• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.9-20
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• 1990

A series of 19 cases with maxillary hyperplasia and mandibular retrognathia were operated on by simultaneous superior repositioning of the maxilla after Le Fort I osteotomy and anterior repositioning of the mandible after bilateral sagittal split ramus osteotomies with or without osteotomy of the inferior border of the mandible. These were evaluated by retrospective cephalometric and computer analysis for the longitudinal skeletal and dental changes for an average of 17.1 months after surgery. For stabilization of the osteotomized segments, the authors used wire osteosynthesis by means of bilateral infraorbital and zygomatic buttress suspension wire at the maxilla, and direct interosseous wire at the split segments of the mandibular rami. Results show generally good stability after simultaneous maxillary and mandibular surgery with wire osteosynthesis, and a minimal to moderate tendency toward skeletal and dental relapse. This article is a preliminary study to defy the efficiency of the wire osteosynthesis (wo)compared with rigid internal fixation (RIF) for simultaneous maxillary and mandibular surgery. 1. The vertical relapse rate of the A point after superior repositioning of the maxilla is 2.2%. 2. The horizontal relapse rate of the B point after advancement of the mandible is 18.3%. 3. The condyle is distracted inferiorly and slightly posteriorly at the immediate postoperative period. 4. At the long term follow up examination, the condyle presents tendency of return to the preoperative position. 5. Condylar segment angle is decreased at the immediate postoperative period, and at the long term follow up evaluation, the angle is increased. 6. Gonial angle is increased at the immediate postoperative period, and then is decreased at the long term follow up evaluation. 7. The dentition is satisfactory with acceptable movement at the long term follow up evaluation. 8. At the mandibular free body analysis, genioplasty shows good stability. 9. Wire osteosynthesis provides excellent stabilization for the simultaneous maxillary and mandibular surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.41-47
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• 1999

The route of bony invasion and spread pattern of tumor in the mandible are important in management of gingival cancer. Ten patients with gingival cancer involving mandibular body region were operated by composite resection. The radiographic and histopathologic features of the mandibular invasion and spread were analysed and compared. Our results showed that histopathologic extent of tumor invasion were greater than the radiographic prediction, especially in width of the tumor. And the pattern of bony invasion in the body area was mostly found in transmedullary spread rather than perineural spread. The vertical involvement in the mandibular body with tumor was evaluated. It indicated that if a oncologic surgeon was to ensure an adequate safety margin for extirpation of tumor, in most cases, the maintenance of the mandibular continuity is difficult. If the mandibular involvement by gingival cancer was identified radiographically and clinically, segmental mandibulectomy was required for the adequate safety margin, in consideration of the spread pattern in the body area.

• Archives of Plastic Surgery
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• 제34권1호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.27.1-27.9
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• 2020

Background: Mandibular setback surgery can change the position of the mandible which improves occlusion and facial profile. Surgical movement of the mandible affects the base of the tongue, hyoid bone, and associated tissues, resulting in changes in the pharyngeal airway space. The aim of this study was to analyze the 3-dimensional (3D) changes in the hyoid bone and tongue positions and oropharyngeal airway space after mandibular setback surgery. Methods: A total of 30 pairs of cone-beam computed tomography (CBCT) images taken before and 1 month after surgery were analyzed by measuring changes in the hyoid bone and tongue positions and oropharyngeal airway space. The CBCT images were reoriented using InVivo 5.3 software (Anatomage, San Jose, USA) and landmarks were assigned to establish coordinates in a three-dimensional plane. The mean age of the patients was 21.7 years and the mean amount of mandibular setback was 5.94 mm measured from the B-point. Results: The hyoid bone showed significant posterior and inferior displacement (P < 0.001, P < 0.001, respectively). Significant superior and posterior movements of the tongue were observed (P < 0.05, P < 0.05, respectively). Regarding the velopharyngeal and glossopharyngeal spaces, there were significant reductions in the volume and minimal cross-sectional area (P < 0.001). The anteroposterior and transverse widths of the minimal cross-sectional area were decreased (P < 0.001, P < 0.001, respectively). In addition, the amount of mandibular setback positively correlated with the amount of posterior and inferior movement of the hyoid bone (P < 0.05, P < 0.05, respectively). Conclusion: There were significant changes in the hyoid bone, tongue, and airway space after mandibular setback surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.447-452
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• 2006

Purpose: In order to clarify the correlation of mandibular setback using bilateral intraoral vertical ramus osteotomy (BIVRO) and post-surgical transverse mandibular width (TMW), this study examined the pre- and postsurgical changes in hard and soft tissues of TMW and the relationship of TMW and the amount of mandibular setback. Patients and Methods: One-hundred seven patients who had undergone BIVRO were evaluated radiographically and clinically. A comparison study of the changes in hard and soft tissue after surgery in all 107 patients was performed with preoperative, 1 month, 3 month, 6 month and 1 year postoperative posteroanterio cephalograms and clinical photographs by tracing. And this changes were evaluated in parts to amounts of mandibular setback. Results: Statistically significant increases of TMW in hard and soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue from 1 month to 1 year postopertive were gradually decreased. TMW in soft tissue was not changed uniformly but almost equal to pre-operative width. And there was no significant correlation between TMW and amount of mandibular setback. Conclusions: The results show that mandibular setback using BIVRO did not significantly influence increasing of TMW in soft tissue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권4호
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• pp.460-467
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• 2008

Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권1호
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• pp.36-43
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• 2011

Purpose: This study evaluated the pharyngeal airway space changes in CT images in patients receiving bilateral sagittal split osteotomy (BSSRO) for the surgical correction of mandibular prognathism. Methods: A total of 22 patients with mandibular prognathism were treated using BSSRO. Computed tomography was performed 1 month (T0) before surgery and, 1 month after surgery (T1). The anteroposterior length (AP), lateral width (LAT) and cross-sectional area (AREA) at the level of soft palate (C2) and base of the tongue (C3) were measured using CT images. Results: The mean amount of mandibular setback was 7.41 mm (${\pm}$3.46 mm). All the AP, LAT and AREA at the C2 and C3 level were decreased significantly 1 month after surgery (P<0.001). As the amount of mandibular setback was increased, the AP, LAT and AREA levels at the level of C2 and C3 had decreased. In addition, the reduction of the AREA at the C3 level was associated with the amount of mandibular setback (P<0.05). Conclusion: A significant decrease in pharyngeal airway space was observed 1 month after the operation. The cross-sectional area at the level of base of tongue was decreased with increasing amount of mandibular setback.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권5호
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• pp.242-245
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• 2013

Impacted mandibular third molars are located between the second mandibular molar and mandibular ramus. However, ectopic mandibular third molars with heterotopic positions are reported in the subcondylar or pterygomandibular space. The usual cause of malposition is a cyst or tumor, and malposition without a pathology is rare. This case report described an impacted mandibular third molar in the pterygomandibular space without any associated pathology.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.357-360
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• 2015

Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.43-48
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• 2010

The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.