• 제목/요약/키워드: Surgical guidance

검색결과 106건 처리시간 0.024초

실시간 광유도 성대주입술의 개발과 임상적 적용 (Development and Clinical Application of Real-Time Light-Guided Vocal Fold Injection)

  • 허진;차원재
    • 대한후두음성언어의학회지
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    • 제33권1호
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    • pp.1-6
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    • 2022
  • Vocal fold injection (VFI) is widely accepted as a first line treatment in treating unilateral vocal fold paralysis and other vocal fold diseases. Although VFI is advantageous for its minimal invasiveness and efficiency, the invisibility of the needle tip remains an essential handicap in precise localization. Real-time light-guided vocal fold injection (RL-VFI) is a novel technique that was developed under the concept of performing simultaneous injection with precise placement of the needle tip under light guidance. RL-VFI has confirmed its possibility of technical implementation and the feasibility in injecting the needle from various directions through ex vivo animal studies. Further in vivo animal study has approved the safety and feasibility of the procedure when various transcutaneous approaches were applied. Currently, RL-VFI device is authorized for clinical use by the Ministry of Food and Drug Safety in South Korea and is clinically applied to patients with safe and favorable outcome. Several clinical studies are currently under process to approve the safety and the efficiency of RL-VFI. RL-VFI is expected to improve the complication rate and the functional outcome of voice. Furthermore, it will support laryngologists in overcoming the steep learning curve by its intuitive guidance.

가상현실을 이용한 수술 전 안내 및 수술실 환경 체험이 수술 전 정보만족도와 불안 감소에 미치는 효과 (The Effect of Preoperative Guidance and Operating Room Environment Experience Using Virtual Reality on Satisfaction with Preoperative Information and Anxiety Reduction)

  • 오인옥;백은정;정지윤;최은영;김종희;김치향
    • 동서간호학연구지
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    • 제30권1호
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    • pp.51-59
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    • 2024
  • Purpose: The purpose of this study was to determine the effect of preoperative guidance and operating room environment experience using virtual reality on increasing satisfaction with information and reducing anxiety in preoperative patients undergoing general anesthesia and local anesthesia. Methods: A non-equivalent control group quasi-experimental design was employed. The participants were 80 surgical patients from 4 wards (40 experimental group and 40 control group) of the general hospital located in Gyeonggi-do. Data collection was conducted from June to November 2023 after completing the control group survey in January 2023. Data were analyzed using Chi-square, t-test, and Mann-Whitney U test using SPSS 23.0 program. Results: Satisfaction with preoperative information was higher in the experimental group than that of the control group. Additionally, anxiety related to surgery in the experimental group was significantly lower than that of the control group. The preoperative state anxiety score in the experimental group was not significantly lower than that of the control group. Conclusions: These results suggest that providing patient education and information using virtual reality technology can not only alleviate patients' anxiety related to surgery, but also have the potential to be used as an effective intervention to improve positive patient experiences.

Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association

  • Seungchul Han;Pil Soo Sung;Soo Young Park;Jin Woong Kim;Hyun Pyo Hong;Jung-Hee Yoon;Dong Jin Chung;Joon Ho Kwon;Sanghyeok Lim;Jae Hyun Kim;Seung Kak Shin;Tae Hyung Kim;Dong Ho Lee;Jong Young Choi
    • Korean Journal of Radiology
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    • 제25권9호
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    • pp.773-787
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    • 2024
  • Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the first-line treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.

근단 변위 판막술을 이용한 상악 영구 절치의 맹출 유도 (ERUPTING GUIDANCE OF IMPACTED MAXILLARY PERMANENT INCISOR WITH APICALLY REPOSITIONED FLAP)

  • 임예진;김영진;김현정;남순현
    • 대한소아치과학회지
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    • 제37권4호
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    • pp.512-518
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    • 2010
  • 임상적으로 흔히 관찰되는 상악 영구 전치의 매복은 대부분 치조골 순측에 매복되어 있다. 치조골의 순측에 매복되어 정상적인 맹출을 기대할 수 없을 때, 매복 원인을 제거 후 관찰하거나 필요시 외과적 노출술 또는 교정 장치물을 부착하여 교정적인 견인을 고려할 수 있다. 일반적으로 매복치아가 치조점막부에 위치하거나, 치조골내 깊이 매복되어있는 경우, 단순히 치은절제술과 치조골 제거에 의한 매복치의 외과적 노출은 부착치은 폭경의 감소, 치은염 발생, 변연 치조골 상실 등을 초래할 수 있다. 따라서 치아를 외과적으로 노출시키고 교정 장치물을 부착시킨 후 다시 판막을 피개하는 폐쇄 맹출법으로 교정적 견인을 하는 것이 일반적이다. 그러나 매복 치아가 가동성 점막 직하방에 존재한다면 근단 변위 판막술을 통해, 단순히 치은의 절제를 통한 노출시 발생하는 합병증을 방지할 수 있고, 매복치의 맹출 유도를 더 용이하게 시행할 수 있다. 본 증례는 상악 영구 절치의 미맹출을 주소로 본원에 내원한 환아들을 대상으로 하여 근단 변위 판막술을 시행한 결과 부착치은의 상실없이 맹출 유도를 얻고 심미성에서 양호한 결과를 얻을 수 있어 보고하는 바이다.

