• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.219-222
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• 2019

The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권3호
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• pp.151-156
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• 2016

Objectives: To assess submental route intubation as an alternative technique to a tracheostomy in the management of the airway in cranio-maxillofacial trauma, along with an assessment of its morbidity and complications. Materials and Methods: Submental intubation was performed in 17 patients who had maxillofacial panfacial trauma and management was done under general anesthesia during a period of one year from 2013 to 2014 at Departments of Oral and Maxillofacial Surgery and Dentistry, the Malankara Orthodox Syrian Church Medical College, Kochi, India. Results: In all 17 cases, the technique of submental intubation was found to be simple and reliable. Hypertrophic scars were noted in three cases, orocutaneous fistula and mucocele in one case each. All these complications were managed comfortably without significant morbidity to the patient. Conclusion: Submental intubation is a good technique that can be used regularly in the management of the airway in cranio-maxillofacial trauma, but with some manageable complications.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.155-160
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• 2020

Submental or submandibular intubation has been reported to cause fewer complications than tracheostomy. However, the risk of infection is always inherent because oral wounds are exposed to microbial flora and bacteria in the oral cavity. A novel technique of submandibular intubation was devised to reduce infection and injury to the soft tissues. We would like to report a novel safe technique that can be performed in patients requiring submental or submandibular intubation. This is the first report of submandibular intubation using a sterile disposable camera cable drape. This novel technique of submandibular intubation is safer, more sterile, easier, and less invasive than conventional submandibular intubation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권1호
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• pp.12-17
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• 2018

Objectives: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. Materials and Methods: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015. In total, 31 patients with complex factures requiring submental airway derivation were included. No complications such as bleeding, infection, vascular, glandular, or nervous lesions were presented in any of the patients. Results: The use of submental airway derivation is a simple, safe, and easy method to ensure airway management. Moreover, it allows an easier reconstruction. Conclusion: Based on these results, we concluded that, if the relevant steps are followed, the use of submental intubation in the treatment of patients with complex facial trauma is a safe and effective option.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.604-607
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• 2008

턱밑 기관내 삽관술은 기본적인 수술적 술기가 필요하지만, 간단하고 안전하며 술식이 빠른 장점을 가지고 있다. 또한 술 중 악간 고정이 가능하며, 수술 시야를 확보할 수 있으며, 술 후 합병증이 적고 기관절개술로 인한 부작용을 줄일 수 있다는 장점을 가지고 있다. 따라서 기본적인 술기의 습득과 마취과와의 협조가 동반된다면 많은 분야에서 사용 될 수 있는 방법이라고 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.29.1-29.11
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• 2018

Background: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures. Methods: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated. Results: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications-observed in 126 patients-had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents. Conclusions: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions.

• 구강회복응용과학지
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• 제39권4호
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• pp.204-213
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• 2023

구강 악안면 영역에서 외상으로 인해 발생한 골절에 대한 치료로 관혈적 혹은 비관혈적인 골절의 정복을 시행할 수 있다. 그러나, 최적의 정복이 이루어지지 않았거나 부정 유합이 발생할 경우, 하악골과 중안모 간의 구조적 관계가 상실되어 부정교합이 일어날 수 있다. 이러한 부정교합은 외상 후 부정교합이라 정의되며 안정적인 턱관절 위치의 확보 후 악교정 수술, 교정치료, 교합 재형성 및 보철적 재건 등이 외상 후 부정교합의 치료방법으로 제시되고 있다. 안정적인 턱관절은 교합 회복 전 부정교합의 재발 및 교합 변화를 방지하기 위해 필수적이며, 중심위 및 적응된 중심위는 가장 안정적인 턱관절의 위치로 교합 회복의 시작점이다. 본 증례는 다발성 안면 골절의 정복 후, 외상 후 부정교합이 발생하여 전악 교합의 회복을 위해 중심위에서 선택적 교합 조정 및 임플란트 지지 고정성 보철물로 보철적 재건을 시행한 증례로 교합 기능적으로 양호한 결과를 얻었기에 이를 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.56-62
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• 2000

Fracture of frontal bone is infrequent, but may have serious complications because of their proximity to the brain, eyes and noses. Fractures of the frontal area range from 5% to 15% of all facial bone fracture and include supraorbital rim and frontal sinus. As frontal bone fractures most frequently occur in the multiply injured patient, a thorough clinical and radiological examination of the patient is required before diagnosis and treatment plans are established. Sometimes coorperative treatment with other department is required. It is specially considered that incision for access to frontal region and surgical methods for open reduction, cranialization, cannulization, sinus obliteration. After surgical or conservative treatment, it may have complication. Complication of frontal bone injury vary in severity and may occur at several years after the incidents. The major types of complications are those that occur directly at the time of injury, infection and chronic problems. This is clinical study on 31 patients with frontal bone fracture, at department of oral and maxillofacial surgery in dental hospital of Wonkwang university during past ten years. The results were as follows; 1. The sex ratio of all patients is 29 (94%) male to 2 (6%) female, the average age is 33 and the prominent groups are 2nd, 3rd decade age. 2. The causative factors are mostly traffic accident 22 cases (70%) and fall dawn, industrial accidents, so on. 3. The 17 cases has shown alert mental status, but neurologic problems is in 14 (45%) cases in initial accessment. 4. Associated facial bone fractures are prominent in the maxilla (42%) and panfacial fracture (39%). 5. Involved general problems are in department of neurologic surgery problems (65%), orthopaedic problems (23%) and ophthalmologic problems (19%) in order. 6. Open reduction has done in 15 cases and 16 cases with conservative management. 7. Postoperative complications are chronic headache (42%), esthetic problems (39%) and ophthalmologic problems (35%)in order.