No abstract available.
Emergencies* ; Hematoma, Subdural, Acute* ; Trephining*

PURPOSE: This study evaluated the effectiveness of endoscopic canaliculodacryocystorhinostomy with two sets of silicone tube intubation in the distal part of canalicular obstruction. METHODS: Endoscopic canaliculodacryocystorhinostomy with double silicone tube intubation was done in 26 patients with canalicular obstruction from January 2002 to December 2002. Probing or trephination was used for recanaliculization of obstructed canaliculi. The silicone tube was left in place for 6 months. RESULTS: The success rate was 76.9% (20 of 26 patients) two months after tube removal. The level of canalicular obstruction or method of bougienage did not affect the success rates. Complications includes granuloma formation (12), synechia of ostium (1), prolepses of tube (2), and acute dacryocystitis(1). CONCLUSIONS: Endoscopic canaliculodacryocystorhinostomy with double silicone tube intubation showed a relatively high success rate and was more effective and convenient than conjunctivodacryocystorhinostomy with Jones tube.
Granuloma ; Humans ; Intubation* ; Silicones* ; Trephining

Trephination was performed for the purpose of correction of undercorrection after epikeratoplasty. We classified two group-Delayed regression group represented regression toward myopia more than 3D again after spherical equivalant become stable. Undercorrection group represented remained myopia after epikeratoplasty. Thirteen trephinations were performed on eleven eyes. Mean follow-up period was 22.4 weeks. In skiascopy, totally 1.15D myopia was decreased. In delayed regression group myopia was increased 0.5D, while in undercorrection group, myopia was dereased 3.5D, The results of three eyes in eleven eyse were satisfactory. Those 3 cases were from undercorrection group. The results suggest that trephination might be effective method for correction of remained myopia in undercorrection group.
Epikeratophakia* ; Follow-Up Studies ; Myopia ; Retinoscopy ; Trephining*

BACKGROUND AND OBJECTIVES: Frontal sinus trephination requires understanding of frontal sinus anatomy. This study aims to identify frontal sinus depth (FSD) and bone thickness of its anterior table (FBT) using the axial images of paranasal computed tomography (CT) scans. SUBJECTS AND METHODS: We obtained the axial images taken from 30 men and 30 women. FSD and FBT were estimated at points 5, 10, and 15 mm from the midline (the straight line passing through the crista galli) on each side using the axial CT images. RESULTS: The mean male FSDs at 5, 10, and 15 mm from midline were 11.08+/-1.92, 11.38+/-2.08, and 11.49+/-2.27 mm, respectively; mean female FSDs were 8.23+/-1.38, 8.47+/-1.65, and 8.87+/-1.76 mm, respectively. Men had significantly larger FSDs than women did at all measurement points (p < 0.001). The mean male FBTs at 5, 10, and 15 mm from midline were 3.59+/-1.11, 3.25+/-0.93, and 3.65+/-1.25, respectively; mean female FBTs were 3.25+/-0.85, 3.11+/-0.91, and 3.28+/-0.87 mm, respectively. There were no significant differences between FBTs of men and women (p > 0.05). CONCLUSION: These data provide the information about the frontal sinus in Korean adults.
Adult* ; Female ; Frontal Sinus* ; Humans ; Male ; Trephining

PURPOSE: The purpose of this study is to evaluate surgical outcomes of canalicular trephination with lacrimal trephine and endoscopic dacryocystorhinostomy in patiens with common canalicular or canalicular obstruction. METHODS: 35 patients (38 eyes) diagnosed as common canalicular or canalicular obstruction undergoing surgery between December 1999 and August 2003. Patients have been followed up more than 5 months after surgery. RESULTS: The average age of patients was 57.3 years old and the average follow-up period was 7.1 months. The overall success rate was 92.1%. With obstructions within lower canaliculus, the success rate was 75.0%. The success rate of the cases with obstructions within upper canaliculus and upper and lower canaliculus was 100%, and the success rate of the cases with obstructions within common canaliculus was 95.2%. CONCLUSIONS: The surgical success rate of canalicular trephination with lacrimal trephine and endonasal dacryocystorhinostomy was better than canaliculodacryocystorhinostomy and this seems to be adequate as an primary procedure before Jones tube bypass surgery.
Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Trephining*

Subdural hygromas are easily treated by trephination and drainage. Therefore, most neurosurgeons do not consider subdural hygromas seriously. However, various complications including intracerebral hemorrhage may develop after rapid drainage of subdural hygroma although rare. Postoperative intracerebral hemorrhage presents with a rapid deterioration of consciousness and focal neurological deficits occurring immediately after drainage of the subdural hygroma. The authors present an unfortunate massive intracerebral hemorrhage and pneumocephalus following drainage of the bifrontal subdural hygroma. The patient subsequently died. To prevent this disastrous complication, close neurosurgical observation and gradual drainage under a closed system seem mandatory. Possible pathogenic mechanisms for this unfavorable complication is discussed with a review of pertinent literatures.
Cerebral Hemorrhage* ; Consciousness ; Drainage* ; Humans ; Pneumocephalus ; Subdural Effusion* ; Trephining

