• Title/Summary/Keyword: surgical lesions

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Clinical Outcome after Surgical Treatment of Recurrent Shoulder Dislocation with Small Bony Bankart

  • Kim, Jung-Han;Kim, Chang-Wan
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.144-151
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    • 2015
  • Background: The consensus is that a bony Bankart lesion shorter than 25% of the length of glenoid does not affect the clinical result; hence, such lesions were often neglected. However, small bony Bankart lesions are associated with various types of capsulolabral lesions. Methods: A total of 82 patients who had undergone arthroscopic capsulolabral lesion repair surgery for anterior shoulder dislocation were reviewed. The prevalence rates of early and late type of capsulolabral lesions were compared between a group of patients with and a group without small bony Bankart lesions. In addition, the types of accompanying capsulolabral lesion were analyzed according to the type of bony Bankart lesion. Finally, the clinical outcomes were evaluated (active range of motion, American Shoulder and Elbow Surgeons score and Rowe's score). Results: Among the 13 patients who had small bony Bankart lesions, the prevalence rate of early and late type of capsulolabral lesions was 38.5% and 61.5%, respectively. Among the 69 patients without bony Bankart lesion, the prevalence rates of early and late type of capsulolabral lesions were 74% and 26%, respectively. Significantly worse clinical outcome was observed for the group of patients with both small bony Bankart lesions and late type of capsulolabral lesion. Conclusions: More severe type of small bony Bankart lesion appears to be associated with late type of capsulolabral lesion. The significantly worse clinical outcome for patients with both small bony Bankart lesion and late type of capsulolabral lesion indicates that small bony Bankart lesions cannot always be neglected.

Surgical Treatment of Sinus of Valsalva Rupture (Valsalva동 파열의 외과적 요법)

  • 이재원
    • Journal of Chest Surgery
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    • v.27 no.7
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    • pp.621-623
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    • 1994
  • Over the past 3.5 years, 5 cases with ruptured sinus of Valsalva were operated upon at Asan Medical Center. Four patients were congenital and 1 traumatic. Coexistent lesions included 2 subarterial VSD, 3 AR requiring procedures [2 AVR, 1 valvoplasty], 2 subaortic membranes, 1 PDA,and 1 bicuspid AV. The communication is noncoronary sinus to RA in I and fight Coronary sinus to RV in the other 4 patients. The ~rstula was repaired through the aorta whenever possible and reinforced through the right sided chamber. There are no surgical mortality and, no recurrence of rupture yet.

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PLEOMORPHIC ADENOMA WHICH OCCURED BUCCAL MUCOSA AND SUBMANDIBULAR GLAND ; TWO CASE REPORTS (악하선(顎下線)과 협점막(頰粘膜)에 발생한 다형성(多形性) 선종(腺腫)의 치험례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Kim, Byung-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.2
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    • pp.93-98
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    • 1993
  • Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50% of all cases of tumors of both major and minor salivary gland origin and approximately 90% of all benign salivary gland tumors. Of the major salivary glands, the parotid gland is the most common site of the pleomorphic adenoma. It may occur, however, in any of the major gland or in the widely distributed intraoral accessory salivary glands. The palatal glands are frequently the site of origin of tumors, and other parts of origins are as follows: upper and lower lip, buccal mucosa, tongue and occasionally other sites. The majority of the lesions are found in patients in the fourth to sixth decades, but they are also relatively common in young adults and have been known to occur in children. It is somewhat more frequent in women than men. The term "mixed tumor" has masquaeraded under a great variety of names throughout the years (e.g., enclavoma, branchioma, endothelioma, enchondroma), but the term "pleomorphic adenoma" suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The accepted treatment for this tumor is surgical excision. The intraoral lesions can be treated somewhat more conservatively by extracapsular excision. In general, Lesions of the hard palate should be excised with the overlying mucosa, while those in lining mucosa, such as the lips, soft palate and buccal mucosa often can be treated successfully by enucleation or extracapsular excision. In our hospital, we experienced two patients who were identified pleomorphic adenoma which occurred at buccal mucosa, submandibular gland. The lesions were successfully treated by surgical excision.

