• Title/Summary/Keyword: Bony deformity

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A SURGICAL METHOD FOR THE EFFECTIVE TREATMENT OF CLEFT ALVEOLUS, ESPECIALLY FOR THE ELEVATION OF ALA BASE (효과적인 비익기저부의 회복을 위한 치조열 환자의 골이식 치험례)

  • Shin, Hong-Soo;Yoo, Yang-Keun;Choi, Young-Joon;Hwang, Soon-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.64-68
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    • 2002
  • The cleft alveolus is one of three parts in cleft deformity. The purpose of cleft alveolus bone grafting is the recovery of normal esthetics, occlusion and speech. If a bony defect is extended to the nasal floor, especially wide bony defect at the ala base, it is difficult to condense the cancellous bone during bone transplantation and to reconstruct the normal anatomy at the alar base. We treated with above mentioned cleft alveolus patients using the autogenous cortical bone effectively. We report this technique with two cases and the literatures review.

Clinical Experience with Nasolabial Cysts Using the Sublabial Approach (구강내 접근법을 이용한 비순낭종의 치료 경험)

  • Kwon, Joon-Sung;Choi, Hwan-Jun;Choi, Chang-Yong;Park, Jae-Hong;Park, Nae-Kyeong;Kim, Sook
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.251-256
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    • 2011
  • Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

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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Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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Cherubism: Review of 2 Cases (체루비즘: 2예 보고)

  • Kwak, Juhee;Kim, Ji-Youn;Kim, Myung-Rae;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.357-362
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    • 2012
  • Cherubism is a rare familial disease of childhood, characterized by proliferative lesion, which is within the maxilla and mandible. In a typical case, painless symmetric expansile lesions develop in the jaws. It shows substitution of the bone by proliferating fibrous tissue exhibiting mature fibroblasts and a number of multinucleated giant cells within an intercellular matrix. Usually, the disease manifests in early childhood, and becomes more marked until puberty, at which time the bony lesions begin to regress. As such, conservative approaches to management are advisable. However, excision of tissue through enucleation or curettage appears to be necessary in more aggressive cases, to reduce the maxillofacial deformity after puberty and to ensure a successful outcome without the risk of progression, requiring additional resection. This report describes 2 cases of manifestation of cherubism of oral and maxillofacial region. We present diagnosis, radiological - histopathologic features, and treatment of cherubism.

Clinical Experience of Maxillary Fibrous Dysplasia: Shaving, Partial Maxillectomy & Maxillary Sinus Formation (상악골에 생긴 섬유성이형성증의 치료 경험: 안면윤곽술, 부분적 상악골 절제술과 상악동 형성)

  • Lee, Yoon Ho;Joo, Chun Seung
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.259-262
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    • 2006
  • Fibrous dysplasia(FD) of the bone is a slowly progressive, benign disease of unknown cause where normal architectures are replaced with fibrous and osteoid tissue. FD of the maxilla usually manifests as a bony enlargement with painless swelling and bone deformity, contouring to facial asymmetry. The lesion may involve the nasal fossae, orbits, or alveolus bone, causing diverse functional disturbance. Treatment options range from shaving to total maxillectomy and reconstruction depending on the presenting symptoms. Shaving, partial maxillectomy and maxillary sinus formation was performed in 5 patients with fibrous dysplasia in the past 2 years. Follow up period ranged from 1 month to 11 months. Aesthetic appearance, CT findings, and relief from symptoms were compared. In all patients, facial asymmetry was restored to symmetry and nasal obstructive symptoms were improved. With this procedure, expansion of the lesion will be controlled until puberty, preventing the development of new functional disturbances. After puberty, no further treatment can be anticipated due to the growth arrest inherent to the disease.

AN EXPERIMENTAL STUDY ON THE BONE REGENERATION OF TIBIAL BONE DEFECT (경골 이식의 골결손부 골재생에 대한 실험적 연구)

  • Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, Soo-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.275-278
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    • 1998
  • Recently, the clinical applications of the autogenous cancellous bone from the proximal tibial metaphysis show satisfactory results in the repair of maxillofacial bony defect or deformity. The proximal tibia has the potential to yield viable cancellous bone with a minimum of morbidity. The purpose of this study was to investigate the regeneration of a full thickness proximal tibial bone defect with covering or uncovering of cortical bone. The follow-up periods were 4, 8, and 12 weeks. Bone defect of right side was uncovered and left side was covered with cortical bone. In the experimental group (uncovered cortical bone) at 12 weeks, the inside of defect was filled to normal marrow tissue. The cortical bone defect was united of inner, outer callus at 4, 8 weeks in both study group. At 12 weeks, the cortical bone defect was remodeled and invaded by osteoclast (giant cell) in experimental group. In the experimental specimen at 12 weeks, the regenerating tissue of bone defect was not differ from the control group.

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Removal of Intradural-Extramedullary Spinal Cord Tumors with Unilateral Limited Laminectomy

  • Sim, Jong-Eun;Noh, Seung-Jin;Song, Young-Jin;Kim, Hyung-Dong
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.232-236
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    • 2008
  • Total laminectomy for the removal of intradural-extramedullary spinal cord tumors has been used widely, but postoperative complications often develop, such as kyphosis, spinal instability, and persistent back pain. In this study, we evaluated seven patients with intradural-extramedullary spinal cord tumors with respect to the value of unilateral limited laminectomy. Our cases included six schwannomas, and one meningioma. The cervical region was involved in four cases, the thoracolumbar region in two cases, and the lumbar region in one case. The rationale for choosing a unilateral approach is to preserve musculoligamentous attachments and posterior bony elements as much as possible. The patients were mobilized on the third postoperative day and preoperative neurological symptoms were recovered within a few weeks. We did not observe any complication relating to unilateral limited laminectomy and at follow-up evaluation (at 3 and 12 months postoperatively), none of the patients showed spinal deformity or spinal instability. We think that the unilateral limited laminectomy is a safe and efficient technique for the treatment of intradural-extramedullary spinal cord tumors. We suggest that this technique is one of the best treatments for these tumors.

Management of Diabetic Foot Ulcer (당뇨병성 족부 궤양의 치료)

  • Seo, Dong-Kyo;Lee, Ho Seong
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.1-7
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    • 2014
  • In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

Galactosialidosis with a Family History in a Sibling (남매에서 가족력을 가진 galactosialidosis 1례)

  • Im, Sun Ju;Nam, Sang Oak
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.6 no.1
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    • pp.32-39
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    • 2006
  • Galactosialidosis is a lysosomal storage disease associated with a combined deficiency of ${\beta}$-galactosidase and ${\alpha}$-neuraminidase, secondary to a defect of another lysosomal protective protein. It is a neurodegenerative disorder clinically characterized by psychomotor deterioration, cerebellar ataxia, coarse facies, generalized bony deformity and organomegaly. Three phenotypic subtype are recognized: early infantile, late infantile and juvenile/adult type. We report a 13 months old boy with a late infantile galactosialidosis. He was presented with progressive mental regression and motor disturbance and observed cherry red spot, hearing loss, moderate dysostosis multiplex and vacuolated lymphocytes in peripheral blood. He showed only ${\beta}$-galactosidase deficiency in the lymphocytes and was initially diagnosed as $GM_1$-gangliosidosis type 1. However, further studies revealed the possible defect of ${\alpha}$-neuraminidase suggesting that he was a case of galactosialidosis which was mimicking $GM_1$-gangliosidosis type 1.

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