• Archives of Plastic Surgery
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• v.38 no.6
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• pp.719-724
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• 2011

Purpose: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing noninvasive operator-independent details of the vascular anatomy. This tool was used to perform an $in$ $vivo$ anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. Methods: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. Results: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. Conclusion: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.13-18
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• 2004

In most patients with facial palsy after temporal bone injury, temporal bone High Resolution CT revealed direct or indirect facial nerve canal involvement, and in complete palsy severe degeneration groups, there were direct findings in most cases. Author believe that meticulous analysis and symptom correlation of the fracture patterns seen in facial canal injury in patients with traumatic facial nerve palsy is helpful for treatment planning and prognosis.

• Imaging Science in Dentistry
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• v.37 no.1
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• pp.45-51
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• 2007

Purpose : This study aimed to identify the range of normal facial asymmetry using three-dimensional CT and to develop a simple method of diagnosis of facial asymmetry. Materials and Methods : Twenty eight adults with normal occlusion (16 males and 12 females; mean age 24 years and 1 month) were selected whose faces were assessed to be symmetric by an orthodontist. Three-dimensional reconstructions were obtained utilizing spiral CT scans and an oral and maxillofacial radiologist evaluated nineteen anatomic landmarks in three-dimensional coordinates. Facial asymmetry index of each landmark was caluculated. Results : The range of normal facial asymmetry of each landmark was identified using mean and standard deviation of facial asymmetry index. Conclusions : The range of normal facial asymmetry identified in this study may be used as a diagnostic standard for facial asymmetry analysis.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.108-116
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• 2008

Background : When surgeons plan mandible ortho surgery for patients with skeletal class III facial asymmetry, they must be consider the exact method of surgery for correction of the facial asymmetry. Three-dimensional (3D) CT imaging is efficient in depicting specific structures in the craniofacial area. It reproduces actual measurements by minimizing errors from patient movement and allows for image magnification. Due to the rapid development of digital image technology and the expansion of treatment range, rapid progress has been made in the study of three-dimensional facial skeleton analysis. The purpose of this study was to conduct 3D CT image comparisons of mandible changes after mandibular surgery in facial asymmetry patients. Materials & methods : This study included 7 patients who underwent 3D CT before and after correction of facial asymmetry in the oral and maxillofacial surgery department of Yeungnam University Hospital between August 2002 and November 2005. Patients included 2 males and 5 females, with ages ranging from 16 years to 30 years (average 21.4 years). Frontal CT images were obtained before and after surgery, and changes in mandible angle and length were measured. Results : When we compared the measurements obtained before and after mandibular surgery in facial asymmetry patients, correction of facial asymmetry was identified on the "after" images. The mean difference between the right and left mandibular angles before mandibular surgery was $7^{\circ}$, whereas after mandibular surgery it was $1.5^{\circ}$. The right and left mandibular length ratios subtracted from 1 was 0.114 before mandibular surgery, while it was 0.036 after mandibular surgery. The differences were analyzed using the nonparametric test and the Wilcoxon signed ranks test (p<0.05). Conclusion: The system that has been developed produces an accurate three-dimensional representation of the skull, upon which individualized surgery of the skull and jaws is easily performed. The system also permits accurate measurement and monitoring of postsurgical changes to the face and jaws through reproducible and noninvasive means.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.546-553
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• 2008

Purpose: The purpose of this study was to estimate validity of posterior anterior cephalometric and 3D-CT for orbital canting analysis. Materials and methods: Three trained observers classified two patients group using standardized frontal photographs of facial asymmetry patients. Group A consisted of patients with facial asymmetry and orbital canting(n=19), and group B consisted of patients with only facial asymmetry(n=43). Orbital canting was measured with line of bilateral inferior orbitale. Orbital canting measurement was done with posterior anterior cephalometric and 3D-CT. Each horizontal reference line was established by bilateral GWSO(cephalometric), FZS(3D-CT). Maxillary canting and mandibular deviation angle were also measured and analyzed with orbital canting. Results: The mean orbital canting was $3.03{\pm}1.00^{\circ}$ in Group A and $1.11{\pm}0.76^{\circ}$ in Group B in frontal photograph. The mean orbital canting was $1.20{\pm}0.74^{\circ}$ in group A and $1.22{\pm}0.65^{\circ}$ in group B by cephalometric analysis(p>0.05). In 3D-CT, orbital canting was almost paralleled with horizontal reference line. The orbital canting, maxillay canting and mandibular deviation between two groups showed no significant differences except madibular deviation in 3D-CT. Conclusion: Common analysis of posterior anterior cephalometric and 3D-CT is not valide method to evaluate orbital canting for facial asymmetry patients with orbital canting.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.18-23
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• 2009

