• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.9-15
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• 1997

Malignant histiocytosis(MH)-like hemophagocytic syndrome(HS) is a fatal complication of nasal angiocentric lymphoma(AL) and difficult to distinguish from MH. Ten of total 42 patients with nasal AL had HS and 9 of them were initially suspected to have MH. Five patients had HS as initial manifestation, 3 at the time of relapse, and 2 during the clinical remission of lymphoma. Four patients were treated by combination chemotherapy(CHOP) and others had only supportive care. Immunohistochemical study and in situ hybridization were performed on the specimen obtained from 10 patients. The median survival of all patients from HS was 18 days(range 2 - 44 days) and all had fatal outcome regardless of the treatment-modality. All cases were positive for UCHL1(CD45RO) and Epstein-Barr virus (EBV) by EBER in situ hybridization. MH-like HS is a fatal complication of nasal AL and has a high association with EBV. Reactivation of EBV may contribute to HS and further investigation of predictive factors and effective treatment of HS should be pursued in future.

• The Korean Journal of Vision Science
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• v.20 no.4
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• pp.421-429
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• 2018

Purpose : We identified correlation between macular thickness and RNFL (retina nerve fiber layer) measured by OCT and axial length in Korean children divided as three groups according to refractive errors. Methods : In total, 134 eyes of 67 Korean children who experienced no eye disease and ophthalmology surgery were involved in this study and then divided as three groups such as hyperopic, emmetropic and myopic groups. Macular thickness and RNFL thickness were measured with Cirrus HD-OCT, and axial length was done with IOL Master.Macular thickness and RNFL thickness were measured by Cirrus HD-OCT, and axial length using IOL Master. Correlation between axial length and retinal thickness in three groups according to refractive errors was investigated. Results : The type of refractive error measured by axial length was myopic, emmetropic and hyperopic groups in order, showing significant difference (p<0.05). The center thickness of macular was myopic, emmetropic and hyperopic groups in order, showing significant difference(p<0.05). The thicknesses of superior, nasal and inferior regions in peripheral macula were the thinnest in myopic group (p<0.05). It was shown that positive correlation was found between the center thickness of macula and axial length (r=0.283, p<0.05), while negative correlation was found between the peripheral thickness of RNFL and axial length. The temporal thickness of RNFL represented the thickest in myopic group, showing positive correlation with axial length(r=0.39, p<0.05). The superior, nasal and inferior thickness of RNFL represented negative correlation with axial length, showing statistically significant in the nasal thickness of RNFL(r=-0.23, p<0.05). Conclusion : Through this study, we identified correlation between macular thickness, the thickness of RNFL and axial length using OCT in Korean children, and also found the differences in three refractive error groups.

• The korean journal of orthodontics
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• v.50 no.6
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• pp.383-390
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• 2020

Objective: To investigate the distribution, side involvement, phenotype, and associated anomalies of Korean patients with craniofacial clefts (CFC). Methods: The samples consisted of 38 CFC patients, who were treated at Seoul National University Dental Hospital during 1998-2018. The Tessier cleft type, sex, side involvement, phenotype, and associated anomalies were investigated using non-parametric statistical analysis. Results: The three most common types were #7 cleft, followed by #0 cleft and #14 cleft. There was no difference between the frequency of male and female. Patients with #0 cleft exhibited nasal deformity, bony defect, and missing teeth in the premaxilla, midline cleft lip, and eye problems. A patient with #3 cleft (unilateral type) exhibited bilateral cleft lip and alveolus. All patients with #4 cleft were the bilateral type, including a combination of #3 and #4 clefts, and had multiple missing teeth. A patient with #5 cleft (unilateral type) had a posterior openbite. In patients with #7 cleft, the unilateral type was more prevalent than the bilateral type (87.0% vs. 13.0%, p < 0.001). Sixteen patients showed hemifacial microsomia (HFM), Goldenhar syndrome, and unilateral cleft lip and palate (UCLP). There was a significant match in the side involvement of #7 cleft and HFM (87.5%, p < 0.01). Patients with #14 cleft had plagiocephaly, UCLP, or hyperterorbitism. A patient with #30 cleft exhibited tongue tie and missing tooth. Conclusions: Due to the diverse associated craniofacial anomalies in patients with CFC, a multidisciplinary approach involving a well-experienced cooperative team is mandatory for these patients.

