• Title/Summary/Keyword: Posterior fossa surgery

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THE EFFECTS OF INCISON OF RETRODISCAL TISSUE AND OCCLUSAL REDUCTION ON TEMPOROMANDIBULAR JOINT OF RABBIT (가토에서 관절원판 후조직 절단 및 교합고경 감소가 악관절에 미치는 영향)

  • Lee, Byeong-Seok;Kim, Jong-Chul
    • The korean journal of orthodontics
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    • v.23 no.4 s.43
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    • pp.645-660
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    • 1993
  • In this study, effects of incision of retrodiscal tissue and unilateral occlusal reduction on temporomandibular joint of rabbit were investigated. Twenty-seven adult New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study. Temporomandibular joint surgery was performed in left temporomandibular joint of 24 rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc. They were divided into two groups : twelve were left untreated after surgery, occlusal reduction was performed on left posterior teeth every 2 weeks in the other twelve rabbits, The remaining three served as the control group. The sample were sacrificed by 8, 12, and 16 weeks after surgery. Histologic examinations were performed after sacrificing them. The results were as follows : 1. Histologic findings which were manifested by flat articular fossa, broad articular surface, generalized recession of articular cartilage and sclerosis of subchondral bone were observed. These findings were similar to internal derangement. 2. In the rabbits untreated after surgery, thin cartilagenous layer and necrotic tissue were observed in 8 weeks group, calcifying cartilagenous layer was observed in 12 weeks group, and cartilagenous layer on anterior portion was observed in 16 weeks group. So, it showed gradual healing pattern into the normal tissue except displaced disc. 3. Occlusal trauma after surgery resulted in generalized recession of upper and lower articular surface. Necrosis and vertical split on condylar process of mandible were observed in 8 weeks group. Osteoclasts, exposure of subchondral bone due to erosion on upper and lower articular surface, and degenerative changes on retrodiscal tissue were observed in 16 weeks group. So, it showed continuous prowess pattern of osteoarthrosis.

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Study of frontal and ethmoid sinus of sinonasal complex along with olfactory fossa: anatomical considerations for endoscopic sinus surgery

  • Kusum R Gandhi;Sumit Tulshidas Patil;Brijesh Kumar;Manmohan Patel;Prashant Chaware
    • Anatomy and Cell Biology
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    • v.56 no.2
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    • pp.179-184
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    • 2023
  • The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive "precision surgery" to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero's classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.

Positional change of the condyle after orthodontic-orthognathic surgical treatment: is there a relationship to skeletal relapse?

  • Zafar, Husanov;Choi, Dong-Soon;Jang, Insan;Cha, Bong-Kuen;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.160-168
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    • 2014
  • Objectives: The purpose of this study was to evaluate the condylar position in relation to the glenoid fossa before and after orthodontic-orthognathic surgical treatment and to investigate the relationship with skeletal relapse. Materials and Methods: Lateral cephalograms and temporomandibular joint tomograms from 19 patients with mandibular prognathism who received orthodontic-orthognathic surgery were included in this study. Samples were divided into two groups based on skeletal change during the retention period. The relapse group consisted of 7 patients (3 females and 4 males; mean age, 21.9 years) whose pogonion or menton displaced more than 1 mm during the retention period and the stable group consisted of 12 patients (5 females and 7 males; mean age, 21.7 years). Anterior joint space, posterior joint space, superior joint space, and anteroposterior index were measured on tomograms at pretreatment and posttreatment timepoints. Condyle position and frequency of the positional change were compared between both groups. Results: In the relapse group and stable group, 42.9% and 45.8% of the condyles, respectively, showed forward or backward displacement at posttreatment. However, the changes were small and the mean anterior, posterior, superior joint spaces and frequencies of the positional changes did not differ statistically between both groups. Conclusion: Our results suggest that small positional changes of the condyle, which may occur after orthodontic-orthognathic surgery treatment, may not be related to skeletal relapse after removal of the orthodontic appliances.

