• 제목/요약/키워드: Oral and maxillofacial reconstruction

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Incidence and management of mandibular fractures in a low-resource health facility in Ghana

  • Frimpong, Paul;Nguyen, Truc Thi Hoang;Sodnom-Ish, Buyanbileg;Nimatu, Edinam Salia;Dampare, Nana Yaa Asantewaa;Rockson, Roberta;Awuah, Samuel Baffour;Amponsah, Emmanuel Kofi;Newton, Cardinal;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권6호
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    • pp.432-437
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    • 2021
  • Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

Scalp injury management by a maxillofacial surgeon in a low-resource hospital

  • Frimpong, Paul;Nguyen, Truc Thi Hoang;Nimatu, Edinam Salia;Amponsah, Emmanuel Kofi;Kim, Soung Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.39.1-39.5
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    • 2020
  • Background: Head or scalp injury is a life-threatening and typically accidental human injury. Most medical departments require immediate medical treatment and proper treatment with specialized medical personnel and facilities. However, in low-resource environments, such as the rural region of West Africa, the authors have treated emergency trauma patients and provided immediate treatment despite lack of resources. Case presentation: We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon. Conclusions: Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.

터널화 안면동맥 협부 근점막 도피판을 이용한 구개상악 결손의 재건: 증례보고 (Tunnelized-facial Artery Myomucosal Island Flap (t-FAMMIF) for Palatomaxillary Reconstruction: A Report of Two Cases)

  • 류다정;장효원;박혜정;김형준;차인호;남웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제35권2호
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    • pp.100-106
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    • 2013
  • There are many challenges for reconstruction after intraoral tumor resection. Especially, palatomaxillary reconstruction has two primary goals: closure of the oronasal communication and re-creation of proper myomucosal function. Prosthodontic treatment using obturator and several surgical procedures are selected depending on the size and site of the defect, the difficulty of operative procedure, operation time and donor site problem. Above all, it is considered that radial forearm free flap is the first choice for palatal reconstruction. Our department introduces a novel method using tunnelized-facial artery myomucosal island flap for palatomaxillary defect reconstruction, which can successfully reduce donor-site morbidity, and duration of surgery and hospitalization.

구강내 연조직 결손부 재건시 유리 전완 피판(Radial Forearm Free Flap)의 유용성 (AVAILABILITY OF RADIAL FOREARM FREE FLAP IN RECONSTRUCTION OF INTRAORAL SOFT TISSUE DEFECTS : REVIEW OF 50 CASES)

  • 김남균;서동준;박세현;김형준;차인호;남웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권4호
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    • pp.353-358
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    • 2008
  • Purpose: The purpose of this clinical retrospective study was to evaluate our experience of radial forearm free flap for reconstruction of the oral cavity. Material and methods: From 1997 to 2006, 50 radial forearm free flaps were employed for head and neck reconstruction in 50 patients at department of oral and maxillofacial surgery, Yonsei University, Korea. Data were obtained from chart review, and clinical follow-up. Results: Patients' age ranged from 26 to 82 years (mean 53.2). There were 39 men and 11 women. 43 of the 50(86%) patients had squamous cell carcinoma. The total flap survival were 47(94%), complication rate were revealed for 15(30%). Conclusion: In the reconstruction of soft tissue within the oral cavity, several free flaps have been used. Because of its constant anatomy, long pedicle allows a hypothetic vascular anastomosis in the contralateral neck, contourability for various type of oral defects, pliability and can be used simultaneous reconstruction in intraoral and extra oral defects, the radial forearm free flap constitutes one of the best choice of intraoral soft tissue reconstruction.

구강악안면 영역에서의 측두근판(temporal muscle flap)을 이용한 재건술 (RECONSTRUCTION OF ORAL AND MAXILLOFACIAL DEFECTS USING TEMPORAL MUSCLE FLAP)

  • 배찬용;황순정
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권1호
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    • pp.69-73
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    • 2002
  • Temporal muscle flap is usefull for the reconstruction of tissue defect at the oral and maxillofacial area. This article reports 3 cases of temporal muscle flap for the soft tissue reconstruction of infraorbital, palatal and mandibular retromolar area after tumor ablation. The advantages and disadvantage, postoperative complications and technical variations were reviewed and our 3 cases were evaluated in this aspects.

