• 제목/요약/키워드: Various surgical approaches

검색결과 79건 처리시간 0.03초

소아 후두기관 협착의 치료 (Management of Pediatric Laryngotracheal Stenosis)

  • 이윤세
    • 대한후두음성언어의학회지
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    • 제33권3호
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    • pp.123-129
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    • 2022
  • Pediatric laryngotracheal stenosis occurs by either congenital or acquired causes and usually indicates subglottic stenosis. The main goals of treatment are decannulation, preserving phonation, and normal swallowing function. Various types and degrees of stenosis and combined anomalies would be the main barriers to reaching successful treatment results unless comprehensive understanding of stenosis. Multidisciplinary team approaches encompassing initial assessment, treatment, and postoperative care, are also necessary to achieve the best treatment outcome. Therapeutic approaches are divided into conservative, endoscopic, and open surgical approaches at length, which are not exclusive to each other. Here, an adequate selection of each therapeutic option and postoperative management will be introduced to achieve decannulation without leaving phonatory or swallowing complications.

남성수태조절법의 신지견 (Evaluation of Male Contraception in Korea)

  • 이희영
    • Clinical and Experimental Reproductive Medicine
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    • 제15권1호
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    • pp.1-9
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    • 1988
  • The contraception practice rate in Korea has steadily increased from 9% in 1964 to 72% in 1987. Accordingly, natural increase rate of population declined from 28.4 per 1,000 in 1964 to 12.4 per 1,000 in 1987. Notably in recent years, the acceptance of surgical contraception services has sharply increased in this country. Now the author analyzes various factors influencing successful vasectomy and vasovasostomy based on his experience in performing more than 8,000 vasectomies and 1,000 vasovasostomies during the past 25 years. These various factors consist of preoperative screening interview, surgical vasectomy technique, vas irrigation technique, open-ended vasectomy, complications from vasectomy, sperm granuloma formation, spermatogenesis and steroidogenesis after vasectomy, immunological consequences after vasectomy, prostatic diseases and vasectomy, late post-vasectomy syndrome, psychological effects after vasectomy, and success rates of vasovasostomy. Besides, the author makes more comments on the results of the clinical trials on new approaches to reversible vas occlusion technique with a new device of Intravasal Thread and to reversible suppression of spermatogenesis with long-acting sex hormones.

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Transfacial Surgical Approaches to Secure Wide Exposure of the Skull Base

  • Kim, Sin Rak;Lee, Jung Woo;Han, Yea Sik;Kim, Han Kyu
    • 대한두개안면성형외과학회지
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    • 제16권1호
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    • pp.17-23
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    • 2015
  • Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.

안와에 발생한 거대 해면상 혈관종 증례보고 (Large Orbital Cavernous Hemangioma: A Case Report)

  • 배상모;정재학;김영환;선욱
    • Archives of Plastic Surgery
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    • 제33권3호
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    • pp.388-391
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    • 2006
  • Hemangioma is one of the most common congenital tumors in the region of the face and neck. Although histologically benign, these facial masses are clinically malignant for their deforming and inexorable growth, especially in so-called 'cavernous hemangioma'. Carvenous hemangioma is the most common primary tumor occurring in the adult orbit. This tumor has symptoms that characteristically develop over several years with slowly progressive proptosis, eyeball deviation, hyperopia, diplopia and optic nerve compression. Today, hemangiomas are being treated by various methods; steroids, electrocoagulation, injection of sclerosing agent, cryotherapy, radiation therapy, laser therapy, and surgical treatment, etc. In principle, surgical approaches to the orbit must provide maximum safety and optimal visualization. We have experienced a case of large cavernous hemangioma in the orbit inferolaterally. The surgical treatment of tumor was achieved by the bicoronal approach combined with inferomedial and inferolateral orbitotomy. This surgical approach allows better visualization of the tumor and greater protection of essential anatomic structures. We obtained satisfactory results in terms of aesthetic and functional consideration. We present our case with a brief review of the literature related to orbital cavernous hemangioma.

심실중격결손증의 수술방법이 심실내 전도장애에 미치는 영향 (effect f Technique of repair on the development of intraventricular conduction disturbancees of surgery for ventricular septal defects; Analysis of 218 patients from January 1983 to October 1984)

