• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.105-109
• /
• 2008

Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.2
• /
• pp.137-143
• /
• 1991

The bulging of mandibular angle area, frequently, make some difficulties in social life due to its reckless appearence, especially in oriental nations. So, many authors had reported its causes and surgical techniques for correction since late 19th century with diagnosis of masseter hypertrophy. But in spite of its muscular origin, major surgical techniques, in general, should aim complete bony reduction or osteotomy and supplemental myotomy as in hemimandibular hypertrophy or mandibular elongation. We used ultrasonogram for soft tissue depth estimation and expearenced some complications such as incomplete lingual cortical bony reduction, condylar fracture in mandibular angle reduction via intraoral circumvestibular approach. So we reported our surgical technique for angle reduction with possible complications.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.12 no.2
• /
• pp.82-87
• /
• 1990

There are some methods of approach to the temporomandibular joint. The preauricular, the endaural and the postauricular incision are frequently used among those. The preauricular incision necessiates a preauricular scar, possible postopertive facial nerve damage and is the least cosmetically desirable incision. The endaural incision is more esthetic than preauricular incision, but it is not sufficient. The postauricular approach allows adequate exposure with decreased occurence of injury to facial nerve and excellent cosmetic results. The purpose of this report is to discuss the surgical approach of postauricular incision to the cases of TMJ ankyloses, internal derangement and condylar fracture of mandible.

• Korean Journal of Cleft Lip And Palate
• /
• v.13 no.1
• /
• pp.23-28
• /
• 2010

대한악안면성형재건외과학회는 2004년도부터 매년 인도적 차원에서 의료 환경이 낙후된 Vietnam의 cleft lip and palate 환자들을 치료하기 위해 무료로 해외 진료 봉사 활동을 해왔다. 초창기 해외 진료 봉사 활동 당시 베트남 의료 기술 발달이 미비하여 준비해야 할 것들이 많았으나 이 후 베트남의 경제 발전과 함께 의료 시설 및 의료 기술이 발달함에 따라 준비 품목 등이 간단명료해지고 현지 지원 및 수술 준비도 원활히 진행되었다. 이러한 무료 의료 봉사 활동을 계기로 개발도상국의 낙후된 의료 시설 및 의료 기술 발전, 의료 혜택을 받지 못한 구순 구개열 환자의 정상적 안모 및 기능 회복, 조건 없는 의료 봉사 활동을 통한 민간외교 효과 및 양국간의 우호 증진 등의 성과가 있었다. 대한악안면성형재건외과학회에서는 2009년도 역시 베트남 National Institute of Odonto-stomatology 에서 11월17일부터 26일까지 cleft lip and palate 무료수술진료단(단장 신효근)을 보내 수술봉사 활동을 펼치고 돌아 왔다. 일반적인 구순구개열 뿐만 아니라 양측성 안면열(Bilateral Facial Cleft), 사경(Torticollis) 등의 희귀 기형을 포함하여 수술을 진행하였으며 총 31례의 수술을 성공적으로 마쳤으며 지난 6년 동안의 성과와 함께 이에 대한 보고를 하고자 한다.

• Korean Journal of Cleft Lip And Palate
• /
• v.5 no.2
• /
• pp.109-112
• /
• 2002

구순 구개열 환자의 악교정 성형수술로 구강내 Le Fort II 골절단술이나 비중격 성형술이 많이 이용되는데, 이때 비골의 외측골절단술을 요하며, 이에 대한 술 후 합병증으로 비루관의 폐쇄나 비골의 분쇄골절 등이 발생할 수 있어, 악안면기형 환자를 다루는 구강악안면외과의사에게 비루관의 웅용해부학적 연구는 중요하다. 본 연구의 목적은 교합면을 기준으로 촬영된 컴퓨터 단충 촬영에서 비루관의 위치와 크기를 조사하는데 있다. 2000년 7월부터 2003년 2월까지 서울대학교병원 구강악안면방사선과에서 컴퓨터 단층촬영을 시행한 환자 62명을 대상으로 비상악봉합선에서 비루관까지의 최단거리와 비루관의 최대반경과 최소반경을 측정하였다. 우측비상악 봉합선에서 비루관까지의 거리는 5.68mm이고, 좌측은 5.67mm였다. 좌우 및 성별간의 차이는 없었다. 이의 해부학적 지견은 악기형 수술시의 비루관 폐쇄라는 합병증의 예방책으로 기여하리라 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.2
• /
• pp.186-190
• /
• 1995

