• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.203-206
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• 2019

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.

• Journal of Korean Dental Science
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• v.13 no.2
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• pp.73-80
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• 2020

Purpose: The purpose of this case study series was to introduce successful implant cases that used the palatal bone in patients with severe maxillary alveolar bone atrophy or defects. Case Presentation: In this case series study, a total of four patients underwent implant placement in the palatal bone of the maxilla. A total of 6 implants were installed using the palatine bone. The patients' ages ranged from 40 to 73 years with an average age of 63.5 years. The patients had maxillary sinus-related diseases, such as maxillary sinusitis, oroantral fistula, and dentigerous cysts, prior to implantation. To achieve initial stability, the implants were placed on the palatal side, and buccally tilted. The average postoperative recovery period was 8 months. No postoperative complications occurred in any of the cases, and the approach was used without reported issues. Conclusion: Implant treatment by securing the initial fixation in the palatal bone is a good alternative when an implant must be installed in a patient who requires extensive and invasive bone graft.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.2
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• pp.83-88
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• 2022

Hunminjeongeum had 17 initial consonant letters. Among them, five consonant letters, those are ㄱ (牙音, molar sound letter), ㄴ (舌音, lingual sound letter), ㅁ(脣音, labial sound letter), ㅅ (齒音, dental sound letter), ㅇ (喉音, guttural sound letter), were served as chief consonants. There was no argument that consonant letters were made by symbolizing the shape of vocal organs during phonation of them. It could be phoniatrically explained that all of five chief consonants were morphologically symbolized from left lateral view of vocal tract during articulation. Although 'ㄱ' was known as molar sound, it was not modeled the shape of molar tooth but modeled the shape of tongue at molar teeth bearing area. The same principle applies to 'ㅅ', and it was represented the shape of upper surface of anterior tongue instead of incisor teeth. 'ㄴ' was a lingual sound and directly shaped the shape of tongue. 'ㄷ' was made by addition of a stroke 'ㅡ' meaning hard palate above 'ㄴ'. 'ㅁ' was represented the shape of lateral view of anterior mouth. 'ㅇ' was looked like shaping left lateral view of laryngopharyngeal space.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.2
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• pp.77-82
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• 2022

Hunminjeongeum was made by the Great King Sejong, and composed of 17 consonant and 11 vowel letters. All the 28 letters were made according to the shape of vocal organ or space at the point of articulation for each letters. This review article focused on phonetic and phoniatric consideration for explanation of the designs of the middle vowel letters, especially three main vowel letters [ • (天, heaven), ㅡ (地, earth), ㅣ (人, human)] using video-fluoroscopic evaluation as well as computed tomography scanning, etc. During articulating / • / sound, a ball-like space at frontal portion of the oral cavity was found, tongue was contracted, and sound was deep (舌縮而聲深). During /ㅡ/ sound, a flat air space between oral tongue and hard palate was created. Tongue was slightly contacted neither deep nor shallow (舌小縮而聲不深不淺). During /ㅣ/ sound, tongue was not contacted and Sound is light (舌不縮而聲淺). Tongue was moved forward making longitudinal oro-pharyngeal air space. So, I'd like to suggest that we had better change the explanation drawing from a philosophical modeling to a more scientific modeling from real vocal tract space modeling during articulating middle vowels of Hunminjeongeum.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.11-14
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• 2023

The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.207-214
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• 2015

Due to the limitations of conventional removable partial denture prostheses to treat a cleft lip & palate patient who shows scar tissue on upper lip, excessive absorption of the maxillary residual alveolar ridge, and class III malocclusion with narrow palate and undergrowth of the maxilla, 4 implants were placed on the maxillary edentulous region and a maxillary removable implant-supported partial denture was planned using a CAD/CAM milled titanium bar. Unlike metal or gold casting technique which has shrinkage after the molding, CAD/CAM milled titanium bar is highly-precise, economical and lightweight. In practice, however, it is very hard to obtain accurate friction-fit from the milled bar and reduction in retention can occur due to repetitive insertion and removal of the denture. Various auxiliary retention systems (e.g. $ERA^{(R)}$, $CEKA^{(R)}$, magnetics, $Locator^{(R)}$ attachment), in order to deal with these problems, can be used to obtain additional retention, cost-effectiveness and ease of replacement. Out of diverse auxiliary attachments, $Locator^{(R)}$ has characteristics that are dual retentive, minimal in vertical height and convenient of attachment replacement. Drill and tapping method is simple and the replacement of the metal female part of $Locator^{(R)}$ attachment is convenient. In this case, the $Locator^{(R)}$ attachment is connected to the milled titanium bar fabricated by CAD/CAM, using the drill and tapping technique. Afterward, screw holes were formed and 3 $Locator^{(R)}$ attachments were secured with 20 Ncm holding force for additional retention. Following this procedure, satisfactory results were obtained in terms of aesthetic facial form, masticatory function and denture retention, and I hereby report this case.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.5 no.1
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• pp.44-58
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• 1994

