• Title/Summary/Keyword: Nasal bleeding

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The Usefulness of Transcatheter Arterial Embolization for Panfacial Injury (전체얼굴손상 환자에서 영상중재시술의 유용성)

  • Kim, Jae Woo;Choi, Hwan Jun;Kim, Mi Sun;Yang, Seung Boo
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.358-364
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    • 2007
  • Purpose: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures. Methods: A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam. Results: After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations. Conclusion: Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.

Correction of bony deviation in rhinoplasty

  • Kim, Kook Hyun
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.516-521
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    • 2020
  • In rhinoplasty, osteotomy is becoming more and more frequent as a way to achieve aesthetically pleasing and functional results, as well as patient satisfaction. In procedures to correct a deviated nose, osteotomy to correct the bone plays an essential role in addition to correction of the septum and cartilage, and osteotomy can reduce the wide nose bridge and give a slightly higher appearance in Asian rhinoplasty. However, osteotomy is relatively invasive, and the nasal bones of Asians are often low and thick, so bleeding or swelling during surgery can be somewhat more severe, and a stuffy nose can occur after surgery if osteotomy is performed incorrectly. Since side effects are possible, it is necessary to have a precise understanding of the relevant anatomy and technique. Several articles have described nasal bone osteotomy in rhinoplasty, and this review article introduces the methods presented in various articles, describes indications and limitations, and reviews the relevant anatomical structures and techniques in an accurate manner. We introduce a method that can increase patients' satisfaction and the completeness of surgery through accurate osteotomy, as well as reducing the risk of side effects.

A CASE OF PALATAL GUNSHOT WOUND OPERATED BY LANGENBECK METHOD (Langenbeck씨 수술법에 의한 구개총상치험례)

  • Yu, Gwang-Hui;Sim, Yeong-Seop;Yong, Ho-Taek
    • The Journal of the Korean dental association
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    • v.13 no.7
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    • pp.629-632
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    • 1975
  • The clinical investigation and operation procedure were described on the gunshot wound which involved on soft, hard palate and nasal cavity. The patient, 19 years old, female, admitted in Han Yang Medical Center with clinical diagnosis of maxillofacial injuries on Nov. 1973. No Significant signs include of airway obstruction, Oro-nasal bleeding were revealed only exception of rupture and perforation on the soft, hard palate. For closure and reduction of destructed palatal wound, operation was done in out patient dental clinic under local anesthesia by means of Langenbeck method. And to control of post-operative inflammation and reactive swelling, administration of accurate antibiotics and physical therapy were performed for 5 days after operation. On the 10th day after administration, patient was discharged with satisfactory result of operation.

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Stereotactic Sphenopalatine Ganglionotomy Using Radiofrequency Thermocoagulation -Case reports- (고주파열응고를 이용한 정위적 접형구개신경절절개술 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.227-230
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    • 1999
  • The sphenopalatine ganglion lies behind the middle nasal concha in the sphenopalatine foramen which connects the fossa to the nasal cavity. It has sympathetic and parasympathetic fibers as well as sensory fibers which innervate the nasal cavity, palate and nasopharynx. Current indications for blockade of the sphenopalatine ganglion include the management of migraine, cluster headache and a variety of facial neuralgias. Blockage of this ganglion can be attempted when more conservative treatments have failed. If the pain relief gained through the procedure is of short duration and the blockage needs to be repeated frequently, then radiofrequency thermocoagulation should be considered. Since the sphenopalatine ganglion lies close to the maxillary nerve, neurolytics can cause facial dysesthesia, radiofrequency thermocoagulation is the preferred method for ganglionotomy. Radiofrequency thermocoagulation of the sphenopalatine ganglion was done for 3 patients who suffered from postherpetic neuralgia, cluster headache, atypical facial pain respectively. Good results were obtained with the exception of the patient suffering from atypical facial pain. Although we were concerned about complications such as epistaxis, none were encountered. However it should be noted that caution must be exercised when repeatedly redirecting the cannula in the sphenopalatine fossa as serious bleeding and pronounced facial swelling may result.

