• Archives of Plastic Surgery
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• v.38 no.3
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• pp.279-286
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• 2011

Purpose: Chin is located in a prominent position, and is important to balance and harmony of the face. Genioplasty is widely performed with patients' high satisfaction, yet being relatively simple procedure. Recently in analysis of dentofacial trait, three rotational variables of yaw, pith, and roll are considered with three translational variables (forward/backward, up/down, right/left). And we could correct chin deformity effectively by applying the three rotational variables with three translational variables in genioplasty. Methods: Twenty-eight patients who have chin deformity underwent osseous genioplasty. Preoperative photography, facial three dimensional computed tomography, and cephalography were taken while chin deformities were accessed. The chin deformity was classified into four categories; macrogenia, microgenia, asymmetric chin deformity, and combined chin deformity groups. According to the nature of chin deformities and the patients' desire, preoperative plans were formulated, in consideration of three rotational variables and translational variables. Through intraoral approach, anterior mandible was exposed in the subperiosteal plane between the mental foramens and beneath the mental foramens. In the anterior mandible, vertical and horizontal grid lines with 5 mm intervals were marked to confirm the spatial location of osteomized bone segment after osteotomy. Chin repositioning was done in consideration of axial rotation and planar translation. Results: Most of the patients had achieved satisfactory results with few complications. By considering the three rotational variables, it was possible to make the chin repositioning effectively. One of the patients complained about insufficient chin correction. In other case, persistent sensory impairment around chin was observed. Conclusion: In conclusion, it is worthwhile to apply preoperative analysis and operative procedures in consideration of a three rotational variables with three translational variables in genioplasty.

• The korean journal of orthodontics
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• v.26 no.3
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• pp.241-246
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• 1996

The chin is one of the factors which express human character, and appropriately protruding chin is very important to harmonious profile, the purpose of genioplasty is to reshape the chin and improve the facial esthetics which is one of the purposes of orthodontic treatment. It can be classified as augmentation genioplasty which enlarge the chin vertico-horizontally and reduction genioplasty which smallen it. The examples to apply this procedure are as follows. 1. advancement of retruded chin 2. reduction of chin prominence 3. control of chin vertical dimension 4. correction of asymmetry

• Journal of Korean Dental Science
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• v.13 no.1
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• pp.11-20
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• 2020

Purpose: This study sought to identify differences in hard and soft tissue chin profile changes in skeletal Class III patients after bimaxillary surgery, with or without advancement genioplasty. Materials and Methods: The retrospective study was conducted based on cephalometric analysis of skeletal and soft tissue variables. Lateral cephalograms taken at 3 different time points were utilized: pre-operation (T0), immediately post-operation (T1), and at least 6 months (11.0±2.6 months) post-operation (T2). The 2 groups were matched for sample size (n=20 each). Data were analyzed using independent t-tests with Bonferroni correction. Result: Group N (bimaxillary surgery alone) and Group G (bimaxillary surgery with an advancement genioplasty by horizontal sliding osteotomy) did not differ significantly in terms of demographic characteristics. The soft tissue chin thickness of Group G increased more after surgery, followed by a greater decrease during the postoperative period, and was eventually not significantly different from Group N at T2. On the other hand, the mentolabial sulcus depth of Group G (5.5±1.3 mm) was significantly greater than that of Group N (4.4±0.9 mm) (P=0.006) at T2. Conclusion: Although Group G showed a statistically significantly greater decrease in soft tissue chin thickness during the postoperative period, there were no significant intergroup differences in the chin profile for at least 6 months after the surgery, except for the mentolabial sulcus depth, which was greater in Group G than in Group N.

• Archives of Craniofacial Surgery
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• v.20 no.5
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• pp.310-313
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• 2019

Post-traumatic hematoma formation is a common complication of contusion. If the hematoma is large enough to aspirate or drain, it can be treated quickly and appropriately. However, if the hematoma is small or concealed by local swelling, it may be overlooked and left untreated. In most cases, a hematoma will resolve following conservative treatment; however, associated infection or muscle fibrosis can occur. Herein, we present the case of a patient with a chin deformity caused by a post-traumatic hematoma. The deformity was treated using botulinum toxin and triamcinolone acetonide injections as minimally invasive treatments. The course of treatment was good.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.184-199
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• 1996

The challenges to achieve three dimensional facial proportionality and occusal stability in many patients with complex dentofacial deformity have been met by the development and use of the maxilla, mandible, and chin surgery techniques in combination with efficient orthodontic treatment. There is a clinical, biological, and biomechanical foundation for simultaneous surgical repositioning of the maxilla, mandible, and chin in a significant proportion of adult and adolescent patients. A combination of the surgical and orthodontic approach may provide increased treatment efficiencies and optimal esthetic results. Art and science to determine the treatment objectives, specifically, the desired soft tissue changes are firstly established by using the clinician's "esthetic sense" of the facial beauty and proportion aided to a few cephalometric guidelines. In this sense, the dependence on the clinician's "esthetic eye" by Dr. Bell is more important in analyzing the facial proportion than the satisfaction of rigid cephalometric norms. The purpose of this article was to elucidate the indication for simultaneous surgical repositioning of the maxilla, mandible, and chin, and to describe the clinical cephalometric analysis for orthognathic surgery. Representative 6 case reports were presented and discussed to illustrate the esthetic, orthodontic, and surgical treatment objectives with long-term follow-up.