• Korean Journal of Head & Neck Oncology
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• v.1 no.1
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• pp.35-61
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• 1985

The surgical treatment of advanced carcinomas and some benign tumors having clinically malignant behaviors of the head and neck region often require extensive resection, necessitating large flaps for reconstruction. Since the original upper arm flap was described by Tagliacozzi in 1597, a variety of technique such as random pattern local flap, axial flap, distant flap, scalping flap, myocutaneous flap, free flap etc. have been proposed for reconstruction of head, face and neck defects. Reconstruction of the facial defects usually require the use of distant tissue. Traditionally, nasal reconstruction has been carried out with a variety of forehead flaps. In recent years, there has been more acceptance of immediate repairs following the removal of these tumors. As a result, patients are more willing to undergo these extensive resections to improve their chances of cure, with the reasonable expectation that an immediate reconstruction will provide an adequate cosmetic result. Authors experienced 13 cases of head and neck tumor during last three and half years that required wide excision and immediate reconstruction with various flaps, not with primary closure or simple skin graft. We present our experience with varied flaps for reconstruction after wide resection of head and neck tumors 3 cases of defect of dorsum of nose or medial canthus with island forehead flaps, lower eyelid defect with cheek flap, cheek defect with Limberg flap, orbital floor defect with Temporalis muscle flap, lateral neck defects with Pectoralis major myocutaneous flap or Latissimus dorsi myocutaneous free flap, subtotal nose defect with scalping flap, wide forehead defect with Dorsalis pedis free flap and 3 cases of mandibular defect or mandibular defect combined with lower lip defect were reconstructed with free vascularized iliac bone graft or free vascularized iliac bone graft concomitantly combined with free groin flap pedicled on deep circumflex iliac vessels We obtained satisfactory results coincided wi th goal of treatment of head and neck tumors, MAXIMAL CURE RATE with MINIMAL MORBIDITY, OPTIMAL FUNCTION, and an APPEARANCE as close to normal as possible.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.741-747
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• 2007

Purpose: In order to determine the differences in speech outcome based on timing of operation in submucous cleft palate, we have reviewed our experiences in the Furlow palatoplasty over the last 11 years. Methods: From March 1996 to March 2006, 38 submucous cleft palate patients received Furlow palatoplasty. 10 developmentally delayed patients were excluded and 5 patients were lost to follow up. The rest 23 patients were reviewed. Speech was evaluated preoperatively and postoperatively, and speech therapy was performed accordingly. Perceptual speech assessment included hypernasality, nasal emission and articulation disorder. Cinefluorography was performed to aid perceptual assessment. Based on timing of operation, the patients were divided into 3 groups as following: Group A under 24 months(8 patients), Group B from 25 to 48 months(6 patients), and Group C over 49 months (9 patients). Except 1 patient under speech therapy yet, resultant speech was compared. 200707Results: The rate of abnormal speech was higher in Group C(3/9, 33.3%) than in Group A(0%) or B(0%). All 3 patients who had been discontinued of speech therapy from the parent's judgment had abnormal speech. The reason for the discontinuation was that the regular speech therapy was a burden at school age. Any patients who had continued speech therapy had normal speech. Conclusion: The results of our study shows that operative timing is associated with speech development. Maintenance of speech therapy was an important factor for normal speech development. It will be helpful to perform a palatoplasty before 48 months of age to complete speech therapy before the school age.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.1
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• pp.21-25
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• 2008

