• 대한두개안면성형외과학회지
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• 제20권5호
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• pp.297-303
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• 2019

Background: Absorbable plates are widely used in open reduction and internal fixation surgeries for facial bone fractures. Absorbable plates are made of polyglycolic acid (PGA), polylactic acid (PLA), polydioxane (PDS), or various combinations of these polymers. The degradation patterns of absorbable plates made from different polymers and clinical courses of patients treated with such plates have not been fully identified. This study aimed to confirm the clinical courses of facial bone fracture patients using absorbable plates and compare the degradation patterns of the plates. Methods: A retrospective chart review was conducted for 47 cases in 46 patients who underwent open reduction and internal fixation surgery using absorbable plates to repair facial bone fractures. All surgeries used either PLA/PGA composite-based or poly-L-lactic acid (PLLA)/hydroxyapatite (HA) composite-based absorbable plates and screws. Clinical courses were confirmed and comparisons were conducted based on direct observation. Results: There were no naturally occurring foreign body reactions. Post-traumatic inflammatory responses occurred in eight patients (nine cases), in which six recovered naturally with conservative treatment. The absorbable plates were removed from two patients. PLA/PGA compositebased absorbable plates degraded into fragments with non-uniform, sharp surfaces whereas PLLA/HA composite-based absorbable plates degraded into a soft powder. Conclusion: PLA/PGA composite-based and PLLA/HA composite-based absorbable plates showed no naturally occurring foreign body reactions and showed different degradation patterns. The absorbable plate used for facial bone fracture surgery needs to be selected in consideration of its degradation patterns.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.85-92
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• 1988

저자는 관골 골절 환자중 일부 안서 골절로 안와내용물의 탈출이 동반된 관골 골절, 경구개 골절이 동반된 관골 골절, 소아의 관골 골절을 제외한 대다수의 삼격면 관골 골절 환자 37례를 구강내 절개와 K-강선고정술을 이용하여 수술 하였던 바, 첫째, 안면부 반흔을 남기지 않고, 둘째, 간단하며, 셋째, 직시하 수술이 가능하며 만족할 만한 결과를 얻을 수 있었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권3호
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• pp.149-155
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• 2015

Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixate the fractured unit tangentially. Tangential fixation is critical to osteosynthesis. Disadvantages of the transmasseteric antero-parotid facelift approach include damage to the facial nerve and a longer operation time. However, after the initial learning curve, facial nerve damage can be avoided and operation time may decrease. We report three cases of subcondylar fractures that were treated with a transmasseteric antero-parotid facelift approach. Among these, two cases had trivial complications that were easily overcome. Instead of dissecting through the parotid gland parenchyma, the transmasseteric antero-parotid facelift approach uses transmasseteric dissection and reduces facial nerve damage more than the retromandibular transparotid approach. The esthetic result is superior to that of other approaches.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.89-96
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• 1992

The purpose of this study was to investigate the fractures of facial skeleton ; mandible, maxilla, zygoma Clinically, we observed 413 patients with facial bone fractures treated at the department of dentistry, Koryo General Hospital from Jan. l989 to Dec. I991. This results ere as follows : 1. The most common fracture was occured in the mandible (63.7%) and the symphysis was occured most freguently(30.4%) 2. The most prevalent age was twenties(37.5%) 3. Main causes was traffic accident(21.7% ) 4. The ratio of male to female was about 9.3 : 1 5. Most combined injuries was head injuries. (54.6%) 6. The most frequent job was a company employee. 7. There were the highest frequency in March, and the lowest frequency in February.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권1호
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• pp.43-52
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• 2010

Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권2호
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• pp.73-78
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• 2018

Objectives: The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. Materials and Methods: A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. Results: Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18-72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. Conclusion: The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

• 대한치과의사협회지
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• 제54권10호
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• pp.799-810
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• 2016

Orbital fractures have a significant portion in facial bone trauma. The important thing in treatment of orbital fractures is variable depending on the patient. Reconstruction of orbital wall demands an understanding of the anatomy and function of the orbit, including the orbital tissues, and the approacheds, materials, and methods available.

• 대한두개안면성형외과학회지
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• 제20권6호
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• pp.370-375
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• 2019

Background: Some parts of a maxillary fracture-for example, the medial and posterior walls-may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. Methods: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. Results: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). Conclusion: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.

• 대한두개안면성형외과학회지
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• 제17권1호
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• pp.1-4
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• 2016

Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권11호
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• pp.588-592
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• 2018

Background and Objectives The incidence of facial bone fracture is increasing. The zygomatic bone, due to its anatomical prominence, is the second most common site of all facial bone fractures. In this study, we present the clinical experiences of zygomatic arch fracture in a tertiary hospital and introduce the Gillies approach for reduction and its outcome results. Subjects and Method We collected data from retrospective chart reviews of patients who underwent surgeries from 2010 to 2017 for zygomatic arch fractures at Chungbuk National University Hospital. Data were analyzed according to age, gender, cause of trauma, location of trauma, and clinical symptoms including trismus. All surgery was performed under general anesthesia and via the use of Gillies approach. The result of surgery was evaluated by postoperative facial computed tomography. Results Sixteen patients underwent surgery for zygomatic arch fracture. The patients had the average age of 41.3 years, a male predominance of 15:1 and physical assault as the most common cause of trauma. The time lag between injury and surgical reduction was 5.5 days. The surgical outcomes were assessed 'good' in 14 cases and 'moderate' in one case. Patients who had trismus preoperatively were resolved of it in all cases after operation. Postoperative complications were absent. Conclusion The Gillies approach proved to be a relatively easy, safe, and reliable method, and its surgical outcomes was satisfactory in our experiences.