• 대한구순구개열학회지
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• 제12권1호
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• pp.7-20
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• 2009

Orthodontic treatment planning of cleft lip and palate requires consideration of the characteristic features, growth pattern and functional disorders related to cleft lip and palate patients. Tissue deficiencies and constriction of the scar tissue in surgically treated cleft lip and palate results in disturbance of maxillary growth and deficiency of midfacial region with anterior and posterior crossbite. These patients often present congenital missing of teeth, supernumerary teeth, malformed teeth, or ectopic position of teeth, which should be treated by orthodontic treatment by expanding upper arch followed by fixed appliance. Proper use of retainer and continuous follow-up is needed to prevent relapse after orthodontic treatment has finished. Also we have to pay attention to correct speech disorder which is caused by the velopharyngeal insufficiency.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.98-104
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• 2000

Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.193-197
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• 2020

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign, fibro-osseous variant of ossifying fibroma. It exhibits short-term rapid growth and has a high recurrence rate. Herein we describe a case of JPOF of the maxilla that was treated via complete excision utilizing an intraoral approach with immediate reconstruction using an iliac bone graft, in conjunction with a comprehensive review of the literature. A 20-year-old man presented with a mass on his right cheek that he reported had been growing over the last 10 months. In that cheek he had noticed fullness and experienced pressure, tenderness, and fluffiness, with no other ophthalmic or dental symptoms. After clinical, radiological, and histological examinations, the diagnosis was confirmed as JPOF. Surgical excision was performed, followed by immediate reconstruction with an autologous iliac cortical and cancellous bone graft harvested from the right iliac crest under general anesthesia. Good cicatrization of the intraoral surgical wounds and right iliac crest were evident. He was monitored for 6 months after the surgery and exhibited appropriate midfacial contour. There were no signs of recurrence or complications.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.76-80
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• 2009

Purpose: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. Methods: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. Results: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. Conclusion: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권2호
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• pp.100-104
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• 1993

저자들은 두개저 골절을 동반하지 않은 단순 안면골 골절환자에서 본과에서 안면골 정복 수술후 발현한 외상성 경동맥해변동루 환자를 신경외과에 의뢰하여 분리풍선술식으로 처치한 후 현저한 임상적 증상의 개선을 가져왔고 12개월간 관찰시 다른 합병증도 유발되지 않았다. 외상성 경동맥해면동루는 두경부 손상시 매우 드물게 발생되는 심각한 합병증으로 임상증상의 복잡성 때문에 혼동하기 쉬으므로 Neurosurgeon과 협조하여 조기에 정확한 진단과 적절한 치료가 이루어지는 것이 바람직하다.

• 대한치과보철학회지
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• 제36권1호
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• pp.120-132
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• 1998

This stusy was to investigate the marginal fitness of porcelain-fused-to- metal crown after succesive firing cycle. Main variables were the degree of marginal curvature of labiocervical margin and the type of alloy. The exaggerated marginal curvature(EMC) was created by additional reduction at the faciocervical wall of the normallized marginal curvature (NMC)-typed ivorine tooth by using milling machine. The difference in the shape was the mid facial margin was placed 2mm apical to cemento- enamel junction in labial surface. Three types of alloy were high noble, noble, and base metal alloy. Test specimens were divided into 8 groups and each group had 8 specimens. Sixty four ceramometal crowns were made totally. Measurement stages were following degassing, opaquing. body porcelain firing, and glazing, and measuring sites were 4. (midmesial, midfacial, middistal, and midlingual). Digital, travelling measuring microscope (0.5 um precision, Olympus. Japan) was used under ${\times}250$ magnification. Within the limitation of this investigation, it was concluded as belows: 1. The pattern of marginal distortion was varied. Degassing stage was not a specific, causative stage that induce most of total marginal distortion during whole procedure fabricating a ceramometal crown. Body firing stage induced discrepancy relatively more than other firing stages. 2. The specimens that were Ni-based alloy and had EMC were distorted persistently following successive fabricating procedures. But marginal openings were decreased after glazing. 3. The release of metal grinding-induced stress was presumed as a cause that induce marginal distortion. 4. The amount of discrepancies of the labial and lingual margins were greater than that of the mesial and distal margin in the specimen that had EMC. 5. Silver-plated die was not enough to resist abrasion during repeated seating of metal copings on the die-holding device.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.177-183
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• 1996

With the increasing esthetic requirement in orthognathic surgeries, midfacial corrective surgeries were developed to improve the paranasal depression. Augmentation with autogenous bones has long been the standard in facial reconstruction, however limited graft availability, donor site morbidity, and difficulties in 3-dimensional shaping were led to limited use. Porous high density polyethylene$(Medpor{(R)})$ was introduced in the 1970s as an alloplastic implants. It can be used in various size and shapes, and shortend operation time. The purpose of this study is to determine, by means of cephalometrics, the degree of long term stability and gaining of the overlying soft tissue thickness. The results were as followings : 1. There was no evidence of foreign body reaction, infection, and tissue necrosis. 2. $(Medpor{(R)})$ implants had an advantage of clinical use ; easy to contour and adapt to obtain a precise 3-dimensional construction. 3. Cephalometric study of 16 cases of paranasal augmentation revealed an overall increase of soft tissue thickness of approximately 82.1% in 6-months following. 4. The successful results could be obtained under the aseptic handling.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.607-612
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• 2010

