The silicon tracheal T-tube was designed to maintain an adequate tracheal airway as well as to provide support in the stenotic trachea which has been reconstructed. Replacement of the T-tube was obviously undesirable following recent reconstruction of an unstable fracture of the airway. The loss of anesthetic gas through a T-tube while it is in place during anesthesia has been a problem. This report describes a simple method of establishing a satisfactory airway in a patient with a tracheal T-tube, and reviews the anesthesia aspects of modern surgical reconstruction of the larynx and cervical traches.
Anesthesia ; Humans ; Larynx ; Silicones ; Trachea

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.
Acute Kidney Injury ; Amputation ; Burns* ; Compartment Syndromes ; Compliance ; Education ; Electricity ; Emergencies ; Emergency Service, Hospital ; Extremities ; Humans ; Length of Stay ; Male ; Mortality ; Myoglobinuria

This is a case report and review of literature of a rare mixed odontogenic tumor, ameloblastic fibro-odontoma in the posterior area of the mandible. The ameloblastic fibro-odontoma which was developed by hyperplasia of dental epithelium and mesenchymal tissue. This tumor was classified from ameloblastic odontoma by Hooker, in 1967. At first and characterized by mixed appearance of odontoma and ameloblastic fibro-odontoma, But, on the point of pathologic feature, there are many controversial opinions among scholars up to the present. The patients of this case report was refereed to our department via the pedodontic department for the treatment of hard mass on the premolar area of the left mandible. And then, on the clinical and radiographic examination at first visit, we had tentative diagnosis that the lesion was benign mixed odontogenic tumor of defined mass margin that was amelblastic fibro-odontoma. The tumor mass was removed by surgical enucleation and curettage and extracted left mandibular second premolar which was impacted on the lesion. And the removed tumor mass was confirmed to ameloblastic fibro-odontoma on the post-operative biopsy. The patients has well done follow-up check postoperatively and shown no sign of recurrence up to the present.
Ameloblasts* ; Bicuspid ; Biopsy ; Curettage ; Diagnosis ; Epithelium ; Follow-Up Studies ; Humans ; Hyperplasia ; Mandible* ; Odontogenic Tumors ; Odontoma ; Recurrence

Maxillofacial infection often place the oral and maxillofacial surgeon in situations where timely decisions have to be made. These decisions can be lifesaving. Odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often repond to surgical and antimicrobial management. Otheriwise odontogenic infections have the potential to spread via the fasical spaces in the head and neck region. They can compromise vital structures in this region or involve distant structures. The classic signs of maxillofacial infections include pain, swelling, fever, dysphagia, and dehydration. The goals of management should be to correct these conditions. We have undertaken clinical studies on infections in the oral and maxillofacial regions (facial space) by analyzing hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Kyung Hee University Hospital past 5 years from 1991. To 1995. And bacterial cultures and antibiotics sensitivity test were performed and the comparative analysis of the antibiotics was done. The results were as follows: 1. The most frequent cause of oral and maxillofacial infection was odontogenic 68% and in 23% patients with signs and symptom aggrevated after teeth extraction. 2. The most common fascial spaces involved was buccal space 36.1%, followed by submandibular space 12.3% and 3 cases were Ludwig's angina. 3. Antibiotics were administrated in all cases and surgical incision and drainage was performed in 88.6%. 4. The most causative organisms isolated from the pus cultures were streptococci group 51.1%.
Anti-Bacterial Agents ; Deglutition Disorders ; Dehydration ; Drainage ; Fever ; Head ; Humans ; Ludwig's Angina ; Neck ; Suppuration ; Surgery, Oral ; Tooth

Nd:YAG laser is well absorbed to water, melanin, hemoglobin and thus, Nd:YAG laser may be used for bleeding control and extraction site sterilization where is easily contaminated by saliva and blood. Additionaly, Nd:YAG laser have analgesic effect by elevation of pain threshold. On the basis of Nd:YAG laser effects, we applied the Nd:YAG laser on extraction socket of 50 patients who visited to our department for lower third molar extraction and evaluated the effects of Nd:YAG laser on the bleeding control, pain relief, swelling reduction after tooth extraction. For the objective assesment on Nd:YAG laser effects, we made up the other 50 patients(control group) who were treated by conventional extraction method and compare the subjective and objective symptoms(pain relief, swelling and oozing time) between each group. The results were as follows: 1. The Nd:YAG laser was effective to relief of postextraction pain and most effective to 2 hours after extraction when local anesthesia disappears. 2. The Nd:YAG laser application was non-effective to reducing the facial swelling after extraction. 3. The Nd:YAG was effective to decrease the oozing time after extraction and the average time was 4 hours.
Anesthesia, Local ; Equidae ; Hemorrhage ; Humans ; Lasers, Solid-State* ; Melanins ; Molar, Third ; Pain Threshold ; Saliva ; Sterilization ; Tooth Extraction

