• Archives of Plastic Surgery
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• 제35권4호
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• pp.419-422
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• 2008

Purpose: Absorbable bone fixation materials for operation of facial bone fracture are composed of poly- lactic acid(PLA) & poly-glycolic acid(PGA). These materials are absorbed after facial bone healing period. Therefore, these materials are harmless in human body. But because of it's radioopacity, the number and the location of the materials are not checked in follow-up X-ray examination. We studied absorbable bone fixation materials checked radiological examination. So, we made the absorbable plate composed of PLA, Hydroxyapatite (HA) and Gold(Au). Methods: Plate 1 was consisted of pure PLA. Plate 2 was consisted of PLA(50%) and HA(50%). Plate 3 - 7 were consisted of PLA(50%), and variable composition of HA & Au. The ratio of Au was as following. From the plate 3 to plate 7, the Au ratio was 1%, 5%, 10%, 17%, and 25%, respectively. Total 3 examinations were used-naked eye examination, simple X-ray examination, and Haunsfield unit of plate in CT examination. Results: Naked eye examination found out that the color of plate 1 was most white. As the Au ratio increases, the color of plate was getting close to khaki color. the radioopacity of plate 2 was similar cortical bone of face in simple X-ray. The Haunsfield unit of cortical bone of face was 1000 HU. Haunsfield unit of titanium plate was 2900 HU. Haunsfield unit of plate 1 through plate 7 were -242, 1489, 1776, 3052, 3092, 3095, and 3095, respectively. Conclusion: Radioopacity of plate 2 was similar to cortical bone of face. In CT examination, Hanusfield unit of plate 2 was similar to Hanusfield unit of cortical bone of face. Hanusfield unit of plate 4 - 7 were similar to Hanusfield unit of titanium plate. So to trace bone fixation materials after facial bone surgery, the best ratio of Au is about 1 - 5%. If this study is applied to facial bone surgery, radiologic follow up would be easy after facial bone surgery.

• 한국의료질향상학회지
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• 제10권2호
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• pp.154-163
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• 2003

Purpose: The aim of this study is to develop and apply the critical pathway to the nasal bone fracture patients and to elucidate its effect. Methods: Critical pathway (CP) sheet and questionnaire were developed by a team approach. Critical pathway were applied to 30 nasal bone fracture patients (CP group) from June 2001 to November 2001. Length of hospitalization, cost for hospitalization and bed turnover rate of CP group were compared to those of the 30 patients who had same disease entities and treated by conventional regimen (control group). Results: Length of hospitalization in the CP group (4.20 day) were significantly shorter than that of control group (6.21 day). Mean cost for hospitalization of the CP group (492,106 won) were significantly lower than that of control group (678,376 won). Bed turnover rate in CP group (2.5) were higher than that of control group. The patients satisfaction for the medical personnel, explanation regarding operation procedure, therapeutic operation fee, and length of hospitalization were all affirmative. Conclusion: Critical pathway that we developed for nasal bone fracture definitely improved the quality of treatment and lowered cost of medical service. Furthermore, other critical pathways should be developed for another facial trauma patients.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.330-334
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• 2013

Background Ultrasound-aided fixation is a recently developed alternative method of treatment of zygomatico-maxillary (ZM) fracture, and it can resolve the problems of excessive torsion force and subsequent fractures of screws. We conducted this study to evaluate the clinical usefulness of ultrasound-aided fixation as compared with the conventional fixation method using a drill and an expander in patients with ZM fracture. Methods We conducted a retrospective study in 35 patients with ZM fracture who had been treated at our hospital during a period ranging from March of 2008 to December of 2010. We divided them into two groups: an ultrasound-aided fixation group, comprising 13 patients who underwent ultrasound-aided fixation (SonicWeld Rx, KLS Martin), and a conventional group, comprising 22 patients who underwent conventional fixation (Biosorb FX, Linvatec Biomaterials Ltd.). We compared such variables as sex, direction, age at operation, follow-up period, operation duration, number of fixed holes, and time to discharge between the two groups. Results The ultrasound-aided fixation reduced the operation duration by about 30 minutes as compared with that of conventional fixation. There was no significant difference in follow-up period, number of fixed holes, or time to discharge between the two groups. Furthermore, there were no complications in either group. Conclusions The ultrasound-aided fixation of fractured ZM bone using an absorbable implant system is safe and effective in promptly reducing the bone fracture and providing satisfactory cosmetic outcomes over time.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권2호
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• pp.100-104
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• 1993

저자들은 두개저 골절을 동반하지 않은 단순 안면골 골절환자에서 본과에서 안면골 정복 수술후 발현한 외상성 경동맥해변동루 환자를 신경외과에 의뢰하여 분리풍선술식으로 처치한 후 현저한 임상적 증상의 개선을 가져왔고 12개월간 관찰시 다른 합병증도 유발되지 않았다. 외상성 경동맥해면동루는 두경부 손상시 매우 드물게 발생되는 심각한 합병증으로 임상증상의 복잡성 때문에 혼동하기 쉬으므로 Neurosurgeon과 협조하여 조기에 정확한 진단과 적절한 치료가 이루어지는 것이 바람직하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권3호
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• pp.264-276
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• 1995