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Fiberoptic bronchoscope and C-MAC video laryngoscope assisted nasal-oral tube exchange: two case reports

  • Ji, Sungmi;Song, Jaegyok;Kim, Seok Kon;Kim, Moon-Young;Kim, Sangyun
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.219-223
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    • 2017
  • In cases of multiple facial trauma and other specific cases, the anesthesiologist may be asked to convert an oral endotracheal tube to a nasal endotracheal tube or vice versa. Conventionally, the patient is simply extubated and the endotracheal tube is re-inserted along either the oral or nasal route. However, the task of airway management can become difficult due to surgical trauma or worsening of the airway condition. Fiberoptic bronchoscopy was considered a novel method of airway conversion but this method is not useful when there are secretions and bleeding in the airway, or if the anesthesiologist is inexperienced in using this device. We report a successful airway conversion under the aid of both, a fiberoptic bronchoscope and a C-MAC video laryngoscope.

A Case of Wegener's Granulomatosis (Wegener씨 육아종증 1례)

  • 박성준;권평중;김중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.13.5-14
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    • 1981
  • Wegener's granulomatosis is characterized by 3 criteria: 1. Necrotizing granulomas with vasculitis of upper and lower respiratory tracts 2. A systemic vasculitis 3. Focal necrotizing glomerulitis. This disease is one of the nonhealing disease in the otolaryngologic and ophthalmologic fields. A 48years old Korean male patient was seen with the complaints of nasal discharge, foul odor and frequent nasal bleeding. The patient was admitted after biopsy of the nasal cavity which diagnosed tuberculous granuloma, for biopsy of the maxillary sinus. After biopsy by Caldwell-Luc's approach this patient was complained with severe headache, visual impairment and cough. And so this patient was readmitted for further evaluation. Generally, the diagnosis was made after autopsy sometimes several years later after reevaluation of the case. Tuberculous granuloma was the pathological diagnosis on the basis of resected material in various cases. The correct diagnosis was made at autopsy occasionally. It is our intention to present this case with. literature review.

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A Case of the Inverted Papilloma of the Nose and Paranasal Sinuses (비강 및 부비동에 발생한 거대란 반전성유두종 1예)

  • 김정래;권평중;김중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.12.4-12
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    • 1981
  • Inverted papilloma of the nose and paranasal sinuses is a rare and benign neoplasm, which has been classified as a true neoplasm by most authors. The most characteristic microscopic feature of inverted papilloma is an increase in thickness and proliferation of the covering epithelium with extensive finger-like inversion into the underlying stroma. Radical aggressive treatment and careful follow up have been advocated in view of the high recurrence rate after inadequate removal and the possibility of malignant transformation. The authors have recently experienced a case of huge inverted papilloma which occupied the left side of nasal cavity, maxillary sinus and ethmoid sinus. A 64 year old female patient who had been suffering from nasal obstruction, hyposmia, headache and frequent nasal bleeding since about 3 years. The patient had had removal surgery as Caldwell-Luc approach with good postoperative effect.

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A study on Allergic Rhrnitis (알레르기성 비염의 임상적(臨床的) 연구(硏究))

  • Lee Hai-Ja;Park Eun-Jeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.2
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    • pp.167-175
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    • 2001
  • Background : Allergic rhinitis is found in approximately 20% of the general population. And the prevalence of allergic rhinitis in the pediatric population also appears to be rising. Despite allergic rhinitis reportedly occurs very frequently, this disease is often overlooked or undertreated. The oriental medicine, allergic rhinitis is belong to the BiGu, BunChe. The symptoms are watery rhinorrhea, sneezing and nasal obstruction. The cause of disease is the weak of lung, spleen and kidney, and invasion in to nasal cavity of Poong Han etc a wrong air. Objective : To allergic rhinitis patients, we use herbal medicine and acupuncture treated. To demonstrate the effect of oriental medicine therapy in the allergic rhinitis before and after treatment. Materials and methods: Thirty five patients (18 male and 17 female) treated in our hospital between February 2001 and October 2001 were studied. Ages ranged from 10 to 56 years (mean age : 27 years). Seventy seven patients had a underlying family history (allergy or sinusitis of parents or brothers). In the past history, 63% patients have atopic disease. Illness period was from 1 month to 20 years (mean period : 5.7 year). Mean duration of treatment were 39 days. Gamihyunggyeyungyo-tang was administered mainly. Result : The symptoms of allergic rhinitis were nasal obstruction(94%), rhinorrhea(86%), itching(80%), sneezing(60%), eye itching(17%), headache(11%), nose bleeding(8%) and nose pain(6%). Compared with before and after treatment, the fourth symptoms of allergic rhinitis - sneezing, rhinorrhea, nasal obstruction and itching- improved significant statistically. (significant <0.005) Conclusion : We know that herbal medicine therapy and acupuncture were the effective treatment of Allergic rhinitis.

