• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권3호
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• pp.180-185
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• 2012

Purpose: An accurate preoperative analysis of the patient is essential in orthognathic surgery in order to acquire superior results. In profile, the location of the chin's position may change according to the neck's inclination. This may ultimately affect the amount of surgical movement. During acquisition of cephalometric radiographs, or in supine position, there is a discrepancy in the neck's inclination. This means that there are also various discrepancies between the actual profile and the various preoperative profile images. In the clinical situation, the decision in performing genioplasty usually lies in the analysis of the patient's profile on the operating table at the final stages of orthognathic surgery. This study aims to analyze the different preoperative profile images and to compare their discrepancies. Methods: Fifty eight patients undergoing orthognathic surgery were chosen. These patients were divided into three groups according to angle's classification of malocclusion, as class I, II or III. The right profile of these patients in centric occlusion was taken in natural head position (NHP). This was set as the 'actual profile image.' Another right profile image was taken on the operating table after insertion of the nasotracheal intubation and with muscle relaxants in effect. This was also taken in centric occlusion. The angle (denoted 'A') between the soft tissue glabella-pognion and the true vertical plane was found in the above-mentioned profile images and in the cephalometric radiographs. The differences of these values were analyzed. Results: There were differences in Angle 'A' in all of the preoperative images. These values were however, not statistically significant. Conclusion: In order to gain an esthetic profile during orthognathic surgery, the NHP is shown to be the most reliable position. Images reproducing such head positions should be used in the treatment planning process.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.7-12
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• 2010

Purpose: 'White-eye blowout' fracture is often occur in young patients and defined as blow out fracture with little or no clinical sign of soft tissue trauma such as edema, ecchymosis, but with marked motility restrictions in vertical gaze. In this conditions, immediate operation is essential. We reported the clinical investigation study of these cases about clinical symptoms and radiologic findings and introduce our experiences about immediate operations in 'white-eye blowout' fractures. Methods: From January 2008 to December 2009, nine pediatric patients who were diagnosed as pure white-eye blowout fractures were involved this study. Patients with other facial bone fractures or with poor general medical condition were excluded. In all cases, we performed immediate operation within 48 hours. Results: All patients had diplopia, vertical gaze restriction or systemic symptoms. Six patients had nausea, vomiting and syncope caused by oculocardiac reflex. In all patients, preoperative symptoms were improved after immediate operation. There were no postoperative complications such as infection, hematoma or wound dehiscence. Conclusion: When we meet the young patients with history of periocular trauma, with little or no soft tissue trauma signs, but with marked vertical gaze restriction or general symptoms caused by oculocardiac reflex, we should immediately examine by facial bone computed tomography and refer the patient to ophthalmologist for ophthalmic evaluations. If patient is diagnosed as orbital floor fracture with entrapped muscle or soft tissue, the earlier surgical reduction get better clinical outcomes.

• Clinical and Experimental Pediatrics
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• 제52권12호
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• pp.1388-1391
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• 2009

Poland 증후군은 일측 대흉근의 부재나 저형성과 다양한 동측 손기형을 특징으로 한다. Mobius 증후군은 완전 혹은 불완전의 안면마비를 특징으로 하는 선천적 신경학적 이상을 말한다. 이들의 병인은 명확히 밝혀지지 않았지만, 이환된 측의 혈류가 감소됨으로서 발생된다 여겨지고 있다. 2.670 g 남자아이가 38주 3일에 왼쪽 안면마비와 우심증이 동반된 왼쪽 흉벽 결손에 2번째, 3번째 손가락 합지증을 가지고 태어났다. Poland-Mobius 증후군은 드물며, 세계적으로 우심증과 관련된 증례는 단지 2례 밖에 없었다. 이에 우리는 우심증이 동반된 Poland-Mobius 증후군의 국내 첫 증례를 보고하는 바이다.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.273-278
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• 2011

Purpose: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. Methods: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. Results: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. Conclusion: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.

• 한방재활의학과학회지
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• 제23권3호
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• pp.125-132
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• 2013

Objectives The purpose of this study was to compare the effects of acupuncture treatment with those of collaborative treatment regarding acute Bell's palsy. Methods Twenty-six patients who received outpatient treatment between March 2012 and February 2013 were divided into 2 groups. The East-West treatment group (EW group, n=12) received prednisolone and then acupuncture afterwards. The Eastern treatment group (E group, n=14) received just acupuncture. Acupuncture was administered 3 to 4 times a week, and both groups were educated to practice facial muscle exercises at home. Evaluations were made before treatment, after 1 week, 2 weeks, and 3 weeks using the House-Brackmann facial nerve grading system. Results Compared to before treatment, the House-Brackmann grades of both EW and E groups after 1, 2 and 3 weeks of treatment significantly decreased (p<0.05). Regarding group comparison, the House-Brackmann grade of the EW group was significantly lower than the E group at 1 week (p=0.043), but there was no significant difference at 2 and 3 weeks. Regarding improvement of House-Brackmann grades, there was no significant difference between the two groups at 1, 2 and 3 weeks (p>0.05). Conclusions Compared to just acupuncture treatment, collaborative treatment with prednisolone significantly improved the House-Brackmann grade after 1 week, but there was no difference as time passed. Because early intervention determines the prognosis of Bell's palsy, collaborative treatment at the early stage will be clinically helpful to patients.