Purpose: In this study, we retrospectively investigated the medical records of patients with facial fractures and suspected cranial injuries in order to determine if there was any relationship between various facial fracture patterns and cranial injuries. Methods: Medical records were reviewed to identify patients diagnosed with facial fractures who underwent cranial computed tomography (CT) scans. Records were reviewed for gender, age, injury mechanism, facial fracture pattern, and presence or absence of cranial injuries. Facial fracture patterns were classified as isolated fractures (tripod, zygomatic arch, maxilla, orbit, and mandible), combined fractures, or total fractures. Cranial injuries included skull fractures, traumatic subarachnoid hemorrhages, subdural hemorrhages, epidural hemorrhages, and contusional hemorrhages. All cranial injuries were established by using cranial CT scans, and these kinds of cranial injuries were defined radiologically-proven cranial injuries (RPCIs). We evaluated the relationship between each pattern of facial fractures and the incidence of RPCIs. Results: Of 132 eligible patients with facial fractures who underwent cranial CT scans, a total of 27 (20.5%) patients had RPCIs associated with facial fractures. Falls and slips were the most common causes of the fractures (31.8%), followed by assaults and motor vehicle accidents (MVAs). One hundred one (76.5%) patients had isolated facial fractures, and 31 (23.5%) patients had combined facial fractures. Fractures were found most commonly in the orbital and maxillary bones. Patients with isolated maxillary fractures had a lower incidence of RPCIs than those with total mandibular fractures. RPCIs frequently accompanied combined facial fractures. Conclusion: Combined facial fractures had a significant positive correlation with RPCIs. This means that facial fractures caused by stronger or multidirectional external force are likely to be accompanied by cranial injuries.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.605-610
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• 2007

Purpose: Facial trauma is increasing along with increasing popularity in sports, and increasing exposure to crimes or traffic accidents. Compared to the 3D CT of 1990s, the latest CT has made significant improvement thus resulting in higher accuracy of diagnosis. The objective of this study is to compare 64 channel 3 dimensional volume CT(3D VCT) with conventional 3D CT in the diagnosis and treatment of facial bone fractures. Methods: 45 patients with facial trauma were examined by 3D VCT from Jan. 2006 to Feb. 2007. 64 channel 3D VCT which consists of 64 detectors produce axial images of 0.625 mm slice and it scans 175 mm per second. These images are transformed into 3 dimensional image using software Rapidia 2.8. The axial image is reconstructed into 3 dimensional image by volume rendering method. The image is also reconstructed into coronal or sagittal image by multiplanar reformatting method. Results: Contrasting to the previous 3D CT which formulates 3D images by taking axial images of 1-2 mm, 64 channel 3D VCT takes 0.625 mm thin axial images to obtain full images without definite step ladder appearance. 64 channel 3D VCT is effective in diagnosis of thin linear bone fracture, depth and degree of fracture deviation. Conclusion: In its expense and speed, 3D VCT is superior to conventional 3D CT. Owing to its ability to reconstruct full images regardless of the direction using 2 times higher resolution power and 4 times higher speed of the previous 3D CT, 3D VCT allows for accurate evaluation of the exact site and deviation of fine fractures.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.251-254
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• 1993

Hemifacial spasm is a distressing condition characterized by involuntary, intermittent, unilateral twitching of all or parts of the muscles innervated by the facial nerve. This occurrence is most common in middle-aged women. Because etiology of idiopathic hemifacial spasm has remained undefined, no causative agent nor reliable treatment has been established. This report describes a case of CT guided chemical facial nerve block for the treatment of hemifacial spasm. An injection of small amount(0.1 ml) of alcohol(95%) provided relief of the facial spasms.

• Journal of radiological science and technology
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• v.34 no.2
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• pp.105-116
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• 2011

In this study, we present the measurements of effective dose from CT of head & neck region. A series of dose measurements in anthropomorphic Rando phantom was conducted using a radio photoluminescent glass rod dosimeter to evaluate effective doses of organs of head and neck region from the patient. The experiments were performed with respect to four anatomic regions of head & neck: optic nerve, pons, cerebellum, and thyroid gland. The head & neck CT protocol was used in the single scan (Brain, 3D Facial, Temporal, Brain Angiography and 3D Cervical Spine) and the multiple scan (Brain+Brain Angiography, Brain+3D Facial, Brain+Temporal, Brain+3D Cervical spine, Brain+3D Facial+Temporal, Brain+3D Cervical Spine+Brain Angiography). The largest effective dose was measured at optic nerve in Brain CT and Brain Angiography. The largest effective dose was delivered to the thyroid grand in 3D faical CT and 3D cervical spine, and to the pons in Temporal CT. In multiple scans, the higher effective dose was measured in the thyroid grand in Brain+3D Facial, Brain+3D Cervical Spine, Brain+3D Facial+Temporal and Brain+3D Cervical Spine+Brain Angiography. In addition, the largest effective dose was delivered to the cerebellum in Brain CT+Brain Angiography CT and higher effective dose was delivered to the pons in Brain+Temporal CT. The results indicate that in multiple scan of Brain+3D Cervical Spine+Brain Angiography, effective dose was 2.52 mSv. This is significantly higher dose than the limitation of annual effective dose of 1 mSv. The effective dose to the optic nerve was 0.31 mSv in Brain CT, which shows a possibility of surpassing the limitation of 1 mSv by furthre examination. Therefore, special efforts should be made in clinical practice to reduce dose to the patients.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.95-100
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• 2014

Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.