• 제목/요약/키워드: Nasal surgery

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기도 폐색을 유발한 성문부 거대 소엽성 모세관 혈관종 1예 (A Case of Giant Lobular Capillary Hemangioma in Glottis Causing Airway Obstruction)

  • 최전하;임성환;이미지;김승우
    • 대한두경부종양학회지
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    • 제32권1호
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    • pp.49-52
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    • 2016
  • The lobular capillary hemangioma (LCH) was previously known to pyogenic granuloma and is benign vascular lesion which grows rapidly on skin and mucosa. It arises from whole body, but oral and nasal cavities are most predilection sites in the head and neck area. The laryngeal LCH looks like a granulomatous lesion of posterior glottis and its common etiology are tracheal intubation and laryngopharyngeal reflux disease etc. The LCH in larynx can cause blood tinged sputum and lump sense. The lesions refractory to medical therapy or causing dyspnea may require surgical excision. A 74-year-old man who presented gradually aggravated dyspnea, lump sensation and hoarseness of one month came to our hospital. The stroboscopic examination revealed large well-margined glottic mass. It was excised with $CO_2$ laser and finally diagnosed as LCH. We present a rare unique case of glottic LCH with a review of literatures.

상악동에 발생한 대세포 신경내분비 암종 1례 (A Case of Large Cell Neuroendocrine Carcinoma of the Maxillary Sinus)

  • 이윤재;정진혁;오영하;지용배
    • 대한두경부종양학회지
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    • 제35권2호
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    • pp.45-49
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    • 2019
  • Large cell neuroendocrine carcinoma is a rare epithelial neuroendocrine malignancy and is preferentially located in gastrointestinal tract and pancreas. Cases of large cell neuroendocrine carcinoma have been reported in many other locations, including the thymus, gallbladder, prostate, larynx, salivary glands, nasopharynx, tonsil and mastoid. However, primary sinonasal large cell neuroendocrine carcinoma never have been reported in Korea. We experienced a case of primary large cell neuroendocrine carcinoma arising from left maxillary sinus recently. A 82-year-old male patient presented with nasal obstruction and epistaxis. The biopsy revealed large cell neuroendocrine carcinoma with poor differentiation. After a general evaluation, the patient was staged as cT3N0M0. The patient was treated by combined radiotherapy and chemotherapy. We report this rare case with literature review.

Primary sinonasal mucosal melanoma simulated as cystic lesions: a case report

  • Shin, Sung-Ho;Seok, Hyun;Kim, Seong-Gon;Hong, Seong-Doo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권1호
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    • pp.29-33
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    • 2018
  • Sinonasal mucosal melanoma (SNMM) in the maxillary sinus is a rare disease condition. Compared to oral mucosal melanoma, SNMM has a bulky, exophytic, and polypoid appearance, is weakly pigmented, and associated with unspecific symptoms. Due to these features, SNMM in the maxillary sinus has been misdiagnosed as nasal polyps and chronic sinusitis. In this case report, we described SNMM occurring in the right maxillary sinus simulated as a cystic or benign lesion. Cortical bone thinning and expansion were observed around the mass. The excised soft mass was encapsulated and weakly pigmented. The mass was clearly excised and covered with a pedicled buccal fat pad graft. Diagnosis using immunohistochemistry with S-100 and homatropine methylbromide-45 (HMB-45) is critical for proper treatment.

구강악안면수술을 위한 악하 기관 삽관 -증례보고- (Submental Intubation for Maxillofacial Surgery -A Case Report -)

  • 김성민;권광준
    • 대한치과마취과학회지
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    • 제4권2호
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    • pp.96-99
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    • 2004
  • 구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

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Correction of Unilateral Nostril Hypoplasia with Z-Plasty in a Child

  • Lee, Dong-Han;Oh, Kap Sung
    • 대한두개안면성형외과학회지
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    • 제15권2호
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    • pp.94-97
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    • 2014
  • Unilateral nostril hypoplasia is an extremely rare congenital malformation of unknown etiology, and only a few cases have been reported in literature. Owing to variability and complexity of the deformity, surgical correction of unilateral nostril hypoplasia represents one of the most significant reconstructive challenges to reconstructive plastic surgeons. We report a 7-year-old Vietnamese child with nasal and periocular deformity resembling a craniofacial cleft. Grossly, the right nostril was patent but with alar rim deformity, and the left nostril was not readily identifiable. A dystopic medial canthus was present on the left side as well. Closer inspection and palpation of the left side of nose revealed a patency through the soft tissue and underlying bony structure, Thus, a new alar rim were reconstructed with an irregularly shaped Z-plasty to create patency on the involved side. Simulatneously, a second Z-plasty was performed to address the medial canthal deformity. Postoperative appearance and function was sastisfactory at one-year follow up visit. In the treatment of patients with nostril hypoplasia, a careful preoperative physical examination is a prerequisite, and Z-plasty can be a valuable option for surgical correction.

편측성 구순구개열 환자에 있어 구순성형술과 동반한 서골피판법 (Simultaneous Repair of Unilateral Cleft Lip and Hard Palate with Vomer Flap)

  • 한윤식;이호;서병무
    • 대한구순구개열학회지
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    • 제13권2호
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    • pp.77-84
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    • 2010
  • Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.

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Concurrent presentation of porocarcinoma and basal cell carcinoma arising on a capillary malformation: a case report

  • Sunkyu Park;Jong-Ho Kim
    • 대한두개안면성형외과학회지
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    • 제24권5호
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    • pp.236-239
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    • 2023
  • Porocarcinoma (PC) and basal cell carcinoma (BCC) are distinct skin cancers. Few studies have documented the occurrence of two concurrent types of skin cancers, and to the best of our knowledge, this represents the inaugural report of such a coexisting lesion arising from a capillary malformation. Herein, we report a case of concurrent PC and BCC presenting with capillary malformation. A 93-year-old woman visited our hospital with a protruding mass in her right nasal ala that appeared as a capillary malformation. A biopsy was performed on the skin lesion, and BCC was diagnosed. A wide excision was performed. Permanent biopsy revealed that the skin lesion was a PC with basal cells and squamous differentiation. The safety margin of the deep tissue margin was < 0.1 cm; however, considering the advanced age of the patient, further excision was deemed to not possess any benefits. This case illustrates the importance of recognizing the possibility of multiple skin cancers, even in patients with benign lesions such as capillary malformations. The rarity of this presentation highlights the importance of thorough investigation and histopathological examination of skin lesions in guiding appropriate surgical excision.

소타액선 종양에 관한 임상적 고찰 (A Clinical Analysis of Minor Salivary Gland Tumors)

  • 이종수;최종욱;이승호;정광윤;이남준
    • 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.

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쥐의 두개골에서 융비술에 사용되는 수종의 이식재에 대한 조직학적 연구 (A HISTOLOGICAL STUDY ON SEVERAL IMPLANTS FOR AUGMENTATION RHINOPLASTY IN MOUSE CALVARIUM)

  • 김현섭;국민석;박홍주;오희균;김형석
    • 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.

구순구개열 태아의 비정상적인 상악골 성장형태에 대한 연구 (ABNORMAL GROWTH PATTERN OF HUMAN FETAL MAXILLA WITH CLEFT LIP AND PALATE)

  • 김성민;김정환;김지혁;박영욱;이종호;이석근
    • 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.