BACKGROUND AND OBJECTIVES: With advancement in technique and the skills of endoscopic sinus surgery (ESS), this surgery is being performed more on elderly people than before. We compared the complication in patients undergoing ESS who were > or =65 years of age with those <65 years. MATERIALS AND METHODS: We reviewed our database of cases that had ESS between 2002 and 2005. Demographics and patient characteristics and complications encountered intraoperatively and immediately postoperatively were reviewed. RESULTS: One hundred patients were older than 65 years of age compared with 100 patients who were 16-65 years old. The older group had a 5% revision rate compared with 3% in the younger group. Complication rates were 11% for the elderly compared with 8% for the younger group. There was a slight higher complication rate in the older group of people than in the younger group of people, but statistically no difference. CONCLUSION: In geriatric population, complications of ESS were mainly minor such as synechiae, orbital entry, hemorrhage, periorbital ecchymosis. Complication rate was not significantly different between geriatric group and adult control group. Therefore ESS in the geriatric group is as safe as that performed in the adult control group.
Adult ; Aged ; Demography ; Ecchymosis ; Hemorrhage ; Humans ; Orbit ; Sinusitis*

PURPOSE: We analysed the clinical data to compare the usefulness of ultrasound guided vacuum-assisted Mammotome biopsy between 8G and 11G probes. METHODS: 108 cases in this study underwent an ultrasound- guided minimally invasive excisional breast biopsy through small incision. Removal of the breast lesions was accomplished Mammotome biopsy with 8G or 11G probes. RESULTS: The 108 lesions was excised. Mean size of the lesions were 10.7 mm in 8G and 9 mm in 11G. 105 lesions (95%) had benign pathology, three lesions (2.8%) were malignant, and two lesions (1.9%) had atypical ductal hyperplasia. As procedural complications, hematoma was 23/58 (39.7%) in 8G and 10/50 (20%) in 11G, and ecchymosis was 33/58 (55%) in 8G and 11/50 (22%) in 11G. But there was no major complications which need hospitalization and surgical intervention. CONCLUSION: Breast biopsy using Mammotome with 8G probe is as safe as 11G and effective technique.
Biopsy* ; Breast ; Ecchymosis ; Hematoma ; Hospitalization ; Hyperplasia ; Pathology ; Ultrasonography

Epidural steroid therapy is a commonly applied "conservative" therapy in the management of acute and chronic back pain, but it is not inherently benign. As the indications for epidural steroid injections increase so do the reports of adverse responses associated with this procedure. Although generalized erythema, retinal hemorrhage, infection, and lipomatosis have been reported, acute generalized ecchymosis has not been reported as a complication of either caudal or spinal epidural steroid injection. We describe here an unique case of transient, profound generalized ecchymosis after receiving an caudal epidural steroid injection for lumbar radiculopathy.
Back Pain ; Ecchymosis* ; Erythema ; Lipomatosis ; Radiculopathy* ; Retinal Hemorrhage

There are two general categories of lateral osteotomy techniques-the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.
Bandages ; Catheters ; Drainage ; Ecchymosis ; Hemorrhage ; Mucous Membrane ; Osteotomy* ; Periosteum ; Rhinoplasty

BACKGROUND AND OBJECTIVES: Osteotomy, usually carried out bilaterally, is a commonly performed procedure to correct the bony dorsum of deviated nose. However, it is an invasive maneuvers which can affect the stability of nasal bone and develop complications, such as, edema and ecchymosis. This study aims to evaluate the usefulness of unilateral osteotomy in correcting a deviated nose with various scoliosis. SUBJECTS AND METHOD: We studied 9 of the 69 patients who underwent corrective rhinoplasty with unilateral osteotomy to correct the bony nasal dorsum between 2010 and 2014. For patients whose bony nasal dorsum was corrected well after performing osteotomy on the convex side of the bony dorsum, the opposite side was not operated on; however, if correction was incomplete, osteotomy was additionally performed on the opposite side. For this study, patients who underwent bilateral osteotomy were excluded from the study. The improvement of correction was assessed by comparing the preoperative and postoperative photos. RESULTS: Of the nine patients treated with unilateral osteotomy, 5 cases were C or reverse C type deviations, 1 case was S type deviation and 3 were straight deviations. Five of the nine patients improved greatly and the rest improved significantly. None of the patients experienced worsening change postoperatively. CONCLUSION: Osteotomy is essential but invasive maneuver, so it is desirable to reduce the number of times to execute. By performing osteotomy on the convex side of the nose first, we can correct the deviated nose effectively while reducing the number of implementation.
Ecchymosis ; Edema ; Humans ; Methods ; Nasal Bone ; Nose* ; Osteotomy* ; Rhinoplasty ; Scoliosis

BACKGROUND AND OBJECTIVES: A precise osteotomy is a requirement for successful rhinoplasty. Osteotomy in rhinoplasty is frequently performed via intranasal route through vestibular incision or can be performed by percutaneous approach. The latter has never been reported in the domestic journal. Thus, we aimed to evaluate in this study the usefulness of rhinoplasty using percutaneous osteotomy. MATERIALS AND METHODS: The pateints age ranged from 19 to 38 years. Surgeries were performed on 6 cases who underwent rhinoplasty during the period of October 1999 to February 2000. Osteotomy via external approach was used with the aid of a sharp, straight 2 mm osteotome. RESULT: Irregularity, scoliosis, and broadness of nasal bony pyramid in the study subjects were successfully corrected using percutaneous osteotomy. During the procedure, hemomhage was minimal. Postoperatively, ecchymosis and edema was negligible and scarring was barely perceptible. However, one female patient who have fair complexion complained of osteotomy scar. CONCLUSION: Our results indicate that the percutaneous osteotomy may be used as a good alternative for the osteotomy approach but must used in judicious manner because of osteotomy scar.
Cicatrix ; Ecchymosis ; Edema ; Female ; Humans ; Osteotomy* ; Rhinoplasty* ; Scoliosis

