• 대한장애인치과학회지
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• 제12권2호
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• pp.87-91
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• 2016

저자는 소하악증으로 인해 기도유지가 어려우며 섭식 장애로 인한 다발성 우식을 보이는 피에르 로빈 증후군 환아의 증례를 보고하는 바이다. 환자는 소하악증 및 구개열, 심방중격 결손, 새끼 손가락의 측만지증(clinodactyly), 외사시(exotropia) 등의 증상을 동반하고 있었으며, 신체 발육이 매우 저하된 상태로 섭식 장애로 인한 구강내 침식 및 다발성 우식의 소견을 보이고 있었다. 환아는 가벼운 자폐 증상을 가지고 있으며 어린 나이로 협조를 구하기가 어려웠고 광범위한 치료가 필요한 상황이었으며 의식하 진정법시 하악의 발육 저하로 인한 기도 확보의 어려움이 예상되었기에 전신마취하 치과치료를 시행하였다. 피에르 로빈 증후군은 기도유지의 어려움과 섭식 장애로 구강위생 관리에 불리한 조건을 가지고 있지만 나이가 듦에 따라 점차 정상적인 하악의 성장이 이루어지므로 행동조절에 의한 일상적인 치과 처치도 가능할 것이다.

• 대한장애인치과학회지
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• 제15권1호
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• pp.55-59
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• 2019

PRS는 소하악증, 설하수증, 구개열의 세가지 임상적 특징을 갖는 질환으로 상기도 폐쇄로 인한 호흡곤란, 섭식장애를 나타낸다. PRS 환아는 치과 치료 시 호흡 관리에 대한 고려가 필요하고 또한 다양한 증후군이 동반될 수 있어 치과 치료시 전신적인 상태에 대한 고려가 필요하다. 본 증례에서는 다발성 치아우식증을 주소로 내원한 PRS 환자에 대한 보고로 기도 확보 및 유지의 어려움이 예상되었으나 치과적 치료를 전신마취 하 성공적으로 시행되었다.

• 대한장애인치과학회지
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• 제15권1호
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• pp.79-83
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• 2019

Treacher Collins 증후군(TCS)은 두개안면 발육의 이상을 보이는 상염색체 우성 질환으로, 외이, 중이 및 이소골(auditory ossicle)의 형태이상과 상악골 발육 부전, 후퇴된 하악, 구개열 등의 특징을 보인다. TCS 환아의 경우, 청각 장애로 인한 환아의 불안으로 적절한 협조를 얻기 어렵고, 개구제한과 기도 확보의 어려움으로 인해 전신마취 하에 치과치료를 진행하는 것이 안전하다. 전신마취 시 하악 후퇴 등의 형태학적인 문제로 인하여 삽관의 난이도가 높을 수 있어 주의가 요구되며, 술 후에도 적절한 호흡의 유지를 위해 지속적인 감시가 필요하다. 마지막으로, 보호자로 하여금 구강 위생의 중요성이 강조되어야 한다.

• 대한소아치과학회지
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• 제26권3호
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• pp.492-498
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• 1999

Oculodentodigital syndrome은 Lohmann에 의해 최초로 보고된 후, 눈과 코, 치아와 골격의 이상을 포함하는 'dysplasia oculo-dento-digitalis'라는 용어로 1957년 Meyer-Schwickerath 등에 의해 명명된 다소 희귀한 유전성 질환이다. 이 질환은 대부분 상염색체 우성이며, 많은 증례에서 다양한 변이를 보인다. 임상적인 양상으로서, (1) 독특한 안모형태, (2) 소안구증, (3) 합지증과 수지절의 굴절, (4) 법랑질 형성부전, (5) 가늘고 광택없는 모발 등으로 특징지을 수 있다. 본 증례는 지능은 정상이나 행동조절이 어려우며 교합면의 과도한 마모, 치아우식을 주소로 부산대학교병원 소아치과에 의뢰된 환자로 합지증에 대한 수술기왕력을 가지고 있었으며, 상기의 임상적 특징을 모두 보이고 있다. 이에 치과적 치료로써 법랑질 형성부전치아에 대한 수복치료와 초진시부터 전 치아에 걸쳐 주기적인 불소도포를 실시하였고, 차후 전치부의 심미수복을 계획하고 있다.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.162-164
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• 2016