Cicatrix ; Congenital Abnormalities ; Facial Asymmetry ; Growth and Development ; Humans ; Maxilla ; Neural Crest ; Orbit ; Orthognathic Surgery ; Tooth, Supernumerary

Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature.
Follow-Up Studies ; Giant Cell Tumors* ; Humans ; Laminectomy ; Polymethyl Methacrylate ; Recurrence ; Spinal Canal ; Spine*

In the management of postoperative fluid collection, the conventional percutaneous drainage method can be employed. Because of abdominal incisions and various types of surgical drains and/or T-tubes, the application of this method is not always easy, however. We inserted a drainage catheter through a pre-existing percutaneous track formed by a surgical drain located adjacent to the site of abnormal fluid collection. There was no need to remove the drain nor make an additional puncture in the abdominal wall. A dilator was inserted along the drain, and a guide wire was used to negotiate its intraperitoneal track and readch the accumulated fluid. The procedure was simple and safe. We briefly deseribe our experience of this modified percutaneous drainage technique, as used in three cases involving postoperative fluid collection.
Abdominal Wall ; Catheters ; Drainage* ; Punctures

PURPOSE: The aim of this study was to determine the risk factors for developing an inguinal hernia after undergoing radical retropubic prostatectomy(RRP). MATERIALS AND METHODS: We retrospectively investigated the hospital records of 382 patients who underwent RRP and who were followed over 12 month periods at our institute between January 2000 and December 2006. All the operations were performed by a single surgeon. The clinical and pathological parameters were compared between the patients with and without inguinal hernia, and the risk factors were analyzed using the Cox proportional hazards model. RESULTS: The mean age of the patients was 64.6 years(range, 40 to 83). 32(8.3%) of the 382 patients developed an inguinal hernia at a mean time of 14 months. 8(25.8%) of 32 patients developed an inguinal hernia within 6 months, 23(61.8%) within 1 year, 26(83.9%) within 2 years and 28 (90.3%) developed an inguinal hernia within 3 years. 25(78.1%) developed an inguinal hernia in the right side, 3(9.4%) in left and 4(12.5%) developed an inguinal hernia in both sides. The operative time(p<0.001), prostate volume(p=0.001), the presence of transfusion (p=0.001) and pelvic lymph node dissection(p=0.007) were significantly different between the patients with and without inguinal hernia. Multivariate analysis showed that the operative time(p=0.039), pelvic lymph node dissection(p=0.002), the presence of transfusion(p=0.012) and the prostate volume(>50cc, p=0.012) were independent predictors for post-prostatectomy inguinal hernia. CONCLUSIONS: The results of our study show that the duration of surgery, pelvic lymph node dissection, the presence of transfusion and the prostate volume all increase the risk of post-radical retropubic prostatectomy inguinal hernia.
Incidence ; Risk Factors

OBJECTIVE: The purpose of this study was to evaluate the clinical presentation and surgical outcome in patients with symptomatic discal cyst. METHODS: The authors reviewed consequent 9 patients in whom microscopic excision of the discal cyst with or without additional discectomy for discal cyst from 2005 to 2012. Diagnostic imagings including simple radiographs, computed tomography with discogram and magnetic resonance images were performed in each case. The patients were reviewed to evaluate the clinical presentation, surgical outcome and related complications. RESULTS: In all patients, discal cyst was located in the lumbar region and they presented with back pain and unilateral radiating pain. The preoperative magnetic resonance images (MRI) and computed tomography (CT) scan with discogram showed a connection between the cyst and the involved intervertebral disc. All patients obtained immediate relief of symptoms after microscopic excision of discal cyst. There were no recurrent lesions during follow-up period. The mean preoperative visual analogue scale (VAS) was 7.8 when compared with 2.6 in preoperative assessment. All patients obtained excellent or good outcome according to modified MacNab's criteria. CONCLUSION: Discal cysts are rare lesions that can lead to back pain and refractory sciatica. Microscopic excision of the cyst can achieve remarkable improvement of symptoms.
Back Pain ; Dental Cements ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Lumbosacral Region ; Magnetic Resonance Spectroscopy ; Sciatica