A simple technique for repositioning of the mandible by a surgical guide prepared using a three-dimensional model after segmental mandibulectomy

  • Funayama, Akinori;Kojima, Taku;Yoshizawa, Michiko;Mikami, Toshihiko;Kanemaru, Shohei;Niimi, Kanae;Oda, Yohei;Kato, Yusuke;Kobayashi, Tadaharu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.16.1-16.6
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    • 2017
  • Background: Mandibular reconstruction is performed after segmental mandibulectomy, and precise repositioning of the condylar head in the temporomandibular fossa is essential for maintaining preoperative occlusion. Methods: In cases without involvement of soft tissue around the mandibular bone, the autopolymer resin in a soft state is pressed against the lower border of the mandible and buccal and lingual sides of the 3D model on the excised side. After hardening, it is shaved with a carbide bar to make the proximal and distal parts parallel to the resected surface in order to determine the direction of mandibular resection. On the other hand, in cases that require resection of soft tissue around the mandible such as cases of a malignant tumor, right and left mandibular rami of the 3D model are connected with the autopolymer resin to keep the preoperative position between proximal and distal segments before surgical simulation. The device is made to fit the lower border of the anterior mandible and the posterior border of the mandibular ramus. The device has a U-shaped handle so that adaptation of the device will not interfere with the soft tissue to be removed and has holes to be fixed on the mandible with screws. Results: We successfully performed the planned accurate segmental mandibulectomy and the precise repositioning of the condylar head by the device. Conclusions: The present technique and device that we developed proved to be simple and useful for restoring the preoperative condylar head positioning in the temporomandibular fossa and the precise resection of the mandible.

Anatomic Study of Pterygomaxillary Junctions in Koreans

  • Kim, Dong-Yul;Cho, Yeong-Cheol;Sung, Iel-Yong;Yun, Dae-Kawn;Kim, Min-Uk;Kim, Ji-Uk;Son, Hyung-Suck;Son, Jang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.368-375
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    • 2013
  • Purpose: This study is to evaluate the location of descending palatine artery, the anatomy of pterygomaxillary junction, and the association between the obtained anatomic values and several variables. Methods: We studied 40 patients who were treated for dentofacial deformites from January 2010 to December 2012 in Ulsan University Hospital, Ulsan, Korea. Cone beam computed tomogram (CBCT) was done for all patients. The reference point was approximately 5 to 7 mm above anterior nasal spine on axial image. We evaluated the location of the greater palatine canal (line a: on the coronal view, the shortest line between the center of greater palatine canal and pterygoid fossa; distance a: the distance of line a). We also measured the thickness (line b: on the coronal view, the shortest line between maxillary posterior sinus wall and pterygoid fossa; distance b: distance of line b), width (line c: on the coronal view, the line perpendicular to the line b and the nearest line from the most concave point of lateral pterygoid plate to the medial pterygoid plate; distance c: distance of line c) and height (line d: on sagittal view, the vertically longest line of pterygoid junction; distance d: the distance of line d) in pterygomaxillary junctions. We evaluated the association between the obtained anatomic values and several variables (sex, age, height and weight). Results: The mean distance a was 4.78 mm, mean distance b was 5.53 mm, mean distance c was 8.01 mm and mean distance d was 13.22 mm. The differences between age and mean distance c and weight and mean distance d in pterygomaxillary junctions are statistically significant. Conclusion: There apparently is anatomic variation of pterygomaxillary junctions by various values, particularly weight and age in a Korean clinical population.

Dandy-Walker Syndrome with Submucous Cleft Palate: A Case Report (댄디워커증후군에 동반된 점막 밑 입천장갈림증 치험례)

  • Kwang, Bum Sik;Na, Young Cheon
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.54-56
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    • 2012
  • Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report (소뇌 종양 적출 후 두개강 내 발생한 난치성 뇌척수액 고임의 치험례)

  • Rha, Eun Young;Oh, Deuk Young;Kim, Hye Young;Lee, Jung Ho;Moon, Suk Ho;Seo, Je Won;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.95-98
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    • 2010
  • Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.