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The Bibliogrphical Study on the Allergic Rhinitis (알레르기性 鼻炎에 對한 文獻的 考察)

  • Kim, Hyun-Ah;Jung, Ji-Chun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.7 no.1
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    • pp.53-84
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    • 1994
  • The study has been carried out to investigate of the Allergic Rhinitis by referring to 87 literatures. The results were as follows; 1. In oriental medical science, Allergic Rhinitis is belong to the category of the 'BiGu'(鼻구) 'GuChe'(구체). The 'Gu'(구) of the BiGu means watery rhinorrhea, the 'Che'(체) of the GuChe means sneezing. 2. The cause of a disease summarize the weak of Lung, Spleen and Kidney, and invasion into the nasal cavity of PoongHan etc a wrong air. Sometimes the pathologial change appear PoongHan changeHwa(風寒化火), HwaYeol is hidden in the inside(火熱內伏). The contributing factors are found a season(spring, winter), an abnormal weather(運氣 : 少陰 少陽 陽明 司天, 歲金不及), an emotional stress, an external wound of the harmful air, a food allergens and fatigue, a contact of substances, a sunlight etc. 3. Predominant symptoms are watery rhinorrhea, sneezing and nasal obstruction. Sometimes accompanic symptoms are nasal bleeding, mucopurulent rhinorrhea, olfactory disturbance, nasal polyp, rhinolalia clausa, respiratory disfunction etc. 4. The treatment-methodes is as follows, OnBoPaeJang GeoPoongSanHan(溫補肺臟 祛風散寒), GeonBilkGi(健脾益氣), BoSinNabGi (補腎納氣). The treatmentherbs is as follows, OnBoJiLuDan GaGam(溫補止流丹 加減), OkByeongPoongSan plus ChangIJaSan GaGam(玉屛風散合 蒼耳子散 加減), BoJungIkGiTang GaGam plus SoCheongLyongTang(補中益氣湯加減 配合 小靑龍湯), SinGiHwan GaGam(腎氣丸加減), GaeJiTang(桂枝湯) etc. 5. The external treatment is as follows, JeokBi(滴鼻), ChuiBi(吹鼻), SaekBi(塞鼻), stick and herbs-injection on the acupuncture-point, pressure ear acupuncture-point, herbs-pillow etc. 6. The acupuncture-moxa treatment is as follows, the methodes of cure apply TongJoGyeongGi(通調經氣), SanTongBiGui(宣通鼻竅) etc. Predominent acupuncture-points are YoungHyang(迎香), InDang(印堂), BiTong(鼻通), SangSeong(上星), HabGok(合谷) and so on. As mentioned above, from now on, it's need to the oriental medical scientific study of the Immunity and Allergy and to the external treatment's application for the ascent of the treatment-effect of the allergic disease.

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A Masked Hemophilia B, Severe Bleeding after Tonsillectomy and Adenoidectomy (잠재성 혈우병 환아에서의 편도 적출후 심한출혈의 1치험례)

  • 박영서;김기헌;김선무;이종무
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.17.1-17
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    • 1972
  • Hemophilia B is hereditary disorder of blood coagulation known as a deficiency of P.T.C. or Christmas factor. Anyway it's indistinguishable clinically with hemophia A and C. Here's one of most interesting problems gave us because we could only find it out as a hemophilia B. when we stood a situation to be met continuous bleeding from the operative wound of tonsillectomy and Adenoidectomy. Wintrobe proposed that easy bruising, difficulty in stopping the bleeding from razor cuts, and prolonged bleeding after tonsillectomy or tooth extraction usually are the major manifestations. For a long time little attention was paid to reports of a milder form of the diseases. In such cases coagulation time, and even prothrombin consumption were normal and the symptoms were correspondinly mild, small wounds as a rule giving little trouble and hemoarthrosis being uncommon. In our cases, there's no specific contributory history except nasal bleeding intermittently and also no specific contributory laboratory data before the operation. After the T. & A., there's continuous bleeding from nasopharynx and the coagulas on the both tonsilar fossas being grown day by day. Therefore we suspected some abnormality of coagulation mechanism and then we could get conclusion of hemophilia B. after various laboratory tests including T.G.T., As I know, this case, hemophilia B. is 3rd one as a report in Korea. We have no data of hemophilia family at present time, so that I propose that we have to make system of hemophilia family in Korea. In a next, we have to make routinely complete laboratory test, ego routine C.B.C., bleeding time, coagulation time, prothrombine time, partial thromboplastine time, before operation of T.& A. If we can solve these problems we can get the T. & A. without any problems of bleeding according to get the operation of T. & A.

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