• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.70-74
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• 2014

Background: Many options are available to cover a palatal defect, including local or free flaps. The objective of this study was to evaluate the usefulness of palatal mucoperiosteal island flap in covering a palatal defect after tumor excision. Methods: Between October 2006 and July 2013, we identified 19 patients who underwent palatal reconstruction using a palatal mucoperiosteal island flap after tumor excision. All cases were retrospectively analyzed by defect location, size, tumor pathology, type of reconstruction, and functional outcomes. Speech and swallowing functions were evaluated using a 7-point visual analog scale (VAS) score. Results: Among the 19 patients, there were 7 men and 12 women with an age range of 25 to 74 years (mean, $52.5{\pm}14.3$ years). The size of flaps was $2-16cm^2$ (mean, $9.4{\pm}4.2cm^2$). Either unilateral or bilateral palatal island flaps were used depending on the size of defect. During the follow-up period (mean, $32.7{\pm}21.4$ months), four patients developed a temporary oronasal fistula, which healed without subsequent operative. The donor sites were well re-epithelized. Speech and swallowing function scores were $6.63{\pm}0.5$ and $6.58{\pm}0.69$ on the 7-point VAS, indicating the ability to eat solid foods and communicate verbally without significant disability. Conclusion: The palatal mucoperiosteal island flap is a good reconstruction modality for palatal defects if used under appropriate indications. The complication rates and donor site morbidity are low, with good functional outcomes.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.218-221
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• 2017

A solitary fibrous tumor is a relatively uncommon neoplasm that usually occurs in the pleura but occurs extremely rarely in the oral cavity. Reported herein is a rare case of a solitary fibrous tumor in the buccal cheek mucosa. A 50-year-old man visited the authors' hospital due to a buccal cheek mass whose size had increased. Excisional biopsy was done under local anesthesia. After the excisional biopsy, the patient was diagnosed to have a solitary fibrous tumor. In immunohistochemistry, the patient's solitary fibrous tumor was characterized by the expression of CD34 and CD99 on the neoplastic cells, and negativity for Bcl-2 and S-100. No recurrence or complication occurred for a period of 5 years. The growth of a primary solitary fibrous tumor in the buccal cheek mucosa is extremely rare and has been rarely reported in the South Korean medical literature. A solitary fibrous tumor must be distinguished from other spindle cell tumors. Presented herein is a case of primary solitary fibrous tumor in the buccal cheek mucosa. The relevant literature is briefly reviewed.

• Archives of Craniofacial Surgery
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• v.21 no.3
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• pp.161-165
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• 2020

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.194-199
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• 2018

Background: Cases of simultaneous multiple skin cancers in a single patient have become more common. Due to the multiplicity of lesions, reconstruction in such cases is more difficult than after a single lesion is removed. This study presents a series of patients with multiple facial skin cancers, with an analysis of the surgical removal, reconstruction process, and the results observed during follow-up. Methods: We reviewed 12 patients diagnosed with multiple skin cancers on the face between November 2004 and March 2016. The patients' medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, methods of surgical removal and reconstruction, complications, and recurrence during follow-up. Results: Nine patients had a single type of cancer occurring as multiple lesions, while three patients had different skin cancer types that occurred together. A total of 30 cancer sites were observed in the 12 patients. The most common cancer site was the nose. Thirteen defects were reconstructed with a flap, while 18 were reconstructed with skin grafting. The only complication was one case of recurrence of basal cell carcinoma. Conclusion: Multiple skin cancers are removed by performing Mohs micrographic surgery or wide excision, resulting in multiple defect sites. The authors emphasize the importance of thoroughly evaluating local lesions surrounding the initially-identified lesions or on other sites when reconstructing a large defect which can not be covered by primary closure. Furthermore, satisfactory results can be obtained by using various methods simultaneously regarding the condition of individual patients, the defect site and size, and the surgeon's preference.

• Archives of design research
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• v.15 no.3
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• pp.83-92
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• 2002

In the 21st century, as localization is reinterpreted as an important part of globalism and as local culture is recognized as a device to increase the competitive power, every city is trying to develop its identity and improve its image while coping with change of the international and domestic environment. Therefore, basic research was preformed to establish the city image identity of Gwangju and as a result, an ideological slogan " City of Light and Life, Gwangju" and basic factors were developed. This study aims to analyze the condition of the city, focusing on design factors that the city image is comprised of, and establishes a long-term strategy for urban environment development by considering the developmental potential of the city. and focuses on case studies for establishment of an image suitable for Gwangju. Case studies focusing on the urban environmental development were presented and the results were applied to Gwangju. From the results, further studies can be pursued according to a long-term strategy. strategy.