Stafne bone cavity is a rare mandibular defect that was first reported by Edward C. Stafne in 1942. It commonly presents with a well-demarcated, asymptomatic, unilateral radiolucency that indicates lingual invagination of the cortical bone. A 52-year-old female patient who with nasal bone fracture, visited the hospital. During facial bone computed tomography (CT) for facial area evaluation, a well-shaped cystic lesion was accidentally detected on the right side of the mandible. Compared to the left side, no swelling or deformity was observed in the right side of the oral lesion, and no signs of deformity caused by mucosal inflammation. 3D CT scans, and mandible series x-rays were performed, which showed a well-ossified radiolucent oval lesion. Axial CT image revealed a cortical defect containing soft tissue lesion, which has similar density as the submandibular gland on the lingual surface of the mandible. The fact that Stafne cavity is completely surrounded by the bone is the evidence to support the hypothesis that embryonic salivary gland is entrapped by the bone. In most cases, Stafne bone cavity does not require surgical treatment. We believe that the mechanical pressure from the salivary gland could have caused the defect.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.119-127
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• 2016

Background: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. Methods: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). Results: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication-oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. Conclusion: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.141-144
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• 2017

An odontogenic cutaneous fistula is a pathological communication between the outer skin surface of the face and the oral cavity. Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with skin infection. We report a rare case, which was diagnosed as basal cell carcinoma based on the biopsy of skin lesions in the patient who had been diagnosed with odontogenic cutaneous fistula. A 64-year-old male patient presented with a cutaneous odontogenic fistula. The patient had undergone surgical extraction of fistula tract and loose tooth before dermatology or plastic surgery consultation. With the biopsy and computed tomography, it was confirmed that fistula and basal cell carcinoma. However, the connection between the fistula and skin cancer was not clear. Positron emission tomography-computed tomography scan was performed and was not detected as other local or distant metastasis. After that, wide excision of the skin lesion was performed. Although skin cancer is not commonly observed, it is necessary to rule out this disease entity by performing biopsy of skin lesions.

• 대한소아치과학회지
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• 제30권4호
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• pp.673-677
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• 2003

선천적 무설증은 매우 드물게 보고되는 증상이다. 무설증을 가진 환자는 구개 이상, 하순 결손, 하악 측절치 결손 등을 포함한 하악골의 발육부전을 나타낸다. 무설증의 원인은 밝혀지지 않았으나 유전적 요인이나 발생 4주시기에 기형유발물질의 영향으로 추정되고 있다. 무설증의 치료는 혀를 재건해주는 외과적 술식과 하악골의 성장을 돕는 교정적 술식, 하악골의 길이를 늘리는 distraction osteogenesis 등이 있으며 무설증의 정도에 따라 달라진다. 본 증례는 선천적 무설증과 situs inversus(장기의 좌우가 바뀐 상태)를 가진 6세 여아에서 무설증으로 인한 하악골의 횡적 수축을 악정형 장치를 이용하여 치료하였으며 향후 2차 교정과 외과적 수술을 계획하기에 양호한 결과를 얻을 수 있었다.

• 대한두개안면성형외과학회지
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• 제18권3호
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• pp.218-221
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• 2017

A solitary fibrous tumor is a relatively uncommon neoplasm that usually occurs in the pleura but occurs extremely rarely in the oral cavity. Reported herein is a rare case of a solitary fibrous tumor in the buccal cheek mucosa. A 50-year-old man visited the authors' hospital due to a buccal cheek mass whose size had increased. Excisional biopsy was done under local anesthesia. After the excisional biopsy, the patient was diagnosed to have a solitary fibrous tumor. In immunohistochemistry, the patient's solitary fibrous tumor was characterized by the expression of CD34 and CD99 on the neoplastic cells, and negativity for Bcl-2 and S-100. No recurrence or complication occurred for a period of 5 years. The growth of a primary solitary fibrous tumor in the buccal cheek mucosa is extremely rare and has been rarely reported in the South Korean medical literature. A solitary fibrous tumor must be distinguished from other spindle cell tumors. Presented herein is a case of primary solitary fibrous tumor in the buccal cheek mucosa. The relevant literature is briefly reviewed.

• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.161-165
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• 2020

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.