Atypical Teratoid Rhabdoid Tumors in Adult Patient with Multiple Lesions

  • Oh, Young-Min;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.387-389
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    • 2005
  • Primary atypical teratoid/rhabdoid tumor[AT/RT] of the central nervous system is a recently described, highly malignant neoplasm that usually occur in the posterior fossa of children. Although AT/RT usually occurs in young children, AT/RT is being recognized in adults with increasing frequency. The authors report 49-year-old man with multiple AT/RT lesions [right lateral ventricle, right temporal lobe and right cerebellum]. Histopathologic findings showed typical rhabdoid cells with eccentric nuclei and prominent nucleoli. Eventhough the tumor was removed, a patient was dead in one month after surgery due to recurrence and rapid regrowth of the tumor.

A Case Report of Conservative Treatment for the Amatuer Baseball Player diagnosis with type 2 Superior labral anterior posterior lesion (제2형 상부관절와순파열로 진단받은 사회인 야구선수에 대한 보존적 치료 치험 1례)

  • Jin, Eun-Seok;Yeom, Sun-Kyo;Kim, Seok;Lee, Jin-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.151-158
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    • 2010
  • Objective : SLAP is rupture of biceps brachii muscle tendon and it's origin, posterior side of superior labral to anterior glenoid fossa. Snapping and Pain, instability are its typical symptoms. SLAP is physical damage so surgeons use arthroscopy. In point of surgeons view, a conservative medicine is not effective for lesion of labrum. So In this article, we report a result of conservative treatment for the amatuer baseball player diagnosis with type 2 superior labral anterior posterior lesion. Methods : In this case, patient played amatuer baseball for 2 years, had diagnosis with type 2 Superior labral anterior posterior lesion by MRI after right shoulder Injury. OS recommened arthroscopy surgery. But he receive conservative Korean medicin treatment in Korean medicine hospital, including Atx, BV, herbal acupunture and rehabilitation excersise. Results : After 6 months, in the end of continuous conservative treatment and rehabilitation excersise, patient can play baseball normally, and felt a little pain. But In physical examination, he still has a some abnormal signs. Conclusion : A Conservative treatment for an amatuer baseball player diagnosis with SLAP type 2 was effective in restore of fuctional activities, but usefulness of this treatment needs more study.

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A STUDY OF THE TEMPOROMANDIBULAR JOINT IN NORMAL OCCLUSION USING T.M.J TOMOGRAM AND CEPHALOGRAM (단층 및 두부 방사선 계측사진을 이용한 정상교합자의 악관절에 관한 연구)

  • Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.16 no.1
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    • pp.85-106
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    • 1986
  • The purpose of this investigation was to know the means of the T.M.J. space and to compare spational differences in centric relation and centric occlusion by the T.M.J. Tomogram and to study the correlation between the articular eminence slope and the lingual surface slope of the maxillary central incisor by the Cephalogram in near normal occlusion subjects. These results could give contribution for the diagnosis of orthodontic treatment and T.M.J. dysfunction and the assessment of orthopedic treatment and orthognathic surgery. 44 young adults (28 men and 16 women, 21 to 27 years of age) were selected from the Dental students in Yonsei Univ. Criteria for selection was normal occlusion, no clinical signs and T.M.J. dysfunction, no history of orthodontic treatment, and no missing tooth. After submental vertex view analysis. each subject was given the T.M.J. Tomogram in centric relation and centric occlusion and the Cephalogram was given with Quint Sectograph. All data was recorded and statistically processed with the CYBER computer system. Results were analyzed: the following findings and conclusions were derived. 1. The mean value for the combined right and left anterior joint space was 2.549mm, the posterior space was 2.260mm, and superior space was 3.31mm in centric relation. The anterior space was 2.316mm, posterior space was 2.474mm, and superior space was 3.435mm in centric occlusion. 2. In the centric relation position, both condyles were placed more posterioly and superioly in their fossae than in the centric occlusion position by the spatial difference. 3. In the centric occlusion position, both condyles were more symmetrically placed in their fossae with equal anterior-posterioly rather than in the centric relation position. 4. The mean articular eminence angle was $48.19^{\circ}$ and the mean fossa height was 7.911mm. A strong positive correlation between the articular eminence angle and fossa height in T.M.J. Tomogram was found. 5. In Cephalometric analysis, there was a strong positive correlation between the articular eminence slope and the lingual surface slope of the upper central incisor to the FH plane, occlusal plane, and S-N plane. 6. There was moderate positive correlation between the S-E measurements and the fossa height, articular eminence angle, and DcGn < F-H.

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