• 대한두경부종양학회지
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• 제10권1호
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• pp.25-30
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• 1994

최근 7년간 저자들이 치험한 소타액선 종양 26례에 대하여 임상양상과 치료 결과를 분석하여 다음과 같은 성적을 얻었다. 1) 발생부위를 구개 10례 (38.5%), 비강 및 부비동 8례 (30.8%), 설근부 2례 (7.7%), 협부 점막 2례 (7.7%), 구순 1례(3.8%), 후두개곡 1례(3.8%), 구강저 1례(3.8%), 비인강 1례(3.8%)이었다. 2) 병리조직학적 소견은 양성 종양 10례, 악성종양 16례이었으며, 양성 종양은 전례가 다형성선종이었으며, 구개에서 6례로 가장 많았고, 악성종양은 비강 및 부비동 5례로 가장 많았으며, 선양낭성암종 9례, 악성혼합종 2례, 점액표피암종 2례, 다형성선암종 2례, 상피근상피성암 1례이었다. 악성화율은 61.5%이었다. 3) 치료는 양성 종양은 모두 적출술을 시행하였고 악성 종양은 광범위 적출술 4례(25.0%), 수술 및 방사선요법의 병합요법 9례(45.2%), 항암화학요법 및 방사선요법의 병합요법 1례(5.25%), 방사선 요법 2례(12.3%)등을 시행하였다. 4) 악성 종양에 대한 치료 결과는 근치적 치료를 시행한 8례에서는 무병생존 6례, 유병생존 1례, 유병사망 1례를 보였으며, 고식적 치료를 시행한 6례에서는 유병생존 2례, 유병사망 4례를 보였다. 이상의 성적에서 소타액선 종양은 대타액선 종양에 비하여 악성화 비율이 높고 선양낭성암종의 발생 빈도가 높아 그 침범 부위를 정확히 파악하는 것이 치료에 많은 도움을 줄 수 있으며, 고식적 치료의 범위를 확대하여 보다 적극적인 치료가 필요할 것으로 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권4호
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• pp.289-300
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• 2007

Purpose: This study was aimed to histologically evaluate $Silicone^{(R)}$, $Gore-tex^{(R)}$, $AlloDerm^{(R)}$, and $Medpor^{(R)}$ implants for augmentation rhinoplasty after graft in the subperiosteum of mural calvarium respectively. Materials and method: Twenty four male ICR mice were used. $Silicone^{(R)}$, $Gore-tex^{(R)}$, $AlloDerm^{(R)}$, and $Medpor^{(R)}$ were grafted respectively in the subperiosteum of frontal bone. Animals were sacrificed at 1 week, 4 week and 8 week after graft. Histological observation was performed after H&E staining. Results: All groups were healed without any extrusion of implant materials and inflammatory cell infiltration. In Silicone group, $Silicone^{(R)}$ was well enclosed by thin fibrous tissue at 1 week, which became thicker and stable at 4 weeks and 8 weeks. And there was no destruction or resorption of $Silicone^{(R)}$ In Gore-tex group, there was no destruction or resorption of $Gore-tex^{(R)}$. Thin fibrous tissue and cell infiltration from peripheral tissue were observed at 1 week, 4 weeks and 8 weeks. In AlloDerm group, $AlloDerm^{(R)}$ was enclosed by fibrous tissue. Cell infiltration was observed at 1 week, 4 weeks and 8 weeks. In Medpor group, there was no inflammation, destruction or resorption of $Medpor^{(R)}$ and it was contacted directly to the bone without interposition of fibrous tissue. Porous area was filled by bone or soft tissue. Conclusion: These results suggest that $Gore-tex^{(R)}$, $AlloDerm^{(R)}$, and $Medpor^{(R)}$ graft are more stable than $Silicone^{(R)}$ graft and that $Silicone^{(R)}$, $Gore-tex^{(R)}$, $AlloDerm^{(R)}$ are appropriate for graft on nasal tip and $Medpor^{(R)}$ is appropriate for graft on nasal dorsum.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권3호
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• pp.238-246
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• 2007

