• 대한구순구개열학회지
• /
• 제8권1호
• /
• pp.31-37
• /
• 2005

In alveolar deformity of cleft patient, the flap design is very important to make the functional and esthetic outcome. Especially in bilateral cleft alveolus with wide defect, deficiency of covering tissue is a greatest problem. Wound dehiscence may develop oronasal fistula of palatal and labial region and loss of the bone graft. We report 2 cases with bilateral cleft alveolus. In both case, bilateral buccal mucosal flap was used for closure of bilateral cleft alveolus with wide defect. The one was operated with iliac bone graft according to secondary grafting method, the other was closed without bone grafting. The patient was 3 years old. So, secondary alveolar bone graft will be required some years later for the establishment of bony continuity and esthetic advantage. In both cases, we found the entire soft tissue closure without the lack of covering flap. In these case, the closure of alveolus defect was accomplished successfully by the use of bilateral buccal mucosal flap. There was no complication, secondary fistula. The most important thing is the tension-free closure of the bilateral buccal mucosal flap. So, we report these cases with literatures.

• 대한두경부종양학회지
• /
• 제35권1호
• /
• pp.21-23
• /
• 2019

Recent studies have reported on the reconstruction of oral mucosal defects using acellular dermal matrix (ADM). This case report describes the reconstruction of a soft-palate mucosal defect using ADM. A 43-year-old man developed a $2.5cm{\times}3cm$ soft-palate mucosal defect after the removal of a lump on the soft palate andreconstructed the defect using ADM without further complications. Reconstruction of the soft palate with ADM could be more convenient than traditional methods including primary closure, skin graft, and local or free flap without complications.

• 대한두개안면성형외과학회지
• /
• 제15권3호
• /
• pp.133-137
• /
• 2014

Reconstruction of a full-thickness alar defect requires independent blood supplies to the inner and outer surfaces. Because of this, secondary operations are commonly needed for the division of skin flap from its origin. Here, we report a single-stage reconstruction of full-thickness alar defect, which was made possible by the use of a nasolabial island flap and septal mucosal hinge flap. A 49-year-old female had presented with a squamous cell carcinoma of the right ala which was invading through the mucosa. The lesion was excised with a 5-mm free margin through the full-thickness of ala. The lining and cartilage was restored using a septal mucosa hinge flap and a conchal cartilage from the ipsilateral ear. The superficial surface was covered with a nasolabial island flap based on a perforator from the angular artery. The three separate tissue layers were reconstructed as a single subunit, and no secondary operations were necessary. Single-stage reconstruction of the alar subunit was made possible by the use of a nasolabial island flap and septal mucosal hinge flap. Further studies are needed to compare long-term outcomes following single-stage and multi-stage reconstructions.

• Archives of Plastic Surgery
• /
• 제48권2호
• /
• pp.208-212
• /
• 2021

Background There are currently no guidelines for the postoperative wound management of the hard-palate donor site in cases involving mucosal harvesting. This study describes our experiences with the use of an artificial dermis for early epithelialization and transparent plate fixation in cases involving hard-palate mucosal harvesting. Methods A transparent palatal plate was custom-fabricated using a thermoplastic resin board. After mucosal harvesting, an alginic acid-containing wound dressing (Sorbsan) was applied to the donor site, which was then covered with the plate. After confirming hemostasis, the dressing was changed to artificial dermis a few days later, and the plate was fixed to the artificial dermis. The size of the mucosal defect ranged from 8×25 to 20×40 mm. Results Plate fixation was adequate, with no postoperative slippage or infection of the artificial dermis. There was no pain at the harvest site, but a slight sense of incongruity during eating was reported. Although the fabrication and application of the palatal plate required extra steps before and after harvesting, the combination of the artificial dermis and palatal plate was found to be very useful for protecting the mucosal harvest site, and resulted in decreased pain and earlier epithelialization. Conclusions The combination of artificial dermis and a transparent palatal plate for wound management at the hard-palate mucosal donor site resolved some of the limitations of conventional methods.

