• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.80-82
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• 2015

The mandibuloplasty for the facial aesthetic reason has been the one of the most popular procedures in aesthetic facial bone surgery in East Asia. Most East Asian women prefer smaller-looking and smooth-shaped facial contour. Prominent mandible angle which are common in Asia would be the main problem for smooth facial contour. In addition, recently, the mandibular body and broad chin shape also are known to be remodeled in order to get the ideal smooth facial shape. However, mandibuloplasty is not that easy to cut because many patients has inward mandibular angle and the visual field in operation is limited. The aim of this trial is to try to provide the prefabricated cutting guide for the symmetric and appropriate mandibuloplasty with the surgeons. Preoperative computed tomography(CT) data were processed for the patient and computer simulation model was produced. Then, mandibuloplasty was done on the computer simulation screen. Based on this data, customized cutting guide was made. This prefabricated cutting guide was used in real mandibuloplasty bilaterally. Premade cutting guide for the mandibuloplasty based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the patients in near future.

• 대한두경부종양학회지
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• 제32권1호
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• pp.29-32
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• 2016

Venous malformation with phleboliths is uncommon cause of unilateral parotid swelling. The clinical and radiographic appearance of venous malformation with phleboliths may masquerade as sialolithiasis. A 49-year-old female complained about unilateral parotid swelling for 6 years. Preoperative evaluation including computed tomography and sonography showed the suspicion of venous malformation with phleboliths. Superficial parotidectomy was performed. Pathological examination confirmed that the mass was venous malformation with phleboliths combined with sialolith in the parotid gland. We present the case of unilateral parotid swelling caused by a venous malformation combined with sialolithiasis.

• 대한족부족관절학회지
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• 제7권2호
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• pp.232-237
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• 2003

The purpose of this article is to evaluate and analyze diagnosis and the clinical result of avulsion fracture of navicular. Eight patients operated from Jan. 1991 to June 2002 were evaluated retrospectively. Clinical tolerability, AOFAS score, patient's satisfaction were evaluated. Preoperative AOFAS score is $59.88{\pm}10.90$. Postoperative AOFAS score is $94.75{\pm}6.11$. All patient satisfied result of operation, and 5 patient return to training wihin 3 month. Navicula avulsion fracure is relatively rare. The small dorsal bone triangular fragment is best seen in lateral view radiographs and bone scan and/or computed tomography help corfirm diagnosis. Operative treatment is the method of choice because of shorter recovery time. Simple excision is enough to get a good clincal outcome.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.77-81
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• 2016

Background: Asymmetry of the infraorbital rim can be caused by trauma, congenital or acquired disease, or insufficient reduction during a previous operation. Such asymmetry needs to be corrected because the shape of the infraorbital rim or midfacial skeleton defines the overall midfacial contour. Methods: The study included 5 cases of retruded infraorbital rim. All of the patient underwent restoration of the deficient volume using polyethylene implants between June 2005 and June 2011. The infraorbital rim was accessed through a subciliary approach, and the implants were placed in subperiosteal space. Surgical outcomes were evaluated using preoperative and postoperative computed tomography studies. Results: Implant based augmentation was associated with a mean projection of 4.6 mm enhancement. No postoperative complications were noted during the 30-month follow-up period. Conclusion: Because of the safeness, short recovery time, effectiveness, reliability, and potential application to a wide range of facial disproportion problems, this surgical technique can be applied to midfacial retrusion from a variety of etiologies, such as fracture involving infraorbital rim, congenital midfacial hypoplasia, lid malposition after blepharoplasty, and skeletal changes due to aging.

