• Journal of Dental Anesthesia and Pain Medicine
• /
• 제15권2호
• /
• pp.101-103
• /
• 2015

In oral and maxillofacial surgery, many complications associated with nasotracheal tube can be caused. In this case, we reported ballooning tube damage of nasotracheal tube during orthognathic double-jaw surgery and replacement of tube through cut down of tube and tube exchange using airway exchange catheter. The patient scheduled for high Le Fort I osteotomy and bilateral sagittal split osteotomy was intubated nasotracheally with nasal endotracheal tube. During maxilla osteotomy, air bubble was detected in the oral blood. In spite of our repeated ballooning, the results were the same so we changed damaged tube using airway exchange catheter aseptically. Tiny and superficial cutting site was detected in the middle of pilot tube. As we know in our case, tiny injury impeded a normal airway management and prevention is important.

• Archives of Plastic Surgery
• /
• 제34권1호
• /
• pp.81-87
• /
• 2007

Purpose: Correction of saddle nose remains problematic both in the technique of reconstruction and in the choice of implant material for nasal augmentation. A large variety of graft materials have been used for the reconstruction of the saddle nose deformity. The purpose of this study is to determinate an algorithm for deciding alternative graft materials used in correction of saddle nose deformity. Methods: Six patients with saddle nose who were corrected using by auricular cartilage and costal cartilage at Chosun university hospital were analyzed. Results: After a mean interval of 12 months, all patients were satisfied with the esthetic and functional result. Conclusion: Auricular cartilage is an excellent graft material for esthetic and functional reconstruction of mild to moderate saddle nose deformity.

• Archives of Plastic Surgery
• /
• 제45권3호
• /
• pp.253-258
• /
• 2018

Background The nasolabial flap is ideal for reconstruction of the nasal alar subunit due to its proximity, color and contour match, and well-placed donor scar. When raised as a random-pattern flap, there is a risk of vascular compromise to the tip with increased flap length and aggressive flap thinning. Surgical delay can greatly improve the chances of tip survival, allowing the harvest of longer flaps with greater reach. Methods We describe our technique of lengthening the nasolabial flap through multiple delay procedures. A bipedicled flap was first raised and then transferred as a unipedicled flap with a 6:1 length-to-width ratio. During the delay process, the flap tip was thinned to the subdermal layer. Results In our case series of seven patients, defects as far as the medial canthal area and contralateral ala were reconstructed successfully with no incidence of tip necrosis or flap loss. The resultant flaps were thin enough to be folded over for the reconstruction of alar rim defects. Conclusions We highlight the success of our surgical technique in creating thin and robust nasolabial flaps for the reconstruction of full-thickness defects around the nose.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권5호
• /
• pp.270-277
• /
• 2023

Objectives: Concha cartilage is recommended for correction of cleft nasal deformities. Morbidities at the donor site have been reported in esthetic rhinoplasty cases. Reports on cleft patients are limited, so we investigated the complications of concha cartilage harvesting using the retroauricular approach in cleft rhinoplasty and their management. Materials and Methods: This was a retrospective review of the charts of 63 patients with cleft deformities who underwent septorhinoplasty with concha cartilage. All cases were harvested using a retroauricular approach. Data on patient demographics, surgery type, amount of cartilage harvested, and complications were gathered. Results: Sixty-three patients were enrolled (21 males and 42 females). The mean age of patients was 20.2±5.9 years. Complications were observed in 6 cases (9.5%) and included delayed wound healing (4.8%), prolonged postoperative pain (1.6%), postoperative paresthesia (1.6%), and prominauris (1.6%). Conclusion: The rate of complications associated with concha cartilage harvesting using a retroauricular approach is low. The use of meticulous surgical techniques, especially hemostasis control and adequate wound dressing, is key to minimizing postoperative complications.

• 대한두경부종양학회지
• /
• 제39권2호
• /
• pp.35-39
• /
• 2023

Solitary fibrous tumor (SFT), which was initially believed to be a subtype of mesothelioma, has been reported to occur outside the pleura. In the head and neck region, it primarily manifests in the oral or nasal cavity, with rare occurrences in the facial region. A 40-year-old woman visited our hospital with a mass on her chin. Prior to surgery, involuntary movement was observed in the ipsilateral corner of the mouth upon palpation of the mass. Special care was taken during the surgical procedure to avoid damaging the facial nerve. The mass was excised, and histological examination and immunohistochemical analysis confirmed the diagnosis of an SFT. Here, we present the first reported case of an SFT diagnosed in a jaw mass in Korea. The objective of this study was to highlight the importance of the diagnostic accuracy of SFTs in lower jaw masses.