The authors analysed 140 cases of subdural hygroma developed after head injury and various neurosurgical operations and was treated at Hanyang university hospital from 1983 to 1989. The results were analysed and summarized as follows. 1) The peak incidence was the age over 50 and under 10. 2) 104 cases(74.4%) were bilateral frontotemporoparietal lesions. 3) Causes were head injury(121 cases), operation for intracranial aneurysms(5 cases), ventriculoperitoneal shunt(5 cases), traumatic(2 cases), external ventricular drainage(1 case). 4) Change in mental status without focal sign of brain damage was presenting symptom. 5) Operation was underwent if 63 cases and the reaccumulation rate was high (26.8%) after trephination but outcome was favorable. 6) Mortality rate in traumatic subdural hygroma was low(5.8%) because brain CT could detect subdural hygroma easily in early stage.
Brain ; Craniocerebral Trauma ; Head ; Incidence ; Mortality ; Subdural Effusion* ; Trephining

We investigated mean keratometric vale(K) after penetrating keratoplasty(PKP) and analyzed the factors which affected the postoperative mean K. We obtained mean K at postoperative 3 months in the 65 eyes of 65 patients which PKP of PKP combined with intraocular lens(IOL) implantation was done, and analyzed those values according to sex, age, preoperative diagnosis, preoperative corneal neovascularization, methods of trephination, methods of suture and methods of operation. The postoperative mean K of all patients was 42.83 diopters(D) and 43.32D in the recipient cornea without neovascularizaion, 42.51D with neovascularization, 42.72D in the cases of hand-held trephination and 43.27D in Hessvurg-Varron trephination, which had no statistical significant difference between K and sex, age, preoperative diagnosis, methods of suture, and methods of operation. This results will be helpful to predict the change of K ofter PKP, and give a better refractive results to use the operator's own mean K for the IOL calculation in the case of PKP comvined with IOL implantation.
Cornea ; Corneal Neovascularization ; Diagnosis ; Humans ; Keratoplasty, Penetrating* ; Sutures ; Trephining

The purpose of this study is to morphologically evaluate the results of arthroscopic meniscal repair by sec- ond-look arthroscopy. We performed the arthroscopic meniscal repair in 40 menisci of 39 knees between March 1994 and August 1997. Among them, 18 menisci of 17 knees were evaluated by second-look arthroscopy at 3 rnonths postoperatively. Lateral meniscus was 9 and medial meniscus was 9. The morpho- logical results were classified with completely healed, incompletely healed, and failed. The overall results showed that 13 menisci completely healed, 3 menisci incompletely healed, 2 menisci failed. The type of tear was 14 peripheral longitudinal tears, 1 oblique tear(incompletely healed), 1 transverse tear(completely healed with augmentation of fibrin clot), 1 tear at posterior tibial attachment, and 1 complex tear(completely healed). 3 menisci had associated lesions that had not been treated, of which 1 incompletely healed, 2 failed. Chronic cases, in which time interval between injury and repair was 6 weeks later, were 8 menisci(4 completely healed, 2 incompletely healed, and 2 failed). 10 long peripheral longitudinal tears of more fhan 2.5cm were resulted in 6 completely healed, 2 incompletely healed, and 2 failed. 5 longitudinal tear with a wide peripher- al rim(>2mm) were resulted in 1 completely healed, 2 incompletely healed, and 2 failed. The good result was expected when the tear was repaired in acute phase after injury and associated lesion was treated. For chronic tears, tears of avascular zone and wide longitudinal tears, the healing enhancement techniques such as fibrin clot insertion, abrasion of meniscus and synovium, and trephination must be taken into consideration.
Arthroscopy* ; Fibrin ; Knee ; Logic ; Menisci, Tibial ; Synovial Membrane ; Trephining

OBJECTIVE: Chronic subdural hematoma drainage is one of the most common procedures performed in neurosurgical practice. Not only burr hole drainage but also small craniotomy (diameter 3–5 cm) is frequently used neurosurgical treatment of chronic subdural hematomas. We assessed to compare the postoperative recurrence rates between burr hole drainage versus small craniotomy with closed-system drainage for chronic subdural hematomas. METHODS: From January 2016 to December 2018, 75 patients who were treated with burr hole drainage and small craniotomy with closed system drainage for the symptomatic chronic subdural hematoma were enrolled. Pre and postoperative computed tomography (CT) were used for radiologic evaluation. The choice of procedure was decided by preoperative CT images. RESULTS: 60 patients out of 75 patients underwent burr hole drainage, whereas 15 patients underwent small craniotomy. The overall postoperative recurrence rate was 16%. The recurrence occurred in 8 patients out of 60 patients in burr hole drainage group (13.3%) and 7 patients out of 15 patients in small craniotomy group (46.7%). The number of days of hospitalization was 10.3 days in burr hole drainage group and 15.7 days in small craniotomy group. CONCLUSION: Burr hole drainage would be sufficient to evacuate chronic subdural hematoma with lower recurrence rate, but small craniotomy was also needed in some cases such as hematoma has solid portion or multiple septum.
Craniotomy ; Drainage ; Hematoma ; Hematoma, Subdural, Chronic ; Hospitalization ; Humans ; Recurrence ; Trephining