• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.86-92
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• 2011

Purpose: The purpose of this study was to investigate the possibility that a dynamic facial composite flap with sensory and motor nerves could be made available from donor facial composite tissue. Methods: The faces of 3 human cadavers were dissected. The authors studied the donor faces to assess which facial composite model would be most practicable. A "panorama facial flap" was excised from each facial skeleton with circumferential incision of the oral mucosa, lower conjunctiva and endonasal mucosa. In addition, the authors measured the available length of the arterial and venous pedicles, and the sensory nerves. In the recipient, the authors evaluated the time required to anastomose the vessels and nerve coaptations, anchor stitches for donor flaps, and skin stitches for closure. Results: In the panorama facial flap, the available anastomosing vessels were the facial artery and vein. The sensory nerves that required anastomoses were the infraorbital nerve and inferior alveolar nerve. The motor nerve requiring anstomoses was the facial nerve. The vascular pedicle of the panorama facial flap is the facial artery and vein. The longest length was 78 mm and 48 mm respectively. Sensation of the donor facial composite is supplied by the infraorbital nerve and inferior alveolar nerve. Motion of the facial composite is supplied by the facial nerve. Some branches of the facial nerve can be anastomosed, if necessary. Conclusion: The most practical facial composite flap would be a mid and lower face flap, and we proposed a panorama facial flap that is designed to incorporate the mid and lower facial skin with and the unique tissue of the lip. The panorama facial composite flap could be considered as one of the practicable basic models for facial allotransplantation.

• Journal of Korean Neurosurgical Society
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• v.44 no.6
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• pp.399-400
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• 2008

Hemifacial spasm induced by intracranial aneurysm is a rare clinical condition. A 45-year-old male patient presented with a 3-year history of progressive involuntary twitching movement on right face. On radiological study, a dilated vascular lesion compressing the brain stem was found at the junction of vertebral artery and posterior inferior cerebellar artery. On operative field, we found the posterior inferior cerebellar artery and the fusiform aneurysm compressing root exit zone of facial nerve. Microvascular decompression was performed and the facial symptom was relieved without complications.

• Anatomy and Cell Biology
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• v.57 no.2
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• pp.316-319
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• 2024

Comprehensive understanding of the variations in the branching of the external carotid artery (ECA) is essential to minimizing vascular complications during cranio-facial and neck surgical procedures. We demonstrate a rare case of unusual branching of ECAs in both carotid triangles and anomalous origin of the left ascending pharyngeal artery (APA) during dissection of embalmed cadaver. The right and left common carotid arteries (CCA) bifurcated at the level of the upper border of the thyroid cartilage. The right superior thyroid artery (STA) originated anterior to the carotid bifurcation (CB), while the left STA originated from the anterior aspect of the left CCA. The right ECA trifurcated into linguofacial trunk, APA, and distal ECA, 15.7 mm from CB. On the left side, lingual artery and APA arose as a short common linguopharyngeal trunk, 1.9 mm from CB. The left facial and occipital arteries originated anteromedially and posteriorly at the same level.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.200-206
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• 2004

Anterior inferior cerebellar artery(AICA) is a branch of the basilar artery which supplies the bloods for ventrolateral cerebellum and the lateral tegmentum of the lower two-thirds of pons. AICA occlusion can cause such symptoms as acute-onset unilateral deafness, vertigo, facial weakness and ataxia. A case of sudden hearing loss, facial palsy and vertigo caused by AICA territory infarction recently presented itself. Korean Oriental and Western medical therapy were applied in combination. Facial palsy and vertigo improved, but hearing loss did not improve. This case is reported with a brief overview of related literatures.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6761-6763
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• 2015

Aims: To investigate the role of swelling anesthesia in repairing facial soft tissue defects after tumor resection and temporal superficial artery frontal branch of narrow pedicle flap. Materials and Methods: From January 2008 to June 2008, 16 patients from Department of Ophthalmology with eye or eyelid tumors after eyeball removal of eye and part resection of surrounding soft tissue, undergoing postoperative swelling anesthesia with superficial temporal artery flap repair to prevent facial soft tissue defect formation and bone exposure, were recruited. Results: In all 16 patients facial soft tissue defect repair had good effects, with limited bleeding, and short operation times. Seven days after surgery, all flaps were in good repair. On postoperative follow-up after 3 months, flaps showed a similar appearance as with facial tissue. Conclusions: Swelling anesthesia for superficial temporoparietal artery frontal branch of narrow pedicle flap to repair soft tissue defect after facial tumor resection is feasible, and is linked with good analgesic effects, high postoperative survival of skin flaps, and good cosmetic effects.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.754-760
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• 2013

