• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.181-185
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• 1990

Lipomas are common soft tissue tumor that are usually located in the subcutaneous tissue. And intramuscular lipomas commonly arise in the upper and lower extremities, where they usually involve the large muscles. Intramuscular lipoma, also referred to as an infiltrating lipoma. is an unusual benign slow growing tumor composed of mature fat cell interdigitating with skeletal muscle. However, intramuscular lipomas are exceedingly rare in the face. We have been experienced a case intramuscular lipoma that located in the malar area. Because of the rarity of these tumors and their propensity to recur without adequate surgery, the case report is presented here. Achievement of surgical margin is essential as the recurrent rate may be as high as 15% to 62.5% without complete excision.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.73-76
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• 2018

IgG4-related chronic sclerosing sialadenitis commonly occurs in the submandibular glands. The gold standard for diagnosis of IgG4-related chronic sclerosing sialadenitis is a tissue biopsy from the affected organ. Herein, we report the probability of occurrence of IgG4-related chronic sclerosing sialadenitis in both submandibular glands that developed at intervals of months. Therefore, long-term follow-up and whole-body evaluation are essential.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.3-9
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• 2019

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.101-105
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• 1998

Compound comminuted mandibular fracture is defined as the presence of multiple fracture lines with open wound resulting in many small pieces within the same area. The incidence of mandibular comminution is difficult to determine but reported as 2.7~18.6 % incidence among mandibular fractures. There are controversies in the treatment of mandibular comminuted fractures. Treatment of comminuted mandibular fracture has traditionally involved closed reduction in an effort to avoid stripping periostcum from the bony segments, but rigid internal rigid fixation is used more popular at present. The extent of comminution, displacement of bony fragments and patient general conditions are important factors in decision of the treatment methods. When significant bone displacement is present, it is necessary to reduce these comminuted fragments to an anatomic, pretraumatic relationship to restore facial form and function. In these cases, ORIF allows anantomic reduction of comminuted segments as well as pretraumatic occlusion. Gentle handling of the soft tissue, rigid fixation of bony fragments and adequate immobilization are essential for reducing the complications. This is the report the incidence, causes, complications and treatment of the patients who visited our department for compound comminuted mandibular fractures.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.107-110
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• 2010

Purpose: Chondroid syringoma is a rare mixed tumor of the skin that was first described by Hirsch and Helwig (1961). Characteristically, it is composed of the proliferation of epithelial cells in a myxoid and chondroid matrix. Most lesions occur on the head and neck region, and their size may range from 0.5~3 cm. Since a chondroid syringoma presents similar characteristics to other masses on the head and neck region, it is significantly important to distinguish with other masses by a surgical biopsy. Methods: A 51-year old woman presented with a painless nodular mass ($0.5{\times}0.5{\times}0.5cm$) on the philtrum, which appeared during the previous year. The mass was treated with a laser without a surgical biopsy. However, the size of the mass showed no changes. Surgical excision under local anesthesia was performed and sent for histopathology. Results: Gross examination showed a mass surrounded by a well developed capsule within the dermal layer. After complete excision without injury to the orbicularis oris muscle, the wound was covered with a local flap. The histology examination revealed numerous cuboid epithelial cells with tuboalveolar structures and keratinous cysts within a chondroid stroma. No recurrence or metastasis was observed at the follow-up visits. Conclusion: Chondroid syringoma is a rare mass on the face. An accurate diagnosis is essential for optimal treatment. This paper reports a case of a chondroid syringoma on the philtrum with a brief review of the relevant literature.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.89-95
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• 2013

Background: If patients have a better understanding about their problem and treatment, compliance and satisfaction with treatment will increase. For this purpose, simple repeated explanations regarding a patients' problem and treatment are essential. Critical pathway (CP) has a very wide range in medicine with the exception of the plastic surgery field. The authors developed a CP for facial bone fractures and implemented it clinically. The aim of this study was to evaluate the effectiveness of the CP on the degree of recognition of the problem along with patient satisfaction with the treatment process. Methods: From May 2011 to October 2011, a total of 82 patients suffering from facial bone fractures were studied. The CP for facial bone fractures was developed by plastic surgeons, residents and nurses. Subsequently, the authors investigated the degree of recognition of the disease and patient satisfaction with the treatment through the use of a questionnaire. The authors compared the score of the questionnaires before and after implementation of the clinical pathway. Results: The degree of the recognition of the problem changed from 3.1 to 4.2 (p<0.001). Further, the degree of satisfaction with the treatment process changed from 3.6 to 4.3 (p<0.05). Overall, there was a two point increase in improvement. Conclusion: Implementation of the CP for facial bone fractures was effective in improving the degree of recognition and satisfaction. The authors expect that hereafter, the CP for facial bone fractures will be implemented actively in the plastic surgery field.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.538-542
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• 2010

Acute mediastinitis is a fatal infection which occurs related to connective tissue of mediastium, in the thoratic organs. Occurrence of mediastinitis due to craniocervical infection is very rare, and is defined as descending necrotizing mediastinitis. November 8th, 2008, man in his early fifties visited ER due to severe swelling on left neck area and dyspnea. Antibiotic were administered immediately, and vast amount of abscess formation on pneumomediastinum and adjacent tissues were observed via chest computed tomography. With cooperation of thoracic and cardiovascular surgery department, emergency incision and drainage with drain insertion was done to remove abscess, and control the infection. After surgery, everyday saline irrigation through drain was done during hospitalization, with continues antibiotic therapy. Descending necrotising mediastinitis is a most rare and dangerous infection which occurs on oropharyngeal area. In case of descending necrotising mediastinitis, accurate diagnosis, airway maintenance, remove of abscess by incision and drainage, aggressive antibiotic therapy and continuous saline irrigation is necessary to increase patient survivability. Also, computed tomography with contrast media is essential to figure out the size and location of the infection and abscess formation.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.6-11
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• 2018

Purpose: The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor. Methods: We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared. Results: The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased. Conclusions: When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1001-1004
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• 1997

Thoracic sympathectomy is the radical and definite treatment of palmar hyperhidrosis. From January 1992 to March 1997, 4 patients with recurrent hyperhidrosis underwent resympathectomy via VATS at the Department of General Thoracic and Cardiovacular Surgery, Young Dong Severance Hospital. There were 2 men and 2 women and mean age was 20.0 years. There were moderate to severe adhesions at previous resection site but no thoracotomies were performed. There was no sweating on palms in all cases and all patients were greatly 5,Btisfied with those results postoperatively. In conclusion, recurrent hyperhidrosis was successfully treated with resympathectomy via VATS. In order to prevent recurrence and minimize the postoperative complication, the proper localization of the 2nd sympathetic ganglion and the radical excision of anatomical variation including Kuntz fiber are needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.77-81
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• 2001

Necrotizing fasciitis is defined as infectious disease showing extensive necrosis of the superficial fascia with widespread involvement of the surrounding tissues and concurrent systemic toxicity. It is found commonly in the extremities, the trunk and the perineum, but shows extremely rare occurrence in the well vascularized area such as head and neck area. Occurred in the head and neck area, it is called "cervicofacial necrotizing fasciitis" (CFNF). It is a fatal disease which carries a mortality rate up to 60%. Early diagnosis, aggressive surgical debridement of necrotic tissues and massive antibiotics therapy are essential for achieving a favorable outcome. We present a case of cervicofacial necrotizing fasciitis in 35-year-old male patient with literature review.