• Title/Summary/Keyword: Facial CT

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Usage of digital technique to facilitate communication between dentist, dental lab technician, and patients in diagnosis and restoration for maxillary anterior implant: a case report (디지털 기법을 활용한 치과의사, 기공사, 그리고 환자 간의 효과적인 소통을 통한 전치부 임플란트의 진단 및 심미수복 증례)

  • Bang, Haemin;Jang, Woohyung;Park, Chan;Yun, Kwi-Dug;Lim, Hyun-Pil;Park, Sangwon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.42-51
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    • 2022
  • Esthetic restoration of maxillary anterior implant heavily depends on the direction of installation of implant fixture. In patients with malpositioned implant, it is crucial to communicate the limitations of prosthetic outcome with the patient before starting on a restoration. To facilitate the communication, three-dimensional virtual representation by superimposing facial and intraoral digital scans with Computed Tomography (CT, dicom file) was used for visualization of the limitations of prosthesis. Through digital diagnostic wax-up, the profile of right maxillary anterior incisor implant was expected to be protrusive, which the patient was not satisfied with. Since the patient already had done root canal treatment on left maxillary anterior incisor due to previous trauma, a new prosthetic design including both right and left maxillary anterior incisors was presented to the patient. The second design was chosen and his comments were delivered to dental lab. The patient was satisfied with the new prosthesis, aesthetically and functionally.

The Reconstruction of the Extensive Inferior Blow-out Fracture Through Endoscopic Transnasal and Subciliary Approaches (광범위한 안와하벽골절에서 속눈썹밑 절개 및 비강 내 내시경적 접근을 동시에 사용한 재건술)

  • Cho, Soo-Jong;Oh, Heung-Chan;Nam, Su-Bong;Kang, Cheol-Uk;Bae, Yong-Chan
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.86-90
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    • 2009
  • Purpose: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The purpose of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of $Medpor^{(R)}$ through subciliary approach. Methods: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of $Medpor^{(R)}$ through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient's charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. Results: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. Conclusion: The ballooning of foley catheter through endoscopic transnasal approach with implantation of $Medpor^{(R)}$ through subciliary approach can be considered one of the appropriate technique for extensive inferior blowout fracture.

The Inferior Orbital Wall Reconstruction by Titanium Micro-mesh Remodeling (Titanium Micro-mesh의 개형을 통한 하벽부 안와골절의 재건)

  • Kim, Han Koo;Choi, Min Seok;Kim, Woo Seob;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.81-85
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    • 2009
  • Purpose: The inferior orbital wall is the most vulnerable to injury and inadequate reconstruction of inferior orbital fracture result in postoperative complications include enophthalmos, ocular dystopia and diplopia. Although the anatomical reconstruction of the inferior orbital wall is necessary to prevent these complications, the complexity of inferior orbital wall makes it difficult. We fabricated and remodeled the titanium micro-mesh plate for the anatomical reconstruction of inferior orbital wall. Methods: Twenty-nine patients with inferior orbital wall blow-out fracture were operated and twelve of them presented large extensive fracture. We intraoperatively fabricated and remodeled the Titanium-micro mesh to angulated lazy S shape similar to contralateral uninjured orbit. The preoperative and postoperative facial CT scan verified the 3-dimensional and anatomical reconstruction of the fractures. The mean follow-up was 19.7 months and postoperative complications was evaluated. Results: All cases showed the exact anatomical reconstruction, but there were minor complications in two cases. one patient had postoperative diplopia until 3months after surgery and the other patient had persistent enophthalmos (2 mm), but no further surgical correction was required. Conclusion: The comprehensive understanding of orbital convexity is the most important factor for anatomical reconstruction of inferior orbital fracture. We could prevent postoperative complications after inferior orbital wall reconstruction by intraoperative fabrication and anatomical remodeling of Titanium micro-mesh.

Application of Calibration Techniques to Enhance Accuracy of Markerless Surgical Robotic System for Intracerebral Hematoma Surgery (뇌혈종 제거 수술을 위한 무마커 수술 유도 로봇 시스템의 정확도 향상을 위한 캘리브레이션 기법)

  • Park, Kyusic;Yoon, Hyon Min;Shin, Sangkyun;Cho, Hyunchul;Kim, Youngjun;Kim, Laehyun;Lee, Deukhee
    • Korean Journal of Computational Design and Engineering
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    • v.20 no.3
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    • pp.246-253
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    • 2015
  • In this paper, we propose calibration methods that can be applied to the markerless surgical robotic system for Intracerebral Hematoma (ICH) Surgery. This surgical robotic system does not require additional process of patient imaging but only uses CT images that are initially taken for a diagnosis purpose. Furthermore, the system applies markerless registration method other than using stereotactic frames. Thus, in overall, our system has many advantages when compared to other conventional ICH surgeries in that they are non-invasive, much less exposed to radiation exposure, and most importantly reduces a total operation time. In the paper, we specifically focus on the application of calibration methods and their verification which is one of the most critical factors that determine the accuracy of the system. We implemented three applications of calibration methods between the coordinates of robot's end-effector and the coordinates of 3D facial surface scanner, based on the hand-eye calibration method. Phantom tests were conducted to validate the feasibility and accuracy of our proposed calibration methods and the surgical robotic system.