타석증을 동반한 만성 악하선 타액선염의 경우 악하선 적출은 일반적인 치료 방법이다. 일반적으로 악하선 적출술은 수술의 용이성, 수술시야의 확보 등의 장점으로 구강외접근에 의해서 시행되어져 왔다. 그러나 시대적으로 심미적인 요구가 증대되고 있는 요즈음 구외 접근으로 인한 술후 반흔은 구외접근법의 가장 결정적인 단점이라 할 수 있다. 또한 설하선과 함께 적출하여야 할 경우 구내접근과 구외접근을 동시에 실시할 경우 술후 치유과정상의 후유증을 유발할 수도 있다. 반면에 구강내 접근에 의한 악하선의 적출은 수술상의 고도의 난이도로 수술자체의 어려움은 있으나 구강의 반흔을 남기지 않아 심미적으로 만족할 만한 결과를 얻을 수 있다. 이에 본 저자 등은 타석증을 동반한 악하선 타액선염의 환자에 있어 구내 접근으로 악하선 및 설하선 적출술을 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.20 no.3
• /
• pp.214-216
• /
• 1998

In the treatment of maxillary lesion including a maxillary sinuses, most of oral and maxillofacial surgeons have used the vestibular incision or the Weber-Fergusson incision. However, the vestibular incision has disadvantage which it provides a rather limited exposure and the Weber-Fergusson incision leaves visible scar in the midface. Furthermore, because the scar is confined on unilateral side only, the technique is hesitated to apply especially in children, younger patients and women. Since Casson first introduced midfacial degloving technique, this approach has been used frequently to treat the lesion on nasal cavity, nasopharynx, skull base and paranasal sinuses by ENT surgeons. But, we think this technique can be used usefully in oral and maxillofacial regions. So, we experienced favorable results which it provided a proper exposure, no visible facial scar and it could be used on bilateral midfacial lesions.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.15 no.4
• /
• pp.329-337
• /
• 1993

Improvement of orthognathic surgical techniques make it possible to design esthetic surgical correction for total esthetic face. In order to find the esthetic line which guide esthetic surgical correction in patients of orthognathic surgery, cephalometric soft tissue analysis of esthetic faces were performed. In esthetic Korean young adults, 25 males and 25 females who were within 1 S.D. of E-line, ANB, P/A facial height ratio, were analyzed in natural position keeping their face eye level. 1. Sn position is constant in males and females. The Sn-N'-N' Vertical plane angle is $5.3^{\circ}$ in both sexes. Sn is positioned in front of 5 mm in female 7 mm in male from the N' vertical plane. 2. The Sn-Ls line make constant angle to horizontal plane with $72.5^{\circ}$ in both sexes, which is called "upper esthetic line". The Ls-Pg' line makes constant angle to $72.4^{\circ}$ (range $72.2^{\circ}$ in female to $72.6^{\circ}$ in male), which is called "lower esthetic line". 3. When inter-esthetic line angle (the Sn-Ls line to Ls-Pg' line) has $144.9^{\circ}$, lower third face has esthetic upper and lower lip. 4. In treatment planning, Sn is first corrected in proper position, and then upper and lower esthetic line are established with the angle of 144.9. The maxilla is moved to tangent Ls to the upper esthetic line, and mandible is moved to tangent Li and Pg' to the lower esthetic line, according to the "y"-shaped esthetic lines, then lower third face showes esthetics.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.20 no.2
• /
• pp.148-151
• /
• 1998

There are many vessels in oral and maxillofacial region. Therefore blood oozing is a frequent findings in this area when operation takes place. Beacuse of this, most oral and maxillofacial surgeons as well as operators of this region usually use bosmine soaked gauze for oozing control during operation. Theoretically overdose of systemic epiniephrine(bosmine) may lead to pulmonary edema due to secondary systemic volume overload. For this reason, oral and maxillofacial surgeons should give more attention to the use of bosmine soaked gauze. In spite of this possibility, epinephrine induced pulmonary edema using bosmine soaked gauze has not been reported. We experienced one case of pulmonary edema which was induced by epinephrine overdose by bosmine soaked gauze that has not been diluted by mistake in preparing bosmine soaked gauze. The authuors report a case with review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.4
• /
• pp.407-413
• /
• 1999

Maxillary duplication is a kind of proliferative neurocristopathy and considered to arise from bifurcation of neural crest elements soon after migration into mandibular arch. Sometimes this malformation is accompanied with oblique facial cleft. Usually this type of maxillofacial malformation requires multiple surgical intervention and the results are far from ideal. It became more troublesome if it had not been properly corrected on time, because secondary deformities could be developed from growth and development of abnormal tissues. This is a case of a 25-year-old-female patient who showed severe facial asymmetry thought to secondary deformity of maxillary duplication and masticatory disturbance due to multiple supernumerary teeth on posterior part right maxilla. We successully treated these deformities through four times of surgery of bone resection, orthodontic treatment, zygomatic and orbital reconstruction, orthognathic surgery and scar revision... ect. So we reported this rare case with review of literatures.