• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.1
• /
• pp.110-116
• /
• 2000

A 61-years old man with diabetes mellitus(DM) was admitted to our hospital, complaining of progressive right periorbital swelling, headache and toothache on the right lower second molar. On the first visit, moderate swelling was noticed from the right periorbital region with exophthalmos and subconjunctival effusion. Intraorally, right lower second molar had a severe periodontal disease and fistular formation on its distal area. From 3 days after hospitalization, the visual acuity of his right eye was gradually worsen and we performed CT scan. CT scan demonstrated an inflammatory change at the right orbit with subperiosteal abscess at the inferior orbital wall, which was extended from the right infratemporal, parapharyngeal and internal pterygoid space. Patient was treated by mean of intraoral(right upper vestibular and retromolar) and extraoral(infraorbital) incision and drainage, massive anti-therapy and DM control. The patient improved gradually and finally was discharged from the hospital, but his visual loss of right side was not recovered.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.3
• /
• pp.545-548
• /
• 1998

Sialolithiasis is the formation of calcareous concretions within ductal system of a major or minor salivary gland. They are formed by deposition of calcium salts around a central nidus which may consist of desquamated epithelial cells, bacteria, foreign bodies, or products of bacterial decomposition. An 11-year-old boy complained of pain during meals and intermittent mild swelling in the right submandibular region. Although it was not detected in true occlusal radiograph, panoramic radiograph showed a round radiopaque mass 3mm in diameter. Computed tomography(CT) was taken for locating the stone and 3-dimensional reconstruction was performed. Under general anesthesia, sialoadenectomy was done through extraoral approach. Diagnosis of submandibular sialolithiasis using high-resolution CT with reconstructions was helpful for surgical decisions, namely radical removal of the submandibular gland and its duct.

• The Journal of the Korean dental association
• /
• v.58 no.2
• /
• pp.103-113
• /
• 2020

Background: Reduction malarplasty is one of the most popular facial contouring surgeries in east Asia for making patients' faces smaller. Currently in Korea, reduction malarplasty surgeries are performed mostly at plastic surgery clinics, but few cases are done at oral and maxillofacial surgery clinics. The reason might be because of post-operative complications after reduction malarplasty, such as undercorrection, overcorrection, asymmetry, cheek drooping, malunion, pain and noise. Those complications should be uneasy to be handled by oral and maxillofacial surgeons, however, they can be prevented by knowing the effective and safe reduction malarplasty techniques. Therefore, in this article the author as an oral and maxillofacial surgeon, would like to suggest safe and effective surgical methods for reduction malarplasty customized for Korean patients. Method: L- shape osteotomy of zygomatic body was performed with intraoral approach via vestibular incision, and the zygomatic arch was osteotomized with extraoral approach via sideburn incision. Then zygomatic complex was separated and rotated mesio-superiorly without removal of a bony strip and fixed with miniplates and microplates without making a bony gap. Conclusion: Surgical results were favorable and satisfied by the patients without cheek drooping, malunion, undercorrection and asymmetry.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.2
• /
• pp.157-161
• /
• 1994

A 14-year-old male patient was referred to us for evaluation of Right TMJ clicking sound and mandibular deviation during mouth opening. On examinaaation, protrusion and lateral excursion was also restricted. Radiographs showed hook-like curved elongation of Right coronoid process with limitation o right condylar translation. His past medical and dental history was noncontributory. This patient underwent an extraoral coronoidectomy and the specimen revealed coronoid process malformation mimicking condylar head. Microcoically, the specimen discloses mature bony trabeculae. At postoperative 5 days, physical therapy was instituted. At present, this patient could open his mouth well with any clicking sound and mandibular deviation. The asymmetric face of this patient is expectated to be corrected by periodic observation and remained growth porential. If not to be corrected, orthognathic surgery will be done.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.3
• /
• pp.227-231
• /
• 2022

Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.50 no.2
• /
• pp.110-115
• /
• 2024

