• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.163-170
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• 1995

The purpose of this study was to investigate the epidemiology of midface fractures. We observed clinically 71 patients with midface fracture who visited the Department of oral and maxillofacial-surgery, Chosun University, Dental Hospital, from 1991 to 1994. The results obtained were as follows. 1. There was the highest age incidence in the third decade(29.6%). 2. There was the highest incidence in the summer(36.6%). 3. The most etiologic factor of midface fracture was traffic accidents(43.6%) and next factor was fall down(38.0%). 4. The highest incidence fracture was zygomatic arch(38.7%) and next fracture was ZMC fracture(31.5%). 5. Most midface fracture was treated within 2 weeks(86.7%). 6. Midface fractures was most frequently combined with mandibular fracture(15.5%), head injuries(14.1%), orthhopedic injuries(8.5), thorax & abdomen(5.6%). 7. The highest complication was the nerve injury(8명), and next complications were infection(3명), epiphora(3명) etc.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.399-406
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• 2000

With the increase of industrialization, leisures, sports activities and traffic, the risk of trauma has increased markedly. Midfacial bones are relatively common sites of trauma, and are difficult sites of correct reduction and reconstruction, because midface is composed of mostly thin cortical bone surrounding cavities filled with either air or fat with discrete areas of bony condensation. A clinical study on 208 patients with midfacial bone fracture who visited Sanggye Paik Hospital during 5 years($1990{\sim}1995$) was done by analyzing sex, age, cause, fracture site, treatment method, complication and involvement of other body part, etc. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with ratio of 2.7 : 1 and most frequently in twenties. 2. Traffic accident was the most common cause of midface fractures. 3. Zygoma was the most frequently occurred site(50%) of midface fractures. 4. Simple fracture(75%) was more frequently occurred than compound fracture(25%). 5. As treatment method, open reduction(76.4%) was used more frequently than closed reduction(23.6%) 6. Generally, operations are done in 5 days after admission(59.1%), and intermaxillary fixation was done in 78.4% of cases. 7. Teeth and alveolar bone damages were occurred in 32.2% of cases. 8. Other injuries that were related to midface fracture occurred in 63.3% of cases. 9. Post-operative complications occurred in 9% of cases.

• 대한두개안면성형외과학회지
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• 제19권1호
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• pp.1-2
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• 2018

Theoretically, panfacial bone fractures involve all three areas of the face: frontal bone, midface, and mandible. In practice, when two out of these three areas are involved, the term "panfacial bone fracture" has been applied. We can use physical examination, simple radiologic examination, and computed tomography study for diagnosis. Linear fracture are treated by conservative treatment. But, most of panfacial bone fracture patients need to be treated by open reduction and internal fixation. Facial width is most important thing that we need to care during operation. There are many ways about sequence like "top to bottom," "bottom to top," "outside to inside," or "inside to outside" and the authors prefer "top to bottom" and "outside to inside" ways. The authors apply arch bar from the first of surgery and then, set frontal bone fracture, midface fracture and mandible fracture in sequence. Usually, we remove the stitches for 5 days after surgery and the intraoral stitch removed after 2 weeks. Usually arch bar is going to be removed 4 weeks after surgery. We could get acceptable results with the above way.

• 대한치과마취과학회지
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• 제4권2호
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• pp.96-99
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• 2004

구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.53-57
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• 2020

A mucocele is an epithelium-lined, mucus-filled cavity in the paranasal sinuses. Mucocele may develop due to scarring and obstruction of the sinus ostium caused by midface sinus trauma, such as orbital bone fracture or endoscopic sinus surgery. The authors report two cases of orbital mucocele as complications following midface sinus injury (endoscopic sinus surgery in one case, and orbital fracture repair in the other). In both cases, imaging studies showed a large orbital mucocele accompanied by bony erosion and orbital wall remodeling, compressing the ocular muscle. Using an open approach, the lesion was excised and marsupialized. The symptoms resolved, and the postoperative eyeball position was normal. Orbital mucocele may cause serious complications such as ocular symptoms, orbital cellulitis, osteomyelitis, and the formation of an abscess with the potential to invade the brain. Therefore, surgeons should consider the possibility of mucocele as a late complication of surgery and initiate an immediate work-up and surgical treatment if needed.

• 대한두개안면성형외과학회지
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• 제17권4호
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• pp.198-201
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• 2016

Background: Zygomatic arch is a bony arch constituting the lateral midface, which consists of 25% of all midface fractures. There are a number of ways to evaluate the extent of zygomatic arch fracture. Some authors have reported successful treatment outcomes using ultrasound (U/S). To add to the previous methods, we have considered ways to accurately display the location of the fracture line while using U/S with 23 gauge needle marking. We introduce our method, which provided satisfactory results for reduction using a portable U/S, and it can evaluate the fracture line simultaneously when reduction of an isolated zygomatic arch fracture is necessary, and needle marking, which can easily point out the fracture line on U/S. Methods: We studied 21 patients with an isolated zygomatic arch fracture who underwent closed reduction using U/S and needle marking between 2013 and 2015. Results: We achieved satisfactory results in all our cases with respect to reduction by using the Dingman elevator after performing a temporal approach incision, while confirming relative positioning between needle marking and zygomatic fracture at the same time, after insertion of a 23 gauge needle in the skin above the zygomatic arch fracture line parallel to it. Conclusion: We treated 21 patients with an isolated zygomatic arch fracture using U/S and the needle marking method, which provided satisfactory results because the extent of reduction of the fracture could be evaluated in real-time during the operation and exposure to radiation was reduced.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.21-31
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• 1989

