• 제목/요약/키워드: Various surgical approaches

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냉동요법(Cryotherapy)을 이용한 점액낭종(Mucocele)의 치료 (Cryotherapy for Treatment of a Mucocele on Lower Lip)

  • 박혜숙;최종훈;김종열
    • Journal of Oral Medicine and Pain
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    • 제23권3호
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    • pp.249-255
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    • 1998
  • Mucoceles of the minor salivary glands are the most common cystic lesions affected the oral mucosa. They are believed to be the result of trauma to the salivary duct caused, for example, by biting the lip, cheek, or tongue. Surgical excision has been the most common treatment for these lesions, but occasional recurrences develop after excision because surgical trauma may damage the surrounding minor salivary glands Although various alternative nonsurgical approaches, such as steroid infection, application of gamma-linolenic acid, have also been reported, they are not used routinely, Lasers, particularly the carbon dioxide laser, have been used in the management of mucoceles. Although this treatment requires specialized equipment. Cryotherapy is another effective nonsurgical method for treating mucoceles. Clinically, cryotherapy has primarily been applied to the treatment of leukoplakia and hyperplastic, granulomatous, vascular, and pigmented lesions. Limited information, however, is available on the application of cryotherapy in salivary gland lesions, including mucoceles. A simple and easy cryotherapy to treat a mucocele on the lower lip is described. A 25 years old female patient with a mucocele on the lower lip was treated by direct application of liquid nitrogen with a cotton swab. The lesion was exposed to 4 or 5 cycles composed of freezings of 10-30 s and thawings of double the freezing times. No anesthesia was required. The lesion nearly disappeared without scar 10 days after the cryotherapy. Cryotherapy has become an established nonsurgical method, characterized by its simple application, therapeutic effectiveness, painless during the procedure and low incidence of secondary infection and hemorrhage.

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Recent Advances of Therapeutic Targets for the Treatment of Periodontal Disease

  • Kim, Woo Jin;Soh, Yunjo;Heo, Seok-Mo
    • Biomolecules & Therapeutics
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    • 제29권3호
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    • pp.263-267
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    • 2021
  • Periodontal disease is primarily associated with bacterial infection such as dental plaque. Dental plaque, an oral biofilm harboring a complex microbial community, can cause various inflammatory reactions in periodontal tissue. In many cases, the local bacterial invasion and host-mediated immune responses lead to severe alveolar bone destruction. To date, plaque control, non-surgical, and surgical interventions have been the conventional periodontal treatment modalities. Although adjuvant therapies including antibiotics or supplements have accompanied these procedures, their usage has been limited by antibiotic resistance, as well as their partial effectiveness. Therefore, new strategies are needed to control local inflammation in the periodontium and host immune responses. In recent years, target molecules that modulate microbial signaling mechanisms, host inflammatory substances, and bone immune responses have received considerable attention by researchers. In this review, we introduce three approaches that suggest a way forward for the development of new treatments for periodontal disease; (1) quorum quenching using quorum sensing inhibitors, (2) inflammasome targeting, and (3) use of FDA-approved anabolic agents, including Teriparatide and sclerostin antibody.

Current status and evolution of microsurgical tongue reconstructions, part I

  • Choi, Jong-Woo;Alshomer, Feras;Kim, Young-Chul
    • 대한두개안면성형외과학회지
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    • 제23권4호
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    • pp.139-151
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    • 2022
  • Reconstructive surgery in the management of head and neck cancer has evolved to include structure-specific approaches in which organ-specific treatment algorithms help optimize outcomes. Tongue cancer management and reconstruction are surgical challenges for which well-executed reconstructive plans should be completed promptly to avoid delaying any subsequently planned oncologic treatment. Crucial considerations in tongue cancer resection are the significant functional morbidity associated with surgical defects, particularly in terms of speech and swallowing, and the consequent negative impact on patients' quality of life. With the evolution of microsurgical techniques and the development of the perforator flap concept, flap options can be tailored to the characteristics of various tongue defects. This has allowed the implementation of pliable flaps that can help restore tongue mobility and yield subsequent functional outcomes. Using an evolutional framework, we present this series of reviews related to tongue reconstruction. The first part of the review summarizes flap options and flap-related factors, such as volume and tissue characteristics. Related functional aspects are also presented, including tongue mobility, speech, and swallowing, as well as ways to evaluate and optimize these outcomes.

Current Issues in Reduced-Port Gastrectomy: A Comprehensive Review

  • Jong Won Kim
    • Journal of Gastric Cancer
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    • 제24권1호
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    • pp.57-68
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    • 2024
  • Reduced-port gastrectomy (RPG) includes all procedures derived from various efforts to minimize surgical invasiveness, with single-incision laparoscopic gastrectomy (SILG) being the ultimate reduced-port technique. However, there are challenges related to its feasibility, oncological validity, training, and education. This review describes the current issues and challenges, as well as the future prospects of RPG for gastric cancer. Gastrectomy, which started as an open surgery, has evolved into a laparoscopic surgery. With the advancements in laparoscopic technology, SILG has been used to minimize surgical scarring. However, owing to the technical difficulties of SILG, cases involving the addition of 1 trocar or needle grasper alongside the multichannel port have also been reported. Additionally, 3-port laparoscopic gastrectomy (3PLG) using only 3 trocars is also being performed. RPG, as a concept, includes a range of approaches such as SILG, 2-port laparoscopic gastrectomy, and 3PLG. These techniques aimed to reduce the number of ports or incisions required for laparoscopic gastrectomy. Despite technical difficulties, RPGs offer numerous advantages, including minimal invasiveness, excellent cosmetic outcomes, and the potential for improved postoperative recovery, such as reduced length of hospital stay and post-operative pain. It could be considered similar to conventional laparoscopic gastrectomy, and may not be oncologically inferior. Ongoing studies, such as the KLASS 12, are required to gain further insights.

