• Archives of Plastic Surgery
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• 제32권1호
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• pp.43-48
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• 2005

Septal deviations interfere with the nasal airflow and contribute to the deformities in the external appearance of the nose. An aesthetically and functionally satisfactory correction of severe septal deformities often requires temporary intraoperative removal of the septal cartilage for appropriate remodeling. This article describes septoplasty through dorsal approach for the correction of septal deviation. From March 2001 to April 2004, the author performed septoplasty through dorsal approach for the correction of septal deviations on 45 patients, of whom 22 of whom had nasal obstruction. Open rhinoplasty was used for dorsal approach in all patients and operation was performed under the general anesthesia or local anesthesia. The follow-up period of the patients ranged from 3 to 15 months with a mean of 10 months, and postoperative results were quite satisfactory. There was neither incidences of patients' complaints, nor any complications such as hematoma, septal perforation, supratip deformity, or recurrence. And there was some improvement of nasal obstruction in 15 patients. In conclusion, Septoplasty through dorsal approach is an effective method for the correction of septal deviation and improvement of the nasal airway obstruction.

• 대한두개안면성형외과학회지
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• 제15권1호
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• pp.7-13
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• 2014

Background: Cryptotia correction by V-Y advancement of a temporal triangular flap was introduced in 2005. However, despite the several advantages of V-Y advancement, visible scars at the donor site are problematic. As a result, a Z-plasty technique was considered for skin deficiency in mild cases. Therefore, we introduce a new surgical scheme for cryptotia correction based on considerations of techniques and complications that arose in our clinic. Methods: Between 2000 and 2013, 26 patients (35 cases) of cryptotia were treated. Seventeen patients had unilateral cryptotia and nine had bilateral cryptotia. Two corrective methods were used, Z-plasty or V-Y advancement, based on the severity. In mild cases, Z-plasty was used for correction and in severe cases, V-Y flap advancement was used for more skin supplement. Results: Follow-up periods ranged from 6 months to 1.5 years. The results obtained were relatively favorable. Nine cases of mild deformity were corrected by Z-plasty, and the other 26 cases with mild or severe deformities were corrected by V-Y advancement. In Z-plasty cases, there was one hypertrophic scar and in V-Y advancement cases, seven resulted in visible scarring and three in skin sloughing. Conclusion: The main advantage of Z-plasty is a lower likelihood of visible scarring at the donor site. In mild cases, Z-plasty may be a good alternative, but in severe cases, V-Y advancement is probably the best option for more skin supplement.

• Journal of Chest Surgery
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• 제32권5호
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• pp.489-493
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• 1999

새가슴은 흉골이 전방으로 돌출 되는 흉벽 기형의 하나로 전방 흉벽이 함몰되는 누두흉보다 그 빈도가 훨씬 적다. 남자에게서 흔하며, 척추 측만증(scoliosis)을 가장 많이 동반한다. 새가슴의 수술적 교정 \ulcorner1952년 Ravitch가 연골흉골병형(chondromanubrial type)에서 다발 기형 늑골 절제와 이중 골 절단술을 처음으로 시행하였다. 저자들은 출생 시부터 관찰되어 성장에 따라 심해진 비대칭성 새가슴 환자 1례에서 양측 기형 늑연골의 연골막하 부분 절제술과 흉골의 단일 골 절단술을 시행하였다. 술후 합병증은 없었으며, 만족할만한 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제23권3호
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• pp.532-536
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• 1990

