• 제목/요약/키워드: Surgical technique

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구순열비변형의 이차 교정에 있어서 Bardach 술식의 유용성 (Usefulness of Bardach's Technique for Secondary Correction of Cleft Lip Nasal Deformity)

  • 유선열;구홍;양지웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권5호
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    • pp.406-415
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    • 2010
  • Purpose: The secondary correction of cleft lip nasal deformity still presents a difficult surgical problems. The present study was aimed to investigate the usefulness of Bardach's technique for secondary correction of cleft lip nasal deformity. Materials and Methods: The subjects were eight patients with unilateral and bilateral cleft lip nasal deformity, who had secondary correction by using Bardach's rhinoplasty technique. Age range was from 2 to 21 years and mean age was 10.6 years. There were 3 boys and 5 girls. Six patients had bilateral and two patients had unilateral cleft lip. Facial photographs were taken before and twenty days after the operation. By using Adobe photoshop, the columella height and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. Results: The degree of improvement of the columella length and the nostril width after Bardach's technique was $70.39{\pm}50.14%$ and $-22.93{\pm}0.15%$ respectively. Bardach's technique resulted in projecting the nasal tip, lengthening the columella, medially advancing the alar bases, restructuring the lower lateral cartilages, and changing orientation of the nostrils from horizontal to oblique. The profile view shows projection of the nasal tip, lengthening of the columella, and the change in the nasolabial angle. The scars remained at the philtrum were matter little in compared with improvement of the nasal appearance. Conclusion: These results indicate that Bardach's technique is an useful surgical technique for secondary correction of cleft lip nasal deformity.

The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes

  • Tyler J. Humphrey;Colin M. Baker;Paul M. Courtney;Wayne G. Paprosky;Hany S. Bedair;Neil P. Sheth;Christopher M. Melnic
    • Hip & pelvis
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    • 제35권2호
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    • pp.122-132
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    • 2023
  • Purpose: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique. Materials and Methods: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired. Results: The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement. Conclusion: Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.

피부밑이마당김술 (Subcutaneous Forehead Lift)

  • 이상열
    • Archives of Plastic Surgery
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    • 제37권3호
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    • pp.271-276
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    • 2010
  • Purpose: The purpose is to present an useful and simple surgical method to improve the aging of upper third face in patients with high frontal hairline as well as low frontal hairline. Methods: Forty eight female patients were treated with subcutaneous forehead lift using an anterior hairline incision over 14 years. This surgical technique is performed under direct vision utilizing a beveled incision made 4 to 5 mm into the anterior hairline with subcutaneous dissection, which is continued near to eyebrow, sometimes extended to supraorbital rim to remove corrugator and procerus muscles. In patients with high frontal hairline, excess forehead skin anterior to incision line is removed. On the contrary in the patients with low frontal hairline, scalp posterior to incision line is removed. Results: This technique provided constant and good results with the forty six patients, who were satisfied with eyebrow elevation and removal of wrinkles in forehead and glabellar region. However two patients were undercorrected, and focal alopecia developed in another two patients. One patient complained of pruritus over one year, but subsided spontaneously without any treatment. Temporary paresthesia developed in the forehead and frontal scalp of all cases after operation but permanent sensory loss never occurred in all the patients. Conclusion: Subcutaneous forehead lift using an anterior hairline incision is suggested to be one of the effective surgical methods to improve the aging of upper third face in the patients with high frontal hairline as well as low frontal hairline.

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

  • Im, Joon;Kang, Sang Hoon;Lee, Ji Yeon;Kim, Moon Key;Kim, Jung Hoon
    • 대한치과교정학회지
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    • 제44권6호
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    • pp.330-341
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    • 2014
  • A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

정위적 삼차신경절 고주파열응고술 (Stereotactic Radiofrequency Gasserian Ganglionotomy)

  • 신근만;신삼철;조용노;임소영;홍순용;최영룡
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.183-186
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    • 1996
  • When medical therapy fail to relieve pain at tolerable level for patients confirmed with trigeminal neuralgia, presence of mass lesion excluded, surgery is indicated. Innumerable surgical strategies have been attempted for the treatment of trigeminal neuralgia but only four have proven appropriate: (1)stereotactic radiofrequency gasserian ganglionotomy, (2) percutaneous glycerol gangliolysis, (3) percutaneous microcompression, (4) microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion stems from the efforts of Sweet. This technique is the surgical treatment of choice around the world for surgical treatment for trigeminal neuralgia. Since 1986, over 14,000 cases have been reported utilizing this technique. To improve the treatment method further, an electrode with a flexible curved tip has been developed for easier and more precise electrode placement and lesion production during the thermocoagulation of gasserian ganglion. This operation was performed recently on three patients at Hallym University Hospital. using a curved tip electrode. Complete relief of pain was achieved for all patient. However, some complications were noted.

