• 대한두경부종양학회지
• /
• 제13권1호
• /
• pp.40-44
• /
• 1997

Background: Lateral rhinotomy and medial maxillectomy, an en bloc resection of the medial maxillary sinus, ethmoid sinus with the lamina papyracea, medial orbital floor, and lacrimal fossa-duct, have been advocated for lateral nasal wall neoplasms as a standard approach method. Objective: This report was conducted to investigate the clinical efficacy of lateral rhinotomy and medial maxillectomy for lateral nasal wall neoplasms. Materials and Methods: We retrospectively analyzed clinical data of 31 patients who were treated at department of otolaryngology-head and neck surgery, Catholic university of Korea, school of medicine between 1990 and 1996. Results: Twenty five patients had benign lesions(80.6%). By far, the largest percentage was inverted papillomas(80%, 20/25). Of the six malignant lesions(19.4%), 33.3%(2/6) was squamous cell carcinoma and other lesions were metastatic renal cell carcinoma, adecarcinoma, transitional cell cacinoma, and hemangiopericytoma. There were a 4% recurrence for benign tumors(1/25), 5% especially for inverted papilloma(1/20), and 50% for malignant neoplasms(3/6). The overall complication rate was 9.7%. Conclusion: Despite the various approach for treatment of lateral nasal wall neoplasms including inverted papilloma, we continue to advocate a lateral rhinotomy and medial maxillectomy as the treatment of choice.

• 대한두개안면성형외과학회지
• /
• 제14권1호
• /
• pp.30-35
• /
• 2013

Background: For reconstruction of the mild to moderate medial orbital wall fractures, various surgical approaches have been used. Prior existing W-shaped incision was a direct local approach through a 3 cm incision on the superior medial orbital area with a titanium mesh implant. In this study, the authors modified W-shaped incision and reconstructed the defect with silastic sheet to improve the result and the postoperative scar. Methods: This study included 20 patients who had mild to moderate size of medial wall defect and therefore relatively suitable for reconstruction with silastic sheets from July, 2009 to December, 2011. A modified W-shaped skin incision approximately 1.2 to 1.5 cm in length was made along the superior medial orbital rim from approximately 1 cm medial to the medial canthus to the lower border of the medial eyebrow. The angles of the limbs of the W ranged from 150 to 160 degrees. Results: By using soft flexible silastic sheet, the authors reduced the incision from 3 to 1.5 cm, and by widening the angle of the W limbs, scars were more effectively hided in the relaxed skin tension line. Scar assessment was done with modified patient and observer scar assessment scale and mean score from patients was 2.08 and mean score from observers was 2.12. Conclusion: Although this method will not be suitable for every case, it can be a consistent method to obtain the surgical goal in treatment of mild to moderate blowout fractures of the medial orbital wall.

• Clinics in Shoulder and Elbow
• /
• 제1권2호
• /
• pp.242-249
• /
• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• 대한정형외과학회지
• /
• 제52권1호
• /
• pp.33-39
• /
• 2017

목적: 근위 경비골 및 상완골 절제 시 문제점은 알려져 있으나 소전자부 주위 골연골종의 임상상 및 수술 접근법에 대한 연구는 미약하다. 대상 및 방법: 소전자부 주위 골연골종으로 수술한 환자 13명의 증상 및 증상기간, 종양위치, 축상면상 돌출방향, 크기, 수술 접근법 및 장요근 손상 여부, 접근법에 따른 합병증을 후향적으로 분석하였다. 결과: 증상은 운동 및 보행 시 통증이 7예, 저림 및 방사통이 6예였다. 증상기간은 평균 19개월이었고 평균 크기는 120 ml였다. 후내 측으로 돌출된 종괴 5예에서 도달법은 후외방접근법 3예, 전방접근법 1예, 내측접근법 1예였다. 전내측 종괴 4예는 전방접근법으로 절제하였다. 전내측 및 후내측으로 돌출된 2예는 내측접근법 1예, 전방접근법이 1예였다. 후내측 돌출된 2예를 내측접근법으로 수술 후 피질골 결손으로 내고정술을 시행하였다. 후내측 돌출이 심한 1예에서 전방도달법 절제 후 좌골신경마비로 신경탐색술을 시행하였고 6개월 후 자연 회복되었다. 결론: 소전자부 주위 골연골종이 크고 후방돌출이 심하면 좌골신경 압박을 의심해야 한다. 내측도달법은 종양이 작을 때만 유용하고 전내측 돌출 및 경부에 있을 때 전방도달법이 유리하다. 후방돌출이 심한 큰 종괴에서 후방도달법이 신경손상을 최소화할 수 있는 방법이다.