The formants of the 9 Korean standard vowels(which used by the average people of Seoul, central-area of the Korean peninsula) were measured by analysis with the linear predictive coding(LPC) and fast Fourier transform(FFT). The author already had reported the constriction area for the Korean standard vowels, and with the existing data, the distance from glottis to the constriction area in the vocal tract of each vowel was newly measured with videovelopharyngograms and lateral Rontgenograms of the vocal tract. We correlated the formant frequencies with the distance from glottis to the constriction area of the vocal tract. Also we tried to correlate the formant frequencies with the position of tongue in the vocal tract which is divided into 2 categories : The position of tongue in oral cavity by the distance from imaginary palatal line to the highest point of tongue and the position in pharyngeal cavity by the distance from back of tongue to posterior pharyngeal wall. This study was performed with 10 adults(male : 5, female : 5) who spoke primary 9 Korean standard vowels. We had already reported that the Korean vowel [i], [e], $[{\varepsilon}]$ were articulated at hard palate level, [$\dot{+}$], [u] were at soft palate level, [$\wedge$] was at upper pharynx level and the [$\wedge$], [$\partial$], [a] in a previous article. Also we had noted that the significance of pharyngeal cavity in vowel articulation. From this study we have concluded that ; 1) The F$_1$ is related with the oral cavity articulated vowel [i, e, $\varepsilon$, $\dot{+}$, u]. 2) Within the oral cavity articulated vowel [i, e, $\varepsilon$, $\dot{+}$, u] and the upper pharynx articulated vowel [o], the F$_2$ is elevated when the diatance from glottis to the constriction area is longer. But within the lower pharynx articulated vowel [$\partial$, $\wedge$, a], the F$_2$ is elevated when the distance from glottis to the constriction area is shorter. 3) With the stronger tendency of back-vowel, the higher the elevation of the F$_1$ and F$_2$ frequencies. 4) The F$_3$ and F$_4$ showed no correaltion with the constriction area nor the position of tongue in the vocal tract 5) The parameter F$_2$- F$_1$, which is the difference between F$_2$ frequency and F$_1$ frequency showed an excellent indicator of differenciating the oral cavity articulated vowels from pharyngeal cavity articulated vowels. If the F$_2$-F$_1$ is less than about 600Hz which indicates the vowel is articulated in the pharyngeal cavity, and more than about 600Hz, which indicates that the vowel is articulated in the oral cavity.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.30-34
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• 2020

Maxillectomy is performed to remove the tumor in the palate, maxillary sinus, buccal mucosa or nasal cavity. The resection range depends on the size and the extent of the tumor and it affects speech production or cause nasal regurgitation during feeding. Obturator can occlude an opening such as an oro-nasal fistula and protect the defect area. Successful reconstrucion of the patient's oral cavity who have gone over the maxillectomy is a difficult task. The condition and number of teeth, the remaining support area, and the extent of the defect area have a great influence on manufacturing the obturator. If these factors are disadvantageous, the prognosis of the prosthesis is uncertain. The final obturator must have a sufficient retention in the patient's oral cavity and must not irritate the surrounding tissue and support area where the resection was performed.In this case, a 55 year old female went through the maxillectomy and the only 3 teeth remained. And the retention of the maxillary prosthesis seems to be poor. So that, we fabricated the closed hollow obturator which has reduced weight compared to the conventional obturator. Consequently the closed hollow obturator can give better sealing and the adaptation.

• Journal of Korean society of Dental Hygiene
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• v.24 no.3
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• pp.209-218
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• 2024

Objectives: This study aimed to develop educational content for a smartphone app on oral muscle training and examine its effects on the elderly population. Methods: A total of twelve training sessions were delivered through the smartphone app over a six-week period, from late August to early October 2023. Each session lasted approximately 60 minutes. Participants were followed up after the program. Results: The experimental group showed significant improvements in oral health before and after using the smartphone app. These improvements included decreased dental plaque (p<0.05) by 0.69 units, decreased gingivitis (p<0.001) by 0.99 units, decreased tongue plaque (p<0.01) by 1.11 units, increased salivary secretion rate (p<0.001) by 0.73 units, increased hard palate strength (p<0.001) by 5.25 units, and increased soft palate strength (p<0.01) by 6.82 units. Compared to the control group, the experimental group showed significant improvements in dental plaque (p<0.001), gingivitis (p<0.001), and tongue coating (p<0.01). Conclusions: This study found that oral muscle strengthening training using the smartphone app effectively improved oral health in the elderly. The developed app content has the potential to be a valuable tool for promoting oral health in this population within their daily routines. However, further efforts are needed to ensure clear communication and effective utilization of the training program through user training or educational materials.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.91-94
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• 2010

Purpose: For the best possible aesthetic reconstruction after craniofacial bone tumor resection, pasteurization has been adopted to devitalize neoplastic cells while maintaining osteoinductive properties and mechanical strength. This case report aims to demonstrate a long-term follow-up result of a monostotic fibrous dysplasia in frontal bone which was reconstructed by pasteurized tumoral autograft in situ. Methods: A 14-year-old girl presented with a hard, nontender, slowly growing mass of 6-year duration on her left supraorbital area. CT showed $5{\times}4{\times}3cm$ sized well defined bony mass confined to frontal bone with heterogeneous density. Tumor was excised completely through bicoronal approach and reimplanted to its original site after pasteurization at $60^{\circ}C$ for 30 minutes. The pathologic examination confirmed fibrous dysplasia. Results: She revisited our clinic 5 years later after suffering some assault on her face. On CT examination, pasteurized tumoral autograft was incorporated to host bone except the fractured upper orbital rim without any evidence of recurrence. She has been satisfied with the result. Conclusion: Pasteurization offers a simple, reliable, cosmetic, economic, and durable reconstruction method for craniofacial skeletal tumor. It has advantages of both biologic incorporation ability and mechanical strength without risk of recurrence. So, it should be considered as one of the primary options in benign as well as resectable malignant tumors of craniofacial skeleton.