• 대한치과마취과학회지
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• 제7권1호
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• pp.22-26
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• 2007

상악과 하악이 선천적으로 붙어서 태어나는 선천성 유합증은 드문 선천성 기형으로 단순히 점막이 붙은 점막유합증에서 악골이 붙은 골유합증까지 다양하게 나타난다. 이중 상악골과 하악골의 골자체가 붙는 골유합증은 아주 드물어서 현재까지 26증례만 보고되고 있는데, 보고된 대부분의 증례는 편측에만 발생하는 불완전형으로 알려져 있다. 7세 된 여아환자가 인디아의 GSR 병원에 입이 벌어지지 않는다는 주소로 내원하였는데 환아의 턱은 완전히 움직이지 않았으며, 2-3 mm 정도 벌어지는 앞니부위에서는 2.5 cm 폭경의 3.0 mm 두께의 단단한 치조점막이 관찰되었다. 전기메스로 전방부의 부착성 섬유밴드를 잘라준 후 즉각적인 개구정도는 16 mm 정도까지 가능하여 구강으로의 기관삽관이 가능하였다. 삽관후 양쪽 후방부 협측점막의 두꺼운 밴드들을 모두 제거하여 개구량을 33 mm까지 증진시킨 후 수술을 종결하였다. 환아의 보호자에게 거즈 블록과 설압자를 이용하여 개구 연습을 능동적으로 시키도록 강조하여 교육하였으며 술후 16개월 경과시까지 특별한 합병증이나 개구량 감소는 관찰되지 않았다. 독립적으로 발생한 선천성 치조점막 유합증 환자에서 비정상적으로 커져있는 과두와 설골이 관찰되었는데, 설-하악 구조의 비정상적인 발육에 기인하여 지속적인 비정상적 운동으로 인한 이차적인 치은과 협점막의 섬유성 부착이 생긴 것으로 추측되었다. 이에 마취과와의 효율적인 협진으로 기관절개술 등의 부가적인 마취방법 없이 효과적으로 치료할 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.27-34
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• 2006

After orthognathic surgery in skeletal class III patients, the hyoid bone position and the upper airway dimension could be changed due to mandibular setback. There has been many studies about airway dimension of the patients with skeletal class II malocclusion or obstructive sleep apnea. but not with skeletal class III. The purpose of this study was to examine the change of position of the hyoid bone and the consequent change of airway space as the result of retrusion of mandible after orthognathic surgery in skeletal Cl III malocclusion patients. It is also to apply this results in predicting, diagnosing and treating the subsequent obstructive sleep apnea. Forty patients who were diagnosed as skeletal Cl III maloccusion, received orthoganthic surgery of both jaws including mandibular setback, and were followed up post-operatively for more than 6 months were selected. There were 10 male patients 30 female patients. The preoperative and postoperative lateral cephalograms were traced and the distances and angles were measured. The nasopharyngeal space increased postoperatively while the oropharyngeal space decreased. Except for the change of oroparyngeal space, the changes in male patients were greater than female patients. The hyoid bone moved in the posterior-inferior direction, and the change was greater in males than in females. If the postoperative mandibular setback is great, then a significant decrease of airway space and posterior and inferior movement of the hyoid bone were observed. This can result in symptoms related to obstructive sleep apnea. This result should be considered in the diagnosis and treatment planning of orthognathic surgery patients.

• 대한치과교정학회지
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• 제24권4호
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• pp.827-839
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• 1994

This study was conducted to assess the positional changes of hyoid bone following the use of activator in Angles class III malocclusion patients with functional factors. For this study, 40 Angle's class I patients and 40 Angle's class III patients, totally 80 subjects were used. They are all in Hellman's dental age IIIB-IIIC ranges. In lateral cephalogram to compare Angle's class I group and Angle's class III group, and the positional changes of the hyoid bone before and after the use of activator in Angle's class III malocclusion group. The results were obtained as follows; 1. Comparison of Angle's class I group and Angle's class III group. In comparison to Angle's class I group, hyoid bone is more anteriorly and superiorly positioned in Angle's class III group. The hyoid bone showed reverse inclination to the mandibular plane in Angle's class III malocclusion group. 2. Comparison of the hyoid positional change before and after use of Activator in Angle's class III malocclusion group. The hyoid bone is displaced posteriorly and inferiorly in vertical relationship. The hyoid bone also showed counter-clockwise rotation. 3. No statistical difference was found between after Activator use data of Angle's class m malocclusion group and Angle's class I group. It is concluded that the hyoid bone in Angle's class III malocclusion group changed its position, similar to Angle's class I malocclusion group.

