Migration of metallic foreign body into the cerebral circulation is rarely seen. Most of the cases reported were due to gunshot wounds and shotgun wounds to the neck and face. When the foreign body is near the great vessel, it must be removed immediately or will cause complications. This study reported a case of delayed metallic foreign body embolus to the ophthalmic artery resulting from an injury to the right neck, which arose from the presence of metallic emboli to the cerebral circulation.
Adult ; Embolism ; diagnosis ; surgery ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Male ; Neck Injuries ; complications ; surgery ; Ophthalmic Artery ; injuries ; pathology ; surgery ; Wounds, Penetrating ; complications

OBJECTIVE: To study the clinical manifestations and treatments of closed injuries of the cervical trachea. METHOD: We carried out a retrospective study of the clinical manifestations, diagnosis and treatment of patients with closed injuries of the cervical trachea that have been treated in our hospital over the last ten years. We analyzed commonly occurring clinical problems, key points of surgical treatment, and postoperative recovery. Fourty-one patients with acute closed injuries of the cervical trachea underwent emergency tracheotomy or anesthesia orotracheal intubation and surgical repair of the trachea within 24 to 48 hours. Twenty six patients had their tracheotomy tubes extubated after surgery and had their anesthesia orotracheal tubes extubated within 48 hours postoperatively; tracheotomy tubes remained in the airway in 15 patients postoperatively, and of them, 12 had extubation successfully in 2 weeks postoperatively, while the remaining 3 were left intubated due to laryngotracheal stenosis. Among the 3, 2 underwent further surgical repair and recovery, and 1 had a stent inserted. RESULT: Twenty-eight patients fully recovered postoperatively. Ten patients mostly recovered postoperatively exception for hoarseness, and their fundamental phonation function recovered within 2 to 3 months but with poor movement of the vocal cords. The breathing and swallowing function of the other 3 patients recovered after the surgery, but they suffer from hoarseness. CONCLUSION In the treatment of closed disruption of the cervical trachea, prompt diagnosis and timely surgical repair of the structure and function of the trachea are key to saving the patients' lives and avoiding tracheal stenoses.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; diagnosis ; surgery ; Retrospective Studies ; Rupture ; Trachea ; injuries ; Tracheal Stenosis ; Tracheotomy ; Young Adult

diagnosis and treatment of the fracture. This is the clinicotatistical study on 277 inpatients who had 450 mandibular fractures and were treated at the Department of Oral and Maxillofacial Surgery, Chonnam University Hospital from Jan. 1, 1992 to Dec. 31, 1996. Results obtained were as follows : The patients age ranged between 3-73 years. The third decade age group revealed the highest incidence of the fracture (35.0%), followed by the second decade (20.2%) and the fourth (17.3%) in order. Two hundred and sixteen patients were male and 61 patients were female (the ratio of male to female was 3.7:1. The fracture was at the highest incidence in August (13.4%), followed by in October (12.3%) and September (11.9%). The most common cause of the fracture was traffic accidents (33.9%), followed by falling down (24.9%) and violence (17.7%). The most common site of the fracture was symphysis (44.3%), followed by condyle (27.3%) and angle(21.5%). The most commonly occurred concomitant facial injury was facial laceration (33.9%). Concomitant injuries of other parts of body were most commonly caused by traffic accident (75.7%) and head and neck were the most common site of the injury (41.7%). Of the 277 patients, 258 patients (93.1%) were treated by open reduction. The average period of intermaxillary fixation was 9.4 days. Postoperative complications were found in 24 (8.7%) of 277 patients in which local infection (5.4%) was the most common. These results suggest that the mandibular fracture is commonly associated with concomitant injury of other parts of body, so that team approaches with other medical departments are recommended for its appropriate diagnosis and treatment.]]>
Accidents, Traffic ; Diagnosis ; Facial Injuries ; Female ; Head ; Humans ; Incidence ; Inpatients ; Jeollanam-do ; Lacerations ; Male ; Mandibular Fractures ; Neck ; Postoperative Complications ; Social Environment ; Surgery, Oral ; Violence