  • 노준량
    • Journal of Chest Surgery
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    • 제19권2호
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    • pp.232-237
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    • 1986
  • The intraventricular conduction disturbances have been documented after correction of ventricular septal defects by any surgical route but debated its etiology. And so the frequency of conduction disturbances following right ventriculotomy, right atriotomy and pulmonary arteriotomy for closure of ventricular septal defects was compared in various conditions. The present series consists of 218 patients with ventricular septal defects. They had the surgical repair at the Seoul National University Hospital from January 1983 to October 1984. Conduction disturbances were studied with conventional 12 leads electrocardiogram. Of the 218 VSD`s 139 patients were repaired via vertical right ventriculotomy, 45 patients via right atriotomy, 34 patients via pulmonary arteriotomy. 1] Of 218 patients the frequency of RBBB was 26.1% and the frequency of RBBB + LAH was 6.0%. 2] There is no statistical difference between right ventriculotomy group [30.2%] and right atriotomy group [24.4%]. But there is significant difference between right ventriculotomy group and pulmonary arteriotomy group [11.8%] [P<0.05]. 3] In respect to anatomical classification by Kirklin`s method, the frequency of RBBB was higher in type II [32.1%] than in type I [14.9%]. [P<0.05] But in each anatomical type, there is no influence of the various surgical approach on the incidence of postoperative RBBB. 4] The frequency of RBBB was 31.8% in patch closure group and 14.3% in direct closure group. [P<0.05] Although the result suggests that there is no significant difference in various surgical approaches on the incidence of postoperative conduction disturbances, it may be reduced by a new-ventricular approach or a limited incision at right ventricular outflow tract in right ventricular approach.

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Gene Therapy for Oral Cancer

  • Chung, In-Jae
    • Biomolecules & Therapeutics
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    • 제15권4호
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    • pp.273-280
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    • 2007
  • New treatment approaches are needed to improve the effectiveness of oral cancer treatment, since surgical resection of the tumor in oral region causes various oral dysfunctions. The molecular biology of oral cancer has been progressively delineated. Concurrently, gene therapy techniques have been developed that allow targeting or replacement of dysfunctional genes in cancer cells, offering the potential to treat a wide range of cancer. Oral carcinoma is attractive target for gene therapy because of its accessibility. In this article, we review the current status of gene therapy as applied to oral carcinoma.

Successful use of Gasserian ganglion block for maxillo-mandibular fixation in a patient with severe pulmonary dysfunction-a case report

  • Vadhanan, Prasanna
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권5호
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    • pp.331-335
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    • 2020
  • Various anesthetic techniques have been utilized for maxillo-mandibular fixation. We report the case of a patient with bilateral condylar and zygomatic arch fractures who had severe pulmonary dysfunction. The patient was administered bilateral image-guided Gasserian ganglion block through the foramen ovale to achieve surgical anesthesia. The technical details, advantages, and disadvantages of this rather unusual technique are discussed. The procedure could be a feasible technique when performed meticulously in cases where other approaches are deemed difficult.

Intraoral reinsertion after extracorporeal fixation in condylar fracture

  • Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권6호
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    • pp.476-479
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    • 2021
  • For treatment of mandibular condyle fracture, this article introduces the surgical protocol of intraoral reinsertion after extracorporeal fixation. This efficient, anatomically acceptable, extraoral scar-free, and relatively uncomplicated approach for condylar fracture can be compared with conventional extraoral fixation through various approaches. Clinical step-by-step procedures with a scientific basis were described in this technical strategy note.

Evolution and current status of microsurgical tongue reconstruction, part II

  • Choi, Jong-Woo;Alshomer, Feras;Kim, Young-Chul
    • 대한두개안면성형외과학회지
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    • 제23권5호
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    • pp.193-204
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    • 2022
  • Tongue reconstruction remains a major aspect of head and neck reconstructive procedures. Surgeons planning tongue reconstruction should consider several factors to optimize the overall outcomes. Specifically, various technical aspects related to tongue reconstruction have been found to affect the outcomes. Multidisciplinary teams dedicated to oncologic, reconstructive, and rehabilitative approaches play an essential role in the reconstructive process. Moreover, operative planning addressing certain patient-related and defect-related factors is crucial for optimizing functional speech and swallowing, as well as quality of life outcomes. Furthermore, tongue reconstruction is a delicate process, in which overall functional outcomes result from proper flap selection and shaping, recipient vessel preparation and anastomosis, surgical approaches to flap insetting, and postoperative management. The second part of this review summarizes these factors in relation to tongue reconstruction.

관절 내 종골 골절에서 거골하 관절경술의 이용 (Use of Subtalar Arthroscopy in Intra-Articular Calcaneus Fractures)

  • 우인하;박철현
    • 대한족부족관절학회지
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    • 제27권1호
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    • pp.1-6
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    • 2023
  • Displaced intra-articular calcaneal fractures are difficult to treat because of complex anatomy and high soft tissue complications. Various surgical approaches have been introduced to solve these problems, but the treatment remains complex. Recently, clinically and radiographically superior results were reported using a subtalar arthroscopy in reducing the posterior facet in both percutaneous and open approaches. In the percutaneous approach, the arthroscopically assistant percutaneous approach must be selected carefully for mild-to-moderately displaced fractures because of the limited view. In the open approach, there is little evidence of the utility of subtalar arthroscopy. Therefore, intraoperative arthroscopy should always be used in conjunction with fluoroscopy to achieve reduction and assess the internal fixation placement.