A 22-year-old male patient presented to the clinic with severe pain in the preauricular area with an inability to completely occlude the jaw. Facial computed tomography and magnetic resonance imaging revealed a well-defined lesion that was tentatively diagnosed as a benign tumor or cystic mass. Surgical approach of a lesion in the condyle is delicate and problematic as many vulnerable anatomical structures are present. There are several methods for surgery in this area. Typically, an extraoral approach is dangerous because of potential injuries to nerves and arteries. The intraoral approach also presents difficulties due to the lack of visibility and accessibility. On occasion, coronoidectomy may be performed. The goal here was to determine an easier and safer new surgical approach to the condyle. We reached the anterior part of the pterygoid plate in the same method as in Le Fort I surgery. From this point, through the external pterygoid muscle, approaching the anterior aspect of the condyle is relatively easy and safe, with minimal damage to the surrounding tissues. Pus was drained at the site, and the lesion was diagnosed as an abscess. Pain and inability to close the mouth resolved without recurrence.

• Journal of Oral Medicine and Pain
• /
• v.23 no.4
• /
• pp.387-401
• /
• 1998

This study was performed to investigate the emotional state related to dental fear, hospital anxiety and depresison, and frequency of stress symproms of orofacial region. For this study, Dnetal Fear Surfey(DFS) scale, the Hospital ANxiety and Depression(HAD) scale, and Stress Symptom Questionnaire(SSQ) designed by the author were used in 549 dental outpatients. Dental Fear Survey scale is composed of avoidance of dentistry(AVOI), physiologic response scale(PRS) and dental stimulus response scale(DSRS). The Hospital anxiety and Depresiosn scale is composed of hospital anxiety(HA) and hospital depressoin (HD). Data were analyzed statistically with SPSS program and the results were as follows : 1. The item of the highest positive response rate in DFS scale was 'feeling drill'(82.0%), and in the HAD scale was ' feel as if I am slowed down'(84.1%). 2. Mean score of AVOI, PRS, DSRS and HD were higher in the older group(>25yr) than the yoiunger group(<25yr) and female patients showed higher score of DSRS, HA than male patients. 3. Mean number of items of stress symptoms in extraoral region were 3.4, and in intraoral region, were 4.7. Tongue wymptoms were increased in the older toup and female patients had more stress symptoms than male patients. 4. Correlation between DFS scale and HAD scale were significantly positive and these scales were also apositively correlated with tongue symptoms. 5. As for treatment types, the patients treated in the department of periodontics,conservative dentistry, and oral surgery showed higher score of DFS scale than the patients with temporomandibular disorders or treatedin the department of orthodontics.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.6
• /
• pp.644-648
• /
• 2008

Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach. Material and Method: Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up. Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm. Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.1
• /
• pp.99-103
• /
• 1994

Various extraoral and intraoral approaches to reduction and fixation of zygomatic complex fractures were used. The method for exposure of inferior orbital area include the subciliary, inferior eyelid, infraorbital rim and conjunctions incisions. For exposure of frontozygomatic suture, lateral brow, coronal and b'ephaloplasty incisions were used. It is necessary that the usual approaches to the inferior and lateral orbit have two incisions. However, lateral canthotomy-conjunctival approach presented on this paper provide optimal exposure to lateral and inferior orbit.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.2
• /
• pp.183-188
• /
• 2010

Leiomyosarcoma is a malignant neoplasm of smooth muscle origin and mostly originate from the wall of uterus and gastrointestinal tract, but primary leiomyosarcoma of the oral cavity is extremely rare. This tumor has a very poor prognosis due to high recurrence and metastasis rate, with 5 year survival rate of 32%. And regional lymph node metastasis is uncommon event. Complete wide surgical excision is the treatment of choice. A 64-year old man who had a painful ulcerative lesion on the labial & palatal gingiva of #11, 21 visited our department, and was diagnosed as leiomyosarcoma through a biopsy. Partial maxillectomy was carried out, with no following radiotherapy or chemotherapy. After months follow-up, there has been no evidence of recurrence or metastasis. But after months, we clinically find out two enlarged immobile palpable lymph node in right submandibular area of patient. So a biopsy was performed via an extraoral incision under local anesthesia. Histopathologic diagnosis diagnosis of the biopsy was lymph node metastasis of prior existed leiomyosarcoma. We report a case of a primary leiomyosarcoma occurred in a 64 year-old male patient involving the anterior maxillary region with regional lymph node metastasis with a review of literature.