• 제목/요약/키워드: Surgical therapy

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매복된 중절치의 재식 (SURGICAL REPOSITIONING OF AN IMPACTED INCISOR IN MIXED DENTITION)

  • 최수미;이긍호;최영철;박재홍
    • 대한소아치과학회지
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    • 제32권4호
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    • pp.687-692
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    • 2005
  • 매복치는 인접치의 이동 및 치근흡수, 악궁의 공간상실, 치성낭종 형성, 부분맹출에 의한 감염, 전위맹출 등 여러 가지 합병증을 유발할 수 있다. 이를 방지하기 위해 매복치의 발육상태, 모양 매복된 위치나 각도에 따라 발치, 외과적 노출 및 교정적 견인, 재위치 및 치아이식 등을 시행할 수 있다. 본 증례는 상악 좌측 중절치의 맹출장애를 주소로 본과에 내원한 환아로, 내원 당시 상악 좌측 중절치는 치조골 내에서 정상적인 맹출 경로를 이탈하여 역위 매복되어 있었다. 역위된 정도를 고려했을 때 외과적 견인 및 노출을 이용한 교정적 처치를 수행하기보다는 재식시키는 것이 바람직할 것으로 판단하였다. 치아를 발거하여 치근 부위의 치낭이 건전함을 확인하고 정상적인 치조와 내로 재식한 후 resin-wire splint로 1주일간 고정하였다 치아의 생활력이 건전하고 치근형성이 미약하여 치수에 퍼한 처치는 하지 않았으며 그 후 일년 동안 주기적인 관찰을 시행하여 치근의 성장이 양호함을 확인하였다. 매복된 영구치의 매복된 위치나 각도가 정상 범주에서 지나치게 벗어나 예후가 불확실하더라도 무조건 발치하기보다는 환자와 보호자의 심리적인 면, 저작기능, 심미성 등을 고려하여 더욱 보존적인 시술을 하는 것이 바람직할 것이다.

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Management of endometriosis-related infertility: Considerations and treatment options

  • Lee, Dayong;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul
    • Clinical and Experimental Reproductive Medicine
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    • 제47권1호
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    • pp.1-11
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    • 2020
  • Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

Merkel cell carcinoma: A series of seven cases

  • Lee, Yong Woo;Bae, Yong Chan;Nam, Su Bong;Bae, Seong Hwan;Kim, Hoon-Soo
    • Archives of Plastic Surgery
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    • 제46권5호
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    • pp.441-448
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    • 2019
  • Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. Methods We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. Results Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a splitthickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. Conclusions We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.

하악골 과두골절의 처치 (TREATMENT OF CONDYLAR FRACTURE)

  • 조병욱;이용찬;김태영;남종훈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.93-100
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    • 1989
  • This is a report of comparison of condyle fracture treatment by functional treatment and surgical treatment. In cases of functional therapy, mode of action of Activator that we used; By fulcrum of posterior teeth, the mandibular elevators of the opposite side cause the gap in the dental arches to be reduced, while the mandible performs a rotational movement about the fulcrum during which the fracture surface of the large fragment moves downward. Condylar fractures are often seen in association with fractures of other regions of the mandible. In our department, such cases were treated by miniplate and intramaxillary fixation. Surgical treatment of fractures of the mandible condylar were treated by intraoral approach. The result were drawn as follows : 1. Lateral displacement of condyle ; functional therapy with activator. 2. Compound fracture ; miniplate osteosynthesis and physiotherapy. 3. Anteriormedially displacement ; surgical treatment.

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Utility of sodium tetradecyl sulfate sclerotherapy from benign oral vascular lesion

  • Choi, Bo-Eun;Kim, Yongsoo;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제38권
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    • pp.44.1-44.4
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    • 2016
  • Background: Hemangioma and vascular malformation are benign vascular lesions that often occur in cephalic and cervical region. Currently, surgical resection, laser therapy, angiographic embolization, use of steroids, and sclerotherapy are used as treatments. Case presentation: This study reports three cases of benign vascular lesions that are remarkably treated by sodium tetradecyl sulfate (STS) injection, of which occurred in oral cavity and around the mouth. Three percent of STS was diluted with 0.9 % of normal saline, and it was injected to the lesion site at least once. The result of treatment was evaluated based on clinical findings. Conclusion: Surgical treatment of hemangioma and vascular malformation occurred in oral cavity is not normally used because of esthetic issues and potential hemorrhage. On the other hand, sclerotherapy using STS is an effective therapy compare to surgical treatment. Despite the number of STS injection was different for each patient, all three patients had reached satisfactory level through the treatment with gradual diminution of lesions.

