• Journal of Chest Surgery
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• 제27권7호
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• pp.634-638
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• 1994

Infection of a median sternotomy incision may result in a large, unsightly,unstable,and potentially fatal wound. During the past 8 years, 5 consecutive patients [ 4 male and 1 female ] had repair of infected sternotomy wound. We describe our current preferred techniques and the results we have achieved with them. As soon as the sternal infection was shown, operative wound was opened and irrigated more than 4 times a day with 0.5% Betadine iodine solution until the exudate became clean with no growth of bacteria. Operation was performed in one-stage, which consisted of aggressive debridement of the infected bone and muscle transposition. Reconstruction was with one-side or both pectoralis flaps in all patients and rectus abdominis in 2 patients. There was no mortality or morbidity within 30 days postoperatively. We conclude that early aggressive debridement and muscle transposition remain the treatment of choice for most patients with infected median sternotomy wounds.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.399-405
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• 1997

Mediastinum is the space located between the right & left lung lobes in the center of the thorax, and contains many vital organs such as heart, aorta, trachea, esophagus, vagus nerve, lymphatics. So the infection of mediastinal space causes a serious and potentially fatal process. Like other infections, surgical drainage, aggressive antibiotic therapy and supportive care are recommended for optimal outcome. Airway management in the presence of the neck, glottic edema, elevation of the tongue is a formidible problem especially in the case from odontogenic origin. We have recently encountered such a case resulting in a number of local and systemic complications.

• Journal of Korean Dental Science
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• 제7권1호
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• pp.25-30
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• 2014

Subcutaneous emphysema and pneumomediastinum is a relatively uncommon phenomenon. It may occur secondary to dental treatment using high-speed air turbine handpieces, especially after extraction of tooth. Subcutaneous emphysema is often limited only to the areas of head and neck, but also can involve deeper structures. Thorough examination and conservative treatment of these problems are essential in preventing life-threatening complications such as airway obstruction and mediastinitis. The subject of this report is a 57-year-old woman with subcutaneous emphysema and pneumomediastinum during the extraction of maxillary third molar using high-speed air turbine handpiece. If there isn't any appropriate measure, severe complications may occur. Therefore it is important to be well-informed of proper diagnosis and treatment. This article shall present a case report with literature review.

• Journal of Chest Surgery
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• 제19권4호
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• pp.699-706
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• 1986

We have experienced 5 cases of Pectus excavatum corrected by Ravitch method without use of K-wire or metal bar from Jan. 1985 to Apr. 1986. All cases were male. The symmetric depression was in 4 cases, asymmetric one was in one case. The chief complaints were dyspnea on exertion, frequent U.R.I. and inferiority. The flail chest was developed in all cases, but it was insignificant in all cases except one who needed assist ventilation. Mediastinitis was developed in one case one week postoperatively but well managed with drainage. A distance from the posterior surface of sternum to the anterior surface of vertebral body was estimated preoperatively and postoperatively. Postoperative result was evaluated as the change of distance postoperatively. The change was 1.5cm minimally to 3.5cm maximally. Late results were "Excellent" in 3 cases and "Good" in 2 cases.uot; in 2 cases.

• Journal of Chest Surgery
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• 제28권1호
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• pp.78-80
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• 1995

We report the thoracoscopic resection of thymus and pericardial fat tissue in a patient who was in the setting of late severe myasthenia gravis[Osserman`s Group II-C-2 and previous tracheostomy state. The patient was 33-year-old female. She had been supported with mechanical ventilator for 88 days and suffered from recurrent pneumonia. Our first aim was to weaning her from mechanical ventilator. Traditional methods such as median sternotomy or transcervial thymectomy or transsternal sternotomy were difficult because of the anticipating complications of mediastinitis or morbidity, especially chest pain, following thoracotomy. We could wean her from the mechanical ventilator at postoperative 9 days. So, we concluded that video-assisted thoracoscopic thymectomy is a useful alternative tool in this case.

