• Title/Summary/Keyword: 악안면 결손

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CRANIOFACIAL RECONSTRUCTION USING VASCULARIZED OUTER TABLE CALVARIAL BONE FLAP : REPORT OF TWO CASES (혈관화 두개골 외층골피판을 이용한 두개안면부 재건)

  • Kim, Ki-Young;Jeong, Seung-Lyong;Jeong, Joo-Sung;Kim, Chang-Lyong;Lee, Seung-Ho;Park, Mun-Seong;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.546-554
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    • 1996
  • Vscularized calvarial bone flaps have been useful tools in the reconstuction of different type of bone defects in craniofacial surgery Vascularized bone transfer are often preferred to nonvascularized bone grafts because nonvascularized bone grafts are less resistant to infection, not as mechanically strong, and do not survive well in a poorly vascularized bed. Potential advantages of vascularized outer table calvarial bone flap include proximity to the operative field, membranous origin similar to that of the facial skeleton, maleability which allows for a variety of shapes and sizes, inconspicous donor sit scar. The following are the case reports of two patients who underwent craniofacial reconstruction suing vascularized outer table calvarial bone flap.

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THE OROFACIAL RECONSTRUCTION USING FREE RADIAL FOREARM FLAP ; THE EXPERIENCE OF 12 CONSECUTIVE FOREARM FLAPS (유리전완요골판(Free Radial Forearm Flap)을 이용한 구강안면부 결손의 재건 ; 전완요골판 12례의 경험)

  • Lee, Jong-Ho;Seo, Ku-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.3
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    • pp.305-318
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    • 1991
  • Reconstructive techniques of orofacial defects are very varied. In recent years, myocutaneous flaps, in particular the pectoralis major or latissimus doris myocutaneous flap have achieved popularity. In 1983, Soutar et. al. used the forearm free flap that had been developed in in China and popularised the radial forearm fasciocutaneous flap to reconstruct defects in the orofacial region. This paper presents the authors experience with 10 consecutive patients in which 12 flaps were used either as a fascioncutaneous flap or as a composite flap incorporating part of the radius. Some literatures were reviewed and the clinical results were discussed.

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MANDIBULAR RECONSTRUCTION BY TISSUE EXPANSION AND ILIAC BONE GRAFT (조직확장술및 장골이식을 이용한 하악골 결손부의 재건)

  • Lee, Kye-Young;Min, Kong-In;Cheung, Soo-Il;Park, Jae-Byum;Ahn, Jae-Jin;Kim, Do-Geun;Kim, Chal-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.4
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    • pp.449-453
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    • 2000
  • Soft tissue expansion is widely used technique in oral & maxillofacial reconstruction and provide new method of reconstruction in posttraumatic alopecia, post burn, wide scar, congenital deformity, benign tumor, tattoo, etc. Expanded tissue flaps have the advantage of increased vascularity, proximity to the defect, and similarity of color and texture. They also preclude the need to advance flaps from distant sites. Tissue expansion can be used to form a well vascularized cavity to accomodate and nourish bone grafts. The following report describes the uses of tissue expanders by allowing bone grafting to correct both soft and bony defects of mandibular region

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FREE VASCULARIZED SCAPULAR FLAP FOR MANDIBULAR RECONSTRUCTION (유리 혈관화 견갑골피판을 이용한 하악골 복합결손 재건)

  • Park, Kwang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.339-347
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    • 1996
  • Prior to the advent of microvascular surgery, conventional prosthetic rehabilitation offered limited success to re-establish the physiological function in oromaxillofacial reconstruction. Microvascular surgery provided a new frontier and there are multitude of flaps. Each flap has the benefits and limitation for the application to various defects. Advantage of the scapular flaps over other reconstructive methods include the ability to design multiple cutaneous panels on a separate vascular pedicle allowing improvement in three-dimensional relationship and osseointegrated implants can be palced to restore occlusal and masticatory function. Here I present the detailed description of the important surgical anatomy as well as graft dissection and clinical application of free vascularized scapular flap.

