• Archives of Craniofacial Surgery
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• v.23 no.1
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• pp.23-28
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• 2022

Background: Intermaxillary fixation (IMF) is a technique that allows for the reduction and stabilization of mandibular fractures. Several methods of IMF, such as self-tapping screws or arch bars, have been developed. This study aimed to validate the usefulness of IMF with a self-tapping screw compared to IMF with arch bars with focus on the patients' perspective. Methods: We retrospectively reviewed the medical records of all patients who were treated for mandibular fractures at our hospital between August 2014 and February 2021. A total of 57 patients were enrolled in this study. Thirteen patients were excluded from the analysis: three patients were lost to follow-up, and 10 patients did not undergo IMF. Finally, 44 patients were analyzed, of which 31 belonged to the arch bar group, and 13 belonged to the screw group. Patient discomfort and pain during IMF application and removal were analyzed using a patient self-assessment questionnaire. The surgeon also assessed oral hygiene, IMF stability, and occlusion. Results: We applied IMF to 34 men (77%) and 10 women (23%). The mean age of the patients was 37.3 years. The most common fracture site was the angle (30%), followed by the parasymphysis (25%), the body (23%), the condyle (11%), and the ramus (11%). Patient discomfort and oral hygiene were statistically favorable in the screw group. The IMF application time was statistically shorter in the screw group (p< 0.001). IMF stability was not statistically different between the two groups. The pain score during IMF removal was lower in the screw group (p< 0.001). Conclusion: Compared to arch bars, IMF screws provide more comfort during the IMF period, help maintain favorable oral hygiene, and have a shorter application time. From the patient's perspective, IMF screws are an excellent alternative to conventional arch bars when applicable.

• The korean journal of orthodontics
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• v.34 no.3 s.104
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• pp.261-267
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• 2004

Nonsyndromic cleft lip and/or palate (NSCLP) is one of the most common congenital deformities and its prevalence in Far East Asia, such as within Korean and Japanese populations, is relatively high. However, in the eastern part of Europe, clefts are relatively rare situations. These ethnic differences infer a genetic background of the disease. The objective of this study was to compare the frequency of single nucleotide polymorphism (SNP) in $TGF-{\beta}3$ between Korean and Romanian cleft families. Korean cleft families samples were collected from twenty-six families (n=78) and Romanian cleft families samples were collected from eighteen families (n=41). For sequencing, the blood or saliva of the subjects was sampled. A single nucleotide polymorphism was observed in the intron 5 of $TGF-{\beta}3$ (Al8141G). The frequency of each allele was significantly different between the Korean and Romanian samples. The Ah allele was present in 18 out of 78 Korean samples (23.1%) and in 27 out of 41 Romanian samples (65.9%). The AG was present in 27 (34.6%) out of 78 Koreans and in 13 (31.7%) out of 41 Romanians. The GG was found in 33 (42.3%) Koreans and in 1 (2.4%) Romanian. The difference between the groups was significant (p<0.001). In conclusion, the frequency of observed SNP was significantly different between the two countries. SNP in $TGF-{\beta}3$ in the Korean population seemed to have a higher possibility of occurrence for nonsyndromic cleft palate than the Romanian population.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.309-312
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• 2016

Patients with cleft lip and palate (CLP) must undergo corrective surgeries during infancy and early childhood. Many patients with CLP undergo orthognathic surgery during their childhood for correction of skeletal asymmetries or pharyngoplasty with a pharyngeal flap to improve the quality of speech and velopharyngeal function. During orthognathic surgeries, nasotracheal intubation is performed under general anesthesia. In our case report, the patient had undergone palatoplasty and pharygoplasty previously. During the orthognathic surgery, a flexible fiberoptic bronchoscope-guided nasotracheal tube was inserted through the pharyngeal flap ostium; however, active bleeding occurred in the nasopharynx. Bleeding occurred because the flap was torn. After achieving hemostasis, the surgery was completed successfully. Thus, if a patient may show the potential for velopharyngeal port obstruction, nasotracheal intubation should be performed with utmost care.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.2
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• pp.88-91
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• 2008

