Ghost Surgeries Must Be Eradicated

No abstract available.

Orbital Volume Change Measured by Computed Tomography in Blow Out Fracture

Enophthalmos is a common result of blow out fracture of the orbit. Prior to CT volume analysis no reliable measurement of the degree of bony and soft tissue deformity was available to identify patients who would develop enophthalmos. Evaluation of orbital volume expansion and volume expansion percentage were performed in 23 patients with blow out fracture, after 1-4 days of injury. All studies were performed on a CT (Somatom Plus, Germany, Siemens), using transaxial scan technique(140 kVp, 206 mA, 3 mm contiguous sections). The radiological boundaries of the orbit were defined anteriorly by a line mrrecting the anterior surface of the zygomaticofrontal process to the nasomaxillary suture and posteriorly to the optic foramen. The Hounsfield Unit(HU) ranges were -100 to 0 and 0 to +100. It is difficult to distinguish blood from fat in the orbital volume measurement. We used three methods to obtain more accurate orbital volume. First, The concave margin or the air meniscus surface area is blood and the convex margin area is fat. Second, It can be distingushed blood from fat by Hounsfield Unit of specific area pixel. Third, The homogenous area is blood and inhomogenous area is fat or mixture of fat and blood. The patients(> or =13% orbital volume expansion) are managed surgically. 15 patients were classified in operative group and 8 patients were in conservative treatment group. The volume expansion percentage is 12.7% to 28.8% in operative group and 4.2% to 11.2% in conservative group. There was no enophthamos in each groups after 3 months of operation and injury. CT measurements of orbital volume expansion and volume expansion percentage can predict the final degree of the late enophthalmos and may facilitate the planning of surgical intervention. To obtain more accurate prediction of enophthalmos, we consider not olny volume expansion but also volume expansion percentage, because everyone doesn't have the same normal orbital volume.

A comparisin of the Operative Results and Costs Between Interosseous Wiring and Miniplate Fixation in Open Reduction of Mandible Fracture

Mandible fractures have recently been managed by rigid internal fixation with miniplate and screws more often than by traditional interosseous wiring methods. The purpose of this paper was to compare traditional interosseous wiring with miniplate fixation in open reduction of mandible fracture, especKweonially in operative results and costs. From June of 1989 to June of 1998, there were 142 patients, admitted to the department of Plastic and Reconstructive Surgery, Chun-Cheon Sacred Heart Hospital, Hallym University. Of those, 101 patients were managed by open reduction, and among them, 83 patients were treated with miniplate fixation, but 18 patients had recently been treated with interosseous wiring methods. No significant difference was noted between the two groups in terms of complications, but the overall cost of miniplate and screws was higher than interosseous wiring, while the mean operative time was longer in the group treated with miniplate fiation. The authors recommend interosseous wiring technique for patients with mandible fractures requiring open reduction and fixation, except for absolute indications of rigid internal fixation.

A Study of Partial Excision and Suvdermal Exicision in Surgical Treatment of Axillary Osmidrosis

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.