• 대한두경부종양학회지
• /
• 제11권1호
• /
• pp.47-55
• /
• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• 대한두경부종양학회지
• /
• 제39권2호
• /
• pp.23-26
• /
• 2023

Lower lip reconstruction in cases with a full-thickness defect over one-third of the vermilion is challenging. Numerous conventional techniques have been applied with unsatisfactory surgical outcomes because of microstomia and oral commissure blunting due to shortened horizontal lip length. Herein, we present a case in which a full-thickness lower lip defect of more than one-third of the horizontal lip length was covered with a novel mucosal roofing flap reconstruction to minimize the loss of horizontal lip length and to preserve mouth opening. No recurrences or metastases were observed during 3 years and 6 months of follow-up, with horizontal lower lip length maintained and mouth opening of 2.5 finger breadths.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• pp.283-286
• /
• 1989

The buccal mucosa is an effevtive and versatile intraoral grafting material. For adequate reconst ruction of avulsed lip, restoration of natural appearance and adequate lip function should be done. We treated avulsed upper lip defect which had been affected underlying orbicularis oris muscle as well as vermilion border. We chose cheek mucosa for upper lip reconstruction and performed surgical correction of avulsed upper lip with pedicled buccal mucosal flap. The result was very good because of its superior color and texture matching to remaining yermilion tissue.

• Journal of Chest Surgery
• /
• 제28권5호
• /
• pp.521-524
• /
• 1995

Esophageal leiomyoma is a very rare disease. We present a patient who underwent enucleation of esophageal leiomyoma through a left thoracotomy. The patient was suffered from substernal pain and chest discomfort for 4 months.The esophagogram revealed irregular ovoid smooth filling defect in just proximal portion of G-E junction with the normal mucosal folds. Chest CT demonstrated well-defined, polypoid tumor mass on the anterolateral wall of the distal esophagus. Esophagoscopy revealed normal intact mucosal patterns with swollen hard protruded tumor mass lesion from the just proximal portion of G-E junction. In June, 1993, patient underwent enucleation of esophageal leiomyoma through the left thoracotomy. A horseshoe and spiral shaped, whitish firm tumor mass was noted on the distal esophagus, and the tumor mass was enucleated by blunt dissection carefully. The esophageal leiomyoma was confirmed with histopathological examination. The postoperative course was smooth and uneventful.

• 대한기관식도과학회지
• /
• 제3권1호
• /
• pp.169-173
• /
• 1997

Cerebrospinal fluid (CSF) rhinorrhea usually occurs as a result of trauma including operation. Unheated CSF rhinorrhea may induce major morbidity such as meningitis and brain abscess, etc. This paper presents a review of four cases of traumatic CSF rhinorrhea Sites of CSF leakage were easily found out by intrathecal fluorescent dye injection. Surgery was performed by external ethmoidectomy approach and dural tear and bone defect was repaired with abdominal fat and free mucosal graft taken from amputated middle turbinates. We conclude that repair using free fat and mucosal graft via external ethmoidectomy approach could be accepted as the intial method of CSF rhinorrhea management.

• 대한수의학회지
• /
• 제36권4호
• /
• pp.973-990
• /
• 1996

To investigate diagnostic imaging of cystitis and to apply it to the small animal practice, ultrasonogram of urinary bladder with moderate distension(4ml/kg) and with complete distension(9ml/kg) to evaluate the irregularity and thickness of bladder, radiography and histopathological examination were performed after experimental cystitis induction. On double contrast cystography, mucosal membrane of the urinary bladder was smooth and thickening urinary bladder wall was not found before cystitis induction. At 3rd day post induction(PI), mucosal irregularity was noted at the cranioventral region of the urinary bladder. Thickening of the urinary bladder wall and filling defect was observed as well. Cystographic findings of 7, 10, 15, 21 day PI were similar to that of 3rd day PI. On ultrasonographic findings of the mural thickness in induction group, it was ascertain that the mural thickness with moderate distention was more thickened than with complete distention at transverse scan. Ultrasonographic findings at longitudinal scan were similar to those of transverse scan. On ultrasonographic findings of mucosal irregularity in induction group, from PI to 7 day PI, mucosal irregularity with moderate distention was more irregular than mucosal irregularity with complete distention. At 10 day PI, there was similarity between moderate distention and complete distention. On histopathologic examination of a section of urinary bladder taken 3 day PI, the mucosal and submucosa were infiltrated by a mixture of thick inflammatory exudate which was composed of neutrophil, plasma protein, bacterial colony and necrotic cells. Congestion, hemorrhage and edema were also observed in the submucosa. At 7th day PI, the mucosal change was similar to that of 3rd day PI, but neovascularization and fibroplasia were observed in the submucosa. At 15th and 21th day PI, mild hyperplasia of mucosal epithelium was observed in the mucosa. Deposition of collagen, neovascularization and severe diffuse infiltration of lymphocyte were observed. These results suggest that ultrasonographic examination with moderate distention is considered to be a more simple, rapid, noninvasive, sensitive and useful diagnostic method than other diagnostic methods for the diagnosis of the cystitis and the differential diagnosis of urinary tract infection.