Microsurgical Experience with Supraorbital Keyhole Operations on Anterior Circulation Aneurysms

  • Park, Heung-Sik;Park, Sang-Kyu;Han, Young-Min
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.103-108
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    • 2009
  • Objective: Conventional pterional approach is a commonly used neurosurgical technique for the treatment of cerebral aneurysms. However, this technique requires more extensive brain exposure than other key hole approaches and is sometimes associated with surgical traumatization or cosmetic problems. The aim of this study was to compare the postoperative outcome between pterional and supraorbital keyhole approaches in the patients with anterior circulation aneurysms. Methods: The authors reviewed patients with anterior circulation aneurysms who underwent aneurysm clipping via pterional or supraorbital keyhole approach at a single institute over a period of 2 years. Ninety-eight patients harboring 108 aneurysms were included in this study. Various outcomes were recorded, which included clinical grade, cosmetic problems, patients' satisfaction and complications such as chewing discomfort, frontal muscle weakness, hyposmia, infection. Results: The supraorbital approach exhibited a shorter operation time compared with the pterional approach. Complications such as chewing discomfort occurred less frequently in the supraorbital approach group. Moreover, the cosmetic outcome was significantly better in the supraorbital group than in the pterional group. Conclusion: The supraorbital keyhole approach reduced intra- and postoperative complications, including chewing discomfort and cosmetic disturbances, compared with the conventional pterional approach.

정기구학 및 역기구학을이용한하지 교정절골술 계획 생성 (Surgical Planning in Deformity Correction Osteotomies using Forward Kinematics and Inverse Kinematics)

  • 정지원;이승열;윤기범;박문석;이제희
    • 한국컴퓨터그래픽스학회논문지
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    • 제20권1호
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    • pp.1-11
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    • 2014
  • 뇌성마비에서 나타나는 하지 변형은 정상 보행 및 자세 유지에 어려움을 준다. 이를 교정하기 위해 임상의는 변형 정도를 측정하여 교정 절골술 계획을 수립하고 계획된 정도만큼 절골술을 시행한다. 그러나 절골술 시행 후 원래 계획보다 더 적거나 더 많이 교정되는 상황이나 의도치 않았던 변형이 발견되는 상황이 종종 발생한다. 이러한 문제 상황들이 발생하는 이유는 절골술 계획수립 시, 기존의 방법이 하지골의 정확한 형태학적 정보를 반영하기 어렵고 하지골을 절골하여 회전 시키는 정도에 따라 최종 결과가 어떻게 나오는지 사전에 예측하는 것이 쉽지 않으며 효과적인 교정 결과를 얻을 수 있는 절골술 방법, 회전각도 등 다양한 입력 조건의 최적 조합을 찾기가 어렵기 때문이다. 본 논문은 이를 해결하기 위해 컴퓨터 그래픽스 분야의 정기구학, 역기구학 및 최적화 기법을 하지 교정 절골술에 적용하여 임상의가 최적의 절골술 계획을 수립할 수 있도록 하는 방법을 제안한다. 하지 골의 3차원 메쉬 모델을 입력으로 받아 이를 분석하여 하지 특징점을 추출하고 임상지표를 자동으로 계산하여 변형 정도를 파악하는 방법, 하지 골을 대상으로 하는 5가지 교정 절골술의 시뮬레이션을 통해 그 결과를 사전에 예측할 수 있는 방법 그리고 비선형 최적화 문제로 변환하여 최적 교정 절골술 계획을 자동으로 수립하는 방법을 제안한다. 이를 통해 하지 골 교정 절골술과 관련된 거의 모든 경우의 수를 사전에 확인해 볼 수 있어서 종래의 방법보다 훨씬 쉽고 효율적으로 절골술을 계획하고 실행할 수 있을 것이다.

중두개와저 종양에 대한 수술적 치료 (Surgical Approaches to the Middle Cranial Base Tumors)

  • 김일섭;나형균;이경진;조경근;박성찬;박해관;조정기;강준기;최창락
    • Journal of Korean Neurosurgical Society
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    • 제30권9호
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    • pp.1079-1085
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    • 2001
  • Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

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Management of Alveolar Cleft

  • Kyung, Hyunwoo;Kang, Nakheon
    • 대한두개안면성형외과학회지
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    • 제16권2호
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    • pp.49-52
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    • 2015
  • The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.

Correction of Posttraumatic Enophthalmos

  • Hazani, Ron;Yaremchuk, Michael J.
    • Archives of Plastic Surgery
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    • 제39권1호
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    • pp.11-17
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    • 2012
  • Management of posttraumatic enophthalmos can present as a challenge to the reconstructive surgeon, particularly in cases of late presentation. This article reviews the pertinent anatomy of the orbit, diagnostic modalities, indications for surgery, and surgical approaches as they relate to the treatment of posttraumatic enophthalmos. Internal orbital reconstruction has evolved to an elegant procedure incorporating various biologic or alloplastic implants, including anatomical pre-bent implants. Successful repair of late enophthalmos has been demonstrated in multiple recent studies and is likely related to the precision with which orbital anatomy can be restored.