• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.68-71
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• 2012

Purpose: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. Methods: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. Results: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. Conclusion: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.56-62
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• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.

• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.198-205
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• 1991

본 저자들은 2명의 편측성 치조, 구개 파열 환자에서 장골능에서 얻은 골수 망상골로 late secondary bone graft를 시행하여 심미적 기능적으로 양호한 결과를 얻었다. 1. 한 증례에서는 골지지가 거의 없는 우측 상악 중절치를 발거하고 술전 교정치료로 변위된 치아의 배열과 소실된 공간을 회복한 후 골 이식을 시행하였고 다른 증례에서는 술전 교정치료 없이 보철물 제거후 골 이식을 시행 하였다. 2. 파열 변연부위에 골점막 절개를 한후 순측, 구개측 및 비점막을 거상 봉합하여 구비강 누공을 폐쇄한후 장골능에서 얻은 골수 망상골을 이식하였다. 3. 수술후 구비강 누공의 폐쇄로 비음이 개선되었고, 술후 6개월뒤 방사선 사진상 파열 부위의 골 재생을 확인후 결손 치아를 보철치료하였다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.100-100
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• 1993

구개인두성형술은 만성 코골음 및 폐쇄성 수면 무호흡증의 치료를 위해 널리 이용되고 있는 수술이며 수술 직후의 치료 효과 및 합병증에 대한 연구는 많이 이루어져 있으나 5년 이상의 장기 추적 관찰에 관한 연구는 드물게 보고 되고 있다. 이에 저자들은 1985년부터 1987년까지 구개인두성형술을 시행한 총 37명의 환자중 추적관찰이 가능했던 25명의 환자(남:18명, 여:7명)를 대상으로 수술전, 수술후 8주 및 수술후 5년이 지난 환자의 주관적 증상을 비교 평가 하였으며 중상의 변화와 함께 체중의 증감도 같이 조사하여 다음과 같은 결과를 얻었다. (1) 수술후 5년된 25명의 환자에서 코골음은 10명(40%)에서 완전히 사라졌고 정도의 차이(Grade 1 - 3)는 있지만 3명을 제외한 나머지 모두에서 호전을 보였다. (2) 수술전 AI>20이었던 15명의 환자에서 발견된 수면 무호흡증은 추적 관찰용 수면 다원 검사상 13명의 환자에서 Grade 0 - 1 (Oxygen saturation 86%)로의 호전을 보였고 수술후 5년이 지난뒤에도 증상의 변화 및 체중 변화는 없었다. (3) 수술 5년후에도 문제가 되는 합병증으로는 물을 급히 마실 때에만 코끝에 물방울이 비치는 정도의 구개인두부전 3례, 인두 비대칭 1례, 인두 건조감이 5례에서 관찰되었다. 그외 비인두 협착, 미각 상실, 및 호흡 순환계의 장애 둥 심각한 합병증은 발견되지 않았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.40.1-40.8
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• 2018

Background: A 9-year-old male showed severe defects in midface structures, which resulted in maxillary hypoplasia, ocular hypertelorism, relative mandibular prognathism, and syndactyly. He had been diagnosed as having Apert syndrome and received a surgery of frontal calvaria distraction osteotomy to treat the steep forehead at 6 months old, and a surgery of digital separation to treat severe syndactyly of both hands at 6 years old. Nevertheless, he still showed a turribrachycephalic cranial profile with proptosis, a horizontal groove above supraorbital ridge, and a short nose with bulbous tip. Methods: Fundamental aberrant growth may be associated with the cranial base structure in radiological observation. Results: The Apert syndrome patient had a shorter and thinner nasal septum in panthomogram, PA view, and Waters' view; shorter zygomatico-maxillary width (83.5 mm) in Waters' view; shorter length between the sella and nasion (63.7 mm) on cephalogram; and bigger zygomatic axis angle of the cranial base (118.2°) in basal cranial view than a normal 9-year-old male (94.8 mm, 72.5 mm, 98.1°, respectively). On the other hand, the Apert syndrome patient showed interdigitating calcification of coronal suture similar to that of a normal 30-year-old male in a skull PA view. Conclusion: Taken together, the Apert syndrome patient, 9 years old, showed retarded growth of the anterior cranial base affecting severe midface hypoplasia, which resulted in a hypoplastic nasal septum axis, retruded zygomatic axes, and retarded growth of the maxilla and palate even after frontal calvaria distraction osteotomy 8 years ago. Therefore, it was suggested that the severe midface hypoplasia and dysostotic facial profile of the present Apert syndrome case are closely relevant to the aberrant growth of the anterior cranial base supporting the whole oro-facial and forebrain development.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.559-566
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• 2007

Distraction osteogenesis(DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia(Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy(IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.