A CLINICAL STUDY ON NASO-ORBITO-ETHMOIDAL FRACTURES (비-안와-사골 복합골절에 관한 임상적 연구)

  • Kim, Soo-Nam;Lee, Dong-Keun;Min, Seung-Ki;Oh, Sung-Hwan;Choi, Moon-Gi;Park, Hwa-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.3
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    • pp.277-283
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    • 1999
  • This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

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Combined Orbital Fractures: Surgical Strategy of Sequential Repair

  • Hur, Su Won;Kim, Sung Eun;Chung, Kyu Jin;Lee, Jun Ho;Kim, Tae Gon;Kim, Yong-Ha
    • Archives of Plastic Surgery
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    • v.42 no.4
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    • pp.424-430
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    • 2015
  • Background Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. Methods We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. Results In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. Conclusions We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon.

Case Report on 4 Patients with Lumbar Disc Herniation Treated with Concurrent Embedding Therapy under Conventional Korean Medical Treatments (매선요법을 병행한 요추 추간판 탈출증 환자 치험 4례)

  • Lee, Hyung Ggeol;Im, Jeong Gyun;Jung, Da Jung;Yook, Tae Han;Kim, Jong Uk
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.124-129
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    • 2013
  • Embedding Therapy keep the stimulation to acupoint. Recently, Embedding Therapy is used for various disease and also studied in many different fields especially in China. In Korea, Embedding Therapy is studied and used for dermatology, face-lift, obesity, facial palsy most frequently. Chinese studies shows us Embedding Therapy could help musculoskeletal system disorder, lumbar herniated intervertebral disc, sprain, spinal canal stenosis. In Korea study concerning lumbar herniated intervertebral disc treatment used Embedding Therapy is few. This study's purpose is to ensure effect of Embedding Therapy at lumbar herniated intervertebral disc treatment. Four lumbar disc herniation patients had been treated with Embedding Therapy were described in this article. The patients(n=4) had been suffering from chronic lower back and leg pain that continued for more than 6 months. All patients had been diagnosed as lumbar disc herniation by MRI or CT, and treated with Embedding Therapy at least 2 times(7 days interval). 2 patients had been treated with concurrent treatment of acupuncture therapy, and the other 2 patients with concurrent treatment of acupuncture and herbal therapy. We observed 4 patients for more than 2 weeks, and their symptoms and quality of daily life had been improved. This suggests that lumbar disc herniation can be successfully recovered with Concurrent Embedding Therapy under conventional Korean Medical Treatment without side effects.

Small Incision and Dual-Top Screws for Treatment of Simple Depressed Anterior Frontal Sinus Fractures (소절개 및 Dual-top screw를 이용한 전두동 전벽 단순 함몰골절의 치료)

  • Moon, Suk Ho;Oh, Deuk Young;Seo, Byung Chul;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.345-348
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    • 2008
  • Purpose: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. Methods: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5 cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary Results: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. Conclusion: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.

Diagnostic Imaging of Nasal Lymphoma in a Cat (고양이에서 비강 림프종의 영상 진단 증례)

  • Jung, Joo-Hyun;Seo, Kyoung-Won;Chang, Jin-Hwa;Bae, Il-Hong;Kim, Dae-Yong;Yoon, Hwa-Young;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.361-365
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    • 2006
  • A spayed female, 5-year-old, weighing 2.7 kg, domestic short hair cat was referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs of this patient were weight loss, sneezing, respiratory distress, nasal discharge, epistaxis, ocular discharge, left exophthalmos, and left facial edema and deformity. The laboratory tests represented mild leukocytosis. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail was found. Destructive and lytic changes of the left nasal bone with soft tissue swelling were identified. On the thorax radiographs, there were a tracheobronchial lymph node swelling and a soft tissue round mass in the left caudal lung field. On computed tomographic scan images, asymmetrical destruction of turbinate and nasal septum and increased soft tissue opacity in the nasal cavity were identified. Destruction of the lateral maxillary bone, invasion to the left retrobulbar region, and craniodorsal deviation of the left eye were seen. Also, there was lysis of hard palate and cribriform plate. Invasion to the brain was found. The patient was diagnosed as nasal lymphoma by cytology and histopathology.

A Submandibular Gland Mucocele Extending to the Skull Base (두개저까지 확장된 악하선 점액류)

  • Kim, Il-Kyu;Yang, Jung-Eun;Chang, Jae-Won;Ju, Sang-Hyun;Pyun, Young-Hun;Kim, Lucia
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.180-184
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    • 2011
  • The mucocele is a mucus extravasation cyst arising from the salivary gland. Although it is a common?lesion of the minor salivary gland, it is uncommon when it originated from the submandibular gland. The ranula is a form of mucocele which specifically occurs in the floor of the mouth and the sublingual gland is generally accepted as the origin of ranula. They can be classified into two types based on extent: simple ranula are confined to the sublingual space and plunging ranula extend into the adjacent space. It is difficult to differentiate the submandibular gland mucocele from the plunging ranula because both of them can occupy the submandibular space. A 37-year old male visited our clinic with the chief complaint of left facial swelling. The patient's history revealed that he had suffered from a cystic lesion on the left side of the floor of the mouth 10 months previously. He supposed the cystic lesion had come from trauma at other dental clinics. Using CT and MRI, we diagnosed a simple ranula on the sublingual space and a submandibular gland mucocele. We then excised the mucocele with the submandibular gland by an extraoral approach and the sublingual gland by an intraoral approach under general anesthesia. We report a rare case of an enormous submandibular gland mucocele which extended into the pterygoid plate and parapharyngeal space with good surgical results.