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개에서 성대 및 성대돌기의 고정에 의한 무성술 (Devocalization of Dogs by Fixation of Vocal Cords and Vocal Processes)

  • 정종태;원상철
    • 한국임상수의학회지
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    • 제15권1호
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    • pp.124-130
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    • 1998
  • This study was performed to evaluate the new surgical technique for debarking. Of the 8 mongrel dogs which underwent devocalization, 4 heads (group 1) received complete surgical removal of the vocal cords and another 4 heads (group 2) received fixation of vocal cords and vocal processes onto the thyroid cartilage. Volume of each dogs' voices was measured by a sound level meter(Function A) over 7 months at intervals of 10 days. All experimental animals'hematological values were measured before operation and postoperative at 2i 5 and 10 days. The changes of volume of dogs'voices and hematological values were analyzed by paired t-test. The volume in the dogs'voices in each group after operation was significantly lower than that before operation. At this results we detected that devocalizing effect was the same in each group. Postoperative volume of dogs'voices in group 1 had a tendency to increaser but group 2 had a tendency to decrease. The number of erythrocytes at 2 days after operation was significantly fewer than those before operation in group 1, but the group 2 did not have significant changes. The number of leukocytes at 2 days after operation significantly increased from those before operation in group 11 but the group 2 did not have significant changes. It was concluded that the new surgical technique, fixation of vocal cords and vocal processes onto the thyroid cartilages could be available for the devocalization of dogs and for the prevention of postoperative inflammation and blood loss.

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가토에서 심낭이완술에 관한 실험적 연구 (Experimental Studies of the Pericardial Releasing Technique in Rabbits)

  • 박만실
    • Journal of Chest Surgery
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    • 제20권3호
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    • pp.451-457
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    • 1987
  • Reoperations following cardiac surgery have an increased risk of the danger of damaging the heart, great vessels or extracardiac grafts because of adhesions to the sternum. We experimentally evaluated 3 different methods for pericardial closure. A standardized procedure for induction of pericardial adhesions was carried out in 30 rabbits. For closure of pericardium, animals were divided into 3 groups, 10 animals respectively: Croup 1 [simple pericardial closure]The pericardium was primarily resuture; Group 2 [Core-Tex surgical membrane as a pericardial substitute]- A Gore-Tex surgical membrane was interposed between the sternum and the heart; and Group 3 [pericardial tension releasing technique]-Three longitudinal overlapping incisions were made on the right side of the pericardium while the midline incison was sutured. Animals were put to death 4 weeks postoperatively and the pericardial space was examined for pericardial adhesions and epicardial reactions. The extent of adhesions and reactions were graded as: I-none; II-minimal; III-moderate; and IV-severe. Histologic studies of the pericardium, the pericardial substitute and the epicardium were also performed. The results were as follows: 1. In group 1 [simple pericardial closure], the degree of pericardial adhesions were grade I in 1 animal, grade II in 2, grade III in 4 and grade IV in 3. Epicardial reactions were grade I in 1 animal, grade II in 3, grade III in 5 and grade IV in 1. Histologic examination revealed thick fibrous tissue that obliterated the pericardial space in 7 animals. 2. In group 2 [Gore-Tex surgical membrane as a pericardial substitute], the degree of pericardial adhesions were grade I in 3 animals, grade II in 3, grade III in 2 and grade IV in 2. The degree of epicardial reactions were grade II in 1 animal, grade III in 5 and grade IV in 4. Histologic studies revealed a thin layer of dense fibrous tissue which covered the Gore-Tex surgical membrane and thick loose fibrous tissue on the epicardium just beneath the substitute. 3. In group 3 [pericardial tension releasing technique], the degree of pericardial adhesions were grade I in 3 animals, grade II in 4, grade III in 2 and grade IV in 1. The degree of epicardial reactions were grade 1 in 4 animals, grade II in 4 and grade III in 2. Severe epicardial reactions were not observed in this group. Histologic examination showed normal epicardium in 4 animals and the epicardium of the other 6 animals only revealed very thin fibrous layer compared to group I and group II. Pericardial adhesions more than grade III were 70% in group 1, 40% in group 2 and 30% in group 3. Pericardial adhesions were reduced in group 2 and group 3 compared to group 1, but statistically not significant. Epicardial reactions more than grade III were 60% in group 1, 90% in group 2 and 20% in group 3. Epicardial reactions were significantly reduced in group 3 compared to group 2. Author`s modified pericardial releasing technique provides marked augment of pericardial surface area and facilitates tension-free pericardial closure. Furthermore, pericardial adhesion and epicardial reaction will be reduced with the pericardial tension releasing technique.

