• Title/Summary/Keyword: Midline crossing

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Management of Contralateral Node Negative Neck in Oral Cavity Squamous Cell Carcinomas (구강 편평세포암종의 반대측 예방적 경부치료)

  • Koo Bon-Seok;Lee Wook-Jin;Rha Keong-Won;Jung Eui-Sok;Kim Yoo-Suk;Lee Jin-Seok;Lim Young-Chang;Choi Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.196-200
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    • 2005
  • Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

Posterior Lung Herniation in Pulmonary Agenesis and Aplasia: Chest Radiograph and Cross-Sectional Imaging Correlation

  • Ji Young Kim;Woo Sun Kim;Kyung Soo Lee;Bo-Kyung Je;Ji Eun Park;Young Jin Ryu;Young Hun Choi;Jung-Eun Cheon
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1690-1696
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    • 2021
  • Objective: To describe the anatomic locations and imaging features of posterior lung herniation in unilateral pulmonary agenesis and aplasia, focusing on radiograph-CT/MRI correlation. Materials and Methods: A total of 10 patients (seven with pulmonary agenesis and three with pulmonary aplasia, male: female = 1:9, mean age 7.3 years, age range from 1 month to 20 years) were included. Chest radiographs (n = 9), CT (n = 9), and MRI (n = 1) were reviewed to assess the type of lung underdevelopment, presence of anterior and posterior lung herniation, bronchus origin, supplying artery, and draining vein of the herniated lung. Results: Pulmonary agenesis/aplasia more commonly affected the left lung (n = 7) than the right lung (n = 3). Anterior lung herniation was observed in nine of the 10 patients. Posterior lung herniation was observed in seven patients with left pulmonary agenesis/aplasia. Two patients showed posterior lung herniation crossing the midline but not beyond the aorta, and five patients showed the posteriorly herniated right lower lobe crossing the midline to extend into the left hemithorax farther beyond the descending thoracic aorta through the space between the esophagus and the aorta. This anatomical configuration resulted in a characteristic radiographic finding of a radiolucent area with a convex lateral border and a vertical medial border in the left lower lung zone, revealing a tongue-like projection on CT and MRI. Conclusion: Posterior lung herniation occurs in unilateral left lung agenesis/aplasia. Approximately 70% of the cases of posterior lung herniation reveal a unique radiolucent tongue-like projection in the left lower lung zone on imaging studies, which is caused by the extension of the posteriorly herniated right lung farther beyond the descending aorta.

Multidisciplinary management of a fused maxillary central incisor moved through the midpalatal suture: A case report

  • Bulut, Hakan;Pasaoglu, Aylin
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.384-393
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    • 2017
  • Fusion of teeth is a developmental anomaly. It occurs at the stage of tooth formation, which determines the shape and size of the tooth crown, when one or more teeth fuse at the dentin level during the morphodifferentiation of the dental germs. Such teeth show macrodontia and may cause crowding, as well as esthetic and endodontic problems. In this article, we report a rare case of a maxillary central incisor fused to a supernumerary tooth showing labial and palatal talon cusps, which was orthodontically moved across the midpalatal suture. A 13-year-old Caucasian boy sought treatment for the unesthetic appearance of his maxillary central incisor and anterior crowding. He was rehabilitated successfully via a multidisciplinary approach involving orthodontic, nonsurgical endodontic, periodontal, and prosthodontic treatments. After a 26-month treatment period, the patient's macroesthetics and microesthetics were improved. The overall improvement of this macrodontic tooth and its surrounding tissues through multidisciplinary treatment was documented using cone-beam computed tomography.

A FRONTAL CEPHALOMETRIC STUDY ON THE REFERENCE LINES TO ASSESS THE CRANIOMAXILLOFACIAL ASYMMETRY (안면 비대칭의 평가를 위한 기준에 관한 정모 두부 방사선 계측학적 연구)

  • Paek, Sun-Ho;Ahn, Byoung-Keun;Kim, Sun-Hae;Sohn, Hong Bum;Han, Ho Jin;Kang, Soo-Man
    • The korean journal of orthodontics
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    • v.23 no.1 s.40
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    • pp.1-15
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    • 1993
  • This study was undertaken to investigate the midline having the least difference between the right and left structures among the lines that had been used in the study of the craniomaxillofacial asymmetry. The sample of this study consisted of twenty six Korean girls(average 18.9 years old) having normal facial appearance and occlusion. On the frontal cephalometric films of the sample, we divided the whole craniomaxillofacial area into four portions, i.e., cranial, upper facial, lower facial, and dental portion. So, we have found the midlines having the least difference in the whole craniomaxillofacial area itself, and in the each divided four portions, furtherly in the other portions from aimed portion. The findings were as follow: 1. In the whole craniomaxillofacial area, the connecting line between crista galli and anterior nasal spine and the perpendicular bisecting line between right and left foramen rotundums were suitable for the midline. 2. In the cranial portion, established all six lines were suitable for midlines. In the other portions, the perpendicular bisection line between both condylion, the line passing the contact point between right and left mandibular central insisiors among the perpendicular lines between right and left mandibular central incisial tips were suitable midlines fer evaluating the asymmetry of cranial portion. 3. In the upper facial portion, the perpendicular bisecting line between right and left zygions was the most suitable midline. In the other portions, the line between the crista galli and the most superior point of the odontoid process, the perpendicular bisecting line between right and left gonions, the perpendicular bisecting line between right and left condylions, and perpendicular bisecting line between right and left foramens rotundum were suitable midlines for evaluating the asymmetry of the upper facial portion 4. In the dental portion, the perpendicular bisecting lines between right and left buccal cusps of both maxillary first molars and between right and left mandibular first molars were suitable midlines. In the other portions, the perpendicular bisecting line between right and left landmarks crossing the lesser wing of the sphenoid bone and orbit, the perpendicular bisecting line between right and left mental foramens, and the connecting line between crista galli and prosthion were suitable midlines for evaluating the asymmetry of dental portion. 5. In the lower facial portion, the perpendicular bisecting lines between right and left condylions and between right and left gonions were suitable midlines. In the other portions, the line between the crista galli and anterior nasal spine, the perpendicular bisecting line between right and left foramen rotundums, and the perpendicular bisecting lines between right and left buccal cusps of both mandibular first molars and between right and left maxillary first molars were suitable midlines for evaluating the asymmetry of the lower facial portion.

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TREATMENT OF IMPACTED CANINE : CASE REPORTS (매복견치의 치료: 증례보고)

  • Ahn, Byung-Duk;Kim, Young-Jae;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.151-158
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    • 2008
  • Upper and lower cuspids are very important teeth in point of function as well as esthetic. However, failure of eruption of the canine sometimes happens and is frequently encountered clinical problems. Upper cuspids are more frequently impacted as compared with lower cuspis and palatally impaction is more frequent event than labially impaction. Impaction of the mandibular canine is unusual event, especially crossing the midline (transmigration) is very rare. Because of, in most cases, there is no signs and symptoms, impacted teeth can be detected by periodic radiograph examination. The etiology of impaction is unclear and multifactorial. The treatment of impacted canine is influenced by presence of obstacles, location and direction of impaction, space for alignment and development of root. There are several treatment options; (1) Surgical removal and/or observation, (2) Window opening and orthodontic traction, (3) Autotransplantation. The first patient (impaction of upper right cuspid) is treated with window opening and orthodontic traction. The second patient (bilaterally impaction of lower cuspids) is treated with autotransplantation, because of transmigration.

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