• Archives of design research
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• v.17 no.1
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• pp.5-14
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• 2004

The study addressed a direction that environmental facilities along avenues will make a progress via urban environment as well as location marketing. The space is specified the campus avenue, which is located in Jongro-gu at Seoul. With the emergence of digital information era, both people' life style and behaviors have been changing in many different ways. As the first approach to the direction, the historical study of the avenue is examined by focusing on the change. All possible related status such as location marketing strategy and various spatial characteristics, environment of the avenue and its facilities are investigated and users' characteristics are analyzed. Through these processes, a new direction and role of design are proposed and are believed to improve the avenue' image and to rediscover its own identity and to make the avenue alive as it used to be. The new proposed direction showed how to approach to design as well as to system of environmental facilities along avenues and in addition to highlighting continuous and synthetic plan. Furthermore, It is expected that both the efforts to improve the avenue' image based on its own cultural characteristic and to foster the cultural-commercialized facilities will contribute to the local residents' life standard and its economic status.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.137-139
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• 2007

Purpose: The mandibular ramus sagittal split osteotomy is a common procedure in cosmetic surgery. A late complication of this procedure, pseudoaneurysm rarely happens. The purpose of this case is to present our experience that is rare late vascular complication after mandibular ramus sagittal split osteotomy. Methods: A 21-year-old male was operated by local plastic surgeon for treatment of mandibular prognathism. After 9 days, the man was transferred to our hospital with persistent bleeding and swelling on the mandibular area. We operated the man three times and failed to control hemorrhage. Therefore, we did angiography and found the pseudoaneurysm on the buccal and pterygoid branches of internal maxillary artery. Then we did selective embolization for removal of the pseudoaneurysm. Results: The man was operated using the therapeutic embolization, and the pseudoaneurysm was removed. The results were successful, and we couldn't find any bleeding and the pseudoaneurysm during the follow-up of 12 months. Conclusion: The selective embolization is the good therapeutic method of late vascular complication after mandibular ramus sagittal split osteotomy.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.111-114
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• 2007

Purpose: Dystrophic calcification occurs in damaged or devitalized tissues in the presence of a normal calcium and phosphorus metabolism. There are many reports on dystrophic calcification caused by injections of various types of drugs. The aim of this report is to highlight the fact that dystrophic calcification can be caused by the injection of a foreign body for aesthetic augmentation. Methods: This case report describes a patient presenting with dystrophic calcification caused by an injection of an unknown foreign body approximately 50 years ago. An 80-year-old man had localized cellulitis with swelling and ulceration on the dorsum of the left hand. The radiographs demonstrated a $5{\times}3.5{\times}1.7cm$ lesion between the first and second metacarpal bones and a $5{\times}2.5{\times}1.5cm$ lesion in the hypothenar region. The laboratory data and physical examinations were generally within the normal limits. The microscopic examination revealed dead bone fragments and dense collagenous tissue with dystrophic calcification. Results: After surgically removing the masses, the resulting defects were treated with an abdominal flap. The result was satisfactory in terms of symptoms and appearance. Conclusion: This case suggests that dystrophic calcification can be caused by an injection of a foreign body for aesthetic augmentation.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.119-122
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• 2007

Purpose: Although liposarcoma is the second most common soft tissue sarcoma in adults, the incidence of liposarcoma of the head and neck is rare. There is only one reported case in Korea and moreover, only in adolescence. We report a case of liposarcoma on the neck in a 32-year-old male in adult. Methods: The patient had a slow growing, none tender mass on the posterior neck without lymphadenopathy, which has been present for 3 years and recurred twice during that time. MRI showed a 1.5 cm sized ovoid, well demarcated mass that was located in the subcutaneous layer of the posterior neck. Results: The mass was surgically removed. The resection margin was free of tumor on frozen biopsy and histopathologic examination indicated myxoid and round cell liposarcoma. The whole body F-18 FDG PET-CT applied on the fourteenth day postoperatively, revealed a moderate FDG-uptaking soft tissue lesion showing postoperative wound healing process on the posterior neck region and there was no distant metastasis. Conclusion: Liposarcoma is the second most common soft tissue sarcoma in adults. But, it rarely involves the head and neck region. Prognosis is principally dependent on histologic subtype and grade. Low grade liposarcoma such as well differentiated and myxoid liposarcoma tend to recur locally, rarely metastasize. On the other hand, high grade liposarcoma such as round cell and pleomorphic liposarcoma have higher rates of local recurrence and distant metastasis. Complete surgical excision provides the most effective means of treatment. Radiotherapy or chemotherapy can be used as an asjunctive treatment modality.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.520-523
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• 2007

Purpose: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. Methods: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was $6.0{\times}4.5cm$ in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. Results: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. Conclusion: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.