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Surgical Jaw Relator를 이용한 양악 수술 치험례 (Two-jaw surgery by use of Surgical Jaw Relator)

  • 양상덕
    • 대한치과교정학회지
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    • 제35권3호
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    • pp.238-249
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    • 2005
  • 악골부조화가 심할수록 기능향상을 위해 악골 및 치아 치조부에서의 보상반응이 현저해진다. 대표적인 현상으로 하악과두의 변위와 상악교합평면의 변화 등을 들 수 있다. 이러한 상하악골에서의 적응성 변화는 안모의 심미성과 교합의 기능 향상을 위해, 술후 안정성을 높이기 위해서 악교정수술을 통해 반드시 수정해야 할 요소이다 적절한 상악골 수술을 위해서 통상적으로 model surgery를 시행하여 왔으나 이의 단점을 보완하기 위해 Surgical Jaw Relator를 고안하였으며 이는 교합기의 mounting plate 대신에 부착함으로써 상하악 모형의 삼차원적 이동과 회전이 가능하도록 설계되어 있으며 기존의 모든 종류(Panadent. Sam, Denar, Hanau 등)의 교합기에 손쉽게 부착하여 수술용 스프린트의 제작 시간을 대폭 줄일 수 있는 장점이 있다 상악골 상방 이동이 필요한 하악전돌 증례와 상악골 하방 이동이 요구되는 하악후퇴 증례 등에 본 기구를 적용한 결과 양호한 수술 결과를 얻었으며, 이로써 정교한 상악 수술을 요하거나 명확한 수술 계획이 설정된 증례 등에서 본 기구를 적절하게 사용할 경우 수술용 스프린트를 효율적으로 제작하는데 다소 도움이 될 것으로 생각된다.

Applicability of Radioguided Occult Lesion Localization for Non-Palpable Benign Breast Lesions, Comparison with Wire Localization, a Clinical Trial

  • Alikhassi, Afsaneh;Saeed, Farzanefar;Abbasi, Mehrshad;Omranipour, Ramesh;Mahmoodzadeh, Habibollah;Najafi, Massoome;Gity, Masoumeh;Kheradmand, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3185-3190
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    • 2016
  • Background: This study was designed to compare radioguided versus routine wire localization of nonpalpable non-malignant breast lesions in terms of efficacy for complete excision, ease of use, time saving, and cosmetic outcome. Materials and Methods: Patients with non-palpable breast masses and non-malignant core biopsy results who were candidates for complete surgical lumpectomy were enrolled and randomly assigned to radioguided or wire localization groups. Radiologic, surgical, and pathologic data were collected and analyzed to determine the difficulty and duration of each procedure, ease of use, accuracy, and cosmetic outcomes. Results: This prospective randomized study included 60 patients, randomly divided into wire guided localization (WGL) or radioguided occult lesion localization (ROLL) groups. The mean duration of localization under ultrasound guidance was shorter in the ROLL group (14.4 min) than in the WGL group (16.5 min) (p<0.001). The ROLL method was significantly easier for radiologists (p=0.0001). The mean duration of the surgical procedure was 22.6 min (${\pm}10.3min$) for ROLL and 23.6 min (${\pm}9.6min$) for WGL (p=0.6), a non-significant difference. Radiography of the surgical specimens showed 100% lesion excision with clear margins, as proved by pathologic examination, with both techniques. The surgical specimens were slightly heavier in the ROLL group, but the difference was not significant (p=0.06). Conclusions: The ROLL technique provides effective, fast, and simple localization and excision of non-palpable non-malignant breast lesions.

매복치(埋伏齒) 주위(周圍)에 발생(發生)한 치성낭종(齒性囊腫)의 치험례(治驗例) (CASE REPORT ON THE DENTIGEROUS CYST OCCURED TO THE PERIPHERY OF THE IMPACTED SUPERNUMERARY TOOTH)

  • 유근원
    • Restorative Dentistry and Endodontics
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    • 제6권1호
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    • pp.149-152
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    • 1980
  • In this article, we found the dentigerous cyst due to the impacted supernumerary tooth. Involved teeth were treated with immediat canal filling and root resection technique. The cystic walls and its contents were marsupialized and perfectly enucleated with surgical techniques. After the operations, no clinical signs and symptoms were found, Radiographic findings after I months of the operations reveal the decrease of the radiolucency on the surgical field. The author thinks that it indicate the formation of the osteoid tissue.

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