This is a series of continuing research on facial bone fractures of Koreans worked by Dept. of Oral and Maxillofacial surgery, Dental College of Yonsei University, Seoul, Korea, since 1972. The study was based on a series of 630 patients with facial bone fractures treated as in-patient at Yonsei Medical Center, Yonsei University, during the period of Jan., 1982 through Dec., 1987. The results obtained are as follows: 1. The ratio of Men to Women was 4.3 : 1, and admissions for facial bone fractures have been increased year after 1984. 2. The age frequency was highest in the third decade(38.3%), and fourth, second, fifth decade in orders. 3. The traffic accident was the most frequent cause of facial bone fractures (51.3%). 4. The most common location of facial bone fractures was the Mandible(35.3%), and Zygoma complex(29.8%), Nasal bone(15.0%), Maxilla(11.0%) were next in order of frequency. 5. In 291 patients of Mandible fractures, 226(77.7%) had fractures only in Mandible and 65(22.3%) had another facial bone fractures. The most frequent fracture site of Mandible was the Symphysis(43.0%) and Angle(22.4%), and Simple fracture was the most frequent in type of fracture(66.9%). Intermaxillary fixatin & Open reduction was major method of treatment(36.9%). 6. In 394 patients of Midface fractures 323)82.0%) had fractures only in Midface and 71(18.0%) had another facial bone fractures. The most frequent site of Midface fractures was zygoma complex & zygomatic arch(42.7%), and Simple fracture was the most common type of fractures. Observation(Maxilla :44.2%, Zygoma :51.0%) and Open Reduction(Maxilla :20.0%. Zygoma :23.5%) were the major method of treatment. 7. The frequency of Nasal bone fracture was about 1/5 of Midface fractures, and Closed Reduction(45.2%) was the major method of treatment. 8. The complication was reported in only 16 patients, and Malunion was the major complication. 9. Head(44.4%), Lower extrimities(14.5%) and Eye(12.3%) were injured commonly with facial bone fractures. 10. The elapsed time from injury to hospital was within 24 hours in 73.8% of patients, however 15.5% of patients arrived the hospital 72 hours after injury.

• 대한치과마취과학회지
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• 제14권4호
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• pp.233-236
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• 2014

In order to reduce jaw fracture accompanied by basal skull or nasal fracture, submental intubation could be generally performed. Albeit submental intubation has been widely accepted, it could develop complications such as nerve injury, glandular duct injury, and orocutaneous fistula. Here, we suggest oral intubation for overcoming complications and providing more stable surgical environment in emergency case. Under oral intubation maintaining in retromolar triangle and buccal corridor space, intermaxillary fixation was successfully underwent in 38-years-old female patient with Le Fort I fracture accompanied by pneumocephalus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권4호
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• pp.192-198
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• 2019

Objectives: Oral and maxillofacial surgeons must gain mastery of various approaches to the midface due to the increasing incidence, complexity, and severity of presenting midfacial fractures. Unlike in the case of other body parts, the need to preserve facial aesthetics makes it more difficult for the surgeon to select an approach for managing the facial injuries. The midfacial degloving (MFD) approach is a combination of intraoral and intranasal incisions made to access the midface without any external incision. The aim of the present study was to evaluate the efficacy of MFD in maxillofacial surgery and to assess its advantages and complications. Materials and Methods: The MFD approach was used in five cases, with three cases treated with open reduction and internal fixation and two cases operated on for posttraumatic deformity. Nasal dorsum augmentation was completed in three cases and nasal osteotomy was performed in one case. The bicoronal flap technique was combined with MFD for frontal bone augmentation in one case. The intraoperative time required for flap completion and the ease of performing the planned procedures were noted. Postoperative evaluation was done for reduction, aesthetics, function, and complications. Results: Access was excellent for performing all planned procedures. Average time spent for flap elevation and exposure of the midface was 63 minutes. Complications like postoperative swelling, infraorbital nerve paresthesia, and intranasal crusting were all transient. No long-term complications like stenosis of the nose, sneer deformity, or weakness of the facial muscles were noticed. Additionally, no complications were noted when MFD was combined with bicoronal flap. Conclusion: Though the MFD approach is technically demanding and takes more time than other facial approaches, it should be learned and applied by maxillofacial surgeons in selective cases, as it provides complete exposure of the midface without facial scarring.

• 대한치과의사협회지
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• 제24권4호통권203호
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• pp.345-357
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• 1986

Computerized tomography has become more widely available in numerous centers throughout the world and is now recognized in many specialities as an important diagnostic procedure. The use of computerized tomography in oral and maxillofacial surgery is discussed. It has been found to be of special value in the diagnosis and assesment of expanding and infiltrating lesions of the jaws, fracture and infections, especially in the midface, in both adults and children.