• Title/Summary/Keyword: Malposition

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Treatment of hearing loss due to temporomandibular joint disorders: Case Report (턱관절 장애로 인한 청각장애의 치료: 증례보고)

  • Kang, Dong-Woo;Kim, Young-Kyun
    • The Journal of the Korean dental association
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    • v.57 no.4
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    • pp.204-212
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    • 2019
  • Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.

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Coronary Artery Compression after an Arterial Switch Operation for Transposition of the Great Arteries - A case report- (대혈관전위로 동맥치환술을 시행했던 환자에서 발생한 관상동맥 압박 -1예 보고-)

  • Yoo, Jae-Suk;Koak, Jae-Gun;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.360-362
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    • 2008
  • An adequate location of the reimplanted coronary arteries is one of the most important prognostic factors for an arterial switch operation for treating TGA (transposition of great arteries). We report here on a case of malposition of the reimplanted coronary artery in a 14-year-old boy who had undergone an arterial switch operation. He had chest pain and dyspnea on exertion. The imaging study showed that the ostium of the left main coronary artery, which was between the neo-pulmonary artery and the neo-aorta, was compressed by the great arteries. We excised the left main coronary artery with a button incision from the aorta and reimplanted it on the left lateral side of the aorta. The patency of the left main coronary artery os after the operation was good and it was not compressed by the surrounding arteries.

Total Ankle Arthroplasty for the Post-traumatic Osteoarthritis (외상후성 관절염에 대한 족관절 인공관절 전치환술)

  • Lee, Keun-Bae;Cho, Sang-Gwon;Kim, Byung-Soo;Choi, Min-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.45-50
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    • 2007
  • Purpose: To evaluate the short-term clinical outcomes of total ankle arthroplasty for the post-traumatic osteoarthritis. Materials and Methods: Fourteen patients who had undergone total ankle arthroplasty from February 2005 to June 2006 were reviewed. Eleven patients were male and three patients were female. The mean age was 52.8 years (range, 33 to 69 years). The mean follow-up duration was 15.9 months (range, 12 to 24 months). Primary injuries were pilon fractures in eight cases, malleolar fractures in three, ankle syndesmotic injury in one, talus fracture and dislocation in one, and distal tibial physeal injury in one. Visual analogue scale (VAS), Range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and complications were evaluated. Results: The mean VAS improved from 8.6 preoperatively to 2.6 at last follow-up. The mean ROM improved from 24.6 degrees preoperatively to 33.1 degrees postoperatively. The mean AOFAS score improved from 44.5 points preoperatively to 75.1 points postoperatively. Radiographically, all components were stable, but there were component malpositions in two cases, including one varus malposition of tibial component and one increased anterior translation of talar component. Complications were deep infection in one case, intraoperative malleolar fracture in three, marginal wound necrosis in two, and heterotopic ossification in one. One prosthesis was revised because of deep infection. Conclusion: Total ankle arthroplasty for the post-traumatic osteoarthritis is believed to be an useful method for preservation of the motion, relief of the pain and high satisfaction of patients in short-term results.

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RESTORATION OF MISSED MAXILLARY CENTRAL INCISOR USING AUTOTRANSPLANTATION OF MESIODENS : A CASE REPORT (정중과잉치의 자가이식을 통한 상실된 상악 중절치의 수복 : 증례보고)

  • Kim, Hye-Kyoung;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.519-525
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    • 2007
  • Supernumerary tooth is developed from overgrowth of dental laminar and is mainly observed in the maxillary anterior area, named 'mesiodens. Mesiodens cause many problems such as malposition of permanent anterior tooth, diastema, formation of cyst, and eruption to oral or nasal cavity. Extraction, therefore, is generally recommended choice of treatment. This case report describes that the patient is a 9 years and 8 months old boy, whose unilateral maxillary incisor was missing due to trauma, and he had a mesiodens. We practiced autotransplantation of the mesiodens to the missing maxillary central incisor area and then restored with prosthetics, substantially kept out alveolar bony resorption and provided esthetic appearance. Mesiodens was too small to be used as an abutment because its length is totally 14mm, so that poor prognosis was anticipated due to bad crown/root ratio. However, we observed clinically acceptable result during the observation period of 8 months after operation.

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Autotransplantation of an impacted maxillary canine using Rapid Prototyping : A case report (Rapid Prototyping을 이용한 상악 매복 견치의 자가이식 치험례)

  • Cho, Nan-Ju;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.498-505
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    • 2007
  • Management options for impacted maxillary canines can include (1) continued observation, (2) extraction of the primary canine to aid spontaneous eruption, (3) uncovering and bonding of the impacted tooth and its eruption using orthodontic traction, (4) autotransplantation, and (5) extraction followed by prosthetic replacement. Autotransplantation should be considered when the degree of malposition is too severe to correct by orthodontic alignment. The present report describes the management of an ectopic eruption of the left maxillary canine in an 10-year-old girl. The treatment included the extraction of primary maxillary left canine and the autotransplantation using a Rapid Prototyping model. By using RP model to contour the recipient bone and check for fitting in the prepared socket, the extra-oral time can reduce. The autotransplanted canine showed mobility within normal limit, negative response to percussion and positive to electric pulp test after 6 months.