비정상 맹출로와 치근 만곡을 지닌 매복 상악영구전치의 자가치아이식 치험례 (SURGICAL REPOSITIONING OF THE DISPLACED IMPACTED MAXILLARY CENTRAL INCISOR WITH DILACERATED ROOT : CASE REPORT)

  • 이예리;최성철;박재홍;김광철
    • 대한소아치과학회지
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    • 제35권3호
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    • pp.516-522
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    • 2008
  • 매복치의 치료는 그 발생원인, 치아의 발육단계, 매복된 위치 및 맹출 경로, 환자의 협조도 등을 고려하여 치료방법을 결정한다. 일반적으로 맹출에 영향을 줄 수 있는 유전적, 전신적 유발인자가 있다면 이의 치료와 더불어 맹출 유도를 위한 조기치료의 필요성이 있으며, 맹출에 장애를 주는 물리적 요소가 존재한다면 이를 우선적으로 제거해야 한다. 그러나 맹출과 관련된 어떠한 요인이나 맹출공간 부족 등이 발견되지 않았다면 유치 발거 이외에 치아를 외과적으로 노출시킨 후 교정장치를 부착하고 교정력을 이용하는 치아맹출 유도법, 그리고 매복치를 외과적 재위치 또는 이식하는 방법을 사용할 수 있다. 자가치아이식술을 시행할 경우 치아발육 상태를 고려한 적절한 시기의 선택, 적절한 치조와 형성 및 이식치아의 발거와 식립에 있어 외상의 최소화 등이 성공에 중요한 요소다. 본 증례에서는 상악우측중절치의 미맹출을 주소로 내원한 7세 여자 환자에서 CT검사결과 상악우측중절치의 치관부가 전비극에 근접하여 협측으로 위치되어 있으며 치관부에서 만곡이 관찰되었다. 치근은 Nolla's stage 7정도의 발육을 보였으며 이에 자가치아이식을 시행하였다. 주기적인 관찰결과 치근흡수 등의 합병증 없이 양호한 치유양상이 관찰되었다.

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사이버나이프를 이용한 수술 불가능한 재발성 구강암의 치험례 (CYBERKNIFE RADIOSURGERY FOR INOPERABLE RECURRED ORAL CANCER)

  • 김용각;이태희;김철;김성진;김혁
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.65-68
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    • 2004
  • CyberKnife is a stereotactic radiosurgery system which could be used to treat many tumors and lesions. It provides the surgeon unparalleled flexibility in targeting using a compact light linear accelerator mounted on a robotic arm. Advanced image guidance technology tracks patient and target position during treatment, ensuring accuracy without the use of an invasive head frame. CyberKnife with Dynamic Tracking Software is cleared to provide radiosurgery for lesions anywhere in the body when radiation treatment is indicated. It has often been used to radiosurgically treat otherwise untreatable tumors and malformations. Moreover, this instrument treats tumors at body sites, most of which are unreachable by other stereotactic systems. Compared with conventional radiotherapy, it is fundamentally different that using non-invasive, frameless, no excessive radiation exposure to normal tissue. In oral malignant neoplasm, surgical excision and radiation therapy should be tried first, additionally chemotherapy could be considered. However, after failure of conventional therapies, patients had poor systemic condition and surgical limitation. So, CyberKnife could be a suitable therapy. A 49 years man was referred in recurred mandibular cancer treated by radiotherapy. The tumor was considered inoperable, because of extensive invasion and was not expected to good response to conventional therapies. We experienced a case of CyberKnife after 4 cycle chemotherapies, so we report it with review of literature.

요추 추간판 탈출증에서 Dekompressor(R)를 이용한 경피적 수핵 감압술 (Percutaneous Discectomy of Herniated Intervertebral Disc with a Dekompressor(R))

  • 조외경;김찬;한경림;이현호;조혜원
    • The Korean Journal of Pain
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    • 제18권2호
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    • pp.192-197
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    • 2005
  • Background: Radicular pain, associated with herniated intervertebral disc, has been treated with either conservative treatments or a traditional surgical discectomy. Several modalities for minimally invasive percutaneous procedures have been developed as alternatives to a surgical discectomy. Percutaneous decompression using a $Dekompressor^{(R)}$ probe has been recently introduced. Herein, we report the outcome of percutaneous decompression with a $Dekompressor^{(R)}$ for the treatment of a herniated intervertebral disc. Methods: Between August 2004 and April 2005, percutaneous decompression was performed using a $Dekompressor^{(R)}$, 1.5-mm percutaneous lumbar discectomy probe in 17 patients with a herniated lumbar intervertebral disc resistant to conservative treatments, with the results reviewed retrospectively. The procedure was performed under fluoroscopic guidance after local anesthesia. Disc access was gained with a posterolateral approach on the symptomatic side and intradiscal placement of the discectomy probe in the herniated disc confirmed from the anteroposterior and lateral views on the fluoroscopy. Results: We obtained satisfactory clinical results in 14 patients with a decrease in the initial Visual analogue scale (VAS) of more than 55% and the elimination or reduction of analgesic medication, with a follow-up of 3 to 11 months. Conclusion: We concluded that a percutaneous discectomy with a $Dekompressor^{(R)}$ probe might be an effective alternative for the treatments of painful disc herniations resistant to conservative managements when performed under proper selection criteria.