• The korean journal of orthodontics
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• v.19 no.3
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• pp.147-160
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• 1989

Long face patients are characterized by excessive anterior facial height, lip incompetence at rest, anterior open bite, and gummy smile. A major problem is an inferior rotation of the posterior maxilla and upper molars. Long face patients have been the most difficult for orthodontist to treat successfully. In growing patients, the methods for impeding excessive vertical growth have been used high pull head gear, functional appliance, and combined type of two. One significant improvement comes from using a full arch splint to deliver force to the maxilla more vertically. In adult patients, orthodontic camouflage treatment is biomechanically difficult and doesn't work when the problem is primarilly vertical. Surgical maxillary impaction provides a means for successfully treating most of problems. Also, superior reposition of the chin via a mandibular inferior border osteotomy is effective in decrease of lower anterior facial height and correction of the poor chin-lip balance. Post-surgical stability and the physiologic response are good. The coordinated orthodontic and surgical treatment is necessary for solution the difficult skeletal deformity.

• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.125-129
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• 2017

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.44-52
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• 2023

Objective : This study aimed to investigate the efficacy of transverse process (TP) hook system at the upper instrumented vertebra (UIV) for preventing screw pullout in adult spinal deformity surgery using the pedicle Hounsfield unit (HU) stratification based on K-means clustering. Methods : We retrospectively reviewed 74 patients who underwent deformity correction surgery between 2011 and 2020 and were followed up for >12 months. Pre- and post-operative data were used to determine the incidence of screw pullout, UIV TP hook implementation, vertebral body HU, pedicle HU, and patient outcomes. Data was then statistically analyzed for assessment of efficacy and risk prediction using stratified HU at UIV level alongside the effect of the TP hook system. Results : The screw pullout rate was 36.4% (27/74). Perioperative radiographic parameters were not significantly different between the pullout and non-pullout groups. The vertebral body HU and pedicle HU were significantly lower in the pullout group. K-means clustering stratified the vertebral body HU ≥205.3, <137.2, and pedicle HU ≥243.43, <156.03. The pullout rate significantly decreases in patients receiving the hook system when the pedicle HU was from ≥156.03 to < 243.43 (p<0.05), but the difference was not statistically significant in the vertebra HU stratified groups and when pedicle HU was ≥243.43 or <156.03. The postoperative clinical outcomes improved significantly with the implementation of the hook system. Conclusion : The UIV hook provides better clinical outcomes and can be considered a preventative strategy for screw-pullout in the certain pedicle HU range.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.85-89
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• 2008

Purpose: Unicoronal synostosis is the craniofacial anomaly caused by premature fusion of unilateral coronal suture. Ipsilateral flattening of the frontal and parietal bones, temporal retrusion with elevation and recession of the supraorbital rim are main clinical features. Compensatory contralateral frontal bossing and deviation of the nasal root and/or chin can also occur. There is a controversy about techniques for surgical correction, however, bilateral approach technique is more effective for correction of deformity. Methods: A 4-year-old patient with unicoronal synostosis had undergone unilateral suturectomy at 28-month-old but fronto-facial deformity had remained and aggravated as she grew older. She had both fronto-facial and endocranial asymmetry. We performed coronal cranial approach and fully exposed affected cranium including supraorbital rim. Anterior 2/3 calvarial reconstruction with bilateral frontal bone osteotomy and fronto-orbital bandeau advancement was performed. Results: Fronto-facial symmetry including fronto-orbital contour, nasal devation was improved. Endocranial twisting was also improved from $158^{\circ}$ to $162^{\circ}$ in CSO(crista gallisella turcica-opisthion) degree. There was no postoperative complications and no need for revision, and facial asymmetry improved at the period of 2 years of follow-up. Conclusion: Bilateral approach with fronto-orbital bandeau remodeling in surgery of unicoronal synostosis looked superior to unilateral approach in achieving better symmetry and preventing recurrence of asymmetry. Remodeling surgery should be tried in patients even at an older age to correct fronto-facial asymmetry.

• Journal of Korean Neurosurgical Society
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• v.44 no.1
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• pp.52-56
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• 2008

Objective : The purpose of this study was to introduce our surgical experiences of scoliosis and to evaluate the effectiveness of anterior correction and fusion in adolescent idiopathic scoliosis (AIS). Methods : Between August 2004 and August 2007, four patients with AIS were treated with anterior segmental fusion and fixation at our hospital. Mean follow-up period was 9 (6-12) months. The average age was 14.0 (13-15) years. According to Lenke classification, three patients showed Lenke 1 curve and one patient with Lenke 5 curve. Single rod instrumentation was performed in one patient, dual rod instrumentation in one patient and combined rod instrumentation in two patients. Coronal Cobb measurements were performed on all curves in thoracic, thoracolumbar and, lumbar spine and the angle of hump was measured by a scoliometer pre- and postoperatively. Results : The average operative time was 394 minutes (255-525) with an average intraoperative blood loss of 1,225 ml (1,000-1,700). The mean period of hospital stay was 19.3 days and there was no complication related to the surgery. The mean Cobb angle was reduced from $43.3^{\circ}$ to $14.8^{\circ}$ (65.8% correction) postoperatively and the rib hump corrected less than $5^{\circ}$. All patients and their parents were satisfied with the deformity correction. Conclusion : Anterior spinal correction and fusion of AIS with Lenke 1 and 5 curve showed excellent deformity correction without any complications. In particular, we recommend anterior dual rod instrumentation because of mechanical stability, better control of kyphosis, and a higher fusion rate.