• 제목/요약/키워드: Ostium

검색결과 73건 처리시간 0.016초

Pharyngeal flap damage caused by nasotracheal intubation in a patient who underwent palatoplasty and pharyngoplasty

  • Oh, Jong-Shik;Choi, Hong-Seok;Kim, Eun-Jung;Kim, Cheul-Hong;Yoon, Ji-Uk;Yoon, Ji-Young
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권4호
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    • pp.309-312
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    • 2016
  • Patients with cleft lip and palate (CLP) must undergo corrective surgeries during infancy and early childhood. Many patients with CLP undergo orthognathic surgery during their childhood for correction of skeletal asymmetries or pharyngoplasty with a pharyngeal flap to improve the quality of speech and velopharyngeal function. During orthognathic surgeries, nasotracheal intubation is performed under general anesthesia. In our case report, the patient had undergone palatoplasty and pharygoplasty previously. During the orthognathic surgery, a flexible fiberoptic bronchoscope-guided nasotracheal tube was inserted through the pharyngeal flap ostium; however, active bleeding occurred in the nasopharynx. Bleeding occurred because the flap was torn. After achieving hemostasis, the surgery was completed successfully. Thus, if a patient may show the potential for velopharyngeal port obstruction, nasotracheal intubation should be performed with utmost care.

부분심내막상 결손증의 교정수술치험 3례 (Surgical Repair of Partial Atrioventricular Canal Defect)

  • 김영호;김공수
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.299-304
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    • 1985
  • The partial A-V canal defect consist of ostium primum type atrial septal defect with a cleft mitral anterior leaflet. The clinical findings depend upon the site and size of the left-to-right shunt, the degree of A-V valvular regurgitation, and the degree of resultant pulmonary artery hypertension. We experienced 3 cases of similar condition. The data were as follow: 1. Chest P-A showed increased pulmonary vascularity and moderate cardiomegaly with left atrial enlargement. 2. E.K.G. showed left axis deviation, left atrial enlargement, and left ventricular hypertrophy. 3. Right heart catheterization showed significant 02 step up of SVC-RA and left-to-right shunt. 4. Left ventriculogram showed mitral regurgitation and filling of both atrium. Operative findings were as follow: 1. Primum type atrial septal defect [2x2 cm]. 2. Cleft in the anterior leaflet of the mitral vave. 3. No evidence of ventricular septal defect and tricuspid anomaly. Through a right atriotomy with moderate hypothermia, the mitral cleft was approximated with interrupted sutures. The interatrial communication was closed by a patch of Dacron/pericardium. The patch was attached to junction of the mitral and tricuspid valves along the crest of the ventricular septum using interrupted sutures and the other site using continuous sutures. Postoperative course was uneventful and discharged in good general condition except postoperative bleeding in case 3.

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승모판막질환을 합병한 심방중격결손증의 수술요법6례 보고 (Coexistent Atrial Septal Defect with Mitral Valve Disease: a report of 6 cases)

  • 조성래;채헌;노준량
    • Journal of Chest Surgery
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    • 제12권4호
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    • pp.339-345
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    • 1979
  • Mitral valve disease is the most common disease of the acquired heart diseases, and atrial septal defect is also one of common congenital heart diseases. Coexistence of these two lesions is rare, but of great hemodynamic interest. Among 443 cases with mitral valve disease and 90 cases with atrial septal defect experienced in the Department of Thoracic Surgery, Seoul National University Hospital, there were 6 cases with atrial septal defect complicated by mitral valve disease. 1. Of the 6 patients, four were female and two were male. The age was ranged from 18 to 46. 2. Atrial septal defect was ostium secundum type in all cases, and the mitral valvular lesions were regurgitation in four and stenosis in two. Type II ventricular septal defect was also combined in one of the cases. 3. The atrial septal defect was corrected by, primary closure and the mitral valve was replaced with the prosthetic or bioprosthetic valve in all cases. The combined ventricular septal defect was closed using Teflon felt patch. 4. The operative result was good except in one who was expired of bacterial endocarditis 4 months after hospital discharge.

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대동맥벽내 혈종의 수술치험-증례보고- (Surgical Treatment of Intramural Hematoma of the Aorta Case Report)

  • 이해원;김관민
    • Journal of Chest Surgery
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    • 제30권3호
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    • pp.340-343
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    • 1997
  • 대동맥벽내 혈종은 진성 대동맥박리증과 구별되는 질환으로 아직 정확한 예후나 치료지침이 알려져 있지 않다. 저자들은 57세 여자환자에서 상행대동맥에 발생한 대동맥 벽내 혈종 1례를 수술 치험하였다. 환자는 질식감과 함께 심한 전흉부동통이 견갑골간으로 전파되는 것이 주소였다. 술전 흉부 전산화 단층왈영에서 흉부대동맥전체와 복부대동맥 일부의 대동맥 벽내에 초생달 형태의 혈종이 관찰되었고, 내벽의 파열 은 관찰되지 않았다. 저자들은 완전순환정지와 역행성 뇌 순환하에서 상행대동맥 치환술을 시행하였다. 우측관상동맥입구 의 손상이 있었으나 복재정 맥을 이용한 우회문합술로 수술하였다. 환자는술후4주만에 퇴원하였으며, 창상감염, 심낭삼출액 등의 합병증외에는 심각한 합병증은 없었다.