• 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.

• 대한구순구개열학회지
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• 제7권1호
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• pp.1-16
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• 2004

본 연구에서는 구순접합술의 효과를 알아보기 위하여, 일측성 완전구순열을 가진 5명의 환아에서 Millard의 high haU-underminded adhesion과 Seibert 의 lip adhesion을 이용한 구순접합술후 Millard 변법을 이용한구순성형술을 시행하였다. 구순접합술은 상악치조분절 간의 관계를 개선해 주고 구순성형술을 쉽게해주며 최종적인 구순성형술 후 더욱 좋은 결과를 나타냈다. High kalf-underminded adhesion과 Seibert의 lip adhesion은 둘 다 넓은 구순열을 하는데 유용한 방법이며, 특히 Seibert의 lip ahesion은 강한 접합력을 얻을 수 있고 변위된 비중격의 개선 효과가 있으며 보다 심미적인 상순의 연속성을 얻게 해 주었다. 이상의 결과에서 넓은 완전구순열 환아에서 구순성형술에 앞서 구순접합술을 시행하면 상악치조분절 간의 관계를 개선시키고 구순성형술 후 최종적인 결과를 향상시킴을 알 수 있다.

• 대한소아치과학회지
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• 제31권4호
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• pp.680-684
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• 2004

혈관종은 혈관의 증식에 의해 발생하는 양성 종양으로 유아와 어린이에서 호발한다. 대부분 진성종양으로 보다는 과오종(hamartoma)으로 보며 구강내 호발부위는 입술 혀, 협점막, 구개부 등이다. 임상소견은 편평하거나 융기된 적청색 병소로 보통 단발성이다. 조직학적 소견을 통해 모세혈관성(capillary), 해면상(cavernous), 혼합성(mixed), 경화성(sclerosing) 등으로 분류되며 확진된다. 본 증례는 6세 남자 환아가 치은에 뭐가 났다는 것을 주소로 전남대학교 병원 소아치과에 내원하였다. 임상검사 결과 #62, 63 부위의 부착치은에 딸기모양 종물(mass)이 관찰되었다. 조직검사 시행 결과 모세혈관종으로 확진되었으며 외과적 절제로 양호한 결과를 얻었기에 보고하는 바이다. 혈관종은 재발이 드물며 악성전환이 없지만 출혈 경향이 높으므로 임상적 시술시 주의가 요구된다.

• 대한두개안면성형외과학회지
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• 제18권4호
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• pp.255-260
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• 2017

Background: Surgery for reconstruction of defects after surgery should be performed selectively and the many points must be considered. The authors conducted this study to compare the local flap and skin graft by facial location in the reconstruction after resection of facial skin cancer. Methods: The authors performed the study in patients that had received treatment in Department of Plastic Surgery, Gyeongsang National University. The cases were analyzed according to the reconstruction methods for the defects after surgery, sex, age, tumor site, and tumor size. Additionally, the authors compared differences of aesthetic satisfaction (out of 5 points) of patients in the local flap and skin graft by facial location after resection of facial skin cancer by dividing the face into eight areas. Results: A total of 153 cases were confirmed. The most common facial skin cancer was basal cell carcinoma (56.8%, 87 cases), followed by squamous cell carcinoma (37.2%, 57 cases) and bowen's disease (5.8%, 9 cases). The most common reconstruction method was local flap 119 cases (77.7%), followed by skin graft 34 cases (22.3%). 86 patients answered the questionnaire and mean satisfaction of the local flap and skin graft were 4.3 and 3.5 (p=0.04), respectively, indicating that satisfaction of local flap was significantly high. Conclusion: When comparing satisfaction of patients according to results, local flap shows excellent effects in functional and cosmetic aspects would be able to provide excellent results rather than using a skin graft with poor touch and tone compared to the surrounding normal skin.