This study is aimed to elucidate the abnormal growth pattern of human fetal maxilla with cleft lip and palate (CLP). Total 71 fetal maxillae with CLP were obtained from aborted human fetuses. They were examined radiologically for the dimensional changes of maxillary trapezoid (MT) formed by maxillary primary growth centers (MxPGC)(Lee et al., 1992). In palatal radiogram of the CLP maxilla, the MT was traced by the anterior and posterior MxPGCs, and the dimensions of anterior and posterior maxillary widths, maxillary length, and MT length (MTL), and MT area were measured for evaluation of the basic growth pattern of the developing maxilla. The growth of anterior and posterior MxPGCs was severely retarded in the prenatal maxillae with CLPs, showing abnormal shape of MT. Cleft lip subjects without cleft palate also showed arrested growth of MT. Unilateral cleft lipalveolar cleft or cleft palate (UCL-AC/CP) and bilateral cleft lip-alveolar cleft or cleft palate (BCL-AC/CP) showed enhanced abnormal MT pattern. The abnormality of MT was most marked in BCL-AC/CP. It was also observed that the craniofacial malformations other than CLPs produced abnormal MT. In conclusion, the MT growth of prenatal CLP maxilla was severely arrested and resulting in abnormal MT shape on the palatal radiogram. BCL-AC/CP showed more protruded nasal septum than other types of CLPs, while UCL-AC/CP showed severe deviation of the protruded nasal septum towards the non-cleft side. Cleft lip only subjects also showed the abnormal growth of MT. These data suggest that the MT is primarily involved in CLPs, and MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.

• 대한구순구개열학회지
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• 제4권2호
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• pp.51-68
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• 2001

Midfacial hypoplasia in patients with clefts of the lip and palate is considered to be the result of congenital dysmorphogenesis. And cleft lip and palate developes facial deformity, jaw abnormality, speech problem, which is most frequent hereditary deformity in maxillofacial region. So cleft lip and palate is characterized by midface deformity which shaws maxillary anterior nasal septal deviation and deformity. Our study describes congenital correlates of midfacial hypoplasia by examining the displacement of a normal complement of parts, a triangular tissue deficiency low on the lip border on the columellar side, and a linear deficiency and displacement in the line of the bilateral cleft lip. 15 patients with bilateral cleft lip and palate were taken impression before operation, but the patient who had other abnormalities and complications were excluded. Average age is 3.4 months and they were classified into both complete, both incomplete and complete & incomplete group. The obtained results were as follows 1. There were no differences on intercanthal width and canthal width between each of the groups. 2. Both complete group had longer lateral ala length than both incomplete group, but there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 3. Columella length was greater in both incomplete group than in both complete group, but there was no difference between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 4. Both complete group had longer ala width & ala base width than both incomplete group had. But there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 5. There were no differences between each of the groups on upper lip length, but nose/mouth width ratio was greater in both complete group than in both incomplete group. 6. Pronasale(pm), subnasle(sn), la~rale superioris(ls), stomion(sto) points were located around the central vertical line of face but deviated to incomplete side in com. & incom. group. 7. Nasal tip protrusion was greater in both incomplete group and com. & incom. group than both complete group, but there was no difference between both incomplete group and com. & incom. group.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.189-195
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• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal & gastric aspiration and hypovolemic shock. Therefore, the rapid & correct bleeding control is very important for life-saving in the medical emergency room. In spite of the bleeding control methods of the wound suture & direct pressure, the postoperative bleeding can be occurred, because of the presence of various bleeding disorders & postoperative delayed wound infections. The proper care of bleeding disorders & wound infections are very important for the control of the delayed postoperative rebleeding. In spite of these methods, active oral bleeding can be presented by the other causes of head injury. A rare but particularly dangerous sort of bleeding that may have an especial importance to the patient with severe basal skull fracture that damage large vessels and even the cavernous sinus. The occurrence of profuse nasal or oropharyngeal bleeding may arise from damage to the anterior and posterior ethmoidal vessels, but when mixed with brain tissue it is evidence of mortal damage. In this condition, rapid entire oropharyngeal packing is essential for the control of active oral bleeding. This is a case report of rapid rational bleeding control method by much amount of wet gauze packings, in a 44-years-old male patient with active oropharyngeal bleeding by basal skull fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.1-11
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• 1989

This is a retrospective study on maxillofacial fractures. This study was based on a series of 442 patients with maxillofacial fractures treated at Dept, of oral and Maxillofacial Surgery, College of Dentistry, Chon Buk National University from Jan, 1984 to Sep. 1988. The results obtained were as follows: 1. The ratio of Male/Female was 4.8 : 1, and 3rd decade (43.9%) was the highest age group in incidence. 2. Monthly incidence was the highest in Oct,(10.6%). 3. The most frequent maxillofacial fracture site was mandible (70.0%), and zygoma & zygomatic arch (13.6%), maxilla(11.7%) and nasal bone (4.7%) were next in order of frequency. 4. Traffic accidents (47.5%), fight(24.8%) were the most common causes of maxillofacial fractures. 5. The most frequent chief complaint was painful swelling(40.7%). 6. In mandibular fractures, the most frequent fracture site was symphyseal area(28.9%) and simple fracture was the most frequent in type of fracture (71.2%). 7. In maxillary fractures, fracture with other facial bones (64.5%) was more frequent than fracture of maxilla only. The most common type of fracture was unilateral fractures(37.1%). 8. In fracture of zygoma complex, zygoma fracture was the most frequent fracture type(40.3%), zygoma and zygomatic arch fx, (30.6%), zygomatic arch fx, (29.1%) were next in order 9. Open reduction was major method of treatment in maxillofacial fractures : Mandible (77.5%), Maxilla (61.3%), Zygoma complex(43.1%). 10. Maxillofacial fractures were most frequently combined with head injury(39.3%), and lower extremities(17.0%), upper extremities(13.6%) were next in order.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.309-312
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• 2010

