• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.91-105
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• 2003

There are significant limitations in the precision of mandibular distraction in setting a desired occlusal and facial esthetic outcome. The purpose of this study is to present the simulation method for the distraction osteogenesis treatment planning. 3-D surgery simulation software programs V-works and V-Surgery(Cybermed, Seoul, Korea) were used from the 3D CT data in addition to the conventional data facial photography, panorama and cephalogram, dental cast model. We have utilized already for the various surgical procedures to get information preoperatively for the maxillofacial surgery like cancer localization and reconstructive surgery, orthognathic surgery and implant surgery in the department of Oral and Maxillofacial surgery, Seoul National University Hospital. On the software, bone cutting can be done at any place and any direction. Separated bone segment can be mobilized in all 3 dimensional direction. After the 3D simulation on the software program, mock surgery on the RP model can be performed. This planning method was applied to two hemifacial microsomia patients. With this protocol, we could simulate the movement of bony segment after maxillofacial distraction osteogenesis

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.3.1-3.7
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• 2015

Hemifacial microsomia (HFM) is the most common craniofacial anomaly after cleft lip and cleft palate; this deformity primarily involves the facial skeleton and ear, with either underdevelopment or absence of both components. In patients with HFM, the management of the asymmetries requires a series of treatment phases that focus on their interception and correction, such as distraction osteogenesis or functional appliance treatment during growth and presurgical orthodontic treatment followed by mandibular and maxillary surgery. Satisfactory results were obtained in a 9-year-old girl with HFM who was treated with distraction osteogenesis. At the age of 19, genioplasty and mandible body augmentation with a porous polyethylene implant (PPE, $Medpor^{(R)}$, Porex) was sequentially performed for the functional and esthetic reconstruction of the face. We report a case of HFM with a review of the literature.

• Archives of Craniofacial Surgery
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• v.24 no.6
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• pp.266-272
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• 2023

Background: In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. Methods: We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. Results: The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Conclusion: Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.9-13
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• 2016

Background: Position of the facial foramina is important for regional block and for various maxillofacial surgical procedures. In this study, we report on anthropometry and morphology of these foramina using three-dimensional computed tomography (3D-CT) data. Methods: A retrospective review was performed for all patients who have undergone 3D-CT scan of the facial skeleton for reasons other than fracture or deformity of the facial skeleton. Anthropometry of the supraorbital, infraorbital, and mental foramina (SOF, IOF, MF) were described in relation to facial midline, inferior orbital margin, and inferior mandibular margin (FM, IOM, IMM). This data was analyzed according to sex and age. Additionally, infraorbital and mental foramen were classified into 5 positions based on the anatomic relationships to the nearest perpendicular dentition. Results: The review identified 137 patients meeting study criteria. Supraorbital foramina was more often in the shape of a foramen (62%) than that of a notch (38%). The supraorbital, infraorbital, and mental foramina were located 33.7 mm, 37.1 mm, and 33.7 mm away from the midline. The mean vertical distance between IOF and IOM was 13.4 mm. The mean distance between MF and IMM was 21.0 mm. The IOF and MF most commonly coincided with upper and lower second premolar dentition, respectively. Between the sex, the distance between MF and IMM was significantly higher for males than for female. In a correlation analysis, SOF-FM, IOF-FM and MF-FM values were significantly increased with age, but IOF-IOM values were significantly decreased with age. Conclusion: In the current study, we have reported anthropometric data concerning facial foramina in the Korean population, using a large-scale data analysis of three-dimensional computed tomography of facial skeletons. The correlations made respect to patient sex and age will provide help to operating surgeons when considering nerve blocks and periosteal dissections around the facial foramina.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.709-716
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• 2005

Patients with cleft tip and palate present severe maxillary hypoplasia due to scar of lip and palate, often accompanied by compromised mastication, speech abnormalities. Sometimes maxillary hypoplasia persist even though active orthodontic treatment was done. In theses cases, patients born with cleft lip and palate will be potential candidates for maxillary advancement with bone grafting after growth to correct the functional deformities and improve aesthetic facial proportions. But, maxillary advancement using standard surgical approaches has several limitations : increased relapse tendency after maxillary advancement, necessity of additional bone graft and mandibular setback surgery. Distraction osteogenesis is current treatment modality to overcome these limitations, thus has become popular for treatment of maxillary hypoplasia associated cleft lip and palate, craniosyntosis. Especially, rigid external distraction, contrary to internal device, has advantages : better vector control of osteotomized segment, effective traction of the bony segments, the ease of the application and removal the distraction device. This study showed that relatively successful result could be generated by using rigid external distraction osteogenesis(RED) in the case of cleft lip and palate with severe maxillary hypoplasia, 6 years 7 months old.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.63-70
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• 2005