• 대한치과교정학회지
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• 제23권4호
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• pp.693-705
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• 1993

The purpose of this study was to investigate the functional adaptation of the tongue, the hyoid bone, the digastric muscle and the upper airway and the variables predicting postoperative stability following orthognathic surgery in patients with mandibular prognathism. 18 patients were selected(8 men and 10 women) for this study, who had received orthognathic surgery. Their lateral cephalograms, those were taken preoperatively, immediate postoperatively and over 6 months follow-up, were traced and analysed. The results were as follows : 1. The downward displacement of the hyoid bone and extended head posture were recognized, right after operation. Statistically significant correlations were found between the changes of the mandibular position and the digastric muscle and the change of head posture during operation. 2. The tongue was displaced downward following the hyoid displacement postoperatively. Statistically significant correlations were found between the change of the mandibular position and the change of the distance of the tongue and hard palate, and between the change of head posture and the changes of the upper airway sizes, the digastric muscle and the hyoid position during over 6 month's follow-up. 3. The change of the distance of the tongue and hard palate was the most significant factor for prognosis during over 6 month's follow-up. 4. There were no variables before operation to predict the postoperative stability and the constriction of the upper airway.

• 한국어류학회지
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• 제10권2호
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• pp.231-240
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• 1998

납자루아과(亞科)에 속하는 가시납지리(Acanthorhodeus gracilis)의 두골(頭骨), 척주(脊柱), 지느러미 골격을 조사하였다. 두개부(頭蓋部)에 천문이 없으며, 상사골(上篩骨)의 전단에 돌기가 없고, 안와설골(眼窩楔骨)은 2개로 되어 있다. 기저후두골(基底後頭骨) 돌기(突起)는 전반부에서부터 발달하였고, 상후두골(上後頭骨)은 높은 삼각형 형태의 돌기를 갖고 있으며, 미설골(尾舌骨)은 선단(先端)이 2분기(分技)되고 수평판(水平板)과 수직판(垂直板)의 후방(後方)이 넓어지며 후연(後緣)이 돌출되어 있다. 인두치(咽頭齒)는 1열로 인두치식(咽頭齒式)은 5 - 5이며 4개의 유리치(遊離齒)를 갖고 있다. 편대(扁帶)에는 오훼골(烏喙骨) 구멍이 없으며, 미골추체(尾骨推體)에는 미신경골(尾神經骨)이 나타나지 않고, 길고 가느다란 후요대돌기(後腰帶突起)를 갖는다. 유리신경간련(遊離神經間練)은 넓은 판상(板狀)이고, 신경간극(神經間棘)은 14~15개이며 제1~제4신경간극(神經間棘)은 하나의 기기골을 나머지는 두 개의 기기골을 기부(基部)에 갖고 있고, 혈관간극(血管間棘)은 11~12개이며 제1~제 4혈관간극(血管間棘)은 하나의 기기골을 나머지는 두 개의 기기골을 갖고있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권4호
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• pp.476-490
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• 1991

Although various technical details of the surgical procedures have been improved, Skeletal relapse is the most noteworthy complication of orthognathic surgery. It seems to be an imbalance of the perioral muscular groups resulting from changes in the cavitas oris propria after surgery. Among other factors, it is widely known with the changes of tongue posture, as indicated by the hyoid position. Ten patients that had undergone mandibular setbacks by way of Modified Obwegeser method were evaluated retrospectively. The serial cephalometric films were taken preoperatively, immediately postoperatively, after removal of IMF, and at a subsequent long-term follow-up period. The cephalometric evaluation of tongue posture were based on stable craniofacial landmarks. The relation between the 2-dimensional changes of tongue posture and hyoid position and the relapse of mandibular setback are discussed. Anatomic changes that were found to accompany such setback are as follows. 1.There are 2 cases of relapse in 10 patients at long-term follow-up(20%) 2.The tongue was moved posteriorly and its size was reduced anteriorly and posteriorly at immediate postoperative change and then the mandible shifted slightly toward the preoperative position, but the long was adapted to its new environment due to changing the position of its posterior part, and also the hyoid that moved posterioly and inferiorly was stabilized sightly posteriorly than its original position. 3.On the distance change of the suprahyoid muscle, the distance of P-H, ST-H was increased at immediate postoperative change(p<0.01) and decreased at IMF period(p<0.001), but the distance of H-Me, H-Ge was slightly decreased at IMF and long-term period(p<0.05). 4.On the width change of the pharyngeal air way, the width of the upper part of the pharyngeal space was lightly contracted at IMF and long-term period(p<0.05). 5.On the relation between mandibular setback and tongue posture and hyoid position, the significant correlation was found between the changes of some parts of mandibular setback and those of tongue posture, and not found those of hyoid position.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.164-171
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• 2000

