• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.77-84
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• 2010

Purpose: The nasal bones are the most common fracture sites of the facial bones, and a careful reduction may still result in secondary deformities, such as saddle nose, deviated nose, hump nose etc, requiring secondary cosmetic rhinoplasty. Therefore, this study examined the clinical characteristics of nasal bone fractures to propose guidelines for patient selection and surgical procedures to achieve more satisfactory results and to prevent secondary deformities with simultaneous augmentation rhinoplasty and bony reduction. Methods: The study was based on 26 out of 149 nasal bone fracture patients who underwent simultaneous augmentation rhinoplasty with bony reduction between May 2008 and April 2009. Retrospective analysis was performed according to the clinical data, surgical techniques and postoperative results. Results: Of the 26 patients, there were 15 males and 11 females. The incidence according to the Stranc's classification revealed that 62% of patients were injured by a frontal impact and 38% by a lateral impact. Frontal impact plane I (50%) was the most frequent type. At the follow up, 18 (81.2%) out of 22 patients were satisfied with their postoperative outcome, and the remaining 4 patients were fair. No one was dissatisfied. However, 5 cases in 3 patients (23%) had some complications; minimal implant deviation in 2 cases, minor irregularity on the nasal dorsum in 2 cases and palpable implant movement under palpation in 1 case. None of these cases required surgical correction. Conclusion: With the proper guidance, simultaneous augmentation rhinoplasty with bony reduction can prevent secondary deformities and satisfy the cosmetic outcomes.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.162-164
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• 2016

Stafne bone cavity is a rare mandibular defect that was first reported by Edward C. Stafne in 1942. It commonly presents with a well-demarcated, asymptomatic, unilateral radiolucency that indicates lingual invagination of the cortical bone. A 52-year-old female patient who with nasal bone fracture, visited the hospital. During facial bone computed tomography (CT) for facial area evaluation, a well-shaped cystic lesion was accidentally detected on the right side of the mandible. Compared to the left side, no swelling or deformity was observed in the right side of the oral lesion, and no signs of deformity caused by mucosal inflammation. 3D CT scans, and mandible series x-rays were performed, which showed a well-ossified radiolucent oval lesion. Axial CT image revealed a cortical defect containing soft tissue lesion, which has similar density as the submandibular gland on the lingual surface of the mandible. The fact that Stafne cavity is completely surrounded by the bone is the evidence to support the hypothesis that embryonic salivary gland is entrapped by the bone. In most cases, Stafne bone cavity does not require surgical treatment. We believe that the mechanical pressure from the salivary gland could have caused the defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.428-434
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• 2020

Orbital floor blowout fractures can result in a variety of signs and symptoms depending on the severity of the bone defect. Large defects often result in enophthalmos and restriction of ocular movement; yet the timing of surgery can be delayed up to two weeks with good functional outcomes. In contrast, an orbital trapdoor defect with entrapment of the inferior rectus muscle usually elicits pain with marked restriction of the upward gaze and activation of the oculocardiac reflex without significant dystopia or enophthalmos. When autonomic cardiac derangement is diagnosed along with an orbital floor fracture, it has been suggested that the fracture should be treated immediately. Otherwise, it will result in continued hemodynamic instability and muscular injury and may require a second surgery. This article reports the management of an unusual presentation of a trapdoor blowout orbital floor fracture surgery with oculocardiac response in an adult, with emphasis on its pathophysiology, management, and differential diagnosis.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.26 no.2
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• pp.65-73
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• 1996

The purpose of this study was to evaluate the clinical and computed tomographic features of 7 cases of maxillofacial gunshot injuries in the suicidal patients visited the emergency room, Capital Armed Forces General Hospital. The obtained results were as follows : 1. The gunshot wounds were directed from submental area to dorsum of nose(3 cases), frontal area(1 case), orbit(1 case), infraorbital area (1 case), and lateral to nasal wing(l case). The shape of inlet in gunshot wounds were round (diameter: l-3cm) and that of outlet were oval shape(size : inlet

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.461-464
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• 2010

Purpose: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. Methods: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. Results: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. Conclusion: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.556-560
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• 2012