• 대한물리치료과학회지
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• 제5권4호
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• pp.785-794
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• 1998

We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

• 대한두경부종양학회지
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• 제2권1호
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• pp.49-59
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• 1986

대흉근근피판은 혈액공급이 왕성하며 회전호가 크고 조직량이 층충해 안면부 결손을 기능적 및 미용적으로 잘 재건해 줄 수 있을뿐 아니라 용도에 따라 다양하게 사용할 수 있다. 저자들은 안면 부에 발생한 거대한 기저세포암 l 예와 보존요법으로서는 치료가 불가능한 만성상악골 골수염을 동반한 거대한 섬유성종괴 1 예를 절제하고 이로써 생긴 안면부의 광범한 조직결손을 도서형대흉근근피판으로 대치하여 좋은결과를 얻을 수 있었다.

• 한국콘텐츠학회논문지
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• 제16권12호
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• pp.327-345
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• 2016

본 연구는 인간발달 과정을 신경과학, 심리학, 운동학습, 근육 생리학 등의 행동과학 자료와 생체역학, 인체운동 분석, 운동조절 기반의 인지 동작치료 프로그램을 정서 행동장애 아동들에게 실시하여 표정에 따른 얼굴 움직임이 감정과 정서변화에 따라 어떤 특성을 갖는지를 표정 움직임의 변화로 정량화 하고자 하였다. 본 연구에서는 영상측정 및 키네마틱 분석의 정서 행동장애 아동의 표정변화를 중재 프로그램 피드백 자료로 활용하였고, 표정 변화를 통해 인지동작 치료프로그램 효과를 알 수 있었다. 또한 정서 및 행동치료의 영상분석과 키네마틱 분석의 정량적 데이터를 통하여 인간발달에 대한 융 복합적 측정 및 분석법을 적용하여 발달장애의 조기발견과 치료과정에 따른 데이터를 축적하는 것도 기대할 수 있었다. 따라서 본 연구의 결과는 아동뿐만이 아니라 자기표현이 부족한 장애와 노인, 환자에게도 확대 적용할 수 있을 것이다.

• Journal of Acupuncture Research
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• 제31권1호
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• pp.149-158
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• 2014

Objectives : The aim of this study is to investigate the influence of anxiety and depression on motor recovery of acute Bell's palsy to estimate how much psychological factors affect the clinical prognosis. Methods : A total of 20 inpatients with acute unilateral Bell's palsy within 1 week of onset participated in this study. The severity of participants' facial palsy was measured by Yanagihara(Y-system) score, FDI and House-Brackmann scale at the time of 1 week and 3 weeks from the onset. The motor recovery of acute Bell's palsy is defined as ${\Delta}Y$-system during 2 weeks. Beck anxiety scale(BAI) and the center for epidermiologic studies depression scale(CES-D) were adopted to assess anxiety and depression, respectively. Correlation analysis and linear regression analysis were conducted between ${\Delta}Y$-system and prognostic factors including anxiety and depression. Results : Significant associations were found between ${\Delta}Y$-system and depression(CES-D) but no significant associations were found between ${\Delta}Y$-system and other prognostic factors, hypertension, diabetes, postauricular pain, disgeusia, age, degree of initial palsy and anxiety(BAI). And a regression equation with 0.295 for coefficient of determination was obtained. Through this analysis, the ${\Delta}Y$-system can be predicted using regression equation which cover 29.5 % of depression index(CES-D). Conclusion : Depression is a significant clinical prognostic factor on motor recovery of acute Bell's palsy. So, Bell's palsy treatment should be combined with psychological care and support.

• 대한두개안면성형외과학회지
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• 제20권3호
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• pp.176-180
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• 2019

Background: Parotidectomy is the treatment of choice in many parotid tumors. Due to the extensive nature of the procedure, unfavorable complications such as gustatory sweating, surgical site depression are common. Various techniques using fascia, muscle or AlloDerm have been developed but debate still remains regarding its availability and affordability. We applied a newly developed acellular dermal matrix (Insuregraf) to the parotidectomy field to act as a physical barrier and to provide adequate filling effect for prevention of functional and aesthetic complications. Methods: From March 2010 to March 2017, 30 patients with parotid tumors underwent superficial parotidectomy. Twenty patients underwent only superficial parotidectomy. Ten patients had Insuregraf applied to the surgical site after superficial parotidectomy. We evaluated the incidence of Frey's syndrome, surgical site depression, and patient satisfaction rate in both groups. Results: The incidence of Frey's syndrome was lower in the Insuregraf group (0 vs. 2). Surgical site depression was also lower in the Insuregraf group (2 vs. 20). Satisfaction score for facial contour in Insuregraf group was 9.2 out of 10, which was comparable to 6.2 out of 10 in the control group. Conclusion: Application of Insuregraf after superficial parotidectomy is an effective surgical procedure to prevent complications such as Frey's syndrome and surgical site depression. This technique is affordable and safe with no immune reactions. Above all this surgical method should be considered as an option for patients who are concerned about the contour of the face after surgery.