조직확장술및 장골이식을 이용한 하악골 결손부의 재건 (MANDIBULAR RECONSTRUCTION BY TISSUE EXPANSION AND ILIAC BONE GRAFT)

  • 이계영;민경인;정수일;박재범;안재진;김도균;김철환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권4호
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    • pp.449-453
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    • 2000
  • 저자등은 하악 복잡골절 정복후 골과 연조직 결손을 보이는 환자에게 internal resorvoir를 이용한 연조직 확장 후 장골 이식으로 골결손 수복을 함으로써 양호한 안모개선을 얻었기에 문헌고찰과 함께 보고하는 바이다.

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화상에 의한 소구증 환자의 구각부 재건 - 증례보고 - (RECONSTRUCTION OF THE CORNERS OF THE MOUTH IN BURN-INDUCED MICROSTOMIA - A CASE REPORT -)

  • 최영달;변성수;정휘동;남웅;김형준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권6호
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    • pp.543-547
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    • 2007
  • The lips and corners of the mouth are not only important for appearance but are also essential for facial expression, speech, and nutrition. Defects in these areas can be caused by congenital clefts of the lip and face, trauma, infection, cysts, and excision of benign or malignant tumors. Numerous techniques have been introduced for reconstruction of the lips and corners of the mouth, and in particular, techniques such as the Kazanjian Roopenian I and II, Converse method, Zisser method, Platz and Wepner method. Gillies and Millard method are commonly utilized for elongation and reconstruction of the mouth corner. Few reports exist in the oral and maxillofacial surgery literature regarding correction of microsomia and reconstruction of the corners of the mouth. As such, the authors report a case of the corners of the mouth elongation in a patient with burn-induced microstomia using the Converse flap which yielded a satisfactory outcome.

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

  • Kim, Bong-Chul;Kim, So-Mi;Nam, Woong;Cha, In-Ho;Kim, Hyung-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.553-558
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    • 2012
  • Purpose: This article reviews a few of the commonly used types of vascularized osseous free flaps in maxillofacial reconstruction, which still represents the gold standard of restoration. We also discuss the developing concepts in maxillofacial reconstruction. Recent findings: Most of the literature reconfirms the established patterns of reconstruction with the aid of vascularized osseous free flaps. This method of free-tissue transfer is also feasible in cases of osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaw. These flaps are also suitable for prosthetic restoration using osseointegrated dental implants. Summary: Vascularized osseous free flaps still remain the standard of care. Improvements upon the free-tissue transfer method employing vascularized osseous free flaps, such as distraction osteogenesis, tissue engineering, and imaging techniques, currently require further development, but these technologies could lead to improved outcomes of maxillofacial reconstruction in the near future.

Vertical distraction osteogenesis of a reconstructed mandible with a free vascularized fibula flap: a report of two cases

  • Saito, Naoaki;Funayama, Akinori;Arai, Yoshiaki;Suda, Daisuke;Takata, Yoshiyuki;Kobayashi, Tadaharu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.32.1-32.8
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    • 2018
  • Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

Walk-Up flap을 이용한 악안면 영역의 결손부 재건 (Walk-Up flap for Reconstruction of Oral and Maxillofacial defects)

  • 신상훈;박성진;이광호;이성근
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권2호
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    • pp.249-253
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    • 2000
  • Oral and Maxillofacial defects is produced by trauma or cancer surgery. This defects have been shown functional loss such as mastication, swallowing, speech and psychosocial esthetic problem. Oral and Maxillofacial defects is reconstructed by the use of many flaps. However although previous flap surgery was done, additional soft tissue defects can be still remained. In this case, Walk-Up flap that is introduced by Marx RE in 1990 is recommended for successful reconstruction. We report Walk-Up flap for reconstruction of remained soft tissue defects of tongue S.C.C. After induction chemotherapy, tongue S.C.C. is excised surgically and reconstructed by use of PMMC flap. Post-op infection results in surrounding soft tissue defect with oro-facial fistula. We have experienced a case of Walk-up flap by use of PMMC flap for reconstruction with satisfactory result, so we report it with literature reviews.

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