• Title/Summary/Keyword: Visual complication

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Carotid Cavernous Sinus Fistula with Abducens Nerve Palsy after Le Fort I Osteotomy : A Case Report (상악골절단술 후 외전신경마비를 동반한 경동맥 해면정맥동루)

  • Lee, Won-Hak;Kim, Dong-Ryul;Hong, Kwang-Jin;Lee, Jeong-Gu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.243-248
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    • 2000
  • Carotid cavernous sinus fistula(CCSF) is an abnormal communication at the base of the skull between the internal carotid artery and the cavernous sinus. Fistula is almost associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of fractures through the base of the skull, which cause the laceration of the internal carotid artery near the cavernous sinus. The signs and symptoms of CCSF are pulsating exophthalmosis, orbital headache, pain, orbital or frontal bruit, loss of visual acuity, diplopia and ophthalmoplegia. Angiography reveals a definite CCSF and a detachable balloon embolization is known to be the treatment of choice. Even though carotid cavernous sinus fistula is an uncommon complication after orthognathic surgery, several cases of CCSF due to congenital anomalies, pre-existing aneurysms and abnormally thickened maxillary posterior wall have been reported in the literature. We have experienced a case of CCSF after Le Fort I osteotomy for maxillary advancement in skeletal class III patient and the cause, pathogenesis, diagnosis and treatment of this case.

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Treatment of Acute Calcific Tendinitis of the Shoulder with Barbotage (다발성 탐침술을 이용한 견관절 급성 석회화 건염의 치료)

  • Tae, Suk-Kee;Jung, Young-Bok;Kim, Kyoung-Hwan;Kim, Tae-Ho
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.42-46
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    • 2002
  • Purpose : To analyze the outcome after barbotage and subacromial corticosteroid injection in acute pain attack with calcific tendinitis of the shoulder. Materials and Methods : Twenty-two patients with acute calcific tendinitis were analyzed with average follow-up of Twenty-two months. The shape and size of calcific deposits were classified. The outcome was assessed by UCLA shoulder score and pain in visual analogue scale(VAS). Results : Sixteen patients(73%) had permanent relief of pain. The results assessed by UCLA score were excellent in fourteen patients and good in two patients. Average VAS for pain was 0.6 ± 0.73 (range:0-2). No complication was enccpuntered, but six patients underwent surgical treatment due to lack of improvement or recurrence. Conclusion : Barbotage as a primary treatment in acute calcific tendinits of the shoulder is simple and effective, and therefore should be tried before surgical intervention.

Mid-face Lift with Preauricular Pre-excision Technique (귀 앞 피부 전 절제술을 이용한 중안면 거상술)

  • Lee, Min Woo;Jung, Jae Hak;Kim, Young Hwan;Sun, Hook
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.525-529
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    • 2006
  • Purpose: Facial nerve injury is a rare but feared complication of face lift. Uncertainty as to the depth and vulnerability of the facial nerve in face lift dissection causes some surgeon, particularly novices, to dissect slowly. Excessively thin flaps can be made because of fear of nerve injury, contributing to skin slough. Methods: From September 1998 to February 2003, the authors operated on 34 aging face patients using classical face-lift. We had analysed about quantity of skin removal and degree of elevated flap. The authors have found quantity of skin removal was 1.5-2.0 cm, degree of elevated flap was 40-45 degree on average. Results: The authors performed preauricular pre-excision face-lift technique on 12 aging face patients from July 2003 to Feburary 2005 based on experienced surgery. This technique reduced fear of dissecting skin flap necrosis and facial nerve injury because of firmly attached pre-auricular skin removed in advance. Conclusions: We easily dissected SMAS without visual field disturbance, nerve damage and reduced operation time and bleeding loss compared to classical face-lift.

A Case Report on a Neuromyelitis Optica Patient with Painful Tonic Spasm and Decreased Motor Function Improved by Korean Medicine Treatment Including Dokwhalgisaeng-tang (시신경척수염으로 인한 통증긴장연축과 하지 운동기능 저하를 호전시킨 독활기생탕을 포함한 한의치료 증례 보고 1례)

  • Kim, Du-ri;Yun, Jong-min
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.130-138
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    • 2018
  • Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder of the central nervous system characterized by optic neuritis and longitudinally extensive myelitis. Painful tonic spasm is a common complication of NMO, but there have been no reports about it in Korean medicine studies. In this case, we treated a 53-year-old woman diagnosed with NMO with paraplegia, painful tonic spasm, and decreased visual acuity using Korean medicine treatment, including acupuncture, herbal medicine, cupping, and moxibustion. We measured changes in clinical symptoms using the manual muscle testing (MMT), the numeric rating scale (NRS), the modified Barthel Index (MBI), and the Functional Independence Measure (FIM). After treatment, clinical symptoms were improved. The results indicate that Korean medicine treatment may be effective in the treatment of an NMO patient with paraplegia and painful tonic spasm.

