• 대한두개안면성형외과학회지
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• 제20권2호
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• pp.84-88
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• 2019

Background: Epidermal cysts are benign, slow growing cysts that often develop on the head, neck, chest, and back of adults. The most common method of surgical excision involves the use of a scalpel and often leaves a scar proportional to the size of the cyst. Therefore, minimally invasive techniques are required. Among these techniques, the $CO_2$ laser-based technique is minimally invasive and has lower complication rate, shorter recovery times, and lesser scarring. This paper aimed to compare the results and postoperative complications associated with a $CO_2$ laser-based excision against conventional surgical excision for epidermal cysts. Methods: We surveyed 120 patients, aged 16 to 65 years, with epidermal cysts on the face measuring 0.5 to 2.2 cm in diameter. Twelve months later, we compared the scar length, recurrence rate, patient satisfaction, and complications between patients treated with $CO_2$ laser excision versus surgical excision. Results: The mean scar length (12 months postoperative) after $CO_2$ laser excision was $0.30{\pm}0.15cm$, and that following surgical excision was $1.23{\pm}0.43cm$ (p= 0.001). The procedure time (time from incision after local anesthesia to the end of repair) was $16.15{\pm}5.96minutes$ for $CO_2$ laser excision versus $22.38{\pm}6.05minutes$ for surgical excision (p= 0.001). The recurrence rates in the surgical excision group and $CO_2$ laser excision group were 3.3% and 8.3%, respectively; this difference was not statistically significant (p= 0.648). Conclusion: The cosmetic outcome of $CO_2$ laser excision is excellent. For epidermal cysts measuring 2.2 cm or smaller, $CO_2$ laser excision is recommended, especially when aesthetic outcome is considered important.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.674-678
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• 2011

Purpose: Straight closure line of classic Weir excision leaves visible scars and makes it difficult to precisely approximate resection margins. Hence this study introduces Park-Weir excision that effectively reduces alar width with minimal alar rim scar by 3-dimensional zigzag incision and properly controls the approximation of edges. Methods: From 2008 to 2010, 14 patients underwent Park-Weir excision, crossed wedge excision on alar rim not exceeding 5 mm in width. Each patient was photographed in the same position. Alar width and columellar height against intercanthal distance was compared preoperatively and postoperatively, using image analysis software. Results: Five patients were female and nine were male. Average follow up period was 8 month. Alar width was reduced by 50.50% to 45.96%, original alar width reduced by 8.98% without significant changes in columellar height which was reduced by 0.39%. No visible scar was reported during outpatient follow-up. Conclusion: Park-Weir excision effectively reduces alar width and corrects the flaring of alar without affecting the columellar height. Zigzag incision of Park-Weir excision leaves aesthetically more pleasant scar than straight single incision of classical Weir excision.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.570-574
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• 2013

Background The elliptical excision is the standard method of removing benign skin lesions, such as congenital melanocytic nevi. This technique allows for primary closure, with little to no dog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scars which are unnecessarily long. This study was designed to compare the predicted results of elliptical excision with those resulting from our excision technique. Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. After an incision on one side of the nevus margin, subcutaneous undermining was performed in the appropriate direction. The skin flap was pulled up and approximated along several vectors to minimize the occurrence of dog-ear deformity. Results Overall, the final wound length was 21.1% shorter than that achieved by elliptical excision. Only 8.5% of the patients required dog-ear repair. There was no significant distortion of critical facial structures. All of the scars were deemed aesthetically acceptable based on their Patient and Observer Scar Assessment Scale scores. Conclusions When compared to elliptical excision, our technique appears to minimize dogear deformity and decrease the final wound length. This technique should be considered an alternative method for excision of facial nevi.

• Journal of Chest Surgery
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• 제53권3호
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• pp.127-131
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• 2020

Background: This study was conducted to evaluate the safety and efficacy of left atrial appendage (LAA) excision using a vascular stapler. Methods: Fifty consecutive patients (mean age, 68±9 years) who underwent LAA excision using a vascular stapler during concomitant cardiac surgery were enrolled. In all patients, the excision site was evaluated using computed tomography at a median of 7 days (interquartile range, 5-13.3 days) postoperatively. The safety endpoint of this study was the occurrence of LAA excision-related events, which were defined as bleeding from the excision site that required reinforcement sutures or reoperation due to excision site bleeding. The efficacy endpoint was LAA excision failure, which was defined as a remnant LAA (a stump >1 cm in maximum length) or extravasation of radiocontrast dye. Results: LAAs were excised using 60- and 45-mm vascular staplers in 49 patients and 1 patient, respectively. Reinforcement sutures were needed in 4 patients due to staple-line bleeding and in 4 patients due to bleeding of the surrounding tissues. No patient underwent reoperation due to staple-related bleeding. A remnant LAA was observed in 2 patients, while extravasation of radiocontrast dye was not observed in any patients. Conclusion: LAA excision using a vascular stapler may be an effective technique for LAA exclusion. Delicate handling of the stapler device and LA tissue is required to prevent procedure-related complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.160-165
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• 2012

