• Title/Summary/Keyword: Surgical result

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SURGICAL STENT FABRICATION AND CLINICAL APPLICATION FOR ORTHOGNATHIC SURGERY USING Cone-Beam CT (Cone-Beam CT를 이용한 악교정 수술용 스텐트 제작과 임상 적용)

  • Kim, Yong-Il;Kim, Jong-Ryoul;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.158-166
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    • 2009
  • The application of CT with basis on 3 dimensional-reconstruction is getting more widely practiced. With the data obtained from cone-beam computed tomography(CBCT), not only the diagnosis of the patient with skeletal abnormality but also the virtual simulation of the orthognathic surgery were performed and its application would be popular in orthodontic field. We reported a case, a 19-year old man who was diagnosed mandibular prognathism and required orthognatic surgery. In this case, the virtual orthognathic surgery was simulated and surgical wafer was fabricated by using CBCT data. That wafer was applied the actual orthognathic surgery. After preoperative orthodontic treatment, we prepared surgery as follows. : (l)Acquisition of 3D image data, (2)Reconstruction of 3-dimensional virtual model, (3)Virtual model surgery, (4)Extraction of stere-olithographic image, (5)Check-up for occlusal interference, (6)Fabrication of surgical stent by stereolithography. Bilateral sagittal split ramus osteotomy was operated and used stereolithographic surgical stent. 1 month later, we superimposed CBCT datas of virtual surgery and that of actual surgery, and then compared the result. CT data's application for othognathic surgery yielded satisfactory outcomes.

Clinical crown lengthening procedure using surgical extrusion in esthetic region (심미적 부위에서 외과적 정출술을 이용한 임상 치관 연장술)

  • Lim, Hyun-Chang;Kim, Min-Soo;Hong, Ji-Youn;Jung, Ui-Won;Kim, Chang-Sung;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.38 no.3
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    • pp.557-564
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    • 2008
  • Purpose: Various methods are used in clinical crown lengthening procedure, Esthetic is more important in anterior region than in posterior region. Therefore when performing clinical crown lengthening procedure in esthetic region, clinicians should choose method which doesn't impair esthetic. Surgical extrusion could be a good method to achieve esthetic results. Material and Methods: Two patients were scheduled to clinical crown lengthening procedure in esthetic region. Teeth were extruded with periotome carefully to the intended level. Extruded teeth were anchored with sutures. Sutures are removed after 7day. Restorations were seated after extruded teeth were stabilized. Result: Five to six months later, both cases showed favorable esthetic outcome that were harmonious with adjacent teeth. Conclusion: When clinicians are to do clinical crown lengthening procedure in esthetic region, predictable esthetic outcome could be achieved with surgical extrusion.

Surgical Comparison of Pterional Approach with Interhemispheric Approach for High Positioned Anterior Communicating Artery Aneurysms (고위의 전교통동맥 동맥류에서의 Pterional Approach와 Interhemispheric Approach의 수술적 비교 분석)

  • Park, Kang Hwa;Jo, Chul Min;Kim, Hyung Dong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.197-202
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    • 2001
  • Objective : The purpose of this study is to evaluate and compare surgical results of pterional(fronto-temporal) approach and interhemispheric approach for the high positioned anterior communicating artery aneurysm with our surgical experience. Methods : During the period between May 1990 and May 2001, 263 anterior communicating aneurysms were treated at the department of neurosurgery of Dong-A university hospital. Among them, 175 patients were operated by same operator. Thirty six out of the 175 cases were high positioned anterior communicating artery aneurysms located more than 15mm above the anterior clinoid process. Results : Pterional approaches were applied in 32 cases and interhemispheric approaches were applied in 4 cases of total 36 cases of the high positioned anterior communicating artery aneurysms. The 32 cases of pterional approach resulted in Good Recovery 20/32(63%), Moderate Disability 6/32(19%), Severe Disability 4/32(12%) and Dead 2/32(6%), and 4 cases of interhemispheric approach resulted in GR 3/4(75%) and MD 1/4(25%). Relatively, pterional approach showed poorer result on high positioned anterior communicating artery aneurysm located more than 19mm above the anterior clinoid process with GR 5/13(39%), MD 3/13(23%), SD 3/13(23%) and Dead 2/13(15%). Conclusion : Interhemispheric approach is preferable to pterional approach for certain cases of high positioned anterior communicating artery aneurysm located more than 19 mm above the anterior clinoid process because it provides adequate orientation to the regional anatomy, less retraction of frontal lobe and preservation of the olfactory tract and gyrus rectus without any surgical complications.

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Clipping of Basilar Trunk Aneurysm - Case Report - (뇌기저동맥 체간부에 발생한 뇌동맥류 결찰술 - 증례보고 -)

  • Yang, Tai-Ki;Kim, Chul-Jin;Ahn, Byung-Jo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.128-132
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    • 2001
  • Aneurysm of the basilar artery trunk are rare and the surgical approach is very difficult because of the complexity of surgical anatomy around the basilar trunk and the vulnerable adjacent neurovascular structures. The development of brain CT and MRI makes the accurate diagnosis and produces the improvement of surgical approaches at the lesion of the skull base. One of the surgical approaches of basilar trunk aneurysms, the retrolabyrinthine presigmoid transtentorial transpetrosal approach to the aneurysm of the basilar trunk has some advantages of minimal retraction of cerebellum and temporal lobe, intact auditory and facial nerve function by the preservation of the vestibulocochlear and facial nerves, a preservation of sigmoid sinus and vein of Labbe and a relatively good operation field. We had a good result with this approach for the patient of basilar trunk aneurysm and reported the case with the review of literatures.

