Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제30권6호
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pp.488-496
/
2004
Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.
Because of the prominence of the nose and its central location, it is the most frequently encountered fractures in the face. Yet reports about the nasal bone fractures are virtually rare in the oral and maxillofacial surgical literatures. This is a retrospective study on 19 nasal bone fractures treated in Chosun university hospital Department of Oral & Maxillofacial Surgery from Jan. 1991 to Sep. 1993, under admission to our Dept. and the obtained results were as follows. 1. Of the 240 patients with facial bone fractures, 28 patients suffered nasal fractures(12%) and male to female ratio was 5.3:1. 2. The most frequent cause was traffic accidents(39%)m, the next fall down(36%), first blow(4%). 3. The age frequency was the highest in the fifth decade (32%). 4. Clinical classification of nasal fractures was simple fractures(74%), combined fractures(26%), and single fractures(37%), combined fractures(63%). 5. The most frequently combined site was maxilla(50%). 6. Treatments of nasal fractures were closed reduction(63%), open reduction(5%), and secondary rhinoplasty(32%). 7. The initial treatment time from accident was 1.7 days in single fractures, and 3.5 days in combined fractures, and the period of splint retained was about 8.2 days in single fracture, about 8.7 in combined fracture. 8. It was necessary to treat secondarily in delayed treatment, and all treatment methods showed relatively good prognosis. 9. Closed reduction was treated under local anesthesia, but open reduction & secondary rhinoplasty was treated under general anesthesia except 1 case. 10. The complications were disturbance of swellings 5 cases, ethetic problem 5 cases, epiphora 3 cases, abnormal sensation 6 cases in relation with other fractures.
Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.
Park, Keun Jeong;Kim, Bok Eum;Lee, Jung Eun;Park, YounJung;Kwon, Jeong-Seung;Ahn, Hyung-Joon;Choi, Jong-Hoon
Journal of Oral Medicine and Pain
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제44권4호
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pp.179-182
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2019
Sjögren syndrome (SS) is a chronic autoimmune disease characterized by dryness of the mouth and eyes due to lymphocytic infiltration of the exocrine glands. In American European Consensus Group (AECG) criteria, abnormal salivary gland scintigraphy (SGS) result is one of the objective signs of SS and it has been proposed as a valid and non-invasive alternative approach to functional evaluation of salivary gland, especially in the case when unstimulated whole salivary flow is more than 1.5 mL in 15 minutes or other AECG criteria is unmet. Patients with SS are more likely to have the thyroid disease (TD), but this association remains controversial. We present a case of the use of SGS for diagnosis of primary SS and TD in patients with dry mouth and burning sensation of tongue. Through this case, we suggest the usefulness of salivary scintigraphy for screening TD in addition to diagnosis of SS.
Carpal Tunnel Syndrome(CTS) is a common entrapment neuropathy of the median nerve at the wrist. An Electrophysiologic study has been widely used for the diagnosis of carpal tunnel syndrome. The subjects of this study were 48 cases (88 hands) with clinically suspected carpal tunnel syndrome who underwent electrodiagnostic examination from Jan 1, 2001 to Sep 30, 2001, The results were as follows: 1. Among 48 persons with a clinically suspected carpal tunnel syndrome, 40 patients were female 83.33$\%$ and the patients who are above 60 years old were 37.50$\%$. 2. Electrodiagnostic results were 22 cases (45.84$\%$) with bilateral carpal tunnel syndrome and 10 cases (20.83$\%$) with normal. 3. Physical findings consisted of tingling sensation in 48.86$\%$ of the involved hands, positive Phalen's Sign in 20.46$\%$ of them, thenar atrophy in 15.91$\%$ of them, and weakness in 14.77$\%$ of them. 4. Electrophysiologic studies showed a decreased sensory conduction velocity in 20 cases (22.73$\%$) of total hands, a prolonged latency in 3 cases (3.41$\%$) of them, abnormal sensory and motor fiber in 33 cases (37.50$\%$) of them, and normal in 27 cases (30.68$\%$) of them. Considering above results, we had better make a diagnosis precisely the patients with clinically suspected carpal tunnel syndrome through subjective symtoms, physical examinations, and electrophysiologic studies.