구강암 절제를 위한 하악골이단술: 합병증과 기여인자 (MANDIBULOTOMY, A SURGICAL APPROACH FOR ORAL CANCER: ITS COMPLICATIONS AND CONTRIBUTING FACTORS)

  • 변성규;최은창;박원서;이의웅;차인호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권4호
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    • pp.422-426
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    • 2000
  • We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.

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구강 악안면 근막간극 감염에 관한 임상통계학적 분석 (A CLINICO-STATISTICAL ANALYSIS ON THE FASCIAL SPACE INFECTIONS OF ORAL AND MAXILLOFACIAL REGION)

  • 주현호;원동환;이상휘;김일현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권5호
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    • pp.490-496
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    • 2000
  • We have conducted a retrospective study of 224 patients with the diagnosis of oral and maxillofacial infection who had been treated between 1988 and 1999 at Gyeong-Sang National University Hospital. This study was aimed to furnish the data of oral and maxillofacial infection and to aid diagnosis and treatment. The most common fascial space involved, as determined by clinical, radiologic, and operative findings, were the submandibular space(39.4%). The most frequent cause of oral and maxillofacial infection was odontogenic 68.8%. In the odontogenic cause, dental caries was the most common cause. Two-hundred three patients required surgical drainage of the abscess. Seventeen patients needed tracheostomy for airway control. The overall mortality was 0.9% despite aggressive anti-microbial therapy and early surgical intervention. All other patients had an uneventful recovery without major complication except osteomyelitis case(6.0%). The combination of early radiologic diagnosis, effective antimicrobial therapy, and intensive surgical management contributed to the good prognosis.

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사례보고: 수술예방적 항생제 Cefotetan에 의한 아나필락시스 보고 및 World Allergy Organization 가이드라인활용 (Anaphylaxis Induced by Surgical Prophylactic Cefotetan and The Application of World Allergy Organization Guide: A Case Report)

  • 정경래;경은정;이희영;김은영
    • 한국임상약학회지
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    • 제22권3호
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    • pp.268-273
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    • 2012
  • The definition of anaphylaxis is 'a serious, life-threatening generalized or systemic hypersensitivity reaction' and is considered as the life threatening adverse drug reaction. We experienced a case of cefotetan induced anaphylaxis with negative pre-skin test, used for surgical prophylaxis. A 82-year-old female was scheduled for total knee replacement therapy. She had no previous history of allergy and her skin test results were also negative. On her right knee surgery, she underwent cefotetan therapy as a surgical prophylaxis for a week with no problems identified. Next left knee surgery, she also received the prophylaxis of intravenous cefotetan. However, a few minutes later, anaphylactic reaction developed with vomiting, severe hypotension, bronchospasm, and dyspnea. After immediate intensive care treatment, she recovered without significant complications. Though commonly used laboratory data in case reports, such as the specific IgE, tryptase, histamine, or allergic skin prick test were limited, we successfully confirmed anaphylaxis based on clinical criteria for diagnosing anaphylaxis based on WAO 2011 guideline with through concurrent patient°Øs medical history review and the process of identifying the causes.

재생불량성 빈혈 환자의 편평상피세포암 (SQUAMOUS CELL CARCINOMA WITH APLASTIC ANEMIA PATIENT)

  • 이계영;민경인;이주현;김철환
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제27권1호
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    • pp.65-68
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    • 2001
  • The major manifestations of aplastic anemia are characterized by persistent bone marrow aplasia and peripheral pancytopenia due to defective stem cells in which differentiation is not curtailed or preferential elimination of stem cells with self-renewal capacity, which results in serious complications such as bleeding and infection. Recent advances in the therapeutic modalities, such as bone marrow transplantation and immunosuppressive therapy, and in supportive measures as component transfusion and infection control with better quality of antibiotics resulted in an improved survival and subsequently increased possibility of complications which need surgical intervention. Considering the fact that surgery may not only control complications, but offers the opportunity to give effective therapy for aplastic anemia and therefore improves chances for survival, it is strongly suggested that active surgical intervention should be performed. We report a case of patient with aplastic anemia who had been performed surgical intervention of partial maxillectomy for the squamous cell carcinoma on maxilla without serious complications during perioperative and postoperative period.

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후두 양성점막 병변의 수술적 치료 (Surgery of Benign Laryngeal Mucosal Lesions)

  • 진성민
    • 대한후두음성언어의학회지
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    • 제24권2호
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    • pp.83-87
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    • 2013
  • The term "phonosurgery," coined in the early 1960s, refers to surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (endoscopic microsurgery of the vocal folds), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection of medications as well as synthetic and organic biologic substances), and reinnervation of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. The purpose of the surgery is usually to improve the vibratory characteristics of the layered microstructure of the vocal folds. Phonomicrosurgery has developed from convergence of microlaryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

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