• Title/Summary/Keyword: Lateral-inferior

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Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

  • Jeong, Yeong Kon;Park, Won-Jong;Park, Il Kyung;Kim, Gi Tae;Choi, Eun Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.331-335
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    • 2017
  • Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

Functional Primary Surgery in Unilateral Complete Cleft Lip (편측구순열 1차수술)

  • NISHIO Juntaro;ADACHI Tadafumi;KASHIMA Yukiko
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.2
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    • pp.41-50
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    • 2000
  • The alar base on the cleft side in unilateral complete cleft lip, alveolus and palate is markedly displaced laterally, caudally and dorsally, By incising the pyriform margin from the cleft margin of the alveolar process, including mucosa of the anterior part of the inferior turbinate, to the upper end of the postnasal vestibular fold, the alar base is released from the maxilla, A physiological correction of nasal deformity can be accomplished by careful reconstruction of nasolabial muscle integrity, functional repair of the orbicular muscle, raising and rotating the displaced alar cartilage, and finally by lining the lateral nasal vestibule, The inferior maxillary head of the nasal muscle complex is identified as the deeper muscle just below the web of the nostril, The muscle is repositioned inframedially, so that it is sutured to the periosteum that overlies the facial aspect of the premaxilla in the region of the developing lateral incisor tooth, And then, the deep superior part of the orbicular muscle is sutured to the periosteum and the fibrous tissue at the base of the septum, just in front of the anterior nasal spine, The nasal floor is surgically created by insertions of the nasal muscle complex in deep plane and of the orbicular muscle in superficial one, The upper part of the lateral nasal vestibular defect is sutured by shifting the alar flap cephalically, The middle and lower parts of this defect are closed by use of cleft margin flaps of the philtral and lateral segments, respectively, Authors stress the importance of nasal floor reconstruction at primary surgery and report the technique and postoperative results.

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The Effects of Tongue Positions on the Cervical Range of Motion (혀의 자세가 경추의 관절가동범위에 미치는 영향)

  • Han, Dong-Wook;Park, Min-Hee;Jeong, Yeon-Hee
    • Journal of Korean Clinical Health Science
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    • v.1 no.1
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    • pp.29-34
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    • 2013
  • Purpose : This study was to investigate that tongue positions have effect on the cervical range of motion (ROM). Methods : 18 subjects, 20 to 25 years of age, were participated in this study. The tongue positions were neutral position, anterior protrusion, posterior protrusion, superior protrusion, inferior protrusion, left side protrusion and right side protrusion. The neck movements were right side flexion, left side flexion, right rotation and left rotation. The cervical range of motion measured by cervical range of motion instrument (CROM, C9266-49, USA). The changes were analyzed using the paired t-test. SPSSWIN (ver. 20.0) was used for data analysis and the significance level was chosen as ${\alpha}$=0.05. Results : In the lateral flexion, the angle of left lateral flexion increased in anterior protrusion(p<0.05) and right side protrusion(p<0.05) significantly. In the rotation, the angle of right rotation increased in anterior protrusion(p<0.05), posterior protrusion (p<0.05), superior protrusion(p<0.05), inferior protrusion(p<0.05), and left side protrusion (p<0.05) significantly. Conclusions : In conclusion, we found that the tongue positions affected some cervical movements.

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A ROENTGENOGRAPHIC STUDY OF NORMAL PAROTID GLANDS USING ISOBARIC SIALOGRAPHY (등압타액선조영촬영법을 이용한 정상성인의 이하선에 관한 연구)

  • Ahn Hee Moon;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.20 no.1
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    • pp.91-102
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    • 1990
  • The aim of this study was to establish the diagnostic criteria of normal parotid glands in adults revealing the anatomical shape, its variations and the postitional relationships of the gland. Materials included 96 lateral and anterior-posterior sialograms of selected person from 23 to 28 years of age. Results were as follows: 1. The average length and lateral displacement of main duct was 48.43㎜ and l6.88㎜. The mean lumen diameter of that was 0.91㎜ in distal end and 1.40㎜ in hilar end in parotid glands. 2. The average angle of main duct to the inferior border of mandib was 34.32 degree. In configurations of main duct, modified curvilinear type was. most prevalent and followed by curvilinear, reverse sigmoid, sigmoid type. 3. The mean caliber of parotid gland was the longest in superior-inferior. 4. The interlobar ducts showed relatively well defined in all cases, its average number was 5.72. Arrangement of these ducts showed at random. Accessory lobe showed 87.5% in the all cases, its average number was 1.7. 5. There were no difference between the well and poorly defined acinar fillings in the glandular parenchyme. 6. There were no differences between right and left parotid glands in size and shape of main duct and parenchymal portion, but there were great variations in each individuals.