Objectives: This study evaluated the clinical results of partial sublingual glandectomy accompanying the excision of ranula as new treatment modality. Materials and Methods: A total of 43 patients who were treated between 1999 and 2007 for oral or plunging ranula were reviewed. All patients were treated surgically by various methods with a total of 55 different procedures performed. Ten cases of partial sublingual glandectomy with excision of the ranula were conducted. All excised specimens were examined. We compared the clinical outcomes resulting from each treatment method. Results: The recurrence rates for marsupialization, excision of ranula, marsupialization with gauze packing, total excision of sublingual gland and ranula, and partial sublingual glandectomy with excision of ranula were 50%, 25%, 25%, 0% and 10%, respectively. Of the 10 patients treated by partial sublingual glandectomy with ranula excision, only one experienced recurrence (10%), i.e., plunging ranula. None of the ranulas contained an epithelial lining, and the excised portion of the feeding sublingual glands showed degenerative changes. Conclusion: In removal of ranulas, we found that excision of the attached sublingual gland, which removed the feeding portion and degenerative acinar cells, yielded good outcomes. Thus, as a new conservative method for treatment, we recommend partial sublingual glandectomy to accompany excision of the ranula.

• 대한족부족관절학회지
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• 제15권2호
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• pp.72-78
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• 2011

Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25 patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon's preference, patient's chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.

• 대한족부족관절학회지
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• 제6권1호
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• pp.40-45
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• 2002

Purpose: To analyze the radiographic results between the simple bone excision and simple bone excision and posterior tibial tendon advancement for prehallux. Materials and Methods: Thirty-four patients who underwent operative treatment for prehallux between 1995 and 2000 were reviewed. Twenty-six patients who underwent simple bone excision and posterior tibial tendon advancement and eight patients who underwent simple bone excision were available for follow-up. Follow-up averaged 44 months(15-59 months). We evaluated and compared the cuboidal height and the talo-1st metatarsal angle in the preoperative and postoperative radiography. Results: The average span of disappearing pain is 3.7 months(2-7 months) after the operation. Mean cuboidal height and talo-1st metatarsal angle were increased $6.7{\pm}1.8mm$, $5.0{\pm}2.1^{\circ}$ before to $7.8{\pm}0.2mm$, $5.6{\pm}0.7^{\circ}$ after simple bone excision and posterior tibial tendon advancement. Mean cuboidal height and talo-1st metatarsal angle were increased $6.6{\pm}0.7mm$, $4.6{\pm}1.1^{\circ}$ before to $7.7{\pm}0.9mm$, $5.1{\pm}0.4^{\circ}$ after simple bone excision and posterior tibial tendon advancement. One case of extra-osseous migration of the Mitek anchor inserted into navicula was seen during the follow-up period. Conclusion: This study shows that the remarkable differences between the two procedures are not found. So, simple bone excision without advancement of posterior tibial tendon for prehallux can generate relatively good results.

• Archives of Plastic Surgery
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• 제47권2호
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• pp.171-177
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• 2020

Background Infrabrow blepharoplasty has become a common surgical method used to rejuvenate aged upper eyelids in Asians. In this paper, we describe the parallel excision method for infrabrow blepharoplasty as a useful alternative to the conventional elliptical excision method. The authors' experience over a 3-year period is presented and reviewed. Methods A retrospective review of parallel excision infrabrow blepharoplasty cases at our hospital between 2014 and 2017 was performed. Three oculoplastic surgeons compared preoperative and postoperative photographs using the Strasser grading system. Results From the medical records of 123 patients, a total of 93 patients with moderate-to-severe bilateral dermatochalasis were selected as subjects. The exclusion criterion was levator function less than 8 mm. The total mean follow-up period was 2 years (range, 0.5-3.5 years). The mean skin excision height and width were 9.75 mm (range, 5-16 mm) and 58.51 mm (range, 42-75 mm), respectively. All patients who underwent surgery recovered without major complications, and all patients had high levels of satisfaction and improvements in their visual field. In the Strasser evaluation performed by the oculoplastic surgeons, most patients were found to have excellent results. Conclusions The parallel excision method for infrabrow blepharoplasty is a safe and effective technique that yields more natural- and youthful-looking eyelids than the conventional elliptical excision method. In our method, more effective manipulation of the orbicularis oculi muscle led to a reduction in frontalis compensation, resolution of sunken eyelids, and correction of lateral hooding.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.711-714
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• 2011

Purpose: Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5 cm. Methods: The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2 cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5 cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed. Results: Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5 cm. Conclusion: Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권3호
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• pp.267-271
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• 2006

Lymphangiomas are benign tumors of the lymphatic system characterized by congenital lymphatic malformation such as anastomosis or obstruction of the lymphatic channels. They are most frequently diagnosed in children younger than 2 years, and the lymphangiomas in head and neck represent about 50-75% of all lymphangiomas. Spontaneous regression is rare, and rapid enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequence such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosing agents. Problems associated with surgical excision include the risk of scarring, damage to surrounding vital structure and the high risk of incomplete excision. The sclerosing agents previously used have numerous local and systemic side effects as their problems. We present a case of lymphangioma occured in tongue that was treated by surgical excision and sclerotherapy with OK-432.