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An epidemiologic study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Pusan National University Hospital (부산대학교병원 교정과에 내원한 구순구개열 환자들에 대한 역학조사)

  • Son Woo-Sung;Baek Jae-Ho;Lee Won-Chul
    • Korean Journal of Cleft Lip And Palate
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    • v.5 no.1
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    • pp.43-58
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    • 2002
  • A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.

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Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

  • Jang, Kyoung-Min;Park, Seung-Won;Kim, Young-Baeg;Park, Yong-Sook;Nam, Taek-Kyun;Lee, Young-Seok
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.350-356
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    • 2015
  • Objective : Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods : We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results : Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion : The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.

The Clinical and Radiological Effect of Abnormal Axis after Cervical Arthroplasty

  • Jang, Hyun Jun;Oh, Chang Hyun;Yoon, Seung Hwan;Kim, Ji Yong;Park, Hyeong Chun;Kim, Yoon Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.225-230
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    • 2015
  • Objective : The clinical outcomes according to the radiological results after cervical total disc replacement (TDR) are not well established. Here, the authors reviewed the clinical results according to the asymmetry in radiographs. Methods : This retrospective analysis included patients after TDR ($Mobi-C^{(R)}$ disc) with at least 12 months follow up, and the clinical and radiological data were obtained preoperatively and postoperatively for 12 months. Clinical outcome measures numerical rating scale (NRS) score for neck pain, visual analog scale (VAS) for arm pain, and the Oswestry disability index (ODI) value. The asymmetries of TDRs were evaluated on the anterior-posterior (AP) and the lateral radiographs, and the radiographic adjacent segment degenerations were evaluated for 12 months. Results : A total of 24 patients (one level cervical TDR; 10 male and 14 female; aged $41.50{\pm}8.35years$) were included in this study. The clinical results including NRS for neck pain, VAS for arm pain, and ODIs were similar between the normal and asymmetrized TDRs in AP and lateral radiographs. The radiographic adjacent segment degenerations were significantly increased in deviated TDRs (AP >10 mm asymmetry and lateral>10 mm asymmetry). Conclusion : Asymmetrical location of TDR is not related to the clinical outcomes, but related to the risk of radiographic adjacent disc segment degeneration.

Ultrasound-guided internal jugular vein catheterization in critically ill pediatric patients

  • Yang, Eu Jeen;Ha, Hyeong Seok;Kong, Young Hwa;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.58 no.4
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    • pp.136-141
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    • 2015
  • Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

Unilateral Posterior Atlantoaxial Transarticular Screw Fixation in Patients with Atlantoaxial Instability : Comparison with Bilateral Method

  • Hue, Yun-Hee;Chun, Hyoung-Joon;Yi, Hyeong-Joong;Oh, Seong-Hoon;Oh, Suck-Jun;Ko, Yong
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.164-168
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    • 2009
  • Objective : Bilateral C1-2 transarticular screw fixation (TAF) with interspinous wiring has been the best treatment for atlantoaxial instability (AAI). However, several factors may disturb satisfactory placement of bilateral screws. This study evaluates the usefulness of unilateral TAF when bilateral TAF is not available. Methods : Between January 2003 and December 2007, TAF was performed in 54 patients with AAI. Preoperative studies including cervical x-ray, three dimensional computed tomogram, CT angiogram, and magnetic resonance image were checked. The atlanto-dental interval (ADI) was measured in preoperative period, immediate postoperatively, and postoperative 1, 3 and 6 months. Results : Unilateral TAF was performed in 27 patients (50%). The causes of unilateral TAF were anomalous course of vertebral artery in 20 patients (74%), severe degenerative arthritis in 3 (11%), fracture of C1 in 2, hemangioblastoma in one, and screw malposition in one. The mean ADI in unilateral group was measured as 2.63 mm in immediate postoperatively, 2.61 mm in 1 month, 2.64 mm in 3 months and 2.61 mm in 6 months postoperatively. The mean ADI of bilateral group was also measured as following; 2.76 mm in immediate postoperative, 2.71 mm in 1 month, 2.73 mm in 3 months, 2.73 mm in 6 months postoperatively. Comparison of ADI measurement showed no significant difference in both groups, and moreover fusion rate was 100% in bilateral and 96.3% in unilateral group (p=0.317). Conclusion : Even though bilateral TAF is best option for AAI in biomechanical perspectives, unilateral screw fixation also can be a useful alternative in otherwise dangerous or infeasible cases through bilateral screw placement.