A Case of Cerebral Vasculitis in Henoch-Shönlein Purpura (알레르기성 자반증에 병발한 대뇌 혈관염 1례)

  • Lee, Soo Yeon;Choung, Ju Mi;Hwang, Dong Jin;Eun, So Hee;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1601-1605
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    • 2002
  • Henoch-Sh${\ddot{o}}$nlein Purpura(HSP) is an immuologically mediated systemic vasculitis of small blood vessels affecting predominantly the skin, gastrointestinal tract, joints, and kidneys. Clinical neurological manifestations such as headaches, behavioral changes, mental changes, seizures, and visual loss are described, but neurological complication are rare during the course of HSP. We experienced a case of an 8 year-old male with HSP who presented with seizures. Magnetic resonance imaging(MRI) showed multiple high signal intensity in both cortical and subcortical areas of frontal and parieto-occipital lobes and magnetic resonance(MR) angiogram showed stenosis of cerebral arteries, compatible with MRI and MR angiogram findings of cerebral vasculitis. We report this case with related literature.

Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

  • Kim, Kwang-Yul;Kim, Hyung-Chun;Cho, Sung-Jun;Ahn, Su-Han;Kim, Dong-Seon
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.21-27
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    • 2015
  • Background: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. Methods: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. Results: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. Conclusions: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Surgical Approach to the Oral Cavity and Oropharyngeal Cancer; Visor Flap Approach (구강 및 구인두암의 수술적 접근방법 ; 면갑피판(Visor Flap)의 임상적 평가)

  • Choi Eun-Chang;Choi Yoon-Suk;Kim Dong-Young
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.226-231
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    • 1999
  • Objectives: Visor flap is one of the useful surgical approach to the oral cavity cancer, but the report on its specific indications, advantages and disadvantages is lacking. Material and Methods: Seven patients treated with visor flap for oral cavity and oropharyngeal cancer were reviewed. Result: Visor flap provided excellent visual field to anterior oral cavity without splitting the lip and chin skin. Postoperative cosmesis was satisfactory. One complication associating with this flap was salivary leak through gingivo-labial and gingivo-buccal suture which was successfully repaired. Conclusion: Visor flap is an excellent approach on extirpation of the oral cavity and oropharyngeal cancer in case of combining with segmental mandibulectomy. Especially it was useful for the approach to the anterior floor of the mouth and oral tongue lesion. But, it has no actual advantage over the other approaches in cases without mandibulectomy.

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A Case Report : Complications of Chemotherapy after Curative Resection in Patient with Ovarian Carcinoma IV (근치적 절제술 시행한 난소암 환자에서 항암치료 후유증 치험 1례)

  • Lee, Ji-Hyun;Kim, Gun-Hee;Choi, Chang-Min
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.124-134
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    • 2014
  • Objectives: We designed this study to evaluate the effect of Korean medical treatment on complications of chemotherapy after curative resection in patient with ovarian carcinoma IV. Methods: The patient got total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) on 9/4 and received chemotherapy on 10/7, 10/28, 11/18. During this period, the patient suffered from anorexia, dyspepsia, nausea, weight loss and insomnia. We treated the patient with herbal medicine and acupuncture. The efficacy of treatment was evaluated with visual analog scale (Vas), weight and 36-item short form health survey instrument (SF-36). Results: After treatment, although the scale values went ups and downs according to chemotherapy schedule, abdominal pain Vas changed 7 to 0, weight changed 46 kg to 51 kg. Also, SF-36 scores increased. Conclusions: This case report shows that the Korean medical treatment is useful in the treatment of complications of chemotherapy after curative resection in patient with ovarian carcinoma IV.

Primary orbital tuberculosis on the lower eyelid with cold abscess

  • Yoon, Hyun Sik;Na, Young Cheon;Lee, Hye Mi
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.274-278
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    • 2019
  • Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule ($1.5{\times}1.2cm$) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.

Comparison of postoperative paresthesia after sagittal split osteotomy among different fixation methods: a one year follow-up study

  • Tabrizi, Reza;Bakrani, Kousha;Bastami, Farshid
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.215-219
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    • 2019
  • Objectives: Postoperative paresthesia is a common complication after sagittal split osteotomy (SSO). This study aimed to compare paresthesia among different fixation methods one year postoperative. Materials and Methods: This prospective cohort study assessed subjects in four groups: class II with miniplate fixation (Group 1), class II with three-screw fixation (Group 2), class III with miniplate fixation (Group 3), and class III with three-screw fixation (Group 4). Paresthesia was evaluated one year postoperative based on a 0-10 visual analogue scale. Pearson correlation was used to evaluate associations of age and mandibular movement with paresthesia. ANOVA was used to compare paresthesia among groups. Results: A total of 80 subjects were enrolled, with 20 subjects in each of the four groups. The Pearson correlation test demonstrated a significant correlation between mandibular movement and paresthesia (P=0.001). Comparison of paresthesia among the groups showed significant differences among groups 1 and 2, 2 and 3, and 3 and 4 (P<0.05). Conclusion: The three-screw fixation method led to more paresthesia one year postoperative compared with miniplate fixation. In addition, the magnitude of mandibular movement had a positive correlation with paresthesia.