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MICROVENOUS ALLOGRAFTS IN RABBIT FEMORAL ARTERIES : EXPERIMENTAL STUDY OF FREEZE-DRIED ALLOVEINS (동종 정맥 이식을 이용한 가토 대퇴동맥 결손부 수복(동결건조 동종정맥이식의 실험적 연구))

  • Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.4
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    • pp.355-369
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    • 1991
  • 미세수술을 이용한 재건외과 분야에서 빈번히 혈관이식이 요구된다. 이러한 경우 자가정맥이 가장 널리 사용되고 있으며 그의 신뢰성도 인정되어 있다. 그러나 정맥 채취에 따르는 부가적인 수술이 요구되며 혈관 공여부에 또다른 결손을 초래한다. 동결건조동종정맥은 이러한 점을 보완하고 자가정맥을 대체할 수 있는 잠재성이 있다. 이에 동결건조동종정맥의 효율성을 알아보고자 2.5cm 길이의 가토대퇴정맥을 $-65^{\circ}C$, 200 mtorr의 음압으로 동결건조시킨 다음 대퇴동맥 결손부에 동종이식하고(n=24), 신선한 가토대퇴정맥 동종이식군(n=24)과 자가정맥이식군(n=24)을 1주 간격으로 4주간 비교 관찰하였다. 2주 개존율은 동결건조동종정맥 이식군, 100%;동종정맥이식군, 50%; 자가정맥이식군, 100%이었으며 4주 개존율은 동결건조동종정맥이식군, 83.3%;동종정맥이식군, 50%;자가정맥이식군, 100%로서 동결건조처치만으로 동종정맥이식의 생존율을 증가시켰다. 미세임파구세포독성검사에서는 동결건조정맥의 항원성이 상당히 낮아져있음을 알 수 있었다. 그러나 동결건조정맥의 내막세포화가 주사전자현미경 및 광학현미경 소견상 자가정맥보다 지연됨이 관찰되었다. 이러한 결과를 종합해 볼 때 동결건조동종정맥은 아무런 처치를 하지않은 신선 동종정맥보다 현저한 장점이 있었지만, 자가정맥이식을 대신할 수 있는 보다 더 좋은 대체방법이라는 견지에서는 임상 적용이 어려울 것으로 사료되었다.

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A Patient with Cleft Lip Combined with Branchial Cleft Cyst : A Rare Case Report (새열낭종을 동반한 구순열 환아의 증례보고)

  • Kwon, Myung-Hee;Leem, Dae-Ho;Ko, Seung-O;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.1
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    • pp.29-34
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    • 2010
  • 구순구개열은 두경부에서 가장 흔히 발생하는 선천적 기형 중 하나로 554명 중 1명의 빈도로 나타나며 인종에 따라 다양하다. 구순구개열 환아들은 다른 선천적 기형을 동반하여 나타나는 경우가 흔하며, 그 빈도는 문헌에 따라 다르지만 1.5~63.4%로 나타난다. 새열낭종은 두번째 인두강의 폐쇄부전으로 나타나는 선천적 결손으로, 주로 흉쇄유돌근 전방에 나타난다. 구순구개열 환자에 있어 새열낭종을 동반하는 경우는 매우 드물다. 전북대학교 구강악안면외과학 교실에서는 새열낭종을 동반한 구순열 환아 1례를 경험하였다. 환아는 우측 불완전 편측성 구순열로 내원하여, 구순성형술과 함께 우측 목에 존재하던 새열낭종에 대한 제거 수술을 시행하였다. 환아는 출생 당시부터 심실중격결손 및 동맥관개존증 등의 선천적 심장질환 및 갑상선 기능저하증을 가지고 있던 환아로 다양한 선천적인 결손을 동반한 본 환아의 증례를 문헌고찰과 함께 보고하는 바이다.

