• Title/Summary/Keyword: Advancement of Korean

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The Adipofascial V-Y Advancement Flap with Skin Graft for Coverage of the Full-Thickness Burns of the Gluteal Region

  • Lee, Yoo Jung;Park, Myong Chul;Park, Dong Ha;Lee, Il Jae
    • Archives of Reconstructive Microsurgery
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    • v.25 no.1
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    • pp.15-18
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    • 2016
  • Any types of burn injury that involve more than deep dermis often require reconstructive treatment. In gluteal region, V-Y fasciocutaneous advancement flap is frequently used to cover the defect. However, in case of large burn wounds, this kind of flap cannot provide adequate coverage because of the lack of normal surrounding tissues. We suggest V-Y adipofascial flap using the surrounding superficially damaged tissue. We present the case of a patient who was referred for full-thickness burn on gluteal region. We performed serial debridement and applied vacuum-assisted closure device to defective area as wound preparation for coverage. When healthy granulation tissue grew adequately, we covered the defect with surrounding V-Y adipofascial flap and the raw surface of the flap was then covered with split-thickness skin graft. We think the use of subcutaneous fat as an adipofascial flap to cover the deeper defect adjacent to the flap is an excellent alternative especially in huge defect with uneven depth varying from subcutaneous fat to bone exposure in terms of minimal donor site morbidity and reliability of the flap. Even if the flap was not intact, it was reuse of the adjacent tissue of the injured area, so it is relatively safe and applicable.

THE SOFT TISSUE CHANGES OF THE NASOLABIAL REGION AFTER MAXILLARY LE FORT I ADVANCEMENT OSTEOTOMY (상악골 Le Fort I 전진 골절단술후 비부의 연조직 변화)

  • Park, Gwang-Bum;Yeo, Hwan-Ho;Kim, Su-Gwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.3
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    • pp.284-287
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    • 1999
  • The nose, a striking features of the human face, is regarded by many clinicians as the keystone of facial esthetics. Clinically, as the treatment of a dentofacial deformity, the soft tissue changes that occurred normally with movement of the skeletal bases. Changes of the soft tissue in the maxillary orthognathic surgery are widening of alar base, elevated nasal tip and flattening of upper lip. In addition, soft tissue change is difficult to predict, it has considerable variability in the response of soft tissue. We reviewed patients who received Le Fort I advancement osteotomy in our department and analysed preoperative and postoperative alar base width, nasal height in clinical measurement and cephalometry and patient's satisfaction of postoperative nasal appearance.

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A clinico-statistical study of soft tissue changes of upper lip & nose following Le Fort I maxillary movement (Le Fort I 상악골이동술 후 상순과 비부의 연조직 변화에 대한 임상통계학적 연구)

  • Park, Jong-Oh;Lee, Sang-Chull
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.310-318
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    • 2000
  • The purpose of this study was to assess the soft tissue changes of upper lip & nose using 38 patients who treated with Le Fort I osteotomy for the correction of dentofacial deformities. Patients were devided into three groups. One was advancement group of maxilla(Group I, N=14), another was impaction group of maxilla(Group II, N=12) and the other was combination group(advancement & impaction)(Group III, N=12). Preop. and 1 month postop. (T1), preop. and 6 months postop.(T2) were analyzed and compared. The results obtained were as follows : 1. The upper lip thickness(UL-VP) moved anteriorly approximately 62% of the horizontal maxillary change and this was significant in the advancement group(Group I) 2. The upper lip length(Stm-Sn) and the lower border of upper lip(Stm) moved superiorly 25%, 40% of the maxillary impaction group(Group II) (P<0.05) 3. There was significancy in the upper lip thicness(UL-VP) approximately 56% of the combination group(Group III) (P<0.05) 4. The nasolabial angle decreased in all groups, but there were no significancy.