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Left Carotid-to-Subclavian Artery Bypass Grafting for Recurrent Angina Caused by Coronary-Subclavian Steal Syndrome

  • Kim, Min-Seok;Paeng, Jin Chul;Kim, Ki-Bong;Hwang, Ho Young
    • Journal of Chest Surgery
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    • 제46권1호
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    • pp.84-87
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    • 2013
  • A 60-year-old man visited the outpatient clinic due to one month of recurrent exertional chest pain. Eleven years earlier he had undergone off-pump coronary artery bypass grafting using bilateral internal thoracic artery (ITA) Y-composite grafts based on the left ITA. Preoperative coronary angiography showed patent distal graft anastomoses and visualized the left ITA retrogradely. The arch aortography revealed near-total occlusion of the left subclavian artery at the level of the ostium. The patient underwent left carotid-to-subclavian artery bypass grafting using a 6 mm vascular conduit. Postoperative computed tomographic angiography revealed a patent bypass conduit between the left common carotid artery and left subclavian artery. The patient was discharged on postoperative day 4 with no symptoms or signs of myocardial ischemia.

기관 게실을 동반한 호산구성 기관지염 1예 (A Case of Eosinophilic Bronchitis Associated with Tracheal Diverticulum)

  • 유승훈;정재호;강병수;강원식;고원준;이민경;박찬섭
    • Journal of Yeungnam Medical Science
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    • 제28권2호
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    • pp.192-195
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    • 2011
  • Tracheal diverticulum is relatively rare. It results from congenital or acquired weakness of the tracheal wall. Most cases are asymptomatic, but when symptoms are present, they are usually nonspecific. A 54-year-old man complained of sputum lasting for several months. Chest computed tomography showed an air-containing cystic structure in the trachea. Fiberoptic bronchoscopy demonstrated ostium arising from the right posterolateral wall at the trachea. Reported herein is a case of eosinophilic bronchitis associated with tracheal diverticulum.

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대동맥판막 폐쇄부전증을 동반한 대동맥판막 상부 협착증 (Supravalvular Aortic Stenosis with Aortic Regurgitation)

  • 김정태;이철주;소동문;한정선
    • Journal of Chest Surgery
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    • 제32권6호
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    • pp.591-594
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    • 1999
  • 대동맥판상부 협착증은 발살바동 상부에서부터 협착이 존재하는 비교적 흔치않은 선천성 질환이다. William 증후군없이 선천적으로 대동맥판 상부 협착증과 대동맥 좌관상판엽의 형성부전으로 인한 대동맥판 폐쇄부전증으로 진단받은 39세 여자환 悶“\ulcorner대동맥판막 치환술 및 Vascutek graft를 이용한 판탈롱 대동맥성형술을 시행 하였다. 환자의 술후경과는 좋았고 술후 9일째 퇴원하였다.

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Eyeball deviation by orbital mucocele after midface sinus injury

  • Oh, Se Young;Choi, Ji Seon;Lim, Jin Soo;Kim, Min Cheol
    • 대한두개안면성형외과학회지
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    • 제21권1호
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    • pp.53-57
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    • 2020
  • A mucocele is an epithelium-lined, mucus-filled cavity in the paranasal sinuses. Mucocele may develop due to scarring and obstruction of the sinus ostium caused by midface sinus trauma, such as orbital bone fracture or endoscopic sinus surgery. The authors report two cases of orbital mucocele as complications following midface sinus injury (endoscopic sinus surgery in one case, and orbital fracture repair in the other). In both cases, imaging studies showed a large orbital mucocele accompanied by bony erosion and orbital wall remodeling, compressing the ocular muscle. Using an open approach, the lesion was excised and marsupialized. The symptoms resolved, and the postoperative eyeball position was normal. Orbital mucocele may cause serious complications such as ocular symptoms, orbital cellulitis, osteomyelitis, and the formation of an abscess with the potential to invade the brain. Therefore, surgeons should consider the possibility of mucocele as a late complication of surgery and initiate an immediate work-up and surgical treatment if needed.

Points to consider before the insertion of maxillary implants: the otolaryngologist's perspective

  • Kim, Sung Won;Lee, Il Hwan;Kim, Soo Whan;Kim, Do Hyun
    • Journal of Periodontal and Implant Science
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    • 제49권6호
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    • pp.346-354
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    • 2019
  • Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the maxillary sinus is thin. Correspondingly, several sinus-lifting procedures conducted with or without bone graft materials have been used to place implants in the posterior area of the maxilla. Even with these procedures available, it has been reported that in about 5% of cases, complications occurred after implantation, including acute and chronic sinusitis, penetration of the sinus by the implant, implant dislocation, oroantral fistula formation, infection, bone graft dislocation, foreign-body reaction, Schneiderian membrane perforation, and ostium plugging by a dislodged bone graft. This review summarizes common maxillary sinus pathologies related to implants and suggests an appropriate management plan for patients requiring dental implantation.

편측 상악동 저형성증의 진단과 치료 (Diagnosis and Treatment of Unilateral Maxillary Sinus Hypoplasia)

  • 김성민;김민근;권광준;이석근;박영욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권2호
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    • pp.127-132
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    • 2012
  • Maxillary sinus hypoplasia (MSH) is an uncommon clinical disease that represents a persistent decrease in sinus volume, which results from centripetal reaction of the maxillary sinus walls. We present a unilateral MSH case of a 46-year-old male patient with a history of nasal obstruction and headache for 3 years. He had a history of Caldwell Luc operation (CLOP) 10 years ago, and no enophthalmos, hypoglobus or facial asymmetry. After confirming the right diagnosis of MSH, filled with bone in the computed tomography scan, hyperplastic bone was removed by the CLOP approach. The uncinate process and infundibular passage were found to be degenerated and ostium was also examined to be obstructed under endoscopic confirmation. MSH can be mistaken for chronic maxillary sinusitis because of the plain x-ray appearance, so the aggravated state of MSH can be the result of surgeon's misjudgment. With additional literature reviews, this rare experience is first introduced in our Korean oral and maxillofacial surgery field.