• 대한두개안면성형외과학회지
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• 제16권2호
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• pp.53-57
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• 2015

Background: Surgical outcomes after orbital wall decompression have focused on the degree of exophthalmos and intraocular pressure. The aim of this research was to evaluate intraorbital volume using computed tomography (CT) images following two-wall decompression using a combined subcilliary and endoscopic approaches. Methods: A retrospective review was performed for all patients who had undergone the two-wall decompression method. The pre/postoperative CT images were used to evaluate changes in intraocular volume. Intraocular pressure was evaluated using applanation tonometry. Surgical details are discussed within the body of text. Results: Two-wall decompression thru the medial wall and floor was associated with an average intraorbital volume change of $7.3cm^3$, with maximal accommodation up to $13cm^3$. Changes in intraocular pressures were not statistically significant. Conclusion: Two-wall decompression was effective in accommodation of up to $13cm^3$ of soft tissue herniation. There was no statistically significant association between changes in volume to pressure.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.397-404
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• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• 대한두개안면성형외과학회지
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• 제23권5호
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• pp.228-231
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• 2022

Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery. A 65-year-old male patient presented with periorbital swelling and an open wound on the right infraorbital area. Computed tomography showed a right orbital floor fracture. After reduction of the herniated tissue into the orbit, an implant was inserted and fibrin glue was applied to stabilize the implant. This procedure was performed without difficulty, but the patient complained of persistent diplopia and limited eyeball movement after surgery. An imaging study showed a mass-like lesion, which was not a hematoma, in the orbital cavity. In a second operation, the mass was identified as clotted fibrin glue that had not been applied properly. After removal, the patient's symptoms were relieved without further complications. Appropriate and careful application of fibrin glue is necessary to avoid unnecessary complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.114-120
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• 1990

This is a case report of correction of posttraumatic diplopia and enophthalmos using autogenous composite conchal cartilage and temporal fascia. The results are as follows. 1. Diplopia and enophthalmos may be persistent complications in zygomatic complex fracture. 2. The concha is a reservior of autogenous cartilage which leaves no cosmetic and functional deformity in reconstruction of orbital floor. 3. Warpping the cartilage in temporal fascia may serve to increase implant stability and get graft with smooth edge. 4. Donor incision lines are well hidden within the scalp and in auriculocephalic fold.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권3호
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• pp.312-316
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• 1999

When the external force was applied to the orbit the most thin area might be displaced. These were usually orbital floor and/or medial wall of orbit. Among these cases some who showed the entrapment of the muscle between the fractured fragments needed the surgical treatment. We had operated 4 cases of the "blow-out" fracture via subciliary approach. The entrapped muscles were freed from fragments and the bony defect was restored with micro-titanium mesh. Mean follow-up periods was 15 months and there were no complication observed.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.85-92
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• 1988

저자는 관골 골절 환자중 일부 안서 골절로 안와내용물의 탈출이 동반된 관골 골절, 경구개 골절이 동반된 관골 골절, 소아의 관골 골절을 제외한 대다수의 삼격면 관골 골절 환자 37례를 구강내 절개와 K-강선고정술을 이용하여 수술 하였던 바, 첫째, 안면부 반흔을 남기지 않고, 둘째, 간단하며, 셋째, 직시하 수술이 가능하며 만족할 만한 결과를 얻을 수 있었다.

• 대한의사협회지
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• 제61권12호
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• pp.740-748
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• 2018

Posttraumatic facial deformities (PTFDs) are very difficult to correct, and if they do occur, their impact can be devastating. It may sometimes be impossible for patients to return to normal life. The aim of surgical treatment is to restore the deformed bone structure and soft tissue to create symmetry between the affected side and the opposite side. In the process of managing PTFD, correcting enophthalmos is one of the most challenging aspects for surgeons because of difficulties in overcoming the scar tissue and danger of injuring to the optic nerve. In this article, surgical options for reconstruction of the medial wall, floor, lateral wall, and roof of the orbit are described. To optimize aesthetic improvement, additional cosmetic procedures such as facial contouring surgery, blepharoplasty and rhinoplasty can be used. Plastic surgeons should join emergency trauma teams to implement an overall treatment plan containing rational strategies to avoid or minimize PTFD.

• Imaging Science in Dentistry
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• 제49권1호
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• pp.71-77
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• 2019

Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.

• 대한두개안면성형외과학회지
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• 제25권1호
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• pp.31-37
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• 2024

Orbital floor fractures are commonly encountered, but the dislocation of the eyeball into the maxillary sinus is relatively rare. When it does occur, globe dislocation can have serious consequences, including vision loss, enucleation, and orbito-ocular deformity. Immediate surgical intervention is typically attempted when possible. However, severe comorbidities and poor general health can delay necessary surgery. In this report, we present the surgical outcomes of a 70-year-old woman who received delayed treatment for traumatic eyeball dislocation into the maxillary sinus due to a subarachnoid hemorrhage and hemopneumothorax. Additionally, we propose a treatment algorithm based on our clinical experience and a review of the literature.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.76-81
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• 2017

Background: A transcaruncular approach is typically used for reconstructions of medial wall fractures. However, others reported that a transconjunctival approach was conducive for securing an adequate surgical field of view. In this study, we aimed to examine the extent of repair of medial wall fracture via a transconjunctival approach. Methods: We retrospectively reviewed the medical records of 50 patients diagnosed as having medial wall fracture via preoperative computed tomography and who underwent surgery between March 2011 and February 2014. The fracture location was defined by dividing each of the anterior-posterior and superior-inferior distances into three compartments. Results: A transcaruncular approach was used in 7 patients, while the transconjunctival approach was performed in the remaining 43 patients. The transconjunctival approach enabled a relatively broad range of repair that partially included the front and back of the medial wall, and was successful in 86% of the entire study population. Conclusion: It is known that more than 50% of total cases of the medial wall fracture occur mainly in the middle-middle portion, a majority of which can be reconstructed via a transconjunctival approach. We used a transconjunctival approach in identifying the location of the fracture on image scans except for cases including the fracture of the superior portion in patients with medial wall fracture. If it is possible to identify the location of the fracture, a transconjunctival approach would be an useful method for the reconstruction in that it causes no damages to the lacrimal system and is useful in confirming the overall status of the floor.