We experienced surgical correction of 2 cases of discrete membranous subaortic stenosis. Case 1 was 19 years old male patient. His complaints were fatigue, exertional dyspnea, syncope and angina for 8 years. Ejection. systolic murmur was heard at the second right intercostal space and diastolic murmur was heard at the apex. A thrill was palpated over the second right intercostal space and area of the carotid artery. 2-D echo, cardiac cath and left ventriculogram revealed discrete membranous subaortic stenosis and VSD. Complete excision of discrete membrane without mymectomy was done. VSD was closed with dacron patch and aortic valve was replaced with St. Jude medical valve. Case 11 was 16 years old female whose complaints were exertional dyspnea and syncope. Ejection systolic murmur was heard at second right intercostal space, but diastolic murmur was not heard. A thrill was palpated over the second right intercostal space and the area of carotid artery. 2-D echo, cardiac cath and left ventriculogram revealed discrete membranous subaortic stenosis. Complete excision of fibrous tissue and myotomy were made and aortic valve was replaced with St. Jude medical valve. Operative finding was followed: both aortic valves showed deformity of leaflets. Subaortic region had a thickened central fibrous body from which the ridge protruded. Both patient`s postoperative course were uneventful and short-term follow-up results were good except soft systolic murmur at the aortic area.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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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.

• 대한정형외과학회지
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• 제52권1호
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• pp.73-82
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• 2017

목적: 화학요법만으로 치료한 소아 척추 결핵 환아들에서의 후만의 경시적 변화를 분석하였다. 대상 및 방법: 2세부터 15세 사이의 101명을 대상으로 하여 후향적으로 단순 방사선 영상과 소수에게서 자기공명영상을 이용하여 치료 시작 시와 치료 종결 시의 잔존 성장판에 의한 후만 변형의 변화를 살폈다. 결과: 영상상 초진 시 추간판의 완전 파괴로 판정한 예들은 경추의 경우 40명 중 2명(5.0%), 흉추 내에서는 30명 중 8예(26.7%), 그리고 요천추에서는 31명 중 6명(19.4%)이었다. 나머지 예들에서는 성장판이 완전하게 또는 부분적으로 잔존하는 것으로 판정하였다. 101명 중 후만 변형이 변치 않고 유지된 경우는 20명(19.8%), 후만각 감소 예는 14명(13.9%), 그리고 후만각의 증가 예는 67명(66.3%)에서 관찰되었다. 결론: 반수 이상의 환아에서 치료 시작 시점에서 이미 병이 심히 진행되었던 것을 알 수 있었다. 후만 변형의 진행 여부는 일차적으로 치료 시작 시점에서 예측 가능하나 그 정확도가 떨어지므로 후만 변형의 변화의 보다 정확한 증거를 확인할 수 있는 투약 종료 시점에서 실시할 것을 권한다. 진행형과 자연 교정군에서는 성장 종료 시까지의 추적 관찰이 필요하다.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.250-255
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• 2010

Purpose: Pincer nail is a relatively rare deformity characterized by an increase in transverse curvature along the longitudinal axis of the nail. This curvature commonly increases from proximal to distal end of nail, leading to pinching, curling, and distortion of the underlying soft tissue and resulting frequently in severe pain. Numerous surgical procedures have been reported. Preserving the width of the nail in the correction of the pincer nail is very important for functional and aesthetic reasons. We report the results of the correction of the pincer nail using autogenous dermofat graft with a good result. Methods: From May 2006 to September 2008, dermofat graft was performed in 6 patients with pincer nail. Patients were four women and two men, and the average age was 51. The affected digits were the unilateral great toes in four patients and the unilateral thumbs in two patients. Average follow-up period was 13 months. Surgical procedure was removal of nail using an elevator to avoid damage to the nail bed. An incision was created in distal portion of hyponychium. Paronychium was dissected from distal phalanx by periosteal elevator through incision of hyponychium and tunnel was made. Then dermofat grafts harvested from inguinal area were inserted into the tunnel. Finally, a silicone sheet was inserted eponychial fold for prevention of synechia. Objective assessment was evaluated by use of the width index and height index. Results: All patients reported resolution of the pain and soft tissue pinching sensation that they had before the operation. There was good adherence between the nail plate and the underlying nail bed. The nails have regrown and were corrected in a normal and flattened appearance. The width index and height index were improved. Conclusion: The autogenous dermofat graft seems to provide an effective treatment of the pincer nail with preservation of the nail matrix.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.740-746
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• 2011