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Cephalometrically assessing the validity of superior, middle and inferior tragus points on ala-tragus line while establishing the occlusal plane in edentulous patient

  • Chaturvedi, Saurabh;Thombare, Ram
    • The Journal of Advanced Prosthodontics
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    • v.5 no.1
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    • pp.58-66
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    • 2013
  • PURPOSE. The purpose of this study was to decide the most appropriate point on tragus to be used as a reference point at time of marking ala tragus line while establishing occlusal plane. MATERIALS AND METHODS. The data was collected in two groups of subjects: 1) Dentulous 2) Edentulous group having sample size of 30 for each group with equal gender distribution (15 males, 15 females each). Downs analysis was used for base value. Lateral cephalographs were taken for all selected subjects. Three points were marked on tragus as Superior (S), Middle (M), and Inferior (I) and were joined with ala (A) of the nose to form ala-tragus lines. The angle formed by each line (SA plane, MA plane, IA plane) with Frankfort Horizontal (FH) plane was measured by using custom made device and modified protractor in all dentulous and edentulous subjects. Also, in dentulous subjects angle between Frankfort Horizontal plane and natural occlusal plane was measured. The measurements obtained were subjected to the following statistical tests; descriptive analysis, Student's unpaired t-test and Pearson's correlation coefficient. RESULTS. The results demonstrated, the mean angle COO (cant of occlusal plane) as $9.76^{\circ}$, inferior point on tragus had given the mean angular value of IFH [Angle between IA plane (plane formed by joining inferior point-I on tragus and ala of nose- A) and FH plane) as $10.40^{\circ}$ and $10.56^{\circ}$ in dentulous and edentulous subjects respectively which was the closest value to the angle COO and was comparable with the values of angle COO value in Downs analysis. Angulations of ala-tragus line marked from inferior point with occlusal plane in dentulous subject had given the smallest value $2.46^{\circ}$ which showed that this ala-tragus line was nearly parallel to occlusal plane. CONCLUSION. The inferior point marked on tragus is the most appropriate point for marking ala-tragus line.

Biomechanical Study of Lumbar Spinal Arthroplasty with a Semi-Constrained Artificial Disc (Activ L) in the Human Cadaveric Spine

  • Ha, Sung-Kon;Kim, Se-Hoon;Kim, Daniel H.;Park, Jung-Yul;Lim, Dong-Jun;Lee, Sang-Kook
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.169-175
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    • 2009
  • Objective : The goal of this study was to evaluate the biomechanical features of human cadaveric spines implanted with the Activ L prosthesis. Methods : Five cadaveric human lumbosacral spines (L2-S2) were tested for different motion modes, i.e. extension and flexion, right and left lateral bending and rotation. Baseline measurements of the range of motion (ROM), disc pressure (DP), and facet strain (FS) were performed in six modes of motion by applying loads up to 8 Nm, with a loading rate of 0.3 Nm/second. A constant 400 N axial follower preload was applied throughout the loading. After the Activ L was implanted at the L4-L5 disc space, measurements were repeated in the same manner. Results : The Activ L arthroplasty showed statistically significant decrease of ROM during rotation, increase of ROM during flexion and lateral bending at the operative segment and increase of ROM at the inferior segment during flexion. The DP of the superior disc of the operative site was comparable to those of intact spine and the DP of the inferior disc decreased in all motion modes, but these were not statistically significant. For FS, statistically significant decrease was detected at the operative facet during flexion and at the inferior facet during rotation. Conclusion : In vitro physiologic preload setting, the Activ L arthroplasty showed less restoration of ROM at the operative and adjacent levels as compared with intact spine. However, results of this study revealed that there are several possible theoretical useful results to reduce the incidence of adjacent segment disease.

Topography of Deep Inferior Epigastric Perforator Flap (심부하복벽천공지의 국소해부학적 고찰)

  • Kim, Chang-Yeon;Oh, Jung-Keun;Hwang, Weon-Jung;Kim, Jeong-Tae;Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.11 no.2
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    • pp.141-145
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    • 2002
  • Rectus abdominis muscle free flap is widely used for breast reconstruction and soft tissue defect in lower leg but donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. Recently, to minimize donor-site morbidity, there has been a surge in interest in deep inferior epigastric perforator(DIEP) free flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. Between August of 1995 and September of 2002, topographic investigation of DIEP was performed during the elevation of 97 cases of TRAM free flap and 5 cases of DIEP free flap. There were 84 cases of breast reconstructions, 12 cases of lower leg reconstructions, and 6 cases of head and neck reconstruction. We could observe total 10 to 12 perforators on each rectus abdominis muscle below umbilicus. Among these, the numbers of large perforators(>1.5mm of diameter) were mean 2.1 in lateral half of rectus abdominis muscle, mean 1.2 in medial half, and mean 0.5 in linea alba and paramedian. DIEP free flap provides ample amount of well vascularized soft tissue without inclusion of any rectus abdominis muscle and fascia and minimizes donor-site morbidity. One perforator with significant flow can perfuse the whole flap. For large flap, a perforator of the medial row provides better perfusion to zone-4 than one of lateral row and, if diameter of perforator is small, $2{\sim}3$ perforators can be used. According to the condition of recipient-site, thin flap can be harvested. As DIEP free flap has many advantage, perforator topography will be useful in increasing clinical usage of DIEP free flap.

