• Archives of Plastic Surgery
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• 제32권2호
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• 대한치과교정학회지
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• 제30권4호
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• pp.399-411
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• 2000

본 연구는 연령 증가에 따른 구순구개열자의 두개저 성장 특징과 비상악복합체 및 하악골의 위치 변화와의 상관관계를 알아보고자 시행되었다. 교정치료 및 악정형적 치료의 경험이 없는 100명의 완전 편측성 구순구개열 남녀와 악골부조화가 없으며 교정치료, 악정형적 치료 및 악교정 수술의 경험이 없는 100명의 정상 남녀를 선정하고, 이들을 접형사골연골결합 성장기, 접형후두연골결합 성장기 그리고,연골결합 성장종료기의 세 연령집단으로 구분하였다. 이들의 측모두부규격방사선사진을 연령별로 비교하여 두개저와 비상악복합체 및 하악골 위치와의 관계를 비교하였고 이를 통해 완전 편측성 구순구개열자가 정상인에 비하여 다음과 같은 차이가 있음을 알 수 있었다. 1. 완전 편측성 구순구개열군에서 사춘기 시기까지 사대 길이 및 두께가 작게 나타났고, 사대 길이의 사춘기 시기 증가량 또한 정상군 보다 작게 나타났다. 두개저 전방 길이 및 사대의 연령에 따른 회전 양상은 정상군과 차이가 없었다. 2. 완전 편측성 구순구개열군에서 비상악복합체는 모든 연령에서 정상군 보다 후방 위치를 보였고, 특히 성장이 활발한 사춘기 시기까지 정상군과의 차이가 보다 크게 나타났다. 반면 수직적 위치는 정상군과 차이가 없었다. 이와 같은 비상악복합체의 전방 성장 결여는 두개저 형태와 깊은 상관관계를 나타내었다. 또한 상악골 자체의 후방성장을 나타내는 PtmS은 정상군과 달리 연령에 따른 증가량이 작아 상악결절부의 성장 결여를 나타내었다. 3. 완전 편측성 구순구개열군에서 하악골은 정상군과 차이가 적었으나, Articular angle이 정상군 보다 매우 작게 나타났고, 하악골 위치와 비상악복합체 및 두개저 계측 항목간에 높은 상관관계를 보였다.

• 대한수의학회지
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• 제34권4호
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• pp.705-714
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• 1994

This study was carried out to identify the craniometric characteristics of the skull of Korean native goat. The results were as follows; The skull index, cranial index, facial index, right orbital index and left orbital index were $55.86{\pm}2.14$, $59.97{\pm}3.68$, $107.03{\pm}5.71$, $92.22{\pm}4.54$and $90.47{\pm}5.48$, respectively. The ratio of facial length to cranial length was 1:1.15 and the ratio of length of cranial base to palatal length was 1:1.35. The skull length was more correlated to the facial length than to the cranial length(p<0.01). The skull width was more correlated to the width between foramina supraorbitales than to the width between foramina infraorbitales. It also showed negative correlation to the medial width between bases of processus cornualis but positive correlation to the lateral width between bases of processus cornualis(p<0.01). The width between tips of both horns showed high positive correlation to the medial width between processus cornualis, but negative correlation to the lateral width(p<0.01).

• Annals of Clinical Neurophysiology
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• 제4권1호
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• pp.74-77
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• 2002

Collet-Sicard Syndrome is one of the variant of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. The possible causes of these multiple lower cranial nerve palsy are variable, including metastasis of systemic malignancy to the base of skull, primary tumor of head and neck, vascular complication, trauma and so on. We experienced two men visited to our clinic with symptoms of headache, hoarsness, swallowing difficulty and showed the evidence of cranial nerve palsy on neurologic examination. Magnetic resonance imaging and computed tomography demonstrated oropharyngeal and hypopharyngeal tumor and electrodiagnostic study supported the diagnosis.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.405-410
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• 2013

