• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.33-36
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• 2011

Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.

• Archives of Craniofacial Surgery
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• v.23 no.5
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• pp.220-227
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• 2022

Background: Frontal sinus fractures are relatively rare. Their surgical management significantly differs depending on whether the posterior wall is invaded and the clinical features vary. A bicoronal incision or endoscopic approach can be used. However, the minimally invasive approach has been attracting attention, leading us to introduce a simple and effective surgical method using multiple-threaded Kirschner wires. Methods: All patients had isolated anterior wall fractures without nasofrontal duct impairment. The depth from the skin to the posterior wall was measured using computed tomography to prevent injury. The edge of the bone segment on the skin was marked, a threaded Kirschner wire was inserted into the center of the bone segment, and multiple Kirschner wires were gently reduced simultaneously. Results: Surgery was performed on 11 patients. Among them, seven patients required additional support for appropriate fracture reduction. Therefore, a periosteal elevator was used as an adjunct through a small sub-brow incision because the reduction was incomplete with the Kirschner wire alone. The reduction results were confirmed using facial bone computed tomography 1 to 3 days postoperatively. The follow-up period was 3 to 12 months. Conclusion: The patients had no complications and were satisfied with the surgical results. Here we demonstrated an easy and successful procedure to reduce a pure anterior wall frontal sinus fracture via non-invasive threaded Kirschner wire reduction.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.61-66
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• 2009

Purpose: The aim of this study is to establish anatomical dimension of the nose and nostril shape in Korean twenties. Methods: Authors measured anthropometry of nose in Korean youths 1,000 individuals (male 363, female 637) and analyzed stastically them. Results: The mean measurements are as follows. 1. The shape of nostrils was classified into 7 types by the angle between both long axis of nostril (male / female). Type I ($<40^{\circ}$)1.7% / 1.72%, Type II ($41-70^{\circ}$) 26.17% / 29.35%, Type III ($71-100^{\circ}$) 39.94% / 38.77%, Type IV (unclassified) 3.85% / 5.80%, Type V ($101-130^{\circ}$) 20.93% / 17.89%, Type VI ($131-180^{\circ}$) 7.43% / 5.96%, Type VII ($>180^{\circ}$) 0% / 0.47% 2. Lengths (male/female) Width of nasal root: $25.29{\pm}2.25mm/24.72{\pm}2.40mm$ Width of nose: $37.63{\pm}2.46mm/34.77{\pm}2.11mm$ Width of columella: $7.18{\pm}0.92mm/6.92{\pm}0.86mm$ Width of alar: $4.99{\pm}1.00mm/4.74{\pm}0.91mm$ Width of nostril floor: $10.98{\pm}1.40mm/10.13{\pm}1.73mm$ Protrusion of nasal tip: $17.12{\pm}1.95mm/16.88{\pm}1.84mm$ Length of alar: $27.10{\pm}2.21mm/24.66{\pm}2.18mm$ Length of nasal root: $17.37{\pm}2.51mm/16.08{\pm}2.90mm$ Depth of nasal root: $7.83{\pm}1.63mm/6.82{\pm}1.36mm$ Length of columella: $8.13{\pm}1.40mm/7.30{\pm}1.46mm$ Height of nose: $60.50{\pm}8.90mm/59.14{\pm}9.22mm$ Height of nasal bridge: $52.68{\pm}7.49mm/50.57{\pm}7.71mm$ 3. Angles Nasofacial angle: $30.19{\pm}3.43^{\circ}/29.13{\pm}6.31^{\circ}$ Nasofrontal angle: $134.88{\pm}7.25^{\circ}/139.94{\pm}6.33^{\circ}$ Nasolabial angle: $95.08{\pm}8.95^{\circ}/95.80{\pm}8.93^{\circ}$ 4. Nasal index: $72.60{\pm}9.57%/68.21{\pm}7.03%$ Nasal tip protrusion-nasal height index: $45.64{\pm}5.21%/47.09{\pm}5.21%$ Nasal tip protrusion-nasal width index: $32.61{\pm}6.83%/31.63{\pm}6.71%$ Conclusion: These data could be useful reference for anthropometry of nose in Korean twenties.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.594-601
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• 2011