• 대한두개안면성형외과학회지
• /
• 제11권1호
• /
• pp.53-57
• /
• 2010

연부조직만으로 경구개를 재건하는데 있어서는 환자군을 적절히 선택하는 것이 중요하며 골재건이 필요하지 않은 Okay 분류 Ia와 Ib가 주요한 적응증이 된다. 하악이나 구강저부 결손을 재건하는 것과는 다르게 경구개 결손은 구강과 비강 점막층을 동시에 수복할 수 있는 피판이 이상적이다. 이중 저자들은 전완유리피판에 전상판화 방법을 좀 더 안정적으로 시행, 경구개 전층을 성공적으로 재건하였으며, 특히 저작과 연하 등 기능적 측면뿐 아니라 경구개 및 비강의 점막을 함께 복원할 수 있는 해부학적인 장점이 있는 피판임을 확인하여 문헌고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
• /
• 제37권1호
• /
• pp.37-45
• /
• 2010

Purpose: In Korean rhinoplasty, alloplasts such as silicone rubber have been used for dorsal and tip augmentations. However, alloplasts have produced complications such as deviation, exposure, and infection. Although autogenous tissue is an ideal material, the amount of the cartilage in Korean is not sufficient. Therefore, the authors developed a method to harvest the maximum amount of the septal and conchal cartilage. The authors first performed a complete septal extension graft for short and retruded columella and then performed nasal augmentation using various autogenous tissues. Methods: These surgical techniques were performed on 11 patients. Their average age was 27 years. An open approach with a V-shaped columellar labial incision was performed. At first, the complete septal extension graft was fixed on the entire caudal margin of the septum, and the alar cartilage was suspended to the septal extension graft to make the tip projected and the columella advanced caudally. A temporal fascial ball was used for radix augmentation. For dorsal augmentation, a batten-shaped septal cartilage graft wrapped with or without the temporal fascia or a diced cartilage graft wrapped with the temporal fascia was performed. For nasal tip augmentation, a shield graft and a cap graft or a folded conchal cartilage graft was performed.Results: The mean follow-up period was 11.2 months. The overall results were natural and satisfactory. Two patients underwent slight absorption and caudal displacement. With the exception of these cases, no complications were observed. Conclusion: Korean rhinoplastic surgeons are accustomed to using the alloplasts despite of serious complications. When rhinoplasty using autogenous tissue was performed, some complications occurred such as the displacement of the diced cartilage graft wrapped with the fascia, but many of the complications of alloplastic rhinoplasty were avoided. Therefore, we propose that by this time Korean rhinoplastic surgeons need to change their preference from alloplastic rhinoplasty to autogenous rhinoplasty.

• 대한핵의학회지
• /
• 제33권6호
• /
• pp.484-492
• /
• 1999

목적: 안구제거술 후 삽입한 hydroxyapatite 안구보충물 내로의 혈관 신생 여부의 평가에 $^{99m}Tc$-MDP 골신티그라피의 임상적 유용성에 대해 알아보고자 하였다. 대상 및 방법: 안구적출술이나 안구내용물 제거술의 방법을 이용하여 안구 제거 후 hydroxyapatite 보충물을 삽입한 24명의 환자를 대상으로 하였다(여자 7명, 남자 17명, 연령 분포 $12{\sim}78$세, 평균 연령 36세, 안구적출술 12명, 안구내용물 제거술12명) Hydroxyapatite 보충물 삽입 후 $3{\sim}33$주($3{\sim}10$주 사이에 4명, $11{\sim}20$주 사이에 10명, $21{\sim}33$주 사이에 10명) 사이에 $^{99m}Tc$-MDP 골신티그라피를 시행하였다. 방사능 섭취 정도는 육안적으로 안구보충물과 비교(nasal bridge) 및 반대측 안구와 비교하여 안구 보충물이 비교보다 강할 경우 등급 4, 같을 경우 등급 3, 비교와 반대측 안구 사이일 경우 등급 2, 그 이하일 경우 등급 1로 하였다. 또한 골신티그라피 정면 영상에서 관심영역을 안구 보충물과 반대측 안구에 같은 크기로 설정하여 방사능 계수 비(H/N ratio)를 구하였다. 검사 시기와 방사능 섭취의 등급 분류, 방사능 계수 비와 안구 고정술 후 성공여부와의 관계를 분석하였다. 결과: 등급 2 이상, 방사능 계수 비가 1.56 이상인 환자 중 추적 관찰할 수 없었던 2명을 제외한 19명 모두에서 천공 시 출혈을 확인하였고, 의안과 연결하여 안구 고정술을 시행하였다. 방사능 섭취 정도를 육안적 분류 방법과 정량적 측정 방법에 의한 결과는 두 방법 모두 통계적으로 유의하였고 검사 시기와 방사능 계수 비 사이에 각각 유의한 상관관계가 있었으나 수술 방법에 따른 차이는 보이지 않았다. 결론: $^{99m}Tc$-MDP 골신티그라피의 방사능 섭취 등급 분류와 방사능 계수 비는 안구고정술의 시기 결정에 도움을 주었다. 안구적출술과 안구내용물제거술의 수술 방법 차이에 관계없이 안구고정술을 위한 첫 검사 시기는 안구보충물삽입 후 $11{\sim}20$주 사이가 좋을 것으로 생각되며, 등급 2, 방사능 계수 비 1.56 이상인 경우에는 안구 고정술을 시행하여 좋은 결과를 기대할 수 있을 것으로 생각된다.

