Masseter Muscle Reduction Using Radiofrequency Rhizotomy

Most Korean women prefer ovoid face to squared one and many female patients with squared face want to reduce their lower facial width. Mandibular angle ostectomy and botulinum toxin injection used to be the most common procedures performed to produce this purpose. After botulinum toxin, a series of non-invasive methods to reduce masseter muscle hypertrophy have been introduced. Radiofrequency rhizotomy was first used to treat chronic pain, such as, trigeminal neuralgia and showed good and long-lasting results. This concept of rhizotomy technique was then modified to block motor nerve conduction and used to treat motor dysfunction including painful spasticity. We tried this technique to reduce masseter hypertrophy by blocking the masseteric nerve using radiofrequency. From March 2007 to October 2007, 19 female patients underwent this masseter reduction using radiofrequency rhizotomy and follow-up period was 2 to 6 months. Most results showed reduction of masseter volume with improvement of lower facial contour and no significant complication occurred. The advantages of this method are safety, durability and cost-effectiveness and we think that this technique can be a good alternative method for treating masseter hypertrophy. But, longer follow-up periods and further studies are required to consolidate long-term results.

Angiographic Analysis of Cerebral Aneurysm

PURPOSE: To analyze the angiographic findings of cerebral aneurysms and to compare them with previousdomestic and foreign reports. MATERIAL AND METHODS: Three hundred and seventeen patients underwent DSA(digitalsubtraction angiography) and the results were retrospectively, reviewed. Among 278 patients, 356 cerebralaneurysms were detected. Patient's age and sex ratio were analysed, as well as the location, size and multiplicityof the aneurysms. RESULT: The most prevalent age group was 40 to 60 years (n=211, 76%), and the male to femaleratio was 1:1.5. Aneurysms were located in the anterior (n=324, 91%) or posterior circulation(n=32, 9%). In theformer, the most common locations were the anterior communicating artery (n=98, 28%), middle cerebral artery (MCA)bifurcation(n=65, 18%) and the posterior communicating artery (n=32, 9%), while in the pasterior circulation, themost common location was the basilar tip(n=11, 3%). One hundred and eighty-eight cerebral aneurysms(53%) were 3-6mm in size, and 75(21%) were 6-10mm. The size of nine aneurysms (3%) was more than 25mm. Multiple aneurysms(n=149)occurred in 65 patients(23%) ; the most common age group was 40 to 60 (74%) and the male to female ratio was 1:4.The most common number of multiple aneurysms were two (77%) and the common locations were the posteriorcommunicating artery (21%), MCA bifurcation (18%) and anterior communicating artery (13%). CONCLUSION: Weanalyzed a large series in a single center and therefore expect that our data will be helpful for the analysis ofaneurysms in the cerebral circulation and for comparison with domestic and foreign studies.

Analysis of Angiographic Findings in Arteriovenous Malformations (AVM) of Brain According to PresentingClinical Manifestations

PURPOSE: To evaluate the different angio-architectures of brain arteriovenour malformatigns (AVMs) accordingto the presence of non-hemorrhagic symptoms or intracerebral (ICH) and/or intraventricular hemorrhage(IVH). MATERIALS AND METHODS: The results of complete cerebral angiography obtained in 215 patients with AVM between1989 and 1994 were retrospectively reviewed. The M:F ratio was 136:78 and their mean age was 29 (ranged 4 - 66)years. On the based of clincal presentation, CT and/or MR images, they were divided into hemorrhagic andnon-hemorrhagic groups. Angiograms were analyzed by two radiologists for the size and location of nidus; thenumber of feeding arteries and the extent of aneurysm, stenosis, dural supply, and angiomatous change; the numberof draining veins and the extent of deep or superficial drainage, stenosis, ectasia, kinking, and stasis. Thestandard chi-square test was used for statistical analysis. RESULTS: Hemorrhage was noted in 140 patients(65%),and no hemorrhage in 75(35%). Hemorrhage was more common in AVM with deep-seated and callosal locations, a nidusof less than 2cm, single feeder and single venous drainage, and deep venous drainage only (p < 0.05 - 0.001).Non-hemorrhagic presentations were more common in AVM with cortical and subcortical location, a nidus of more than5cm, angiomatous change, dural supply, both superficial and deep venous drainage, kinking, and stasis (p <0.05-0.001). CONCLUSION: The angio-architechture of AVM with hemorrhage correlated with clinical symptomaticpresentation. Analysis of the patterns of angioarchitectureis useful for prognosis and in deeiding the direetionof freatment.

A CLINICAL REVIEW OF EXPOSED FRONTAL SINUS

No abstract available.

THE APPROACH OF SKULL BASE LESIONS IN THE VIEW POINT OF PLASTIC SURGERY

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.

Aorto-bicarotid-subclavian bypass in Takayasu's arteritis: one case report / 대한흉부외과학회지

No abstract available.