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A Case Report of a Surgical Correction of the Mandibular Retrusion (하악골 후퇴증의 외과적 치험례)

  • Im, Nan-Hee;Park, Jin-Ho;Chin, Byung-Rho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.393-399
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    • 1995
  • Mandibular retrusion showing the facial problem with a marked maxillarry incisors protrusion and chin deficiency, resulting in a highly convex profile is uncommon in Korea.. The large incisor overjet and deep-bite create functional limitations and unpleasing esthetic result. The majority of theses cases are susceptible to correction by orthodontic therapeutic methods. But severe Class II retrognathic cases in which orthodontic treatment alone has not been capable of achieving good results. Orthognathic surgery offers several approaches. In this case, mandibular advancement by bilateral sagittal split ramus osteotomy and augmentation genioplasty has a special surgical problems. The suprahyoid muscle gorup are lengthened if the body of the mandible is surgically repositioned anteriorly. Instability of results and relapse return to original position shoud predicted during post-surgical muscular readjustment.. To maintain maximum correction with this technique, it is suggested that the mandibular body be well rotated forward at time of surgical intervention and overcorrected anteriory as much as possible. So, the authors report the case with review of concerned literature.

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A Case Series of Symptomatic Distal Biceps Tendinopathy

  • Lee, Jung Hyun;Kim, Kyung Chul;Lee, Ji-Ho;Ahn, Kee Baek;Rhyou, In Hyeok
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.213-219
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    • 2018
  • Background: The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture. Methods: Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39-69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2-14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer. Results: There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment. Conclusions: Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.

A Study of Orthognathic Surgical Guides with Two-stage Split Path (2단 절개 형태를 가지는 악교정 수술 장치 연구)

  • Min Uk, Kim;Chung Hwan, Park;Ji Hyoung, Rho;Eui Sung, Jung;Young Sang, Park;Dong Guk, Kim;Yohan, Seo;Young Jea, Woo;Jong Min, Lee
    • Journal of Biomedical Engineering Research
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    • v.43 no.6
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    • pp.382-389
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    • 2022
  • In this study, the accuracy of the orthognathic surgical guides with single-stage split path was upgraded to realize orthognathic surgical guides with two-stage split path and simulated surgery was performed to verify its accuracy. As a result, the average error distance between the simulation model and the scan model was + 0.289 / - 0.468 mm (standard deviation 0.128), which was confirmed to be within ± 0.5 mm, which is a clinically acceptable level. Also, there was no significant difference compared with the average value of + 0.313 / - 0.456 mm (average standard deviation 0.106) of the conventional single-stage split path type device. It is judged that the use of this device can contribute to the reduction of surgical time and increase in accuracy since a separate finishing operation for bone preparation is unnecessary.

Surgical Resection and Polypropylene Mesh Reconstruction for Canine Chest Wall Soft Tissue Sarcoma

  • Youngsoo Hong;Youngrok Song;Woojin Song;Myung-Chul Kim;Joo-Myoung Lee;Hyunjung Park;Jiwhan Moon;Jongtae Cheong
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.24-29
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    • 2024
  • A 6-year-old spayed female French Bulldog presented with a left-sided chest wall tumor. Physical examination revealed that the tumor was firmly adhered to the chest wall. A preoperative punch biopsy of the tumor revealed a grade 2 soft tissue sarcoma (STS). On computed tomography, the tumor's dimensions were assessed as 6.5 × 5.7 × 3.5 cm, and it exhibited invasiveness near the tissue surrounding the ninth rib. The tumor size was large in comparison to the dog's chest wall area. Hence, if the traditional wide-margin resection surgery were to be performed, primary wound closure seemed impractical and could potentially result in respiratory function complications. Therefore, considering the extent of tumor invasion and grade, deep margins were established to include the removal of the eighth to tenth ribs, and a 1-cm lateral margin was designated to enable primary wound closure. To reconstruct the chest wall, polypropylene mesh was attached to the adjacent ribs and the remaining muscles were sutured and covered over the mesh. The dog exhibited a rapid recovery beginning the day after the operation. Postoperative biopsy confirmed that the tumor was a grade 2 STS, and the surgical margins were evaluated as incomplete. The owner chose to pursue follow-up observation instead of chemotherapy. In this study, the surgical approach was chosen based on the importance of functional recovery after surgery. Recent research indicates that the tumor grade is more critical for postoperative prognosis than the extent of surgical margins when removing an STS.

THE ERUPTION GUIDANCE OF IMPACTED MAXILLARY ANTERIOR TEETH (맹출장애를 보이는 상악 전치의 맹출유도)

  • Sim, Jeung-Ho;Eum, Jong-Hyeok;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.34-40
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    • 2004
  • Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

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External Fixation of Retaining Ligament in Correction of Facial Disfigurement in Type-1 Neurofibromatosis Patients (유지 인대의 외부 고정을 통한 제1형 신경섬유종증 환자의 안면부 변형 교정)

  • Myung, Yu-Jin;Lee, Yoon-Ho
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.257-262
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    • 2011
  • Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.