Purpose: Maxillectomy for malignant tumor resection often leads to functional and aesthetic sequalae. Reconstruction following maxillectomy has been a challenging problem in the field of head and neck cancer surgery. In this article, we described three dimensional midface reconstructions using free flaps and their functional and aesthetic outcomes. Methods: We reconstructed 35 cases of maxillectomy defects using 9 radial forearm free flaps, 7 lattisimus dorsi musculocutaneous free flaps, 6 rectus abdominis musculocutaneous free flaps, 4 fibular osteocutaneous free flaps, and 9 anterolateral thigh free flaps, respectively. We classified post-maxillectomy defects by Brown's classification. 1 Articulation clarity was measured with picture consonant articulation test. Swallowing function was evaluated with the University of Washington quality-of-life Head and Neck questionnaire by 4 steps.2 Aesthetic outcomes were checked to compare preoperative with postoperative full face photographs by 5 medical doctors who did not involve in our operation. Results: The average articulation clarity was 92.4% (100-41.9%). 27 (81.9%) patients were able to eat an unrestricted diet. Aesthetic results were considered excellent in 18 patients (51.4%). Functional results were best in the group reconstructed with fibular osteocutaneous free flap. Considering the range of wide excision, aesthetic results is best in the group reconstructed with anterolateral thigh free flap. Conclusion: The free flap is a useful technique for the reconstruction of the midface leading to good results, both functionally and aesthetically. Especially, because osteocutaneous flap such as fibular osteocutaneous free flap offered bone source for osteointegrated implant, It produces the best functional results. And perforator flap like as anterolateral thigh free flap reliably provides the best aesthetic results, because it provides sufficient volume and has no postoperative volume diminution.

• Toxicological Research
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• 제17권
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• pp.11-16
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• 2001

The development of the central nervous system is a continuous process during the embryonic and fetal periods. For a better understanding of congenital anomalies of central nervous system, three major events of normal development, i.e., neurulation (3 to 4 weeks), brain vesicle formation (4 to 7 weeks) and mantle formation (over 8 weeks) should be kept in mind. The first category of anomalies is neural tube defect. Neural tube defects encompass all the anomalies arise in completion of neurulation. The second category of central nervous system anomalies is disorders of brain vesicle formation. This is anomaly that applies for "the face predicts the brain". Holoprosencephaly covers a spectrum of anomalies of intracranial and midfacial development which result from incomplete development and septation of midline structures within the forebrain or prosencephalon. The last category of central nervous system malformation is disorders involving the process of mantle formation. In the human, neurons are generated in two bursts, the first from 8 to 10 weeks and next from 12 to 14 weeks. By 16 weeks, most of the neurons have been generated and have started their migration into the cortex. Mechanism of migration disorders are multifactorial. Abnormal migration into the cortex, abnormal neurons, faulty neural growth within the cortex, unstable pial-glial border, degeneration of neurons, neural death by exogenous factors are some of the proposed mechanism. Agyria-pachygyria are characterized by a four-layerd cortex. Polymicrogyria is gyri that are too numerous and too small, and is morphologically heterogeneous. Cortical dysplasia is characterized by the presence Q[ abnormal neurons and glia arranged abnormally in focal areas of the cerebral cortex. Neuroglial malformative lesions associated with medically intractable epilepsy are hamartia or hamartoma, focal cortical dysplasia and microdysgenesis.ysgenesis.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.581-588
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• 2008

Purpose: It is generally accepted that anatomical structures of the soft tissue in Asian faces are quite different from those in Caucasian. It is presumed that these differences are due to collagen rich thick dermis and durable superficial musculo-apponeurotic system (SMAS) in Asian. We classified the aging lower eyelids and reviewed the operative procedures according to the types of aging lower eyelids in Asian. Methods: We compared preoperative and postoperative photos of 117 patients over 30 years of age, who underwent lower blepharoplasty at the Kyunghee Medical Center from January 2001 to April 2006. We classified the patients based on the degree of skin laxity, presence of nasojugal groove and malar bag, the extent of aging process. We also reviewed the operative procedures according to each type of classification. Results: We classified our patients into four types as following. Type I patients showed minimal skin-muscle excess confined to lower eyelids regardless of the facial line. For these patients, we performed only transcutaneous or transconjunctival blepharoplasty. In type II patients, nasojugal grooves were shown and skin- muscle laxity was limited to the medial side of imaginary vertical line at lateral margin of pupil. In these cases, we performed free fat graft or fat repositioning on nasojugal groove or fat removal and septal duplication confined to medial side. Type III patients displayed more advanced medial bulging and remarkable laxity over the lateral side, the same operation methods as those of type II were applied at the lateral side of the line. Type IV patients demonstrated extensive midfacial aging changes including malar bags and underwent superficial subciliary cheek lift. Conclusion: The lower eyelid aging of Asian is different from those of Caucasian. We think that our classification is useful in selection of appropriate operative procedure to address specific problems for Asian patients.