A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.165-168
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• 2016

Nasal-type extranodal natural killer/T-cell lymphoma (ENKTL) is a rare disease presenting with non-specific symptoms, typically originating in the nasal cavity, palate, or midfacial region. Oral cavity is an extremely rare site for this type of lymphoma. In this report, we present a case of palatal perforation and oro-nasal fistula as a manifestation of recurrent ENKTL. Complicated disease entity should be considered when surgeons deal with palatal perforation and oro-nasal fistula.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.155-157
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• 2007

Objective : There are close relationship between intraoral abnormal structure and speech-functional problem. Patients with cleft palate & ankyloglossia are typical examples. Patients with abnormal structure can be repaired toward normal structure by operation. Ankyloglossia may cause functional limitation - for example, speech disorder - even if adequate surgical treatment were done. And, each individuals have each speech disorders. The objective of this study is to evaluate the speechs of childrens with ankyloglossia, and to determine whether ankyloglossia is associated with articulation problem. We wanted to present criteria for indication of frenectomy. Study design The experimental group is composed of 10 childrens who visited our department of oral and maxillofacial surgery, dental hospital, Chonbuk university, due to ankyloglossia and articulation problem,. The average age is 5 Y 7M, M : F ratio is 4 : 1 at the time of speech test. The VPI consonant discrimination degree, PPVT, PCAT, Nasometer II, Visi-Pitch test result were obtained from each group. Result : There was significant difference for 'language development' through PPVT. Except 3 members of experimental group, all remainder showed retardation for 'language development'. For 'errored consonant rate', data showed more higher scores in alveolar consonant. There 'consonant error' in experimental group, mostly showed 'alveolar consonant', also a major modality of 'consonant error' was mostly distortion. Conclusion : We can judge the severity of ankyloglossia patient by examinig language development degree & speech test of 'alveolar consonant' . And we can make a decision for frenulotomy using these results.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.72-75
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• 2012

Purpose: Dermatofibroma is a common benign dermal tumor characterized by a proliferation of fibroblast-like spindle cells. It is commonly localized on the skin of extremities and presents as a slow growing solitary nodule. To our knowledge, the occurrence of dermatofibroma in the oral cavity is rare. Herein, we report a rare case of dermatofibroma on the lower lip. Methods: A 60-year-old woman presented with a slow growing mass that measured $1{\times}0.8cm$ in diameter on the lower lip. The mass was surgically excised with clear margins. Results: Histologically, the mass was characterized by a nodular tumor composed of collagen bundles, fibroblasts, and histiocytes, which were findings consistent with dermatofibroma. The postoperative course was uneventful without any complications. Conclusion: When evaluating nodular tumors of the oral area, dermatofibroma should be considered in the differential diagnosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.22-39
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• 1992

The purpose of this study was to evaluate hypernasality, nasal air emission, glottal stop, articulation disorder in patients with velopharyngeal incompetency(V.P.I.) and to analyze speech improvement after pharyngoplasty. In this study 61 patients with velopharyngeal incompetency were tested, and in patents with pharyngoplasty speech problems before pharyngoplasty were compared with those after pharyngoplasty. The results obtained are as follows : 1. There are few speech problems in pronouncing the vowel sounds. 2. There are many speech problems in pronouncing the pressure sounds and few speech problems in non-pressure sounds. 3. Speech problems in patients with cleft palate are influenced not by anatomical defect but by severity of velopharyngeal incompetence after palatorrhaphy. 4. Operation methods which decrease the velopharygeal incompetence must be considered for reducing the speech problems. 5. Among the 61 cases with V.P.I. 19 cases(31%) showed nasal air emission and 24 cases(39%) showed glottal stop. 6. Pharyngoplasty is of benefit to primary precipitating components such as hypernasality, nasal air emission but of no benefit to secondary compensating component such as glottal stop. 7. There as no significant difference in speech improvement between pre-and post-pharyngoplasty(p<0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.23.1-23.6
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• 2018

Background: Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. Case presentation: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated. Conclusions: Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.39-42
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• 2015

Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a $1{\times}1cm$ abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.