients. There were no postoperative complications. Conclusion: We discovered the one stage operation for radical correction was sufficient procedure to provide excellent clinical outcomes in patients with severe cleft lip nose deformity.

Contrecoup Injury associated with Fatal Portal Vein Bleeding: A Case Report (반충손상 기전에 의한 간문맥손상에 대한 증례 보고)

  • Joonghyun Yoo;Sung-Joon Park;Seung Hwa Lee;Hwan Hoon Chung
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1594-1599
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    • 2021
  • A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.

Recurrent ossifying and cemento-ossifying fibroma of the jaws;report of 2 cases (재발된 골섬유종과 백악질골섬유종)

  • Ryu, Sun-Youl;Oh, Hee-Kyun;Kim, Geon-Jung;Yun, Young-Su;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.297-308
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    • 1989
  • These are two case reports of recurrent ossifying and cemento-ossifying fibroma in a year or 5 months following conservative treatment. Ossifying fibroma or cemento-ossifying is a relatively uncommon benign fibro-osseous tumor of the jaws, and is generally believed to originate from periodontal ligaments. In recent, it is not demanded more differentiation of ossifying, cementifying and cemento-ossifying fibroma due to the thought that these lesions represent a spectrum of the same disease process rather than separate entities. The tumor commonly presents as an asymptomatic mass lesion and is usually well-circumscribed clinically so that conservative surgical excision has been the treatment of choice, but on occasion extended surgical procedures may become necessary, especially for those tumors which demonstrate rapid expansions and are poorly encapsulated (either initially or when recurrent) and when tumor growth is progressed aggressively or recurrent. En-bloc resection of mandible with iliac bone and inferior alveolar nerve graft was performed in case 1, recurrent cemento-ossifying fibroma of 32-year old male patient, and extended surgical enucleation of mass including normal marginal bone was done in case 2, recurrent ossifying fibroma of 72-year old female patient. By follow-up check of the patients, we obtained good result without any sings of recurrence.

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