• 대한두경부종양학회지
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• 제4권1호
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• pp.35-40
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• 1988

A transhiatal esophagectomy without thoracotomy and esophageal reconstruction with gastric transponsition was performed in a recurrent laryngeal carcinoma spread to cervical esophagus. There were several benefits to performing this method: 1) It could be performed in one stage, took shorter operating time, and provided safe and efficient palliation in the patient with esophageal carcinoma. 2) The possible maximum surgical margin was obtained and the incidence of suture line tumor recurrence was minimized. 3) Postoperative death from anastomotic disruption and secondary mediastinitis and sepsis were virtually eliminated. 4) Clinically significant gastroesophageal reflux rarely occured.

• 대한기관식도과학회지
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• 제4권2호
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• pp.254-257
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• 1998

Esophageal foreign body are not uncommon problems in the otolaryngologic field. Esophageal foreign body may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheo-esophageal fistula, mediastinitis, pneumothorax pyothorax according to the kinds, shape, size, duration of lodgement of foreign body. The majority of esophageal foreign U which lodge in the esophagus can be removed endoscopically, but the following type of foreign body may require removal by external route. 1. an impacted foreign body 2. a foreign body producing esophagitis after unsuccessful attempts at removal through the esopahgoscope 3. a periesophageal abscess with a foreign body lodging in the abscess itself. Recently, we experienced a case of esophageal foreign body (fish bone) which penetrate the cervical esophageal wall and formed retropharyngeal abscess in 54-year old female. The foreign body are successfully removed and abscess was drained by external route through the lat neck.

• 대한기관식도과학회지
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• 제9권2호
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• pp.44-48
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• 2003

Rupture of the esophagus is an uncommon condition that can be a formidable challenge to treat. Unless early treatment is applied, life-threatening complications, such as mediastinitis, sepsis, occurs and continue to be associated with a mortality rate of more than 20%. Definitive repair of esophageal perforation is considered the preferred treatment in the past. In the present study, conservative treatment acquired a good results by help of the development of antibiotics and nutritional supportive methods. Iatrogenic causes constituted most of the injuries, followed by external trauma, spontaneous, ingested foreign bodies, and malignancy. The incidence of perforation following ingestion of foreign bodies is very rare, so recommendations regarding treatment remain controversial. We analyzed the course of 31 patients with esophageal perforation by foreign bodies, concentrating on the diagnostic & treatment delay and methods of treatment, complications.

• 대한기관식도과학회지
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• 제13권1호
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• pp.47-50
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• 2007

Foreign bodies of the parapharyngeal space can cause severe complications such as descending suppurative mediastinitis, jugular thrombophlebitis, cavernous sinus thrombosis and carotid erosion. Therefore, early diagnosis and surgical intervention are needed to reduce morbidity and mortality. We present a case of a toothbrush as foreign body in the parapharyngeal space in 28-year-old male patient. The tooth brush was broken and the remnant of that was left in the patient's mouth. Under general anesthesia, intraoral approach was undertaken and successfully the toothbrush was removed, and then incision and drainage was done by transcervical approach. We report this case with review of literature.

• Journal of Chest Surgery
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• 제27권1호
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• pp.43-47
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• 1994

Prompt recognition and proper treatment of esophageal perforation or rupture may ax~ert death or minimize complications. We have experienced sixteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Hallym Medical college during the period fromJan. 1986 to Sep. 1993. The ratio between male and female patient was 13:3 and their age ranged from 23 years to 67 years old. The major cause of esophageal perforations was spontaneous rupture in 7 cases[45%], surgical trauma in 2 cases[12%], instrumental trauma in 2 cases[12%], and others in 5 cases[31%]. The common site of esophageal perforation was in the lower third portion of the esophagus[10 cases, 62%]. The most consistent symptom of esophageal perforation was chest pain in 11 cases, temperature elevation within a few hours was 9 cases.Contrast roentgenographic studies demonstrated the perforation in all but 2 of the 16 patients. The frequent complications of esophageal perforation were empyema in 7 cases[45 %] and mediastinitis in 2 cases[12%]. fourteen patients had suture closure and drainage with 2 deaths, and 2 patient received only drainage procedures. The mortality rate was 12%[2 cases] and cause of death was sepsis and aortic rupture.