Purpose: An osteoma is one of the common benign tumors that penetrate the nasal portion, paranasal and frontal sinus. This tumor is mostly found by radiation test accidentally, however in rare cases; it can be found to be touched or with its symptoms as the tumor grows. We report this case since we found and healed the benign tumor which was affecting orbit and the both sides of fronal sinus. Methods: A 19 year old female patient visited to our hospital due to the mass on her forehead. The symptoms began 3 years ago but no special symptom was found except for touchable mass. She was diagnosed as the osteoma of superior orbital parts and both sides of frontal sinus using X-ray and CT scanning. The size of osteoma was $5{\times}2.5{\times}3.5\;cm$ and indicated the patterns penetrated to the right side of orbital region. The osteoma excision was conducted with coronal incision and wide area of defect part in frontal sinus and superior orbital part were reconstructed by cranial bone graft and resorbable fixation plates. Results: The patient recovered without any postoperative infections or complications and symptoms. Dysaesthesia was found on her frontal area but improved in 1 month after the surgery. Conclusion: The occurrences of osteoma in frontal sinus are rare and can be treated with conservative methods if there are no infections and symptoms. We report this case since we found the benign tumor, which was affecting orbit and the both sides of fronal sinus and healed it with coronal resectomy without any complications.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.65-68
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• 2010

Purpose: Dermoid cysts are benign neoplasms that are derived from both ectoderm and mesoderm. Approximately 7 percent of all dermoid cysts occur in the head and neck, as most common sites are the lateral ends of the eyebrows, the midline in the nasal root and neck. Rarely they can be found in the frontal sinus, temporal bone, maxilla and the floor of the mouth. Dermoid cysts in the temporal fossa are extremely rare. We experienced a characteristic dermoid cyst that occupied the temporal fossa. Methods: A 16-year-old man had a progressive enlarging mass on the left eyebrow. Computerized tomographic scan showed a bulging mass in the temporal fossa, and it had the density similar to that of fat. The size of the mass was $3{\times}3{\times}2cm$, and it was composed of high density of fat with clear margin. There was no bony invasion, but the mass was fixed on bone. Results: We performed the surgery through coronal incision under general anesthesia. Because the mass was closely connected with temporal fat pads, we removed this mass with some portion of temporal fat pads, avoiding damage to the facial nerve. The postoperative course was ordinary without complication. Conclusion: The reports about dermoid cyst on the temporal fossa is uncommon. However, if there is a mass in the temporal fossa which has the density similar to that of fat in CT scan, we should consider the possibility of dermoid cyst. We suggest that excision through coronal incision with bewaring temporal fat pad can induce good result.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.387-391
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• 2013

Background The most common cutaneous malignant masses are basal cell carcinoma (BCC) and squamous cell carcinoma. The predominant site of a malignant mass is the face, which has many opportunities to be exposed to ultraviolet radiation. However the predilection sites of malignant masses have been equivocal due to the use of general regions, rather than anatomical landmarks, in surveys. A facial esthetic unit is an anatomical site classified as an area of similar facial contour characteristics that can be distinguished from other areas. The purpose of this study is to determine widely accepted anatomical landmarks using the esthetic unit. Methods We retrospectively analyzed 118 cases of malignant masses in our clinic from January 2005 to October 2012. We evaluated the patients' age, gender, and predilection site of the malignant mass by esthetic unit through pathology, medical records and patient photographs. We mapped the occurrence site of the malignant mass on schematic drawings of the esthetic units. Results Most of the malignant masses were BCC. The ratio of males to females was 1:1.41. The frequent predilection site of a malignant mass was on the nasal unit (33.1%), followed by the buccal unit (11.0%). Primary closure was the most common method of repairing a surgical defect (38.9%), followed by a local flap (35.5%). Conclusions This review described the relationship between clinical characteristics and esthetic units by proposing objective predilection sites for malignant masses, which can be used commonly as a framework in the study of malignant masses by unifying equivocal occurrence sites.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.8-13
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• 2011

Purpose: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. Method: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. Result: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. Conclusion: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.