Morphometries of the Maxillary Sinus in Koreans / 체질인류학회지

The anatomical description and the relationship between the root apex and the inferior wall of sinus are critical in diagnoses and surgeries of the sinus pathoses, and in dental implantation. So, identification of the proximity between the root apex and the inferior wall of sinus and the clarification of cortical thickness of inferior wall of sinus are indicated the topography of spreading dental infection into the maxillary sinus. Therefore, anatomical knowledge of the topography between the root apex and the inferior wall maxillary sinus are important in the diagnosis and treatment planning of the dental implantation, endodontic procedures, and orthodontic treatment. The purposes of this study were 1) to clarify the morphological and clinical characteristics of the maxillary sinus, especially the inferior wall of sinus in Korean, 2) to identify the relationship between the inferior wall of maxillary sinus and the roots of maxillary teeth, and 3) to evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus. 33 sides of maxillae of the hemi -sectioned Korean heads were used in this study. All specimens were taken periapical radiographs, computed tomography and DentaScan reformatted cross -sectional images were taken for the radiographic evaluation of the maxillary teeth and inferior wall of maxillary sinus. From the CT images, 3 -dimentional reconstructive images of maxillary sinuses were made using the V -works TM 3.0 program. All specimens were decalcificated and then were sectioned coronally. On the sectioned specimen, 21 metric items were measured using the image analyzing system. The results were as follows: 1. In 6 categories of maxillary sinus according to their lateral aspects and shapes of the inferior walls, flat (54.5%) and round (21.2%) inferior wall of maxillary sinus were prominent. In 58.4%, the anterior limit of maxillary sinus was located in the 1st premolar area and the posterior limit was in the 3rd molar and maxillary tuberosity area (93.9%). The lowest level of the maxillary sinus was in the 1st molar and 2nd molar area. 2. From the 3 -dimentional reconstructive images of maxillary sinus, the maximum anteroposterior length of sinus was 39.3 +/-4.2 mm, the maximum height was 37.1 +/-5.6 mm, and the maximum width was 32.6 +/-6.5 mm. And the average volume of sinus was 15.1 +/-6.2 ml. All measurements were larger in male than female. Taken all together, this study demonstrated various anatomical characteristics and relationships between the maxillary sinus and their surrounding structures. Recognition of these findings may have an impact on the clinical management of patients.

Topography of the Inferior Wall of the Maxillary Sinus in Koreans / 체질인류학회지

The anatomical description and the relationship between the root apex and the inferior wall of sinus are critical in diagnoses and surgeries of the sinus pathoses, and in dental implantation. So, identification of the proximity between the root apex and the inferior wall of sinus and the clarification of cortical thickness of inferior wall of sinus are indicated the topography of spreading dental infection into the maxillary sinus. Therefore, anatomical knowledge of the topography between the root apex and the inferior wall maxillary sinus are important in the diagnosis and treatment planning of the dental implantation, endodontic procedures, and orthodontic treatment. The purposes of this study were to clarify the morphological and clinical characteristics of the maxillary sinus, especially the inferior wall of sinus in Korean, and to identify the relationship between the inferior wall of maxillary sinus and the roots of maxillary teeth. 24 sides of maxillae of the hemi -sectioned Korean heads were used in this study. All specimens were taken DentaScan reformatted cross -sectional images were taken for the radiographic evaluation of the maxillary teeth and inferior wall of maxillary sinus. All specimens were decalcificated and thenp were sectioned coronally. On the sectioned specimen, 21 metric items were measured using the image analyzing system. The results were as follows: 1. The distance between the each root apex and the inferior wall of maxillary sinus were measured. In the 2nd molar area the distance from the root apex to the inferior wall of sinus was the shortest and the longest in the 1st premolar area. 2. The thickness of the cortical plate of the inferior wall of maxillary sinus was thinnest in the 1st premolar area, whereas, the thickest in the 2nd premolar area. 3. The vertical relationship between the inferior wall and the roots of the maxillary molars was classified into 5 types. Type I (the inferior wall of sinus was located above the level connecting the buccal and lingual root apices) was predominant (54.5% in the 1st molar area, 52.4% in the 2nd molar area). 4. The horizontal relationship between the inferior wall of sinus and root apex were classified into 3 types. Type 2 (the alveolar recess of the inferior wall of sinus was located between the buccal and lingual roots) was predominant (80% in the 1st and 2nd molar area). Taken all together, this study demonstrated various anatomical characteristics and relationships between the maxillary sinus and their surrounding structures. Recognition of these findings may have an impact on the clinical management of patients.

Operative Treatment of Winged Scapula: A Report of 2 Cases / 대한정형외과학회잡지

Winging of the scapula is characterized clinically by a prominence of the vertebral border and inferior angle of the scapula. Trauma, neuritis, neural injury during surgical procedure and many other causes may develop winging of scapula. When pain and functional impairment persist, surgical intervention may become appropriate. We report two cases of winged scapula. One case was serratus anterior palsy due to blunt trauma, which was treated by transfer of teres major and pectoralis minor elongated with a tensor fascia strip. Another case was trapezius muscle palsy due to iatrogenic spinal accessary nerve injury, which was treated by transfer of the levator scapulae, rhomboid major and rhomboid minor muscle. In the former case, there was no weakness nor deformity of affected shoulder. In the later case, there was some residual pain and limitation of motion.

Fibrous Mass Complicating Epidural Steroid and Local Anesthetic Injection: A Case Report / 대한척추외과학회지

The use of epidural injection of local anesthetics with steroid for the treatment of back pain and sciatica is a widely used procedure. There have been several reports about spinal cord compression by granuloma or fibrous mass related to intrathecal or epidural morphine injection. There have been also some reports about arachnoiditis after epidural injection of steroid. However, there have been no reports regarding dural sac or nerve root compression by fibrous mass after epidural steroid injections. We would report a case of dural sac and nerve root compression secondary to the formation of fibrous mass in the lumbar epidural space after epidural steroid and local anesthetic injections. In this case, the characteristic radiologic findings before and after epidural injection therapy and clinical progress were documented.