역위 매복된 상악 중절치의 교정적 처치를 통한 치근 형성유도 (GUIDANCE OF ROOT FORMATION BY FORCED ERUPTION FOR INVERTED MAXILLARY CENTRAL INCISOR)

  • 장은영;임광호;이창섭;이상호
    • 대한소아치과학회지
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    • 제26권4호
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    • pp.644-651
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    • 1999
  • 미맹출된 상악 중절치는 비교적 흔히 임상에서 8세이상의 아동에서 관찰될 수 있다. 맹출실패의 원인으로는 치배의 비정상적인 발육이 언급되는데 아직 명백히 밝혀지지는 않았지만, 이는 외상이나 선행유치의 치근단 감염으로 유발될 수 있다. 본 증례는 외상의 병력이 없어 유치의 치근단 감염에 의한 상악 중절치의 매복을 고려해 볼 수 있다. 치아의 맹출과 Hertwig's epithelial root sheath 에 의한 지속적인 치근 발육을 유도하기 위해서는 외과적 노출과 가철성 장치를 이용한 교정적 견인이 치료방법으로 시행될수 있다. 본 증례는 역위 매복으로 인해 치근의 만곡이 예상되며 치근의 발육이 지연된 치아를 치근형성 전 조기에 가철성 장치를 이용한 교정적 견인에 의해 정상적인 맹출과 인접치와 유사한 치근 발육이 얻어졌다. 하지만 향후 완전한 치근 형성 유무에 대한 주기적인 검진과 부착치은 획득을 위한 치주적인 처치가 필요하리라 사료된다.

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Guidance and rationale for the immediate implant placement in the maxillary molar

  • Kezia Rachellea Mustakim;Mi Young Eo;Ju Young Lee;Hoon Myoung;Mi Hyun Seo;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제49권1호
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    • pp.30-42
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    • 2023
  • Objectives: While the reliability of immediate implant placement in the maxillary molar has been discussed, its significance is questionable. There have been no guidelines for case selection and surgical technique for successful treatment outcomes of immediate maxillary molar implants. Therefore, in this study, we classified alveolar bone height and socket morphology of the maxillary molar to establish guidelines for immediate implant placement. Materials and Methods: From 2011 to 2019, we retrospectively analyzed 106 patients with 148 immediate implants at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Inclusion and exclusion criteria were applied, and patient characteristics and treatment results were evaluated clinically and radiologically. Results: A total of 29 tapered, sand-blasted, large-grit, and acid-etched (SLA) surfaces of implants were placed in 26 patients. The mean patient age was 64.88 years. Two implants failed and were reinstalled, resulting in a 93.10% survival rate. Fluctuating marginal bone level changes indicating bone regeneration and bone loss were observed in the first year following installation and remained stable after one year of prosthesis loading, with an average bone loss of 0.01±0.01 mm on the distal side and 0.03±0.03 mm on the mesial side. Conclusion: This clinical study demonstrated the significance of immediate implant placement in maxillary molars as a reliable treatment with a high survival rate using tapered SLA implants. With an accurate approach to immediate implantation, surgical intervention and treatment time can be reduced, resulting in patient satisfaction and comfort.

외상 후 발생한 얕은관자동맥 가성동맥류의 치험례 (A Case Report of Posttraumatic Pseudoaneurysm of the Superficial Temporal Artery)

  • 김남훈;양정열;천지선;김규보
    • 대한두개안면성형외과학회지
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    • 제11권1호
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    • pp.49-52
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    • 2010
  • Posttraumatic pseudoaneurysm of the superficial temporal artery is very rare and occurs secondary to trauma. Clinical diagnosis is based on past history of trauma and physical examination and can be confirmed by duplex ultrasonogram, digital subtraction angiography, CT and MRI. Ligation of proximal and distal ends of the superficial temporal artery and excision of the pseudoaneurysm has been the standard treatment. Compressive therapy, endovascular coil embolization, percutaneous thrombin injection under ultrasound guidance have been reported as alternative treatment methods. When surgical excision of the superficial temporal artery pseudoaneurysm is performed, surgeon must be concerned about the anatomical relation between superficial temporal artery and temporal branches of the facial nerve. In this article, we report a rare case of superficial temporal artery pseudoaneurysm with some review of the literatures about anatomical relation between superficial temporal artery and temporal branches of facial nerve.