Objective : The objective of this study was to investigate changes in the posterior cranial fossa in patients with symptomatic Chiari malformation type I (CMI) compared to a control group. Methods : We retrospectively reviewed clinical and radiological data from 12 symptomatic patients with CMI and 24 healthy control subjects. The structures of the brain and skull base were investigated using magnetic resonance imaging. Results : The length of the clivus had significantly decreased in the CMI group than in the control group (p=0.000). The angle between the clivus and the McRae line (p<0.024), as the angle between the supraocciput and the McRae line (p<0.021), and the angle between the tentorium and a line connecting the internal occipital protuberance to the opisthion (p<0.009) were significantly larger in the CMI group than in the control group. The mean vertical length of the cerebellar hemisphere (p<0.003) and the mean length of the coronal and sagittal superoinferior aspects of the cerebellum (p<0.05) were longer in the CMI group than in the control group, while the mean length of the axial anteroposterior aspect of the cerebellum (p<0.001) was significantly shorter in the CMI group relative to control subjects. Conclusion : We elucidate the transformation of the posterior cranial fossa into the narrow funnel shape. The sufficient cephalocaudal extension of the craniectomy of the posterior cranial fossa has more decompression effect than other type extension of the craniectomy in CMI patients.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.352-353
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• 2012

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 1997년도 종합학술대회
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• pp.48-48
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• 1997

• 대한치과교정학회지
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• 제18권2호
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• pp.343-366
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• 1988

Craniofacial complex is influenced by numerical skeletal elements. Though the analysis of growth change has been done by various analytical methods, it was dependent on any method of registration and superimposition, based on reference plane and reference point. However, the craniofacial growth is composed of a number of local growth elements. Therefore, it will be necessary to use a clinically useful method for estimating craniofacial skeletal growth independently. The author analysed longitudinal cephalometric roentgenogram of 15 Korean males and 15 Korean females aged from 6 to 12 years by the finite element method and results were as follows : 1. The finite element method for craniofacial skeletal complex and soft tissue made it possible to analyze the independent local growth. 2. Regression equations from the value of each strain will make it possible to predict the craniofacial growth. 3. The growth of anterior cranial base was different from that of other facial bone. 4. The growth of posterior cranial base influenced the growth of upper pharyngeal region, midfacial region, maxilla and posterior region of mandible. 5. The growth of maxillary complex was vertical rather than horizontal. 6. The growth direction of ramus, mandibular body, alveolar bone was various. 7. The relation between hard tissue and soft tissue by finite element method was variant.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.97-102
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• 2009

Purpose: To close anterior cranial base, various types of pedicle flaps have been developed previously. However, the results of those pedicle flaps were not constant. To solve such problem, the author designed bipedicle temporalis-pericranial (BTP) flap based on various types of existing flaps and this study intends to introduce this flap and present clinical application case. Methods: The pedicle of the proposed temporalis-pericranial flap is temporalis muscle. The point of this BTP flap is that because of both sides of the unilateral temporalis-pericranial flap are connected by midline pericranial tissue connected with dense vascular network communicate one another locally, that BTP flap can be safely elevated. The case is a 14 months old male patient of frontoethmoidal encephalomeningocele. Surgery was done in a way that after elevating BTP flap and removing encephalomeningocele, BTP flap was moved intracranially, and to prevent cerebrospinal fluid leakage, anterior cranial base was closed. Results: During 1 year and 6 month outpatient tracking observation, no particular finding like CSF leakage, meningitis or hydrocephalus was observed. Conclusion: The benchmarked BTP flap, effective in the treatment of frontoethmoidal encephalomeningocele, is one of the methods to close intracranium and extracranium.

• 대한치과교정학회지
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• 제8권1호
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• pp.49-58
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• 1978

This investigation was undertaken to know how the bony facial profile could be changed with age. The 5 serial lateral cephalometric roentgenograms of the fourteen boys and fourteen girls between 7 and 11 years of age were studied and the findings seems to warrant the following conclusions. 1. The manaible tended to become more prognathic in relation to the cranial base (S-N) during growth, but the maxilla showed very little change. 2. There was increase in the inclination of the lower border of mandible associated with the increase in mandibular prognathism. 3. There was a tendency to being straight in bony facial profile due to the decrease in angle ANB with age. 4. The chin portion had a tendency to forward and downward growth in relation to the cranial base but there was slight strong tendency in downward growth. 5. The vertical growth was more prominant in the maxilla than in the mandible. 6. There was uniform and gradual increase of all measurements during growth. 7. Dimension of the craniofacial complex was larger in the boys than in the girls but this difference was not statistically significant. 8. Individual variation in skeletal growth was a normal occurrence.