This is a clinical and retrospective study on the patients with oral and maxillofacial trauma. This study was based on a series of 917 patients were treated as in-patients, at Chon-buk National University Hospital, during the period of Jan., 1989 through Dec., 1993. The results obtained were as follows : 1. The ratio of men to women were 3.59 : 1 in oral and maxillofacial injuries, 3.92 : 1 in facial bone fractures, and 3.18 : 1 in soft tissue injuries. 2. The oral and maxillofacial injuries occurred most frequently in the third decade(32.2%), and fourth, second, fifth decade in orders. 3. The major etiologic factors were traffic accident(57.4%) and fall-down(17.1%), interpersonal accident(16.6%), and industrial accident were next in order of frequency. 4. The incidence of facial bone fracture was 72.1%, soft tissue injury 58.8%, and dental injury 40.5%. 5. The most common site of fracture were mandible(62.9%) and maxilla(19.9%), zygoma and zygomatic arch(18.7%), and nasal bone(4.7%) were next in order of frequency. 6. The most common type of soft tissue injury was laceration(51.0%). The lesion of soft tissue injuries were mostly 1 or 2 lesions and deep.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• 대한두개안면성형외과학회지
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• 제23권3호
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• pp.111-118
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• 2022

Background: Although the zygomatic arch is an important structure determining facial prominence and width, no consensus exists regarding the classification of isolated zygomatic arch fractures, and the literature on this topic is scarce. To date, five papers have subdivided zygomatic arch fractures; however, only one of those proposed classifications includes the injury vector, although the injury vector is one of the most important factors to consider in fracture cases. Furthermore, the only classification that does include the injury vector is too complicated to be suitable for daily practice. In addition, the existing classifications are clinically limited because they do not consider greenstick fractures, nondisplaced fractures, or coronoid impingement. In the present study, we present a rearrangement of the previously published classifications and propose a modified classification of isolated zygomatic arch fractures that maximizes the advantages and overcomes the disadvantages of previous classification systems. Methods: The classification criteria for isolated zygomatic arch fractures described in five previous studies were analyzed, rearranged, and supplemented to generate a modified classification. The medical records, radiographs, and facial bone computed tomography findings of 134 patients with isolated zygomatic arch fractures who visited our hospital between January 2010 and December 2019 were also retrospectively analyzed. Results: We analyzed major classification criteria (displacement, the force vector of the injury, V-shaped fracture, and coronoid impingement) for isolated zygomatic arch fracture from the five previous studies and developed a modified classification by subdividing zygomatic arch fractures. We applied the modified classification to cases of isolated zygomatic arch fracture at our hospital. The surgery rate and injury severity differed significantly from fracture types I to VI. Conclusion: Using our modified classification, we could determine that both the injury force and the injury vector meaningfully influenced the surgery rate and the severity of the injuries.

• 대한두개안면성형외과학회지
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• 제23권1호
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• pp.29-33
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• 2022

Background: There have been many reports of nasal bone fractures in adults, but there are few clinical reports of them in adolescents, although adolescence is the main growth period of the nasal bone. In addition, previous studies have tended to classify and describe child and adolescent nasal fractures in the same category. The aim of this study was to identify the clinical aspects of nasal fractures in adolescents, and to evaluate the characteristics of nasal fractures in the growth period. Methods: Our institution's database was reviewed to extract data on adolescent patients between the age of 13 to 18 who had isolated nasal bone fractures from March 2012 to February 2020. The study excluded patients with other facial fractures, previous facial fractures, or congenital deformities. Results: This study included 243 boys and 26 girls. Interpersonal violence and sports-related accidents accounted for 85 and 79 cases, respectively. There were 128 frontal impact injuries and 132 lateral impact injuries, and 97 patients had accompanying septal fractures. An accompanying septal fracture was present in 36.06% of all patients, but in 51.20% of those who underwent surgery. Conclusion: The prevalence of adolescent nasal fractures was significantly higher in boys, to a greater extent than observed for pediatric or adult fractures. The main causes of fractures were interpersonal violence and sports-related accidents. An explanation for these results is that adolescent boys are more prone to have violent accidents or companionship with active sports than other age or sex groups, leading to substantially more fractures.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.150-158
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• 2006

Purpose: There are two theories about the relationships between facial fractures and cranial injuries. One is that facial bones act as a protective cushion for the brain, and the other is that facial fractures are the marker for increased risk of cranial injury. They have been debated on for many years. The purpose of this study is to identify the relationship between facial fractures and cranial injuries. Methods: A retrospective study was performed on 242 patients with facial fractures. The data were analyzed based on the medical records of the patients: age, gender, cause of injury, Injury Severity Score (ISS), alcohol intake, type of facial fractures, and type of cranial injury. The patients were divided into two groups: facial fractures with cranial injury and facial fractures without cranial injury. We compared the general characteristics between the two groups and evaluated the relationship between each type of facial fracture and each type of cranial injury. Results: Among the 242 patients with facial bone fractures, 96 (39.7%) patients had a combination of facial fractures and cranial injuries. Gender predilection was demonstrated to favor males: the ratio was 3:1. The mean age was $36.51{\pm}19.63$. As to the injury mechanism, traffic accidents (in car, out of car, motorcycle) were statistically significant in the group of facial fractures with cranial injury (p=0.038, p=0.000, p=0.003). The ISS was significant, but alcohol intake was not significant. No significant relationship between facial fractures and skull fractures was found. Only maxilla fractures, zygoma fractures, and cerebral concussion had a significant difference in cranial injury (p=0.039, p=0.025). Conclusion: There is a no correlation between facial fractures and skull fractures, which suggests that the cushion effect is the predominent relationship between facial fractures and cranial injuries.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.365-370
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• 2007

Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.