Patients with cleft lip and palate usually show up maxillary hypoplasia. In these cases, a large amount of maxillary advancement is often needed to correct the severe deformity, but local soft-tissue scars around the maxilla restrict maxillary advancement and increase the relapse rate. Maxillary distraction osteogenesis is an effective method for facial and occlusal improvement in these patients. By gradually lengthening both the bones and the soft tissues, distracted midface can greatly increase postoperative stability and decrease the relapse rate. However, the maxillary extraoral appliances of the early days used were esthetically unappealing as well as difficult for the patient to manage. Recently, more inconspicuous intraoral distraction appliances have been developed and used with success. We acquired favorable result in two patients(bilateral 1 patient and unilateral 1 patient) with severe maxillary hypoplasia secondary to complete cleft lip and palate were treated with midface distraction using internal distractor (Zurich Pediatric Maxillary Distractor, KLS Martin, Tuttlingen, Germany). So, we report our experience with literatures.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.1
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• pp.23-28
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• 2010

대한악안면성형재건외과학회는 2004년도부터 매년 인도적 차원에서 의료 환경이 낙후된 Vietnam의 cleft lip and palate 환자들을 치료하기 위해 무료로 해외 진료 봉사 활동을 해왔다. 초창기 해외 진료 봉사 활동 당시 베트남 의료 기술 발달이 미비하여 준비해야 할 것들이 많았으나 이 후 베트남의 경제 발전과 함께 의료 시설 및 의료 기술이 발달함에 따라 준비 품목 등이 간단명료해지고 현지 지원 및 수술 준비도 원활히 진행되었다. 이러한 무료 의료 봉사 활동을 계기로 개발도상국의 낙후된 의료 시설 및 의료 기술 발전, 의료 혜택을 받지 못한 구순 구개열 환자의 정상적 안모 및 기능 회복, 조건 없는 의료 봉사 활동을 통한 민간외교 효과 및 양국간의 우호 증진 등의 성과가 있었다. 대한악안면성형재건외과학회에서는 2009년도 역시 베트남 National Institute of Odonto-stomatology 에서 11월17일부터 26일까지 cleft lip and palate 무료수술진료단(단장 신효근)을 보내 수술봉사 활동을 펼치고 돌아 왔다. 일반적인 구순구개열 뿐만 아니라 양측성 안면열(Bilateral Facial Cleft), 사경(Torticollis) 등의 희귀 기형을 포함하여 수술을 진행하였으며 총 31례의 수술을 성공적으로 마쳤으며 지난 6년 동안의 성과와 함께 이에 대한 보고를 하고자 한다.

• Korean Journal of Cleft Lip And Palate
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• v.14 no.1_2
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• pp.37-44
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• 2011

Amniotic fluid is a complex and biological reservoir that provides mechanical cushioning and has many nutrients required for fetal growth and development. During our main research works about the fetal surgery of congenital facial defects, we reviewed several recent articles about the effectiveness and composition of amniotic fluid. Among these review processes, amniotic fluid, as the convenient medium to store sking grafts, was focused especially for its growth factors and rich nutrients, and we summarized some experimental investigations of skin grafts stored in amniotic fluid in rats. We reviewed mainly the article, "Turhan-haktanir N. et al. Histological assessment of skin grafts in amniotic fluid and saline. J Plast Surg Hand Surg 2010;44:226-30."

• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.35-40
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• 2018

Background: When a skin defect occurs, clinicians must work to restore the original skin quality as soon as possible. Accordingly, an artificial dermis can be used to supplement the wound and prevent severe scar contracture formation. The Terudermis is an artificial dermis that is simple and easy to use. We investigated the effectiveness of the Terudermis in the treatment of facial skin defects by analyzing previous relevant cases treated in our institution. Methods: We retrospectively examined 143 patients who were treated with the Terudermis graft in facial skin defect at Dong Kang General Hospital in 2015 and 2016. The patients' age, sex and location, wound size, complications were analyzed. In addition, the patients were asked to complete a self-satisfaction questionnaire after 18 months from the completion of treatment. The results were compared with that of autologous full-thickness skin graft (FTSG) and split-thickness skin graft (STSG) patients in same period. Results: The mean self-satisfaction scores evaluated by patients were $4.1{\pm}1.0$, $4.0{\pm}1.3$ and $3.5{\pm}1.8$ for the Terudermis graft, FTSG and STSG patients, respectively. With respect to complications, there were fewer incidences of hematoma, partial skin loss and complete skin loss in the Terudermis graft patients. Conclusion: In the present study, the Terudermis, when used to treat post-traumatic facial skin defects, is a good alternative option to obtain satisfactory aesthetic outcomes. Also, the Terudermis grafting is a simple and easy treatment method to perform.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.43-47
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• 2011

Purpose: Romberg's disease manifests as progressive hemifacial atrophy of the skin, soft tissue and bone, which usually begins in the first or second decade of life. When present, atrophy may originate from the cutaneous stigmata and may become so sharply delimited by the midline. Methods: A 10-year-old girl, who had suffered from right mandibular area atrophy for 3 years, visited us and was diagnosed with Romberg's disease. The depressed lesion of the face was augmented successfully using a deepithelialized groin free flap. The superficial circumflex iliac vessels were used as the donor pedicle and the facial artery and vein were used as the recipient vessels. Results: After surgery, the flap survived well and she was satisfied with the result. Although there are various methods of facial augmentation using free flaps, this flap has some advantages. First, there is a considerable amount of fat tissue components for augmentation. Second, flap elevation with thinning is possible. Third, the donor site can be hidden. Conclusion: The groin dermo-fat free flap is a good method for the facial augmentation of Romberg's disease.