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Correction of the deviated tip and columella in crooked nose

  • Suh, Man-Koon
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.495-504
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    • 2020
  • The primary procedural components of deviated nose correction are as follows: osteotomy to correct bony deviation, septal deviation correction, manipulation of the dorsal septum to correct upper lateral cartilage deviation, and correction of functional problems (manipulation for correction of internal valve collapse and hypertrophy of the inferior turbinate). The correction of tip and nostril asymmetry cannot be overemphasized, because if tip and nostril asymmetry is not corrected, patients are unlikely to provide favorable evaluations from an aesthetic standpoint. Tip asymmetry, deviated columella, and resulting nostril asymmetry are primarily caused by lower lateral cartilage problems, which include deviation of the medial crura, discrepancy in the height of the medial crura, and asymmetry or deformity of the lateral crura. However, caudal and dorsal septal deviation, which is a more important etiology, should also be corrected. A columellar strut graft, correction of any discrepancy in the height of the medial crura, or lateral crural correction is needed to correct lower lateral cartilage deformation depending on the type. In order to correct caudal septal deviation, caudal septal shortening, repositioning, or the cut-and-suture technique are used. Surgery to correct dorsal septal deviation is performed by combining a scoring and splinting graft, a spreader graft, and/or the clocking suture technique. Moreover, when correcting a deviated nose, correction of asymmetry of the alar rim and alar base should not be overlooked to achieve tip and nostril symmetry.

A Case Study about Treatment of Taeumin Patient diagnosed as Lateral medullary syndrome(wallenberg syndrome) (외측연수증후군(外側延髓症候群)(wallenberg syndrome)으로 진단받은 태음인환자를 치료한 1예(例)에 대한 증예보고(症例報告))

  • Lee, Si-Woo;Park, Hye-Sun;Kim, Kyung-Yo;Kim, Hyoung-Soon
    • Journal of Sasang Constitutional Medicine
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    • v.13 no.2
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    • pp.182-189
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    • 2001
  • If the proximal portion of the fourth segment of the vertebral onery is occluded before the posterior inferior cerebellar artery branch, ischemia usually affects the lateral medulla oblongata or the ipsilateral side of the cerebellum. The lateral medullary syndrome(wallenberg syndrome) resulting from occlusion in this area is common. 62 years old male who has swallowing difficulty, dizziness and diagnosed as the lateral medullary syndrome(wallenberg syndrome) is admitted in Wonkwang university oriental medical hospital Kwangju. We have diagnosed him as Taeumin and treated by east integrated therapy. We classified this as Taenmin-liyoiljung(太陰人 裏熱症) and prescribed chungsimyoinjatang(淸心蓮子湯) to the principle of cheongganjoyoil(淸肝燥熱). In the result, we had the improvement of the symptoms. This report described the process and contents about the way the patient was cured.

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Anatomical Study for Vascular Distribution of the Perforator of Deep Inferior Epigastric Artery in Koreans (한국인에 있어 깊은아래배벽동맥(Deep Inferior Epigastric Artery)의 천공지(Perforator)에 관한 해부학적 연구)

  • Kim, Jee Hoon;Lee, Paik Kwon;Rhie, Jong Won;Kim, Deog Im;Han, Seung Ho
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.28-35
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    • 2008
  • Purpose: The pedicle of transverse rectus abdominis myocutaneous(TRAM) flap and deep inferior epigastric arterial perforator flap is deep inferior epigastic artery (DIEA) and accurate anatomic knowledge about perforator of DIEA is very important for the elevation of these flap. The authors investigated a detailed vascular network of perforator of DIEA in Koreans. Methods: 24 fresh cadavers were studied. Among them, 15 were examined based on the plain X-ray examination for the distribution and location of perforator of DIEA. And 9 fresh cadavers were examined based on the 3-dimensional computed tomography(CT) study for the distance between ending point of perforator of DIEA and mother artery, the distance between most medial mother artery and midline, the distance between most lateral mother artery and midline, and the running type of perforators of DIEA. Results: Based on the plain X-ray examination, suitable(external diameter$${\geq_-}0.5mm$$) perforators of DIEA are located between the level of umbilicus and 8 cm below it. Based on the 3D-CT study, average distance between the ending point of perforator of DIEA and the mother artery is 30.26 mm on the left, 28.62 mm on the right, respectively. The average distance between most medial mother artery and midline is 17.13 mm on the left, 15.76 mm on the right, respectively. The average distance between most lateral mother artery and midline is 56.31 mm on the left, 50.90 mm on the right, respectively. The main running course of suitable perforators of DIEA is type a, which is a direct musculocutaneous perforator vessel from main vascular axis passing outward to join the subdermal plexus, directly. Conclusion: 3-dimensional computed tomography study as well as plain X-ray examination provided more accurate and detail informations about perforators of DIEA in Koreans. These informations will help us understand the detailed vascular anatomy and operation with ease and safe in the lower abdomen of Koreans.