• Archives of Craniofacial Surgery
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• v.20 no.4
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• pp.255-259
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• 2019

Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.117-121
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• 2022

Infantile osteomyelitis is a rare disease that is infective in nature and may rapidly turn fatal, as the disease is often misdiagnosed due to its varied presenting signs. Early diagnosis may help in avoiding systemic involvement and permanent deformity. The disease presents with signs of orbital involvement, nasal congestion, and emesis, as well as other standard hallmarks of infection. Furthermore, the maxilla is a highly vascular and porous bone and the occurrence of osteomyelitis in an infant maxilla is highly uncommon. In addition, routine blood work is not suggestive of the presence of this disease. Thus, prompt diagnosis of this condition poses a challenge to surgeons due to the confusing array of symptoms combined with the rarity of the disease. One such case of osteomyelitis of the maxilla in a young child is presented. The dilemma encountered by the surgeon during the diagnosis and treatment of the disease is discussed.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.54-58
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• 2023

Patients with Crouzon syndrome have increased risks of cerebrospinal fluid rhinorrhea and meningoencephalocele after LeFort III osteotomy. We report a rare case of meningoencephalocele following LeFort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed tomography and magnetic resonance imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencephalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during LeFort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.27-31
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• 2023

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare immunological small vessel disease which usually affects respiratory tract and kidneys. However, salivary gland involvement in GPA is rare as a primary manifestation. We report a case of GPA with the primary presentation of submandibular gland involvement. A 48-year-old female patient presented submandibular swelling with a skin defect that lasted for 1 month. Although the biopsy result was chronic inflammation, the skin defect did not heal for a month. Further imaging study revealed multiple lung and renal masses. More clinical manifestations such as gingivitis, ischemic change of finger joint and nasal tip skin, and positive c-ANCA test was presented. Additional biopsy was made at the submandibular gland, lung, and finger skin. The patient was finally diagnosed with GPA and treated with steroid pulse therapy and cyclophosphamide. The patient showed improvement of prior clinical symptoms.

• Journal of Korean Academy of Nursing
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• v.9 no.2
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• pp.17-26
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• 1979

This research is to prevent the infection of maternity in the hospital by examining the microbes contaminations in maternity through airbone microbes and those who are engaged in the ward of O.B. ＆ G.Y. and to furnish the basic data available to hospital management. The bacterial growth of airbone microbes contaminations in nosocomial air and who thor the nasal cavity of passers by (doctors, nurses, parturient women) who went to the ward of O.B. ＆ G.Y. contaminated or not were examined in“E”Univ. Hospital from July to August, 1979 by using thioglycollate broths and agar plates. The following results were obtained: 1. The average colony number of airborne microbes revealed as follows the pediatric ward (36 colonies), the internal ward (33 colonies), the ward of O.B. ＆ G.Y. (30 colonies), the ward of surgery (24 colonies), delivery-waiting room (11 colonies), and the delivery room (3 colonies). 2. The bacterial growth beforenoon differed from that of afternoon. Namely, the latter (24 colonies) was higher than the former (21 colonies). 3. The type of strains isolated from the air of the ward revealed staphylococci (82%), Gram negative bacilli (18%), fungi (17%), Gram positive diplococci (13%), and Bacillus subtilis (2.8%). 4. The strains isolated in the delivery-waiting room revealed staphylococci (66.7%), Gram negative bacilli (33.6%), and revealed staphylococci (75%), Gram positive diplococci (8.3%), and fungi (8.3%), in delivery room. 5. Most of strains isolated in the ward of O.B. & G.Y. revealed staphylococci (100.0%), Gram positive diplococci (8.3%), and Gram negative bacilli (6.7%). 6. The strain isolated in the surgical ward revealed staphylococci (91.7%), fungi (33.3%), Gram positive diplococci (25%), Gram negative bacilli (25%) and Bacillus subtilis (8.3%). 7. The strain isolated in the pediatric ward revealed staphylococci (75%), fungi (25%), Gram positive diplococci (8.3%), Bacillus subtilis (8.3%), and Gram negative bacilli (8.3%). 8. The strain isolated in the internal ward revealed staphylococci (91.7%), fungi (33.3%), Gram positive diplococci (25%), and negative bacilli (16.7%). The strains isolated from the nasal cavity of those doctors and nurses who and enaged in the ward of O.B. & G.Y. revealed staphylococci (80%), Bacillus subtilis (10%), and Gram negative bacilli (10%), from doctors and Gram positive diplococci (10%), instead of Gram negative bacilli (10％), from nurses. 10. The strain isolated from nasal cavity of parturient women on admission revealed staphylococci (90%), and Gram negative bacilli (10%), but after admission revealed staphylococci (70％), Gram positive diplococci (10%), and Gram negative bacilli (10%). 11. Of the total 91 staphylococci isolated from the air of the ward, the Coagulase pastive was 36 (39.6%), and the negative 55 (60.4%), As a result of the coagulase experiment of the staphylococci isolated from the nasal cavity of those who are engaged in the ward of O.B. ＆ G.Y. all were revealed as negative that belonged to non-pathogenic. 12. Consequence of the biochemic examination of the gram negative bacilli isolated from the air of the ward the aerobacter aerogens revealed was (16.7%) E-coli 5％ in the nasal cavity of those came and went to the of O.B. ＆ G.Y. and Aerobacter aerogens 7.5%.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.133-139
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• 2012