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Cemento-Ossifying Fibroma in the Fracture Area of Mandibular Body: a Case Report (하악 체부 골절부위에 이환된 백악질 골화성 섬유종: 증례보고)

  • Jung, Tae-Young;Kim, So-Hyun;Jo, Hyun-Joo;Park, Sang-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.484-487
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    • 2010
  • Cemento-ossifying fibroma is a true osteogenic neoplasm. It is also called as ossifying fibroma or cementify-ing fibroma. Small lesions seldom cause any symptoms and are detected only on radiographic examination. Large lesions result in a painless swelling of the involved bone. In radiographic features the lesion most often is well defined and unilocular. It may appear completely radiolucent, or more often varying degrees of rdiopacity. It is composed of fibrous tissue that contains a variable mixture of bony trabeculae,cementum-like spherules, or both. Treatment of most lesions generally is enucleation of tumor. However, some lesions which have grown large and destroyed considerable bone, may necessitate surgical resection and bone grafting. This case was the bony lesion that was found by accident in patient with mandibular left body and subcondylar fracture. In radiographic examination, there was a mixed radiolucent and radiopaque lesion in mandibular left body area with fracture line. We treated on mandibular left body and subcondylar fracture and enucleated the lesion on the left body area simultaneously. At surgical exploration, the lesion was well demarcated from the surrounding bone, thus permitting relatively easy separation of the tumor from its bony bed. In histopathologic examination, the lesion contained bony trabeculae and cementum-like spherules within a background of cellular fibrous connective tissue. It finally diagnosed as cemento-ossify-ing fibroma from the result of biopsy.

Possible Prognostic Role of HER2/Neu in Ductal Carcinoma In Situ and Atypical Ductal Proliferative Lesions of the Breast

  • Daoud, Sahar Aly;Ismail, Wesam Maghawri;Abdelhamid, Mohamed Salah;Nabil, Tamer Mohamed;Daoud, Sahar Aly
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3733-3736
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    • 2016
  • HER2/neu is a well-established prognostic and predictive factor for invasive breast cancer. However, the role of HER2/neu in ductal breast carcinoma in situ (DCIS) is debated and recent data have suggested that it is mainly linked to in situ local recurrence. Although molecular data suggest that atypical ductal hyperplasia (ADH) and duct carcinoma in situ (DCIS) are related lesions, albeit with vastly different clinical implications, the role of HER2/neu expression in atypical ductal hyperplasia is not well defined either. The aim of this study was to evaluate over expression of HER2/neu in DCIS and cases of ADH in comparison with invasive breast carcinoma. Archival primary breast carcinoma paraffin blocks (n=15), DCIS only (n=10) and ductal epithelial hyperplasia and other breast benign lesions (n=25) were analyzed for HER2/neu immunoexpression. Follow up was available for 40% of the patients. HER2/neu was positive in 80%of both DCIS and invasive carcinoma, and 67% of atypical ductal hyperplasia (ADH) cases. Thus at least a subset of patients with preinvasive breast lesions were positive, which strongly suggests a role for Her2/neu in identifying high-risk patients for malignant transformation. Although these are preliminary data, which need further studies of gene amplification within these patients as well as a larger patient cohort with longer periods of follow up, they support the implementation of routine Her2/neu testing in patients diagnosed as pure DCIS and in florid ADH.

US-guided 14G Core Needle Biopsy: Comparison Between Underestimated and Correctly Diagnosed Breast Cancers

  • Kim, Hana;Youk, Ji Hyun;Kim, Jeong-Ah;Gweon, Hye Mi;Jung, Woo-Hee;Son, Eun Ju
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3179-3183
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    • 2014
  • Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

A clinical review of reconstructive techniques for patients with multiple skin cancers on the face