Purpose : This study was aimed at measuring the changes in the hyoid bone position, tongue position, and pharyngeal airway space in subjects with mandibular setback osteotomies. Methods : Twenty patients were evaluated retrospectively for their changes in pharyngeal airway space, tongue and hyoid bone positions. All patients underwent surgical mandibular setback using bilateral sagittal split osteotomies. The cephalometric analysis was performed preoperatively, and 1 week, 3-6 months, and 1 year postoperatively. Result : The hyoid bone moved inferiorly and posteriorly immediately after surgery, and it returned to the preoperative position during follow-up period. The nasopharyngeal airway space was not significantly changed after surgery. A considerable decrease in the oropharyngeal and hypopharyngeal airway spaces following mandibular setback surgery was found. The upper and lower tongue was posteriorly repositioned immediately after surgery. During follow-up period, the hypopharyngeal airway space and lower tongue posture returned to the preoperative positions, but the oropharyngeal airway space and upper tongue posture were not significantly changed. The position of pogonion remarkably changed to backward immediately after surgery, but slightly anterior advancement was found during follow-up period. Conclusion : Immediately after mandibular setback surgery, the oropharyngeal and hypopharyngeal airway spaces obviously decreased due to posterior and inferior repositions of the tongue and hyoid bone. During follow-up period, lower tongue and hyoid bone returned to the preoperative positions, it was related to advancement of the pogonion in this period. The narrowing of the oropharyngeal airway space and posterior movement of the upper tongue posture were relatively permanent after mandibular setback surgery. We suspected this phenomenon had an influence on maintaining the total volume of oral cavity against mandibular setback.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권3호
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• pp.173-181
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• 2003

Purpose : This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. Materials and methods : Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT & cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me & H, long axis angle of left & right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me & H. The angular & lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA & FH-NB, and coordinates(x,y) of B, Pog, Me & H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. Results : The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me'& H' were revealed the strong positive correlation. Conclusion : The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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• pp.7.3-8
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• 1977

이비인후과 영역에서 유표피낭종이 구강내에서 흔히 발생하지는 않으나 만약 존재한다면 보통 하악과 설골사이에 위치한다. 더구나 후두개에 발생한 유표피낭종은 드물게 보는 것으로서 최근 저자들은 후두개의 후두면에 발생한 유표피낭종 1례를 경험하고 경설골 인두절개술을 이용하여 종물에 접근하여 조대술을 시행한 후 성공적으로 치료된 1례를 보고하는 바이다. 환자는 46세된 남자로서 입원 이년전부터 간헐적인 인두통, 8개월부터 사성 및 1개월여의 호흡곤란을 주소로 내원하였다. 간접 후두경 검사로 후두개의 우측 후두면에 둥글고 표면이 매끄러우며 탄력성이 있고 그 크기가 구난 크기인 종물을 발견 할 수 있었다. 생검조직검사 결과 상피세포성 폴립으로 판명되어 입원하고 경설골 인두절개술을 이용하여 낭종의 조대술을 실시하였다. 술후 조직검사 결과 유표피낭종으로 판명되었고 경과가 양호하여 아무런 후유증 또는 합병증이 없이 퇴원하였기에 보고한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.343-350
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• 2000

The goal of this study is the comparison of upper airway size and change of skeletal Class I group and skeletal Class III group (before operation, within 2 weeks after operation, 6 months after operation) respectively. At first, we measured the lines between selected upper air way landmarks on lateral cephalometric x-ray film of skeletal Class I 40 persons whoes age were 23-26 years old, ,and did the same lines of landmarks of skeletal Class III 44 persons who had not been operated yet, were within 2 weeks after operation, were 6 months after operation. And we compared it respectively and analyzed it with paired t-test. We studied the relationship of those on produced data. 1. Skeletal Class III group was narrower in nasopharyngeal air way space than that of skeletal Class I group, and increased in thickness of oropharyngeal, hypopharyngeal wall within 2 weeks after operation, and reduced in nasopharyngeal, oropharyngeal air way space, and did in thickness of nasopharngeal, hypopharyngeal wall 6 months after operation. 2. Skeletal Class III group reduced in nasopharyngeal, oropharyngeal air way space, and increased in thickness of nasopharyngeal, oropharyngeal, hypopharyngeal wall within 2 weeks after operation, restored the thickness of nasopharyngeal, oropharyngeal wall, but did not restored nasopharyngeal, oropharyngeal, hypopharyngeal air way space. 3. Vertical length from hyoid bone to mandibular plane did not have signifacant difference from Class I group but after operation, it increased more than Class I group significantly. 4. The size of airway reduced after operation. Among this, oropharyngeal airway most reduced.