A 18-month-old, male Maltese dog with acute seizure was referred to Veterinary Medical Teaching Hospital, Kyungpook National University. Abnormal neurologic findings included a tendency to fall to the left, turn and circle to the right, negative bilateral menace responses and pupillary light reflexes, and diminished responses to facial sensation testing on both sides. Radiographic signs were normal, except for occipital dysplasia. Magnetic resonance imaging of the brain revealed bilateral asymmetric ventriculomegaly, which is more on left side. Cerebral edema was also suspected. The dog died after 9 days from the onset of seizure, and a necropsy was performed. Histopathologically, the brain lesions in the meninges and the cerebral cortex of this dog was presented. There was severe diffuse nonsuppurative inflammation in perivascular area of the meninges and the cerebral white matter. Based on the results, this case was diagnosed as necrotizing meningoencephalitis in Maltese dog.
We analyzed statistics study in 1695 patients, who had visited to the Dept. of surgery, ophthalmology & otolaryngology Hospital of Downtown Orirental Medicine Kyung Hee University from March, 1996 to July, 1998. The results were as follows. 1. Distribution of ophthalmology, otolaryngology and dermatology classification was $43.48\%\;in\;ophthalmology,\;16.70\%\;in\;rhinology,\;5.72\%\;in\;laryngology,\;17.94\%\;in\;dermatology\;and\;16.17\%$ in otiatrics. 2. Ophthalmology group were $31.93\%$ males and $47.90\%$ females in 10 years old within. In treatment term, opthalmology patients who had treated for 1 month within was $59.70\%$. Strabismus and visual disorder was the most common ophthalmo-disease. 3. Rhinology group were $30.00\%$ males in 10 years old within and $21.56\%$ females in 21-30years old. In treatmentm, rhinology patients who had treated for 1 month within was $53.71\%$. Rhinitis and sinusitis was the most common rhinio-disease. 4. Otiatrics group were $30.54\%$ males in 41-50 years old and $31.78\%$ females in 51-60 years old. In treatment term, otiatries patients who had treated for 1 month within was $53.28\%$. Tinnitus, hearing loss and otitis media was the most common otiatrics-disease. 5. Laryngology group were $29.27\%$ males in 31-40 years old and $28.57\%$ females in 51-60 years old. In treatment term. Laryngology patients who had treated for 1 month within was $91.75\%$ Epipharyngitis and abnormal sensation pharyngolarylgeal region was the most common laryngo-disease. 6. Dermatology group were $39.82\%$ males and $39.79\%$ females in 21-30 years old. In treatment term, dematology patients who had treated for 1 month within was $83.55\%$. Acne and Pruritus was the most common ophthalmo-disease.
Kim, Seo-Yeong;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
Journal of Oral Medicine and Pain
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제44권3호
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pp.103-111
/
2019
Purpose: Patients with taste complaints presenting with various abnormal perceptions and alterations in gustatory function are often encountered in dental clinics. Since taste perception is thought to be influenced by numerous factors including neurological and psychological factors, the gustatory profiles of patients complaining of taste abnormalities should be very different. However, the gustatory profiles based on the clinical subtypes of taste complaints have not been fully studied. This study aimed to better understand the gustatory profiles depending on the clinical subtypes of taste complaints. Methods: Clinical data from 169 patients with complaints of altered taste were retrospectively collected to analyse their clinical and gustatory profiles. These complaints were subdivided into hypergeusia, hypogeusia, and dysgeusia for each taste quality according to the clinical types of these complaints. The gustatory profiles were then established by analysing the detection and recognition thresholds for each taste quality depending on the clinical subtypes of taste complaints. Results: Clinical analysis revealed that patients with taste complaints had widely diverse clinical profiles. There were significant differences between males and females with taste complaints in the prevalence rates of symptoms like dry mouth, tongue coating, and burning sensation. While hypogeusia (76.3%) was the most frequent type of taste complaint, it was revealed that the taste thresholds were not always consistent with the patient's description of gustatory symptoms. Conclusions: Patients with taste complaints exhibited diverse clinical profiles with sex differences. Considering the diversity of the taste complaints, the quantitative gustatory testing methods can be valuable to differentially evaluate the presence and intensity of altered taste in patients with these complaints.
Objectives The purpose of this study was to report a case of a woman diagnosed with post hysterectomy syndrome treated with combined Korean medical treatment. Methods A combination of treatment including chuna manual therapy, pharmacopuncture at the lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month. Progress was assessed using the Numeric Rating Scale, Oswestry Disability Index, EuroQol-5Dimension, and Hot Flush Score before and after treatment. Results After treatment, the symptoms were reduced and the quality of life was enhanced, although there was no improvement in the abnormal sensation in the anterior part of the thigh. No adverse events were observed. Conclusions The findings indicate that a combination of Korean medical treatment can be a safe and effective alternative treatment in reducing LBP and hot flushes after hysterectomy.
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