Purpose: In the treatment of the unilateral cleft lip nasal deformities, the correction of the low-nostril height and short-columella are very difficult problems. We report the treatment outcomes of web uni-limb Z-plasty used for correction of unilateral cleft lip nasal deformities by using photographic analysis. Methods: A total of 36 patients with unilateral cleft lip nasal deformities were enrolled in this study, who underwent web uni-limb Z-plasty and were followed up for at least 6 months. First, a triangular flap was made on the medial side of alar-columella web. The nostril apex of cleft side was corrected to a higher point compared to noncleft side by 2 mm. The flap was transposed into the defect of the vestibule. To reduce the bulging of the flap, horizontal cinching sutures were added. Postoperative outcomes were evaluated by using photographic analysis. 2 indices and 1 angle were measured on their photographs taken before and after the surgery. Symmetry was also evaluated by means of the noncleft side to cleft side index. For anthropologic assessment, observers described postoperative outcomes, using Ordinary Scale Method. Results: The postoperative values obtained in photographic analysis improved compared to preoperative ones. More improving anthropologic assessment was shown in post-than pre-operative. Conclusion: Although, further long term follow up is needed, we found this technique to be an effective procedure to the symmetry of nostril apex level and the lengthening of columella in the unilateral cleft lip nasal deformities.

• 대한치과의사협회지
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• 제52권10호
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• pp.623-632
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• 2014

안면비대칭의 주원인은 하악골이며, 하악골의 비대칭 성장에 대한 상악골의 보상성장에 따라 교합면 경사 등이 초래된다. 디지털 사진과 삼차원 CT 등 다양한 방법으로 정확한 진단을 하고 수술을 포함한 치료계획을 세운다. 술전 교정 치료는 상악골과 하악골 치열의 치성 보상(dental compensation)을 제거하면서 상악 치열의 중심은 상악골의 정중선에, 하악 치열의 중심은 하악골 정중선에 맞게 이동하여 술후 상하악 치열궁이 일치하면서 동시에 안모 정중선에 일치하게 맞추어야 한다. 악교정 수술은 일반적으로 상하악 동시 수술을 하게 되며 우각부 풍융도 교정과 이부 성형술(genioplasty) 등을 부가적으로 할 수 있으며, 교합면 경사 교정과 수평 회전 등의 이동이 상하악 위치에 서로 영향을 주면서 수술 후 안모 변화에 대한 예측을 어렵게 만들기 때문에, 다양한 분석을 통해 정확한 예측으로 최선의 결과를 얻는 것이 가장 중요하다.

• 대한족부족관절학회지
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• 제20권1호
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• pp.27-31
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• 2016

Purpose: Several techniques have been introduced for correction of pes cavo-varus deformity. We retrospectively reviewed and compared the data of patients who underwent 1st metatarsal osteotomy alone, Dwyer's osteotomy alone, and 1st metatarsal osteotomy combined with Dwyer's osteotomy to determine the effect on radiographic parameters. Materials and Methods: Data on 28 cases in 27 consecutive patients recruited from 2006 to 2014 who underwent 1st metatarsal osteotomy alone (group F), Dwyer's osteotomy alone (group H), or 1st metatarsal osteotomy followed by Dwyer's osteotomy (group HF) with a minimum 1-year follow-up were reviewed retrospectively. Results: Calcaneal pitch angle on the standing foot lateral radiographs was significantly decreased after the operation in groups H and HF whereas Meary angle was decreased in groups F and HF. Hindfoot alignment angle and ratio on the hindfoot alignment view were improved in groups H and HF. Maximal medial cuneiform height reduction was observed in group HF. 1st ray was significantly shortened in groups F and HF. Conclusion: Combined forefoot and hindfoot operation took the largest correction power of all radiologic parameters.