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RECONSTRUCTION OF MANDIBULAR DEFECT WITH COMPOSIITE AUTOGENOUS ILIAC BONE AND COSTOCHONDRAL GRAFTS (자가장골 및 늑연골의 복합이식을 통한 하악골 재건술)

  • Chang, Se-Hong;Ann, Jye-Jynn;Soh, Jae-Jung;Park, Chi-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.104-109
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    • 1991
  • Loss of mandibular continuity due to neoplasm, trauma, or infection results in major esthetic and biologic compromise. The use of costochondral grafts for reconstruction of temporomandibular joint, described first by Gillies in 1920, has been accepted as a suitable method for replacing the mandibular condyle, especially in growing children. Autogenous iliac bone graft has been a satisfactory source of mandibular reconstruction since Sykoffs report in 1900. Autogenous bone grafts from the posterior aspects of the ilium provide large amount of PMCB with acceptable donor site morbidity. In timing of reconstruction, initial disease, age, medical history, growth and development, esthetic and psychologic factors should be considered. We present a case of osteosarcoma in the mandible that was treated by a hemimandibulectomy and the defect was reconstructed 20 months later with composite method of costochondral and posterior iliac bone graft.

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USE OF AUTOGENOUS DERMIS-FAT GRAFT FOR RECONSTRUCTION OF ORAL AND MAXILLOFACIAL SOFT TISSUE DEFECT;A CASE REPORT (구강 악안면 연조직 결손 재건을 위한 진피 지방 이식의 이용;증례보고)

  • Park, No-Seung;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Lee, Byung-Joon;Hwang, Kyung-Kon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.348-352
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    • 1996
  • Soft tissue defects in oral & maxillofacial region caused by tumor resection, trauma, congenital deformities have been treated in autogenous soft tissue flap, allogenic material, free dermal graft, fascia graft. Of these methods, autogenous dermis graft had initially been applied in hernia treatment at the beginning of nineteenth century and have been applied in soft tissue augmentation coverage of vital structure, dead space removal and reconstruction of fascia. A fat graft is used in reconstruction of orbit at the enucleation, restoration of facial contours, etc. In this case, patient with chin soft tissue defect in traffic accident was treated in autogenous dermis-fat graft from patient's abdominal and gluteal region. Chin defect was reconstructed favorably. There was no severe atrophy of grafted area 12 months postoperatively. We will report the result that is favorable esthetically with literature review.

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Use of artificial palate for improving facial support in the fabrication of a maxillary obturator: A case report (상악골 부분 절제술 시행한 환자에서 Artificial Palate로 안모지지를 재현한 폐색장치를 이용한 수복 증례)

  • Yoon, Hee-Kyoung;Hwang, Hee-Seong;Kim, Chul-Hoon;Kim, Jung-Han;Kim, Bok-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.319-324
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    • 2017
  • Patients with maxillectomy defects predisposed to not only difficulty in deglutition, mastication, speech but also psychological depression from impaired facial esthetics that affect life quality. Obturator prostheses play a important role in restoring the lost form, function and the quality of life for patients with maxillectomy defects. This clinical report presents the simplified approach to predict the degree of adequate facial support by Artificial palate which reflected from a maxillary interim obturator during the stabilization period after maxillectomy.

FUNCTIONAL RECONSTRUCTION OF MANDIBULAR DEFECTS WITH FREE BONE GRAFT (유리골 이식을 통한 하악골 결손부의 기능적 재건술)

  • Kim, Jong-Won;Nam, II-Woo;Kim, Myung-Jin;Choung, Pill-Hoon;Seo, Byung-Moo;You, Jun-Young;Nam, Ki-Weon;Song, Min-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.338-345
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    • 1993
  • Mandibular discontinuity defect due to benign tumor, malignant tumor, infection, or truma results in major esthetic and biologic compromise. The primary goal of reconstruction is full restitution of function, which secondarily lead to normalization of the cosmetic deformity. The authors make a clinical study of 61 consecutive bone graft cases for mandibular reconstruction of discontinuity defect which were studied retrospectively using clinical data and radiographic findings. The cases were reviewed to evaluate the clinical success in the period from 1981 to 1990 in the Dept. of Oral & maxillofacial Surgery, Seoul National University Hospital. The criteria of the success in bone graft, are no residual infection, graft in with maintain its integrity, and remain over a half of its original size of graft in the radiographic features. The purpose of this clinical survey is to study of the mandibular discontinuity defects and success rate of free bone graft in mandibular defects. To summarize the clinical study of free bone graft, the main type of autogenous bone graft is iliac bone and corticocancellous type. Overall success rate is 80.3% in 61 followup cases over 6 months. Wire fixation and Extraoral approach has realtively better prognosis than other methods. It showed relatively poor prognosis in symphysis defects than other recipient site.

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