• Title/Summary/Keyword: Intraoral approach

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Transoral removal of proximal submandibular stone: report of 5 cases and review of the literature (구강 내 접근법에 의한 심부 악하선 타석제거술)

  • Lim, Kyoung-Min;Lee, Seung-June;Kil1, Tae-Jun;Choi, Eun-Ju;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.548-552
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    • 2010
  • The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

Digital approach integrating 3D facial scan and a virtual mockup for esthetic restorative treatment: A case report (심미보철 수복을 위한 3차원 안면스캔과 가상 보철물 시각화를 이용한 디지털 치료 증례)

  • Mai, Hai Yen;Choi, Yong-Do;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.425-431
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    • 2019
  • This clinical case report describes the digital workflow that combines a face scan, cone beam computed tomography and an intraoral scan to visualize the outcome of prosthodontic treatment in the anterior region. This approach improves communication between clinic, laboratory and patients. A patient with healthy general condition came for a restorative treatment to treat post-traumatic central incisors of maxilla. A virtual patient replica was made by incorporating a face scan, cone beam computed tomography and an intraoral scan. Design mockup of definitive restorations was shown to the patient and modified according to the patient's desire. This digital workflow facilitates the fabrication of optimal esthetic restorations, and enhances the predictability of outcome of restorations.

Ultrasound-guided intraoral botulinum toxin injection into the lateral pterygoid muscle for chronic temporomandibular joint dislocation

  • Sung-Tak Lee;Dohyoung Kim;Jae-Hyeong Park;Tae-Geon Kwon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.41-48
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    • 2024
  • Objectives: Botulinum toxin type A (BTX), a powerful neurotoxin, can be an effective treatment choice for diverse muscular disorders and can reduce abnormal muscle activities. Abnormal movements of the mandible can be caused by involuntary and uncontrolled contractions of the lateral pterygoid muscle (LP) in various pathological situations. Previous reports have shown that BTX can reduce abnormal contractions of the LP. However, needle placement into the LP for BTX injection requires skill, experience, and sufficient anatomical knowledge. To place the needle precisely into the LP, ultrasonography (USG) can be used as an effective needle-guidance modality. USG is a non-invasive imaging modality able to create real-time images without any potential risks, including radiation exposure. Patients and Methods: The patients who had been performed USG-guided BTX injection into the LP using an intraoral approach were included in this study with a literature review and case presentations. Using the USG, four patients received BTX injections to treat recurrent temporomandibular dislocation and oromandibular dystonia resulting from involuntary LP activity. Result: Involuntary movements of the mandible were improved successfully in all patients, and showed satisfactory results without significant complication. Conclusion: The intraoral approach could prevent potential complications during needle placement. USG-guided BTX injection is an effective, convenient, and safe method that provides real-time imaging without unnecessary pain to the patient.

THE CLINICAL STUDY OF MANDIBULAR FRACTURE

  • Lee, Dong-Keun;Yim, Chang-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.69-77
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    • 1989
  • This is a retrospective study on 219 patients with mandibular fracture. The patients were treated in the Dept. of Oral Maxillofacial Surgery of WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30. 1988. The results were as follows. 1. The mandibular fractures occured most frequently in the twenties(35%) and male were predominant (74.7%) than females. 2. The most frequent etiologic factor was traffic accident(34.3%). 3. The most common location of fracture was symphysis(37.1%). And angle(27.6%), condyle(25.7%), ramus(1.6%) were next in order of frequency. 4. In mandible fracture, they have an average 1.8 fracture line. 5. The use of plate & screw system were more increased in the comparison of each year. 6. Intermaxillary fixation period was more reduced from the concept of 6 weeks fixation, due to the use of Plate & screw system. 7. Postoperative acute wound infection was developed 9.6% in 219 mandibular fracture patients. The compression osteosynthesis was most common cause of acute wound infection than any other treatment method. 8. Postoperative malocclusion was developed 4% in 219 mandibular fracture. And the compression osteosynthesis was most common cause of malocclusion. 9. Acute wound infection was detailed by the approach method. The Intraoral & extraoral combination method was most common cause on acute infection and intraoral, extraoral approach method was next in order of frequency. 10. Normal mouth opening process was proportioned to IMF period. The short IMF period have a fast normal mouth opening process.

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Intraoral Approach and K-Wire Fixation of Zygomatic Tripod Fractures (강선 고정술을 이용한 관골골절의 치료)

  • Choi, See-Ho
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.85-92
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    • 1988
  • To avoid external facial scar which resulted from ordinary infraorbital and lateral eyebrow incision in surgical treatment of zygomatic tripod fractures, the author used intraoral incision and K-wire fixation method in 37 selected patients. This method contraindicated for the patient with multiple comminuted zygomatic fracture, patient combined with hard palatal fracture, and patient combined with herniated orbital floor fracture. The advantages of this method are simple, no external facial scar, and operate under direct visual field. The postoperative results were satisfactory. Balanced facial symmetry and good cosmetic results were obtained.

