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        Cumulative Sum Analysis of the Learning Curve of Ptosis Surgery: External Levator Advancement versus Müller Muscle-conjunctival Resection

        Mehmet Serhat Mangan,Akin Cakir,Serhat Imamoglu 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.5

        Purpose: Even though it is stated that external levator advancement (ELA) has a much longer learning curve than Müller muscle-conjunctival resection (MMCR) in the treatment of aponeurotic ptosis, there is no study in the literature regarding the learning curves of these two surgical techniques. We aimed to objectively determine the length of the learning curves of ELA and MMCR using cumulative sum (CUSUM) analysis. Methods: The first 30 unilateral ELA and the first 30 unilateral MMCR consecutively performed by a single surgeon were retrospectively reviewed. The CUSUM method was used to analyze the learning curves of ELA and MMCR based on operation times of consecutive surgeries and the clinical outcomes were compared. Results: CUSUM analyses revealed that the operation time stabilized after around 11 ELA surgeries and 12 MMCR surgeries and R2 value for ELA and MMCR were 0.93 and 0.91, respectively. There was no significant difference in these stratified analyses. Mean operation time was 45.7 minutes in the ELA group and 34.1 minutes in the MMCR group (p = 0.002). Total number of intraoperative complications was 37 in the ELA group and 16 in the MMCR group (p = 0.015). Symmetry success rate was significantly higher (p < 0.0001) and reoperation rate was significantly lower in the MMCR group (p = 0.045). Conclusions: Even though ELA is more challenging than MMCR, comparable learning curves indicate that surgeons in training need to be encouraged to perform both techniques. The challenges and obstacles that the surgeons in training face in these two techniques need to be analyzed in detail.

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        Autologous blood injection to the temporomandibular joint: magnetic resonance imaging findings

        Candirli, Celal,Yuce, Serdar,Cavus, Umut Yucel,Akin, Kayihan,Cakir, Banu Korean Academy of Oral and Maxillofacial Radiology 2012 Imaging Science in Dentistry Vol.42 No.1

        Purpose : The aim of this study was to investigate the effect of the autologous blood injection (ABI) for chronic recurrent temporomandibular joint (TMJ) dislocation using magnetic resonance imaging (MRI). Materials and Methods : ABI was applied to 14 patients who had chronic recurrent TMJ dislocation. MRIs of the patients were taken and compared before and one month after the injection. Results : All of the patients had no dislocations of their TMJs on clinical examination one month after the injection. In the pre-injection, unilateral or bilateral TMJ dislocations were observed on MRIs in all patients. One month after the injection, TMJ dislocations were not observed in MRI evaluation of any patients. A significant structural change that caused by ABI was not observed. Conclusion : The procedure was easy to perform and it caused no foreign body reaction. However, it was unclear how the procedure prevented the dislocation.

      • SCOPUSKCI등재

        Autologous blood injection to the temporomandibular joint : Magnetic resonance imaging findings

        Celal Candirli,Serdar Yüce,Umut Yücel Cavus,Kayihan Akin,Banu Cakir 대한구강악안면방사선학회 2012 Imaging Science in Dentistry Vol.42 No.1

        Purpose : The aim of this study was to investigate the effect of the autologous blood injection (ABI) for chronic recurrent temporomandibular joint (TMJ) dislocation using magnetic resonance imaging (MRI). Materials and Methods : ABI was applied to 14 patients who had chronic recurrent TMJ dislocation. MRIs of the patients were taken and compared before and one month after the injection. Results : All of the patients had no dislocations of their TMJs on clinical examination one month after the injection. In the pre-injection, unilateral or bilateral TMJ dislocations were observed on MRIs in all patients. One month after the injection, TMJ dislocations were not observed in MRI evaluation of any patients. A significant structural change that caused by ABI was not observed. Conclusion : The procedure was easy to perform and it caused no foreign body reaction. However, it was unclear how the procedure prevented the dislocation.

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