Background Classical flaps for perinasal defect reconstruction, such as forehead or nasolabial flaps, have some disadvantages involving limitations of the arc of rotation and two stages of surgery. However, a perforator-based flap is more versatile and allows freedom in flap design. We introduced our experience with reconstruction using a facial artery perforator-based propeller flap on the perinasal area. We describe the surgical differences between different defect subtypes. Methods Between December 2005 and August 2013, 10 patients underwent perinasal reconstruction in which a facial artery perforator-based flap was used. We divided the perinasal defects into types A and B, according to location. The operative results, including flap size, arc of rotation, complications, and characteristics of the perforator were evaluated by retrospective chart review and photographic evaluation. Results Eight patients were male and 2 patients were female. Their mean age was 61 years (range, 35-75 years). The size of the flap ranged from $1cm{\times}1.5cm$ to $3cm{\times}6cm$. Eight patients healed uneventfully, but 2 patients presented with mild flap congestion. However, these 2 patients healed by conservative management without any additional surgery. All of the flaps survived completely with aesthetically pleasing results. Conclusions The facial artery perforator-based flap allowed for versatile customized flaps, and the donor site scar was concealed using the natural nasolabial fold.

• Korean Journal of Head & Neck Oncology
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• v.29 no.2
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• pp.41-47
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• 2013

Background : The purpose of this study is to review our experience with the variable applications of the facial artery muscolomucosal(FAMM) flap for oral cavity reconstruction following treatment for head and neck malignancies. Methods : We performed retrospect medical record review from January 2012 to June 2013. This flap technique was applied in 3 patients to reconstruct the defects of oral cavity induced by treatment for head and neck malignancies. Results : The defects and fibrosis occurred due to variable causes related to previous treatment for head and neck malignancies such as tumor resection and chemoradiation. Two patient suffered from defect on hard and soft palate and one patient suffered from trismus related to fibrotic scar band. We performed oral cavity reconstruction using FAMM flap even though these all patients had history of neck dissection surgery or radiation therapy. Conclusion : FAMM flap is an ideal option for reconstruction following treatment not only for primary tumor resection but also for defects induced by variable causes. Preoperative radiation and neck dissection surgery, which are previously considered as some challenges, are no longer contraindication in our cases.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.131-135
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• 2008

Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.100-106
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• 2013

There are many challenges for reconstruction after intraoral tumor resection. Especially, palatomaxillary reconstruction has two primary goals: closure of the oronasal communication and re-creation of proper myomucosal function. Prosthodontic treatment using obturator and several surgical procedures are selected depending on the size and site of the defect, the difficulty of operative procedure, operation time and donor site problem. Above all, it is considered that radial forearm free flap is the first choice for palatal reconstruction. Our department introduces a novel method using tunnelized-facial artery myomucosal island flap for palatomaxillary defect reconstruction, which can successfully reduce donor-site morbidity, and duration of surgery and hospitalization.

• Clinical and Experimental Pediatrics
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• v.55 no.1
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• pp.29-33
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• 2012

PHACE association is a rare neurocutaneous condition in which facial hemangiomas associate with a spectrum of posterior fossa malformations, arterial cerebrovascular anomalies, cardiovascular anomalies, and eye anomalies. We reported a case of PHACE association in a premature infant showing facial, intracranial, and oropharyngeal hemangiomas with evidence of the Dandy-Walker variant and complicated cardiovascular anomalies, including a right-sided aortic arch and an atypical patent ductus arteriosus arising from a tortuous left subclavian artery. To our knowledge, intracranial hemangiomas are rare in PHACE association, and a concomitant oropharyngeal hemangioma has not been previously reported in the PHACE association literature. In infants presenting with large, plaque-like facial hemangiomas, it is important to conduct active cardiovascular and neurological evaluations. Special attention should be given to the laryngoscopic examination to search for additional hemangiomas in the airway.