• 대한두개안면성형외과학회지
• /
• 제10권1호
• /
• pp.55-60
• /
• 2009

Purpose: For blowout fracture of the medial orbital wall, the goals of treatment are complete reduction of the herniated soft tissue and anatomic reconstruction of the wall without surgical complications. Surgeons frequently worry about damage to the optic nerve from the dissection, when the part over the posterior ethmoidal foramen was fractured. The authors performed small incision and inlay grafting for reconstruction of medial orbital wall fracture. Methods: Between January 2007 and April 2008, 15 out of 32 patients were included in an analysing the outcome of corrected medial orbital wall fracture. In 15 patients of posterior comminuted fracture of medial orbital wall, insertion of porous polyethylene($Medpor^{(R)}$ channel implant, Porex, USA) to ethmoidal sinus was performed in multiple layer, through the transconjunctival approach (inlay grafting). Results: In all cases, the orbital bone volume was reconstructed in its normal anatomical position. The associated ocular problems disappeared except for mild enophthalmos in 2 patients and there were no surgical complications associated with inlay grafting. Conclusion: The advantage of inlay grafting include anatomical reconstruction of the orbital wall; the avoidance of optic nerve injury; the simplicity of the procedure; and consequently, the absence of surgery-related complications. This technique is presented as one of the preferred treatments for posterior comminuted fracture of medial orbital wall.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제30권3호
• /
• pp.241-248
• /
• 2008

Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

• 한국실내디자인학회논문집
• /
• 제21권5호
• /
• pp.217-226
• /
• 2012

The purpose of this study had started from trying to look for a new standard in new media era and sounding out possibility of perspective of digital poetry, and had been extracting interpretational elements based on characteristics of otology in digital poetics research in technical method. Through examination of many documentary records, we suggested interpretive elements of medial space based on meaning and the theory of digital poetics. We deduced three perspectives based on relationship between the basic thesis in poetics and interpretive elements of medial space. We used them as tool for analysis of example. We chose as an example that change of program in space is clear through connection of media and space in where new form of creation happens through digital instruments and chose article as subject to which digital technology is applied and had been since 2000, The result of this study is as following: First, epistemological analysis about a space of digital media in new media era requires poetical approach unlike aesthetic approach. We can endow creative action and creation process with significance and pay attention to technical method of manufacturing, stating appropriateness of perspective in digital poetics. Second, the justice of digital poetics and its basic thesis help derive analytic elements from medial space and study purpose of production, technical method, ontological characteristics, which are three perspectives of digital poetics. Third, it analyzed characteristics of example according to three perspectives above and we can analyze characteristics of spacial expression in space of digital media into potential, trans-active, and semiosis space. It would be possible through analyzing examples in digital poetic perspective to overlook new methods of design in 21th and various perspectives and possibilities of medial space design.

• Archives of Plastic Surgery
• /
• 제41권5호
• /
• pp.480-485
• /
• 2014

Background The objective of this article is to evaluate clinical outcomes of combined orbital floor and medial wall fracture repair using a three-dimensional pre-bent titanium implant in an East Asian population. Methods Clinical and radiologic data were analyzed for 11 patients with concomitant orbital floor and medial wall fractures. A combined transcaruncular and inferior fornix approach with lateral canthotomy was used for the exposure of fractures. An appropriate three-dimensional preformed titanium implant was selected and inserted according to the characteristics of a given defect. Results Follow-up time ranged from 2 to 6 months (median, 4.07 months). All patients had a successful treatment outcome without any complications. Clinically significant enophthalmos was not observed after treatment. Conclusions Three-dimensional pre-bent titanium implants are appropriate for use in the East Asian population, with a high success rate of anatomic restoration of the orbital volume and prevention of enophthalmos in combined orbital floor and medial wall fracture cases.

• Journal of Acupuncture Research
• /
• 제39권1호
• /
• pp.59-63
• /
• 2022

Spontaneous osteonecrosis of the knee (SONK) is a common form of osteonecrosis of the knee and mainly affects the medial condyle due to localized vascular insufficiency. We report a case of SONK in a 65-year-old woman who had severe knee pain in her left knee whichimpeded her capacityto walk beyond 10 minutes. Bilateral knee X-rays revealed degenerative osteoarthritis of both knees and magnetic resonance imaging revealed R/O SONK in the lateral aspect of the medial femoral condyle, as well as a medial meniscal posterior horn root tear, and a Grade 1 medial collateral ligament injury. She was hospitalized at Jaseng Hospital of Korean Medicine for 21 days and receivedcombination therapy includingacupuncture, pharmacopuncture, and herbal medicine. Patient-reported scales indicated that her pain and physical functional limitations were alleviated. Combination therapy consisting of Korean traditional medicine may bean alternative nonoperative treatment approach for patients with SONK.

• The Korean Journal of Pain
• /
• 제31권4호
• /
• pp.289-295
• /
• 2018

Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee. Methods: A total of 96 knees with osteoarthritis were randomized placed into the two groups, which were group I (anterolateral approach to the medial condyle) and group II (anterolateral approach to the lateral condyle). The primary outcome was to compare the success rate of the two methods of IA injection. The required length of the needle for injection was also measured and compared. Pain intensity was assessed using the Numeric Rating Scale in order to evaluate the success of injection. Results: There were no significant differences in the success rate between both groups. The success rate of group I and group II were 87.8% (95%, CI 78.7-97.0) and 91.5% (95%, CI 83.6-99.5), respectively (P = 0.549). The needle depth was $5.0{\pm}0.8$ (3.0 to 6.1 cm) in group I, and $3.0{\pm}0.8$ (1.5 to 5 cm) in group II (P < 0.001). Conclusions: The anterolateral approach to the lateral femoral condyle, using ultrasound, is an alternative method to the approach targeting the medial femoral condyle, using shorter needle.