• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.61-63
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• 2002

In the field of oromaxillofacial surgery, it is not common to meet arteriovenous malformation(AVM) patients. AVMs are the result of congenital abnormality, or the result of trauma of adjacent vessels. This patients need special care in surgical procedure. Also, they need management include clinical, radiographic, and angiographic assessment. We report a case of the AVM in right maxillary artery, who embolized PVA and obtained good result.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.174-177
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• 2013

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a disease characterized by jaw necrosis and delayed wound healing in patients who had received bisphosphonates. Buccal fat pad (BFP) can be used as a pedicled flap in the posterior region of the oral cavity. BFP pedicle flap needs simple surgical technique and it shows less donor site morbidity and aesthetic problem than other vascularized flap. BFP pedicled flap was fed by 3 arteries-facial, internal maxillary, and transverse facial artery. Osteomyelitis was generally related with poor blood supply. Thus, rich blood supply of BFP pedicle flap can have a potential advantage to BRONJ patients. In this case report, we presented 3 BRONJ patients treated by BFP pedicle flap after sequestrectomy.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.739-743
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• 2005

Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

• Imaging Science in Dentistry
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• v.51 no.3
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• pp.313-321
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• 2021

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.168-172
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• 2021

Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.9-18
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• 1995

Purpose : A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. Materials and Methods : Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were availalbe, respectively. Cervical lymph node metastases was observed in 5 patients(N 1;4/33, N2b; 1/33). Patients were classified as 3 groups according to management method. The first group, named as 'FAR' (16 patients), was consisted or preoperative intra-arterial chemotherapy with 5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered:3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as 'SR'(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). The third group, named as 'R'(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. Results : Local recurrence free survival rate in the end of 2 year was $100\%$, $50\%$ and $0\%$ in FAR, SR and R group, respectively. Disease free survival rate in 2 years was $88.9\%$, $28.0\%$ and $0\%$ in FAR, SR and R group, respectively. Overall survival rate in 2 years was $88.9\%$, $40\%$ and $50\%$ in FAR, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survial rates. But difference of each survival rate between SR and R group was not significant. Conclusion : In this study FAR group revealed better results than SR or R group. In the future prospective randomized study is in need.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.2
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• pp.459-475
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• 1999

Objectives : The purpose of this study is to evaluate the computed tomographic (CT) images of the paranasal sinusitis(PNS). Materials and Methods : The author examined the extent and recurring patterns of the paranasal sinusitis and some important anatomic landmarks. The author analyzed PNS images retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. Results : The most frequently affected sinus was maxillary sinus (82.9％), followed by anterior ethmoid sinus(67.9％), posterior ethmoid sinus(48.9％), frontal sinus(42.0％) and sphenoid sinus(41.4％). The characteristic features of CT images of the sinusitis were sinus opacification(22.4％), mucoperiosteal thickening(34.3％), and polyposis(2.0％). Sinonasal inflammatory diseases were categorized into 5 patterns according to Babber s classification. They were 1) infundibular(13.0％), 2) ostiomeatal unit(67.4％), 3) sphenoethmoidal recess (13.0％), 4) sinonasal polyposis (9.6％) and 5) unclassifiable patterns(18.0％). The incidences of contact between sinus and optic nerve were as follows ; the incidences of contact with posterior ethmoid sinus, sphenoid sinus. both posterior sinuses were 11.4％. 66.8％, 6.3％. respectively. The incidences of contact between sphenoid sinus and maxillary nerve, vidian nerve, internal carotid artery were 74.5％. 79.2％. 45.1％. respectively. The incidences of pneumatization of the posterior ethmoid sinus were as follows ; normal 70.6％ and overriding type 29.4％. The incidences of sphenoid sinus pneumatization were as follows; normal 56.9％ , rudimentary 12.5％, pterygoid recess 22.7％, anterior clinoid recess 2.7％, and both pterygoid and anterior clinoid recess type 5.2％. Conclusions : The inflammatory sinonasal diseases were classified into five patterns using the CT of PNS, which was proven to be an excellent imaging modality providing detailed information about mucosal abnormality, pathologic patterns, and the proximity of the important structures to the posterior paranasal sinuses. This result will aid in the interpretation of CT of PNS functionally and systemically.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.2
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• pp.143-153
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• 2006

Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

• 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.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.2
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• pp.97-104
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• 2018

Mandibular anterior region has high implant survival rates and better accessibility compared with any other region. Even if there are possibilities for perforation on lingual cortical bone due to improper drilling and bleeding caused by lingual artery damage, mandibular anterior region is a safe region because less amount of major anatomical structures exist compared with other regions. However, because of narrow bucco-lingual width of alveolar ridge, it is challengeable to obtain esthetic implant prosthesis. Although patients are less sensitive subjectively, mandibular anterior region is as difficult as maxillary anterior region in that implant placement location plays a critical role on the prognosis of implant prosthesis. One-piece implant is a very useful option for mandibular anterior region. Considering the narrow roots and thin alveolar bone of mandible, it is clinically difficult for implant diameter to be greater than 3mm In this case, we could approach the esthetic restoration in mandibular anterior region with one-piece implant and immediate loading.