Osteoradionecrosis is one of the most serious complications of patients receiving radiation therapy. It is characterized by hypovascularity, hypocellularity, and hypoxia-inducing necrosis of bone and soft tissue following delayed healing. In this case, a 72-year-old man was referred to the Department of Oral and Maxillofacial Surgery complaining of trismus following extraction three months before first visit. He had a history of right tonsillectomy, radical neck dissection and radiotherapy performed due to right tonsillar cancer seven years prior. After the diagnosis of osteoradionecrosis on right mandibular body and angle, conservative antibiotic therapy was used first, but an orocutaneous fistula gradually formed, and extensive bony destruction and sequestrum were observed. Sequestrectomy, free particulated iliac bone and umbilical fat pad graft were performed via a submandibular approach under general anesthesia. Preoperative regular exams and delicate wound care led to secondary healing of the wound without vascularized free flap reconstruction.
Adipose Tissue* ; Aged ; Anesthesia, General ; Diagnosis ; Fistula ; Free Tissue Flaps ; Head and Neck Neoplasms* ; Humans ; Jaw* ; Neck Dissection ; Necrosis ; Osteoradionecrosis* ; Radiotherapy ; Surgery, Oral ; Tonsillar Neoplasms ; Tonsillectomy ; Transplants* ; Trismus ; Wounds and Injuries

OBJECTIVETo study the clinical characteristics and treatment of flexion-distraction stage I injuries in subaxial cervical spine.

METHODSTwelve cases of flexion-distraction stage I injuries with delayed symptoms, admitted in our hospital between January 1995 and December 2004, were studied retrospectively. In acute phase, all of 12 cases had neck pain and limited neck movements, neurological deficits were found in 6 of 12 cases. Eight cases had a correct diagnosis, and 2 cases had a error diagnosis, 2 cases missed. All cases were satisfactory by the primary conservative treatment. After 274 days average asymptomatic intervals, all of 12 cases had recurrence of neck pain, delayed neurological deficits were found in 10. MRI showed that all of 12 cases were unstable injuries.

RESULTSAll of the 12 patients were treated operatively. Decompression, fusion and fixation were performed by anterior approach in 9 cases, and by combined anterior and posterior approach in 3 cases. The average follow-up period was 33.1 months. Neck pain had great recovery in all cases, 10 cases with neurological deficits, 7 returned normal. Radiographic evidences of intervertebral bony fusion and good cervical alignment were observed in all of 12 cases.

CONCLUSIONSFlexion-distraction stage I injuries is often caused by ligament and disc injuries, and often missed with subtle symptoms and radiographic changes. Inadequate primary treatment options are often due to failure to recognize the instability, and maybe result in delayed injuries. MRI is helpful for the early accurate evaluation of spinal stability. Unstable injury require early surgical treatment. The anterior approach operation is recommended to most of these patients with acute and old injuries. Combined anterior and posterior approach operation should be considered in these patients who have old injuries with stiff kyphosis.

Adult ; Bone Transplantation ; Cervical Vertebrae ; injuries ; Diskectomy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck Pain ; etiology ; Retrospective Studies ; Spinal Fusion ; Spinal Injuries ; complications ; diagnosis ; surgery ; Time Factors

PURPOSE: To report a patient who developed an unusual combination of central retinal artery occlusion with ophthalmoplegia following spinal surgery in the prone position. METHODS: A 60-year-old man underwent a cervical spinal surgery in the prone position. Soon after recovery he could not open his right eye and had ocular pain due to the general anesthesia. Upon examination, we determined that he had a central retinal artery occlusion with total ophthalmoplegia. RESULTS: Despite medical treatment, optic atrophy was still present at the following examination. Ptosis and the afferent pupillary defect disappeared and ocular motility was recovered, but visual loss persisted until the last follow-up. CONCLUSIONS: A prolonged prone position during spinal surgery can cause external compression of the eye, causing serious and irreversible injury to the orbital structures. Therefore, if the patient shows postoperative signs of orbital swelling after spinal surgery the condition should be immediately evaluated and treated.
Visual Acuity ; Severity of Illness Index ; Retinal Artery Occlusion/*complications/diagnosis ; Postoperative Complications ; Ophthalmoplegia/*complications/diagnosis ; Neck Injuries/diagnosis/*surgery ; Middle Aged ; Male ; Magnetic Resonance Imaging ; Laminectomy/*adverse effects ; Humans ; Fundus Oculi ; Follow-Up Studies ; Fluorescein Angiography ; Diagnosis, Differential ; Cervical Vertebrae/injuries/*surgery ; Blindness/*etiology