BACKGROUND AND OBJECTIVES: Medial orbital wall fractures are seen in association with fractures of the orbital floor or more complex bony disruptions. It is important to diagnose and manage medial orbital wall fractures as early as possible, because of the possibility of functional orbital damage later. In this study, fractures were divided into the following types based on location and severity of injury according to Nolasco and Mathog: type I (confined to the medial orbital wall), type II (medial orbital wall continuous with floor, type III (medial orbital wall with floor-malar fractures), and type IV (medial orbital wall and complex midfacial injuries). MATERIALS AND METHODS: We reviewed 22 cases of medial orbital wall fractures according to the classification of Nolasco and Mathog at Soonchunhyang University Chunan Hospital. RESULTS: 1) Types of fractures observed were type I (9 cases), type II (10 cases), type III (2 cases), and type IV (1 case). 2) The most common age groups were the thirties and the fourties. The male-to-female ratio was 3:1, and more injuries were found at the left orbit. 3) Assault was the most common cause, as observed in 10 of 22 cases (45.5%), and types III and IV injuries only occurred in falls. 4) Diplopia was the most common symptom, as in 15 of 22 cases (68.2%). Ecchymosis and periorbital swelling were more common with type I; diplopia was more common with type II. 5) Type I fractures were generally explored through intranasal approach, whereas the other types were commonly treated with subciliary or Caldwell-Luc approach. SUMMARY: Medial orbital wall fractures were more common in type I and II, the male, and the left side. Commonly, type I fractures caused ecchymosis and periorbital swelling and were treated with conservative treatment. In most cases, type II fractures caused diplopia and were treated with surgery 1 or 2 weeks after trauma.
Chungcheongnam-do ; Classification ; Diplopia ; Ecchymosis ; Humans ; Male ; Orbit* ; Orbital Fractures

Retrobulbar hematoma is a rare complication following septal surgery under general anesthesia. Symptoms and physical findings include temporary blindness, ophthalmoplegia, mydriasis, ptosis, proptosis and eyelid ecchymosis. Recently, we experienced a rare case of the right retrobulbar hematoma after septal surgery. At present, there is no literature about the occurrence of retrobulbar hematoma following septal surgery. We hereby present this case with an emphasis on the importance of prevention, identification and management of retrobulbar hematoma.
Anesthesia, General* ; Blindness ; Ecchymosis ; Exophthalmos ; Eyelids ; Hematoma* ; Mydriasis ; Ophthalmoplegia

Korean small eyes are characterized in thickness and pseudoptosis of the skin of the upper eyelid. They also have a large amount of subcutaneous and preaponeurotic fat. The hypertrophic orbicularis oculi muscles and the lower positioned transverse ligaments are included in their structural characteristics. These special features act as various burden factors in Korean double eyelid operation. Just burden factors restrict the movement of the upper eyelid and so Korean eyes looks like Ptosis (pseudoptosis). For creation of double fold eyelid, we performed continuous 2-loop single stitch buried suture to make an en bloc fixation with dermis, levator aponeurosis and Muller muscle through three small incisions. And then we tried to eliminate the burden factors through small sized lateral incision. After removal of the external sutures at postoperative 3 days, we obtained our intended double fold lines such as in-fold, in-ward fold and out fold successfully and only experienced minor complications such as edema, ecchymosis and loss of fold. And also the range of excursion in the upper eyelid improved without levator shortening or any other operation such as a sling. The objective of this article is to share our experience and to introduce our method of treating Korean pseudoptotic eyes by using 2-loop en bloc fixation through three small incisions with various reviews of literature.
Dermis ; Ecchymosis ; Edema ; Eyelids ; Ligaments ; Muscles ; Skin ; Sutures

Recently many studies have demonstrated that perforating method of lateral nasal osteotomy causes less edema and echymosis than those of continuous method of lateral nasal osteotomy. For lessening the damage of nasal mucosa, authors performed continuous nasal lateral osteotomy(NLO) with an aid of silastic strip insertion into the subperiosteal pocket on the medial side of nose along the line of osteotomy. NLO was performed in 5 patients for correction of bony abnormality. In each patient, internal perforating NLO was performed on one side of nasal bone using 2-mm straight osteotome and protected continuous NLO was performed on the other side using 4-mm curved guided osteotome. The condition of nasal mucosa was checked using endoscopy immediately after the procedure. On postoperative days 2, 7, 14, and 21 the degrees of ecchymosis and edema of each side evaluated using clinical photos(Canon EOS 300D). Mild edema and ecchymosis were observed in both sides on postoperative days 2, 7, 14, there were no significant differences between right side and left side. This study confirmed that concerning postoperative ecchymosis and edema there were no significant differences between in protected continuous NLO and in perforating NLO. We conclude that whatever the technique of NLO, the degrees of post operative edema and ecchymosis may depends on the degree of nasal soft tissue trauma.
Ecchymosis ; Edema ; Endoscopy ; Humans ; Nasal Bone ; Nasal Mucosa ; Nose ; Osteotomy*