Zygomatic fractures are the second most common facial bone fractures encountered and treated by plastic surgeons. Stable fixation of fractured fragments after adequate exposure is critical for ensuring three-dimensional anatomic reduction. Between January 2008 and December 2010, 17 patients with zygomatic fractures were admitted to our hospital; there were 15 male and 2 female patients. The average age of the patients was 41 years (range, 19 to 75 years). We exposed the inferior orbital rim and zygomatic complex through a lateral brow, intraoral, and subciliary incisions, which allowed for visualization of the bone, and then the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperative complications such as malar asymmetry, diplopia, enophthalmos, and postoperative infection were not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17 patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report, we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures. Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and safely than other devices, without leaving facial scars.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.419-427
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• 1994

Because of the prominence of the nose and its central location, it is the most frequently encountered fractures in the face. Yet reports about the nasal bone fractures are virtually rare in the oral and maxillofacial surgical literatures. This is a retrospective study on 19 nasal bone fractures treated in Chosun university hospital Department of Oral & Maxillofacial Surgery from Jan. 1991 to Sep. 1993, under admission to our Dept. and the obtained results were as follows. 1. Of the 240 patients with facial bone fractures, 28 patients suffered nasal fractures(12%) and male to female ratio was 5.3:1. 2. The most frequent cause was traffic accidents(39%)m, the next fall down(36%), first blow(4%). 3. The age frequency was the highest in the fifth decade (32%). 4. Clinical classification of nasal fractures was simple fractures(74%), combined fractures(26%), and single fractures(37%), combined fractures(63%). 5. The most frequently combined site was maxilla(50%). 6. Treatments of nasal fractures were closed reduction(63%), open reduction(5%), and secondary rhinoplasty(32%). 7. The initial treatment time from accident was 1.7 days in single fractures, and 3.5 days in combined fractures, and the period of splint retained was about 8.2 days in single fracture, about 8.7 in combined fracture. 8. It was necessary to treat secondarily in delayed treatment, and all treatment methods showed relatively good prognosis. 9. Closed reduction was treated under local anesthesia, but open reduction & secondary rhinoplasty was treated under general anesthesia except 1 case. 10. The complications were disturbance of swellings 5 cases, ethetic problem 5 cases, epiphora 3 cases, abnormal sensation 6 cases in relation with other fractures.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.3
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• pp.105-115
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• 2019

Objectives : The purpose of this study is to analyze the trends of phamacopuncture used in facial nerve palsy related articles that have been published in the Korean medicine journal. Methods : 242 papers related to facial nerve palsy were retrieved from Oriental Medicine Advanced Searching Integrated System(OASIS) and Korean Traditional Knowledge Portal(KTKP). We selected 13 research papers treated with pharmacopuncture for facial nerve palsy. We analyzed for type of pharmacopuncture used, treatment point and clinical type. Results : 1. The number of searched articles is thirteen. 2. The most common clinical type of facial nerve palsy is Bell's palsy. Other types are accompanying tympanitis type, herpes zoster oticus, caused by traumatic temporal bone fracture type, Foville syndrome, Foville-Millard-Gubler syndrome and multiple cerebral neuritis. 3. In the case of pharmacopuncture, the most frequently used type is Hominis Placenta Pharmacopunture. The second is Hwangreonhaedok-tang and Hwangreon Pharmacopuncture. Other than that BV, Sinbaro, Jungsongouhyul Pharmacopuncture, Cornu Cervi Pantotrichum Pharmacopuncture and Ginseng pharmacopuncture are used. 4. The most frequently used part as a treatment point is ST4, ST6, TE17.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.1-10
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• 1989

The major causes of the facial bone fractures are fractures are automobile collision or other accident, and fights. Of the facial bone fractures, the nasal bone fractures are monst common. According to Schroeder et al., 50% of facial bone fractures are isolated fractures of the nasal pyramid. But the fractured nasal bone is not immediately treated as other facial bone fractures. And it is necessary to delay the treatment of the combined nasal bone fractures with other jaw bone fractures because of the difficult anesthetic techniques. Therefore there are many residual nasal deformities following a fracture; nasal hump, saddle nose and alar rim defect. Many authors have suggested the methods to correct the post-traumatic nasal deformities. We have treated several patients with several methods and this paper presents the operating methods and results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.1
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• pp.74-81
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• 2005

In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.