• Title/Summary/Keyword: Periosteum

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Adequacy of Local Anesthesia on the Anterior Ethmoidal Nerve and the Dorsal Periosteum for the Reduction of the Fractured Nasal Bones (비골골절정복술에 있어서 전사골신경과 골막 마취의 유용성)

  • Cho, Jae Hyun;Lee, Hye Kyung;Rah, Dong Kyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.445-448
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    • 2006
  • Purpose: The nose is the most prominent skeletal feature of the face and is thus prone to frequent injury. Closed reduction of nasal bone fractures can be performed under general or local anesthesia. However, the benefits and the drawbacks in either form of anesthesia chosen are seldom perceived by the surgeon. A retrospective study was performed to assess the differences in the outcome among the two groups subjected to surgery under different type of anesthesia and to introduce our method of local anesthesia and its adequacy. Methods: Two hundred and fifteen patients during a 2-year period were included in the study. 2% Lidocaine mixed with 1:100,000 epinephrine was injected on the anterior ethmoid nerve and the periosteum. Assessment factors included intra-operative adequacy of analgesia, post-operative analgesic requirement and functional and aesthetic outcome of surgery. Results: 19 patients were manipulated under general anesthesia and 196 patients were manipulated under local anesthesia on the anterior ethmoidal nerve and dorsal periosteum. No statistically signigicant variable in performance of surgery could be attributed to the mode of anesthesia employed(p > 0.05). Four patients experienced complications after reduction. One developed septal deviation and three nasal obstruction. But, no secondary operations were needed. Conclusion: Anterior ethmoidal nerve block and dorsal periosteal injection of 2% Xylocaine, combined with topical intranasal 4% lidocaine and epinephrine provided sufficient analgesia comparable to that of general anesthesia.

Does periosteum promote chondrogenesis? A comparison of free periosteal and perichondrial grafts in the regeneration of ear cartilage

  • Yoo, Hyokyung;Yoon, Taekeun;Bae, Hahn-Sol;Kang, Min-Suk;Kim, Byung Jun
    • Archives of Craniofacial Surgery
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    • v.22 no.5
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    • pp.260-267
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    • 2021
  • Background: Elastic ear cartilage is a good source of tissue for support or augmentation in plastic and reconstructive surgery. However, the amount of ear cartilage is limited and excessive use of cartilage can cause deformation of the auricular framework. This animal study investigated the potential of periosteal chondrogenesis in an ear cartilage defect model. Methods: Twelve New Zealand white rabbits were used in the present study. Four ear cartilage defects were created in both ears of each rabbit, between the central artery and marginal veins. The defects were covered with perichondrium (group 1), periosteum taken from the calvarium (group 2), or periosteum taken from the tibia (group 3). No coverage was performed in a control group (group 4). All animals were sacrificed 6 weeks later, and the ratio of neo-cartilage to defect size was measured. Results: Significant chondrogenesis occurred only in group 1 (cartilage regeneration ratio: mean±standard deviation, 0.97±0.60), whereas the cartilage regeneration ratio was substantially lower in group 2 (0.10±0.11), group 3 (0.08±0.09), and group 4 (0.08±0.14) (p= 0.004). Instead of chondrogenesis, osteogenesis was observed in the periosteal graft groups. No statistically significant differences were found in the amount of osteogenesis or chondrogenesis between groups 2 and 3. Group 4 showed fibrous tissue accumulation in the defect area. Conclusion: Periosteal grafts showed weak chondrogenic potential in an ear cartilage defect model of rabbits; instead, they exhibited osteogenesis, irrespective of their embryological origin.

THE COMPARATIVE STUDY OF THE EFFECT OF THE SEMI RIGID AND RIGID FIXATIONS OF THE GROWTH OF THE CRANIOFACIAL SKELETON (반강성(半剛性) 및 강성고정(剛性固定)이 두개안면골(頭蓋顔面骨)의 성장(成長)에 미치는 영향(影響)에 관한 연구(硏究))