A 33-years-old female pateint with cerebral palsy showing spastic quardriplegia and severe mental retardation was scheduled for dental implant restorations. Before implant surgery we had to take implant CT. But, because of her involuntary motion and communication difficulty, sedation was needed in order to take CT. After 8 hour NPO, propofol infusion sedation with TCI (target controlled infusion) system was administered. The propofol blood concentration of the patient was maintained 2-3 ${\mu}$/ml to keep deep sedation to prevent uncontolled movement. During sedation, we monitored ECG, pulse oximetry, blood pressure, capnometry for patient safety. Oxygen was administered via nasal prong for preventing hypoxemia and to keep airway during sedation some bands were applied to lift mandible. Total duration was 20 minutes for taking CT, and she was discharged from hospital after 30 minute rest without complication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.606-612
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• 2000

This study was performed to investigate the average anthropometric value of normal Korean men and women and to compare the preceding literatures. Additionally, average Korean profilogram was made to serve as a template for diagnosis of facial form. Eighty five Korean subjects(41 men, 44 women) aged between 21 to 26 were selected by members of the author's department on the basis of intact dentition and Class I occlusion without facial asymmetry. Frontal and lateral photographs were taken under standardized condition with digital camera. The image was magnified and adjusted according to the FH plane of cephalometric radiographs and digitized using personal computer. To compare the Western beauty, 25 esthetically pleasing female was selected to measure various angle and distance of the face. 1. It was possible to calculate the mean coordinate value of Korean normal samples which enables the direct visualization and comparison with the use of template. The method in this study was easy to applicate under the Microsoft $Windows^{(R)}$ bases. 2. Maxillary vertical hypoplasia, upper and lower lip protrusion was characteristics of Korean norms and relatively narrow alar base distance, less conspicuous nasal projection was observed. As the vermilion exposure and upper lip length was more than western norm, chin looks shorter than western. To compare the Korean and Western esthetically pleasing profile, facial convexity and nose was less conspicuous in Korean women.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.188-192
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• 1996

The biological behavior of mucosal melanoma is aggressive with frequent local recurrence and distant metastasis owing to the abundantly surrounding blood vessels and lymphatics adding to the fact that diagnosis is frequently delayed due to non-specific clinical outcome. The management for mucosal melanoma of the head and neck is controversial in view of the poor prognosis. Ten cases treated over the past 10 years are reported. The average age of the patients was 54.4 years. Seven cases were localized in the nasal cavity and paranasal sinuses and three cases in the oral cavity and nasopharynx. Eight patients had local tumors, one had regional lymph node metastases and one hed lung metastases. Six patients underwent surgical resection, with postoperative radiotherapy in five patients, three patients received radiotherapy and one patient received combination therapy. Recurrence occured in 80% of the patients and the median time to recurrence was 10.5months. The median survival for those who received surgical resection followed by postoperative radiation therapy was 20.8 months and 14.7 months in the radiation therapy only treated group. The author's conclusion is that mucosal melanoma is a highly aggressive disease of the upper respiratory tract in which the best treatment modality is wide surgical resection followed by postoperative radiation therapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.401-406
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• 1999

Secondary deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may vary in severity, depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic technique. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. Residual lip deformities after primary repair may be esthetic or functional and include scars, skin shortage or excess(vertical and transverse), orbicularis oris muscle malposition or diastasis. The key to accurate repair of secondary cleft lip deformities is a precise diagnosis. This requires observation of the patient in animation and repose. The quality of the scar is not the only factor determining the overall appearance of the lip. Observing the patient in the animated position is critical to assess muscular function. Factors that require precise analysis include lip length, the appearance of the Cupid's bow and philtrum, and nasal symmetry. Only after this detailed analysis can a decision be made as to wether a major or minor deformity exists. We report successful cases using various techniques for the secondary lip deformities.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.54-56
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• 2012

Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.