• 한국안광학회지
• /
• 제20권2호
• /
• pp.157-165
• /
• 2015

목적: 근시성 굴절교정수술안에서 수평경선에 따른 중심부 및 주변부의 굴절력 변화를 정시안과 비교 평가하고자 하였다. 방법: 수술안 120 안(평균: $23.56{\pm}2.54$세, 범위: 20~29세)과 정시안 40 안(평균: $22.50{\pm}1.74$세, 범위: 20~25세)을 대상으로 개방형 자동굴절력계를 사용하여 중심시야를 기준으로 코 쪽과 귀 쪽의 수평방향 $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$의 굴절력을 각각 측정하였다. 수술안은 수술 전 등가구면 굴절이상에 따라 -6.00 D 미만은 수술안 그룹 1, -6.00 D 이상은 수술안 그룹 2로 분류하여 비교 분석하였다. 결과: 수술안 그룹 1의 수술 전 등가구면 굴절이상은 $-4.56{\pm}0.92D$(범위: -2.50 ~ -5.58 D)였고, 수술안 그룹 2는 $-7.09{\pm}0.96D$(범위: -6.00 ~ -9.00 D)로 나타났다. 정시안의 등가구면 M 평균값의 범위는 $-0.20{\pm}0.22D$(중심)에서 $-0.64{\pm}0.83D$(귀 방향 $25^{\circ}$)와 $-0.20{\pm}0.67D$(코 방향 $25^{\circ}$); 수술안 그룹 1의 M 평균값의 범위는 $-0.16{\pm}0.29D$(중심)에서 $-5.29{\pm}1.82D$(귀 방향 $25^{\circ}$)와 $-4.48{\pm}1.88D$(코 방향 $25^{\circ}$); 수술안 그룹 2의 M 범위는 $-0.20{\pm}0.32D$(중심)에서 $-7.98{\pm}2.08D$(귀 방향 $25^{\circ}$)와 $-7.90{\pm}2.26D$(코 방향 $25^{\circ}$)로 나타났고, 세 그룹 사이의 M 굴절력은 중심(p=0.600)과 귀 방향 $5^{\circ}$(p=0.647)에서 통계적으로 유의한 차이가 없었으나, 주변부 방향으로 갈수록 M 굴절력은 큰 차이를 보였다(p=0.000). 결론: 정시안은 망막의 중심부와 주변부에서 상대적으로 일정한 굴절이상을 보였고, 수평경선에서 주변부 근시흐림의 형태가 나타난 반면, 근시 굴절교정수술안에서는 중심부와 주변부 굴절이상이 정시안과는 다르고 중심부와 주변부의 굴절력 차이가 큰 것으로 나타났다.

• Archives of Plastic Surgery
• /
• 제35권5호
• /
• pp.603-606
• /
• 2008

Purpose: Sclerosing lipogranuloma is an unusal benign condition of the genitalia following injections into the genitalia with exogenous paraffin or mineral oil. A few cases have been reported in which sclerosing lipogranuloma of the lid was caused by paraffin-containing ointment plugs after the endonasal sinus surgery. A 52-year-old man presented with a painless hard mass of the right lower lid after the MRI scan at the Ophthalmology department. Nine months before, he had undergone right maxilla sinus surgery through the oral incision. And he was also gotten nasal packing with Vaseline gauze after the surgery. Methods: The round shaped two masses in the Right lower lid were approximately $1.0{\times}1.0cm$ in size. There were no size or color change, bleeding and ulceration. The MRI scan showed a suspicious part of an abscess of benign tumor. Also, He was planned cyst remove through the endonasal surgery due to the mucoid cyst in the right maxillary sinus in the ENT dept. Under the general anesthesia, the patient underwent surgical excision through a subcilliary incision with endonasal sinus surgery. The masses were in deep subcutaneous orbital fat with no connection with right maxillary sinus. Results: The masses were excised $2.1{\times}0.7cm$ in size including surrounding necrotic fatty tissue. Histopathological diagnosis was 'sclerosing lipogranuloma' due to paraffin or similar substance with fat necrosis and cystic change. This tissue was positive in PAS, S-100, CD68 reaction. Conclusion: It is extremely rare to find a granulomatous orbital lesion arising to a endonasal surgery. In conclusion, if sclerosing lipogranuloma is suspected excisional biopsy should be undertaken. Surgery should be reserved for recurrent or refractory cases when steroids have failed as first-line treatment at the 6-month follow-up examination, There was no complication or recurrence.