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Neurilemmoma in the floor of the mouth: a case report

  • Shim, Seung-Kee;Myoung, Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.60-64
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    • 2016
  • Neurilemmomas are well-encapsulated, benign, slow-growing tumors originating from Schwann cells of the nerve sheath surrounding cranial, peripheral, or autonomic nerves. Intraoral neurilemmomas are relatively rare and have a wide variety of morphologic and radiologic features. This makes differential diagnosis difficult, and only histopathological features can lead to a definitive neurilemmoma diagnosis. In this report, we present the case of a 30-year-old woman whose chief complaint was a solitary, nodular mass on the right floor of the mouth. After computed tomography and magnetic resonance imaging, we performed an incisional biopsy that showed the typical characteristics of a neurilemmoma. The mass was removed completely through an intraoral surgical approach. Despite losing a portion of the lingual nerve, the patient did not complain of any specific discomfort. Wound healing was uneventful and there were no signs or symptoms of recurrence.

Correction of Malunited Fracture of Zygoma Through Limited Incisions (제한적 접근을 통한 부정유합된 관골골절의 교정)

  • Kim, Yong-Ha;Kim, Sung-Ho;Seul, Jeung-Hyun;Lee, Kyung-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.1
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    • pp.22-31
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    • 1996
  • It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.

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Open reduction of zygoma fractures with the extended transconjunctival approach and T-bar screw reduction

  • Song, Seung Han;Kwon, Hyeokjae;Oh, Sang-Ha;Kim, Sun-Je;Park, Jaebeom;Kim, Su Il
    • Archives of Plastic Surgery
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    • v.45 no.4
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    • pp.325-332
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    • 2018
  • Background Zygomaticomaxillary complex (ZMC) fractures mostly occur in the form of tripod fractures. The surgical field is accessed using a combination of three classic approaches. However, the subciliary incision may have unfavorable aesthetic results. Herein, the authors report the advantages of the extended transconjunctival approach (ETA) combined with T-bar screw reduction in minimizing scarring and complications for the treatment of ZMC fractures. Methods A total of 26 patients underwent ZMC reduction through the ETA and intraoral approach. A skin incision measuring roughly 5 to 8 mm in length was placed following the lateral canthal skin crease. After releasing the inferior crus of the lateral canthal tendon for canthotomy, the medial periosteum of the lateral orbital rim was preserved for canthal reattachment. A limited subperiosteal dissection and partial relaxing incision of the orbicularis oculi were performed to expose the fracture line of the inferior orbital rim and zygomaticofrontal suture. Reduction was performed using a T-bar screw through the transconjunctival incision and an elevator through the intraoral incision. Results The aesthetic and functional results were excellent. Successful reduction was achieved and the skin incision was less than 8 mm in 20 cases (76.9%). Only six patients had an additional skin incision (less than 5 mm) to achieve reduction. No cases of ectropion, entropion, or excessive scarring were noted. Conclusions The ETA using a T-bar screw is a useful method for maximizing aesthetic results in ZMC fractures, with the advantages of minimal scarring, faster recovery, and maintenance of pretarsal fullness.

Per-oral cross-facial sural nerve graft for facial reanimation

  • Jeong, Joohee;Almansoori, Akram Abdo;Park, Hyun-Soo;Byun, Soo-Hwan;Min, Seung-Ki;Choung, Han-Wool;Park, Joo Yong;Choi, Sung Weon;Kim, Bongju;Kim, Soung-Min;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.22.1-22.4
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    • 2018
  • Background: Cross-facial nerve graft is considered the treatment of choice for facial reanimation in patients with unilateral facial palsy caused by central facial nerve damage. In most cases, a traditional parotidectomy skin incision is used to locate the buccal and zygomatic branches of the facial nerve. Methods: In this study, cross-facial nerve graft with the sural nerve was planned for three patients with facial palsy through an intraoral approach. Results: An incision was made on the buccal cheek mucosa, and the dissection was performed to locate the buccal branch of the facial nerve. The parotid papillae and parotid duct were used as anatomic landmarks to locate the buccal branch. Conclusions: The intraoral approach is more advantageous than the conventional extraoral approach because of clear anatomic marker (parotid papilla), invisible postoperative scar, reduced tissue damage from dissection, and reduced operating time.

Organized Hematoma of the Maxillary Sinus: Surgical Excision by Midfacial Degloving Approach

  • Lee, Seul Ki;Moon, Mi Ri;Park, Sang Rae;Jo, Hye Hyeon;Lee, Yong Bin
    • Journal of Korean Dental Science
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    • v.15 no.1
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    • pp.68-74
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    • 2022
  • Organized hematoma of maxillary sinus is a rare pathologically benign mass in which pressure in the hematoma increases as it undergoes a process of organization, causing the deformation of the surrounding tissue, mimicking malignancies. The midfacial degloving approach can be used when extensive exposure is required in the treatment of lesions or traumas in the midfacial area with intranasal and intraoral incisions. We report a surgical excision case of organized hematoma of maxillary sinus using midfacial degloving approach without major complications and recurrence after one-year follow up.