  • Kim, Geon Woo;Bae, Yong Chan;Bae, Sung Hwan;Nam, Su Bong;Lee, Dong Min
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.194-199
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    • 2018
  • Background: Cases of simultaneous multiple skin cancers in a single patient have become more common. Due to the multiplicity of lesions, reconstruction in such cases is more difficult than after a single lesion is removed. This study presents a series of patients with multiple facial skin cancers, with an analysis of the surgical removal, reconstruction process, and the results observed during follow-up. Methods: We reviewed 12 patients diagnosed with multiple skin cancers on the face between November 2004 and March 2016. The patients' medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, methods of surgical removal and reconstruction, complications, and recurrence during follow-up. Results: Nine patients had a single type of cancer occurring as multiple lesions, while three patients had different skin cancer types that occurred together. A total of 30 cancer sites were observed in the 12 patients. The most common cancer site was the nose. Thirteen defects were reconstructed with a flap, while 18 were reconstructed with skin grafting. The only complication was one case of recurrence of basal cell carcinoma. Conclusion: Multiple skin cancers are removed by performing Mohs micrographic surgery or wide excision, resulting in multiple defect sites. The authors emphasize the importance of thoroughly evaluating local lesions surrounding the initially-identified lesions or on other sites when reconstructing a large defect which can not be covered by primary closure. Furthermore, satisfactory results can be obtained by using various methods simultaneously regarding the condition of individual patients, the defect site and size, and the surgeon's preference.

Surgical endodontic management of infected lateral canals of maxillary incisors

  • Jang, Ji-Hyun;Lee, Jung-Min;Yi, Jin-Kyu;Choi, Sung-Baik;Park, Sang-Hyuk
    • Restorative Dentistry and Endodontics
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    • v.40 no.1
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    • pp.79-84
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    • 2015
  • This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.

A COMPARATIVE CLINICAL STUDY ON DECOMPRESSION AND ENUCLEATION TO TREAT CYSTIC LESIONS OF THE JAWS (악골내 낭종성 병소의 감압술과 적출술에 관한 임상적 연구)

  • Jung, Young-Soo;Paek, Song-Hum;Lee, Eui-Wung;Park, Hyung-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.43-48
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    • 2004
  • Purpose: Among the various surgical methods used for the effective treatment of cystic lesion in the jaws historically, decompression procedure has some of superior prognosis compare to direct enucleation. In order to propose the efficacy of decompression we performed this retrospective study to compare decompression procedure with one-stage enucleation in clinical results and prognosis. Patients and Methods: We reviewed 175 patients who had been histopathologically diagnosed cystic lesions from 1996 to 2000 in our department. Patients who had been received decompression alone or secondary enucleation after decompression were 31 cases, and enucleation alone were 144 cases. The age and sex of the patients, the area, size, and histological type of the lesions, and detailed operation and complications including recurrence were investigated. The minimal follow-up period was 2 years. Results: In 31cases of decompression, male patients were 22cases(71%) similar to male predilection(62.3%) in total 175 cases. Cystic lesions were developed evenly in all age groups totally. Decompression was mainly performed in teenagers but enucleation was used in elder decades. In decompression cases the lesions were located in mandibular posterior, maxillary posterior, mandibular anterior, and maxillary anterior in order, which had some differences in total and enucleation cases. In enucleation cases, less than 3cm in size was 77.1% but larger than 3cm was 93.5% in decompression cases. Histopathologically, dentigerous cysts(54.8%), unicystic ameloblastomas(16.1%), and odontogenic keratocysts(12.9%) were seen in decompression cases and no recurrence or metaplasia and infection was observed. On the other hand, permanent tooth loss, numbness, recurrence, and so on were accompanied after enucleation. Conclusion: Although decompression procedure has disadvantages such as many of visiting times and slow recovery of the surgical defect, decompression is the best choice of treatment for large cystic lesions of the jaws, because it prevents functional and cosmetic defect, allows bone regeneration, and makes easy secondary enucleation.

Heterotopic Ossification

  • Hong, Seok-Hwan;Lee, Yong-Bin;Jung, Young-Soo;Jung, Hwi-Dong
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.84-86
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    • 2016
  • Heterotopic ossification (HO) is the formation of mature bone in soft tissue where bone normally does not exist. Although HO is among the most common complications after orthopedic surgery, it is not familiar to oral and maxillofacial surgeons. Here we report rare cases of HO. When a patient presents atypical osseous lesions, HO as well as similar lesions such as osteoma, osteochondroma should be considered in the provisional diagnosis. Three-dimensional reconstruction of preoperative computerized tomography imaging improves surgical success.