Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techiques. The basic disciplines of approaching skull base lesions are to provide direct vision, minimize brain retraction, allow excellent exposure and minimal blood loss. Although many advantages listed above are reported, objective long-term follow up results about post-operative complications of this procedures were not introduced. This study was designed to review the complications of skull base approach that we experienced 43 cases by a team approach with neurosurgery-supraorbital rim osteotomy, orbitozygomatic osteotomy, orbitozygom aticoglen-oidotomy, orbitozygomaticoglenoidocondylotomy, and transfrontonasomaxillary osteotomy-through objective evalutation criteria. The result of this study demonstrated that the type of complications were consisted with perioperative infection (5 cases), subdural empyema (1 case), CSF leakage(1 case), hematoma (1 case), meningitis (3 cases), ophthalmic nerve injury (1 case),facial nerve injury (2 cases), T-M joint problem ( 2 cases), & enophthalmos ( 2cases). In conclusion, after performing the different skull base approaches, we analyzed several complications of the above procedures. We analyzed with the purpose of preventing complications in the next skull base approach.
Brain ; Empyema, Subdural ; Enophthalmos ; Follow-Up Studies* ; Hematoma ; Joints ; Meningitis ; Ophthalmic Nerve ; Osteotomy ; Skull Base* ; Skull*

No abstract available.
Animals ; Peripheral Nerves* ; Rats* ; Regeneration* ; Silicones*

Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techniques. The basic disciplines of approaching skull base lesions are provide direct vision, minimizing brain retraction, excellent exposure and minimal blood loss. The focus of this report is to review the advantages of skull base approach in our cases and suggest some indications. We experienced 20 cases of skull base surgery by a team approach consisting of a neurosurgeon and plastic surgeon. The surgical approach were supraorbital osteotomy(5 case), orbitozygomatic osteotomy(8 case), orbitozygomaticoglenoid osteotomy (5 case ) and orbitozygomaticoglenoidocondylar osteotomy (2 case). In our experience, these approaches provided excellent exposure of the lesion, direct access to lesions and minimal brain retraction thereby better outcome.
Brain ; Osteotomy ; Skull Base* ; Skull* ; Surgery, Plastic*

No abstract available.
Colorectal Neoplasms* ; Humans* ; Oncogenes* ; Point Mutation* ; Polymerase Chain Reaction*

No abstract available.
Frontal Sinus*

12 cases of retinal detachment treated with scleral buckling Procedure of 4392 visitors the department of ophthalmology. Yonsei University medical school from Feb. 28th 1958 to April 30th 1959. 30 cases of retinal detachment were found 12 cases out of 30 received the scleral buckling procedure, and exhibited the following results. 1) a. Successful, b. Fair 3(25%), c. Failure 2(16.6%). 2) The shorter the duration of retinal detachment existed the better the resutls of the operation was. However in 2 cases of old retinal detachment lasted more than 7 months the results of the operation were also successful. 3) Results of the surgery were more favourable in the cases of having no definite hole. 4) In one case, retinal detachment was recurred a year after the first procedure and a secondary procedure was performed with fair results.
Ophthalmology ; Retinal Detachment ; Retinaldehyde* ; Schools, Medical ; Scleral Buckling*

Reconstruction of extensive soft tissue defect of the head and neck after or resection or injury has improved with advances in surgical techniques. Traditional local flap techniques are not easy to reconstruct the extensive soft tissue defects and irradiated or contaminated recipient beds. Then musculocutaneous flaps such as pectoralis major flap, trapezius flap, latissimus dorsi flap and sternocleidomastoid flap have been performed. These musculocutaneous flaps are effective in resurfacing the neck and lower face, for example, mandibular area but difficult to reconstruct the upper face and scalp and the result is poor. Other alternative flap used to cover this area is free flap, but this flap has many limitation too and therefore reconstructive surgeons have attempted to develop new flaps. There are three distinct musculocutaneous flaps, the superior, the lateral island, and the lower island flaps, that can be harvested from the trapezius muscle that are used in head and neck reconstruction. The lower trapezius musculocutaneous flap provides a long paddle of thin, pliable skin and muscle and offers the long are of rotation and thus the greater versatility of the three types of trapezius flaps. But this lower trapezius musculocutaneous flap has may problems to reconstruct the upper part of face and scalp by traditional method and has used mainly to resurface the neck and lower face. Thus, authors modified the procedure of lower trapezius flap and tried to reconstruct the upper part of face and scalp. The modification is that during the dissection, the trapezius muscle must be totally mobilized and the dorsal scapular artery must be preserved. By this procedure, blood flow can circulate effectively to the distal portion of flap and then modified flap has greater are of rotation and reliably reach higher portion of face and scalp. The operative results me that among the eight cases performed by modified lower trapezius musculocutaneouas flap, seven were reconstructed successfully, and remaining one presented partial flap necrosis and secondary procedure was needed. The functional defecits of donor site were minimal in all cases.
Arteries ; Free Tissue Flaps ; Head ; Humans ; Myocutaneous Flap* ; Neck ; Necrosis ; Scalp ; Skin ; Superficial Back Muscles* ; Surgical Flaps ; Tissue Donors

No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

BACKGROUND: Tourniquet pain is probably mediated by C-fiber. The ability of fentanyl to interrupt this nociceptive conduction was studied by administering either fentanyl or saline intrathecally along with hyperbaric bupivacaine for spinal anesthesia. METHOD: The incidence of tourniquet pain was evaluated in 60 patients having orthopedic surgery of the lower extremities during spinal anesthesia by administering either 30 mcg fentanyl (group 2) or saline (group 1) along with 0.5% hyperbaric bupivacaine 10 mg. We measured the maximal sensory spread of analgesia to pinprick, the incidence of tourniquet pain, and the sensory anesthesia to pinprick at the onset of tourniquet pain. RESULTS: The average maximal sensory spread of analgesia was the same in both groups (T9). The incidence of tourniquet pain was significantly greater in group 1 (33%) than in group 2 (10%). The sensory levels of anesthesia at the onset of tourniquet pain were not different in two groups. CONCLUSIONS: Intrathecal fentanyl was effective against tourniquet pain for 2 hours of the orthopedic surgery of the lower extremities.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Fentanyl* ; Humans ; Incidence ; Lower Extremity ; Orthopedics ; Tourniquets*

To compare the results of the chemonucleolysis and the automated percutaneous lumbar discectomy(APLD) for symptomatic lumbar disc herniation, retrospective study of 19 chemonucleolysis and 20 APLD was done from July, 1984 to February, 1993. Number of male patients was 23 and female 16. The patients ranged in age from 14 to 56 years. L4-5 was the most commonly involved level comprising 73.6%, and 2 level involvement was 20.5%. Clinical results were evaluated according to Mcnab s criteria. Excellent and Good result were 31.6% and 47.3% in chemonucleolysis with an average follow up period of 6.2 years, and those were 35% and 45% respectively in APLD with an average follow up period of 18.7 months. Among 19 chemonucleolysis, there were loss of disc height in 8, and lateral recess stenosis in 1. Among 20 APLD, there were loss of disc height in 2, and nerve root irritation symptoms in 2. Chemonucleolysis and APLD have a low morbidity, can be performed under the local anesthesia and are simple, rapid and less traumatic procedure.
Anesthesia, Local ; Constriction, Pathologic ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Chemolysis ; Male ; Retrospective Studies