  • Lee, Sang-Chull;Kim, Yeo-Gab
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.157-170
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    • 1993
  • To prove the effct of semi-rigid fixation which utilize wire and rigid fixation which utilizes miniplate toward cranio-facial growth and development of growing children for teenagers, 28 rabbits-6 weeks, about 1.5kg-were experimented. They were classified three groups the semi-rigid group was 12 rabbits which were fixed with 26 gauge stainless steel wire to cross a fronto-nasal suture, the rigid group was the other 12 rabbits which were fixed with miniplate and screw, the control group was 4 rabbits which were get rid of only periosteum. The sample of fronto-nasal of rabbits which were sacrified after 2 weeks, 4 weeks, 8 weeks, and 12 weeks of the operation were investigated and made a comparative study with the light microscops. 1. At the control group, the central part of bony suture was connected with colagen bundle, the osteoblastic layer was investigated at the bony ending, new bone which covered the inside and outside faces of the bone suture was formed between periosteum. 2. Two weeks later from the experiment, ran slightly irregularly the collagen bundle which connects both bony endings of the rigid group. 3. Four weeks later from the experiment, collagen bundle of bone surface were arranged parally a little and comparing to the semi-rigid group, newly formed woven bone of surface of the adjacent bone was made obviously a little. 4. Eight weeks later from the experiment, collagen bundle which is located between both bony ending become close. Both the semi-rigid group and the rigid group showed significant formation of new bone at the periosteum and the bone surface. 12 weeks later from the experiment, both the semi-rigid group and the rigid group showed the regular running in the collagen bundle and smooth, dense periosteum. Then they assumed a similar aspect of the control group. I think that it does not give the influence to the cranio-facial growth of children or teenager to utilize a rigid fixation for a short period. Because as the time goes on, the surface of the bone suture was recovered and adjacent bone surface of the miniplate fixation showed compensatory growth, although both the semi-rigid group which utilized wire and rigid group which utilized a miniplate brought about the change of the area of the bone suture at the early period.

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Chondrogenesis of Periosteum-derived Progenitor Cells on Hyaluronic Acid Fiber Scaffold (Hyalograft $3D^{\circledR}$)

  • Shin, Hyun-Chong;Choi, Yong-Soo;Lim, Sang-Min;Lee, Chang-Woo;Kim, Dong-Il
    • 한국생물공학회:학술대회논문집
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    • 2005.04a
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    • pp.239-243
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    • 2005
  • Periosteum-derived progenitor cells (PDPCs) were isolated and characterized by flow cytometric analysis using fluorescence-activated cell sorter (FACS). The chondrogenesis of PDPCs was performed on hyaluronic acid fibers ($Hyalrograft^{\circledR}$) 3D) in chondrogenic induction medium. PDPCs showed the chondrogenic potential when cultured on hyaluronic acid fibers. These results showed that the characterized PDPCs were the chondrogenic progenitor cells and $Hyalrograft^{\circledR}$ 3D served as a useful carrier for PDPCs in transplantation proliferation, matrix synthesis and differentiation. Therefore, it could be used as a matrix for healing the defected cartilage.

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Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

  • Rho, Bong Il;Lee, In Ho;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.43 no.1
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    • pp.88-92
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    • 2016
  • There are two general categories of lateral osteotomy techniques-the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.

Periosteal Ganglion of the Distal Fibula - A Case Report - (원위 비골에서 발생한 골막하 결절종 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.178-181
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    • 2008
  • In contrast to ganglion of the soft tissue, periosteal ganglion occurring within or beneath the periosteum is a rare disorder. The differential diagnosis includes periosteal chondroma, lipoma, giant cell tumor of tendon sheath and periosteal osteosarcoma. Most common location for periosteal ganglion is the tibia, followed by radius, femur and ulna. To our knowledge, only 1 case of periosteal ganglion of the fibula has been reported in the literature. We report a case of periosteal ganglion of the distal fibula in a thirty-year-old woman treated with excision of the cyst and the adjacent periosteum.

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Biodegradable Hydroxyapatite/Chitosan Composites on the Bone Defect of Canine Model

  • Kim, Jooho;Lee, Dongbin;Heo, Suyoung;Kim, Namsoo
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.410-413
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    • 2017
  • Composites of hydroxyapatite (HAp) and chitosan (CS) have been successfully used in bone healing in humans and animals. However, the characteristics of HAp and CS are different. Therefore, the effects of HAp/CS composites on canine bone formation could differ according to their ratio. This study investigated the therapeutic effects of different contents ratios (100, 80:20, 60:40 wt%) on bone defects in a canine model. Thirty intrabony cylindrical defects were created in the humeruses and femurs of 5 beagle dogs, and then the defects were implanted with different composites. The evaluations were performed using radiographs obtained at 10 weeks post-surgery and by histological findings. In radiographic evaluation including the grades of bone filling, periosteal and endosteal reactions, pure hydroxyapatite composite had a significant effect on bone filling, and chitosan containing the composites showed vigorous responses at the periosteum and endosteum. In histological findings, the defect implanted with pure hydroxyapatite had healed completely into mature bony tissue with an obvious osteon structure, and the defect implanted with chitosan containing the composites had the amount of fibrous connective tissue increased significantly within the cortical bone tissue. The results indicate that hydroxyapatite/chitosan composites are therapeutically useful, promoting effective bone healing in defects when the ratio of hydroxyapatite is high and enhanced fibrous connective tissue formation at the periosteum as more chitosan is added.

Reconstruction of the Lower Extremities with the Large Latissimus Dorsi Myocutaneous Free Flap (넓은 유리 광 배 근피부 판을 이용한 하지 재건술)

  • Lee, Jun-Mo;Huh, Dal-Young
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.80-87
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    • 2000
  • Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

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