This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.277-283
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• 1999

This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.3
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• pp.200-204
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• 2012

In the repair of unilateral complete cleft lip, the most popular method is the rotation-advancement by Millard. Despite advantages of Millard repair, a few pitfalls exist. Above all, some of the scars, at the height of the cleft side philtral ridge, cross the Langer's line. Further, in the repair of complete cleft lip, small triangular lateral lip flap is often added in the base of an advancement flap to level the Cupid's bow. Moreover, preservation of the advancement flap has some negative effects on a primary nasal repair. As a result, the shape of philtrum is somewhat unnatural. Therefore, I applied the extended Mohler repair in the six cases of complete wide cleft lip to get a more esthetic scar. As a result, more natural, straight philtral ridge was obtained, without adding small triangular flap in the base of the advancement flap.

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.81-87
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• 1996

We studied the clinical charcteristics of 265 cases of nasopharyngeal carcinomas diagnosed at Korea Cancer Center Hospital over a span of 8 years from Jan. 1987. Male were 187 and Female were 78 and male: female ratio was 2.4 : 1. The age distribution ranged from 2nd decade to 9th decade evenly and mean age was 46.1 years old. Histopathologically squamous cell carcinoma (WHO type 1, 2, 60.8%) were 161 cases and undifferentiated carcinoma (WHO type 3, 39.2%) were 104 cases. Main symptoms and signs were neck mass 199 cases (75.1%), ear symptoms 126(47.5%), nasal symptom 101 (38.1%). The distribution of anatomical subsites were posterior wall 75 (24.7%), lateral wall 175 (72.8%), Inferior wall 15 (2.5%). Tumor staging by AJCC classification, 1992, distributed with stage I 3 cases (1.1%), stage II 5 cases (1.9%), stage III 24 cases (9.1%), stage IV 233 cases (87.9%).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.414-421
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• 2000

The objective evaluation of velopharyngeal closure function is the key to diagnosis and therapy control of velopharyngeal incompetency. The aim of this study is to evaluate the aerodynamic and acoustic characteristics of the velopharyngeal closure function of patients who have developed velopharyngeal incompetency after management with speech aids. The test words were composed of sustained vowels /a/, /i/, /e/, /u/, /ja/, /je/, /wi/ and polysyllabic words /p'ap'i/, /siso/, /mami/ for measuring nasalance, The data was collected before the placement of the speech aids and one to three months after. The results were as follows: The nasalance score of the velopharyngeal incompetency speakers was higher than that of the normal control group, except for nasal sounds, and was decreased after placement of the speech aids, especially in high vowels /i/ (P<.01) and /wi/ (P<.05).