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Combined Rotation and Advancement Flap Reconstruction for a Defect of the Upper Lip: 2 Cases

  • Lee, Jun-Sang;Oh, Suk-Joon;Jung, Sung-Won;Koh, Sung-Hoon
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.244-248
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    • 2012
  • Many types of upper lip reconstruction have been introduced to treat defects after a tumor excision or trauma. The authors treated two cases of upper lip defects. A 35-year-old woman presented with a squamous cell carcinoma of the left upper lip that had invaded the corner of the mouth. After resecting the tumor, the defect was $3.7{\times}3.5cm$ in size. A 52-year-old woman presented with a dog bite of the right upper lip. The defect measured $4.0{\times}2.2cm$ in size. The two cases were reconstructed by combined rotation and advancement of a cheek flap. This technique produced a good functional outcome that allowed for oral competence and created an opening of adequate size. A combination of rotation and an advancement flap can be used to treat upper lip defects in a single-stage procedure. This approach produces a good functional and cosmetic outcome.

Cranial Base Reconstruction and Secondary Frontal Advancement for Meningoencephalocele Following LeFort III Osteotomy in a Patient with Crouzon Syndrome: Case Report

  • Sungmi Jeon;Yumin Kim;Ji Hoon Phi;Jee Hyuk Chung
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.54-58
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    • 2023
  • Patients with Crouzon syndrome have increased risks of cerebrospinal fluid rhinorrhea and meningoencephalocele after LeFort III osteotomy. We report a rare case of meningoencephalocele following LeFort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed tomography and magnetic resonance imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencephalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during LeFort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

A Case of Giant Sacral Chordoma (천추부에 발생한 거대 척색종 치험 1례)

  • Suh, Bum-Sin;Na, Young-Cheon;Park, Jong-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.702-704
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    • 2010
  • Purpose: Chordoma is a rare primary osseous tumor arising from the remnants of the primitive notochord. It occurs once in 2,000,000. It is characterized by its slow growth, high frequency to invade destroy bone by direct extension. We experienced giant sacral chordoma and reconstructed with gluteal advancement flap. Methods: A 52-year-old woman presented with a 2-years history of gluteal pain. In the biopsy study revealed sacral chordoma. MRI study showed $13{\times}12{\times}10\;cm$ sized m0cs. We approached anterior and posterior resection and reconstructed with bilateral gluteus maximus advancement flap. Results: After the operation, blader and anal function were slightly decreased. But, 4 months later those were almost fully recovered. There was no significant complication and recurrence after 2-years follow-up. Conclusion: Chordoma is characterized by its slow growth, high frequency to invade and destroy bone by direct extension. Wide surgical resection is the only curative procedure. We report a ase of giant sacral chordoma which was successfully treated by anterior and posterior approach and reconstructed with bilateral gluteal advancement flap.

POSTOPERATIVE STABILITY OF FIXATION WITH ABSORBABLES IN SIMULTANEOUS MAXILLOMANDIBULAR ORTHOGNATHIC SURGERY (상하악 동시 악교정수술에서 흡수성 고정판을 이용한 골편고정시 술후 안정성에 대한 연구)

  • Park, Jung-Min;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.126-131
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    • 2010
  • Objectives: This study is aimed to determine any differences in the postoperative stability between absorbable and titanium plate systems for fixation in orthognathic surgery with simultaneous maxillomandibular procedures especially including maxillary posterior impaction and advancement. Study Design: Forty patients with dentofacial deformities were randomly assigned into titanium (4 males and 6 females) and absorbable (17 males and 13 females) fixation group. All patients had undergone surgical alterations of maxilla with posterior impaction and advancement. A comparison study of the change in the maxillary position after the simultaneous surgery was performed with 1-day, 6-months postoperative lateral cephalograms compared to preoperative lateral cephalogram by tracing. Wilcoxon rank sum test was used for statistical analysis. Result: The position of the maxilla was stable after surgery and was not changed significantly from 1 day to 6 month after the simultaneous maxillomandibular surgery both in the experimental (absorbable plates) and control (titanium plates). Conclusion: This study suggests that application of absorable plating system in the fixation of maxillary segment in the simultaneous maxillomandibular procedures, leads to a predictable short-term postoperative skeletal stability comparable to the titanium plating system. Long term follow-up and further studies will be needed.