Purpose: The frontal sinuses are a pair of triangularly shaped, air-filled chambers lined by mucoperiosteum and located between the inner and outer tables of the frontal bone. Until recently, our understanding of gender variations in craniofacial anatomy has been chiefly built upon anthropometric studies, which typically employ facial surface measurements or plain film radiography. The aim of this study i to determine the sizes of the frontal sinus in both sexes in Koreans. Methods: 95 Korean subjects who underwent maxillofacial 3-Dimensional computed tomography (CT) between January 2009 and December 2009 were enrolled. Frontal sinus dimensions and forehead measurements were taken at midline and at 10, 20, and 30 mm to the left and right of midline using sagittal, coronal, and axial images. The data was analyzed for significant differences between measurements made at the selected points in the frontal sinus, for left to right variations, for gender variations, and for racial differences. Results: The mean thickness of the anterior table ranged from 2.31 to 3.23 mm. Mean anteroposterior depth of the frontal sinus ranged from 7.38 to 9.45 mm and did not vary significantly at any distance from midline. Frontal sinus height was greatest at midline (mean=29.24 mm) and progressively lessened at lateral distances. Mean total width at the level of the supraorbital ridge was 53.66 mm. For all measurements, no significant left to right variation was noted. Comparing the sexes, males were found to have greater dimensions in most frontal sinus measurements, though these differences were only found to be significant at or close to midline. The male forehead was marked by more acute nasofrontal angle ($133.3^{\circ}$ versus $141.6^{\circ}$) and a steeper posterior forehead inclination ($14.9^{\circ}$ versus $7.7^{\circ}$). Conclusion: Using CT imaging, forehead and frontal sinus dimensions have been described. Generally, males had larger overall frontal sinus dimensions. And Korean had similar sized frontal sinus to Caucasian in height and width. But in AP distance Korean had lesser measurement. The result of this study may be helpful in the comprehension of normal size of frontal sinus in Korean.

• Archives of Craniofacial Surgery
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• v.23 no.4
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• pp.152-162
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• 2022

Background: The efficacy and safety of equine cartilage as a competent xenograft material for rhinoplasty were evaluated and compared to the outcomes of rhinoplasty using silicone implants. Methods: We performed a multicenter, double-blind, non-inferiority, and randomized confirmatory study. Fifty-six patients were randomized 1:1 to the study group (using MegaCartilage-E) and control group (using silicone implants). The Rhinoplasty Outcome Evaluation (ROE) score, photo documentation, Global Aesthetic Improvement Scale (GAIS), and adverse event data were obtained until 12 months after surgery. The primary efficacy, which is the change in ROE score 6 months after surgery, was assessed in the modified intention-to-treat set. The secondary efficacy was evaluated in the per-protocol set by assessing the change in ROE score 6 and 12 months after surgery and nasofrontal angle, the height of the nasion, and GAIS 1, 6, and 12 months after surgery. Results: The change in ROE score of the study group was non-inferior to that of the control group; it increased by 24.26±17.24 in the study group and 18.27±17.60 in the control group (p= 0.213). In both groups, all secondary outcome measures increased, but there was no statistical difference. In the safety set, treatment-emergent adverse events occurred in 10 patients (35.71%) in the study group and six patients (21.43%) in the control group (p= 0.237). There were 13 adverse device events in the study group and six adverse device events in the control group (p= 0.515). Conclusion: Processed equine cartilage can be used effectively and safely as xenograft material for rhinoplasty.

• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.14-29
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• 2006

Developments in computer technology have made possible the 3-dimensional (3-D) evaluation of hard and soft tissues in orthodontic diagnosis, treatment planning and post-treatment results. In this study, Korean adults with normal occlusion (male 30, female 30) were scanned by a 3-D laser scanner, then 3-D facial images formed by the Rapidform 2004 program (Inus Technology Inc., Seoul, Korea.). Reference planes in the facial soft tissue 3-D images were established and a 3-D coordinate system (X axis-left/right, Y axis-superior/inferior, Z axis-anterior/posterior) was established by using the soft tissue nasion as the zero point. Twenty-nine measurement points were established on the 3-D image and 43 linear measurements, 8 angular measurements, 29 linear distance ratios were obtained. The results are as follows; there were significant differences between males and females in the nasofrontal angle $(male:\;142^{\circ},\;female:\;147^{\circ})$ and transverse nasal prominence $(male:\;112^{\circ},\;female:\;116^{\circ})$ (p<0.05). The transverse upper lip prominence was $107^{\circ}$ in males, $106^{\circ}$ in females and the transverse mandibular prominence was $76^{\circ}$ in both males and females. Li-Me' was 0.4 times the length of Go-Me'(mandibular body length) and the mouth height was also 0.4 times the width of the mouth width. The linear distance ratio from the coronal reference plane of FT, Zy, Pn, ULPm, Li, Me' was -1/-1/1/0.5/0.5/-0.6 respectively. The 3-D facial model of Korean adults with normal occlusion were be constructed using coordinate values and linear measurement values. These data may be used as a reference in 3-D diagnosis and treatment planning for malocclusion and dentofacial deformity patients and applied for 3-D analysis of facial soft tissue changes before and after orthodontic treatment and orthognathic surgery.