• 대한두개안면성형외과학회지
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• 제18권3호
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• pp.207-210
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• 2017

Sarcoidosis is a systemic inflammatory disease characterized by non-caseating granulomas of unknown origin. Of the fewer than 6% of sarcoidosis cases that occur in subcutaneous tissue, most occur on the face or forearm, but rarely in the toe. A 33-year-old man was admitted to our institute with a 2-cm mass on his chin and a 0.5-cm mass on his right fourth toe. Based on preoperative ultrasonography, epidermal cysts were suspected, and histopathological tests were performed after removing the masses. Histopathologically, the chin and toe tissue samples showed chronic granulomatous inflammation, without necrosis, indicative of sarcoidosis. Chest computed tomography revealed a large number of small nodules in both the interlobar fissures and the peribronchial area, and a large number of small lymph nodes in both the hilar and interlobar node areas. On the basis of the histopathologic and imaging findings, the patient was diagnosed with sarcoidosis. This very rare case of sarcoidosis, occurring in both chin and toe, suggests that thorough evaluation is needed to find other mass when we find sarcoidosis in facial area.

• Journal of International Society for Simulation Surgery
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• 제3권1호
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• pp.28-32
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• 2016

Background Congenital muscular torticollis (CMT) is a benign condition. With early diagnosis and appropriate management, it can be cured completely, leaving no residual deformity. However, long-standing, untreated CMT can lead to permanent craniofacial deformities and asymmetry.Methods Nineteen patients presented to the author with congenital muscular torticollis. Three dimensional computed tomography (3-D CT) scans was obtained upon patient’s admission. Adjustment of skull’s position to Frankfort horizontal plan was done. Cervical vertebral segmentation was done which allowed a 3D module to be separately created for each vertebra to detect any anatomical or positional changes.Results The segmented vertebrae showed an apparent anatomical changes, which were most noticeable at the level of the atlas and axis vertebrae. These changes decreased gradually till reaching the seventh cervical vertebra, which appeared to be normal in all patients. The changes in the atlas vertebra were mostly due to its intimate relation with the skull base, while the changes of the axis were the most significantConclusion Cervical vertebral segmentation is a reliable tool for isolation and studying cervical vertebral pathological changes of each vertebra separately. The accuracy of the procedures in addition to the availability of many software that can be used for segmentation will allow many surgeons to use segmentation of the vertebrae for diagnosis and even for preoperative simulation planning.

• Journal of International Society for Simulation Surgery
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• 제1권2호
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• pp.75-79
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• 2014

Purpose The region growing has a critical problem that it often extract vessels with unexpected objects such as a bone which has a similar intensity characteristics to the vessel. We propose the new method to extract arterial vascular anatomy around the stomach from the CTA volume without the post-processing. Materials and Methods Our method, which is also based on the region growing, requires the two seed points from the use. I automatically extracts perigastric arteries using the adaptive region growing method and it does not need any post-processing. Results The three region growing based methods are used to extract perigastric arteries - the conventional region growings with restrict and loose thresholds each and the proposed method. The 3D visualization from the result of our method shows our method extracted the all required arteries for gastric surgery. Conclusion By extracting perigastric arteries using the proposed method, over-segmentation problem that unexpected anatomical objects such as a rib or backbone are also segmented does not occurs anymore. The proposed method does not need to sensitively determine the thresholds of the similarity function. By visualizing the result, the preoperative simulation of arterial vascular anatomy around the stomach can be possible.

• 대한두개안면성형외과학회지
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• 제18권4호
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• pp.273-276
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• 2017

Osteomas are benign, slow-growing tumors that most frequently occur in the craniomaxillofacial region. These tumors are mostly asymptomatic and are generally found incidentally. A giant osteoma is generally considered to be greater than 30 mm in diameter or 110 g in weight. A 35-year-old female presented to us with complaints of a firm mass that showed continuous growth on the forehead following trauma. A hairline incision was made to expose the osteoma. Biopsy of the tumor confirmed a osteoma. There were no complications after surgery. Postoperative computed tomography revealed that the tumor was completely removed. Because a peripheral giant osteoma of the frontal bone with a history of trauma is a rare finding, thorough history-taking, physical examination, and preoperative imaging tests are needed for patients with a history of trauma to rule out a giant osteoma.

• Journal of Chest Surgery
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• 제49권1호
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• pp.42-45
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• 2016

Thrombosis at the left ventricular outflow tract occurs without any detectable heart disease or predisposing factors only extremely rarely. A 48-year-old male visited Konkuk University Medical Center with loss of consciousness one month prior to presentation. Before he visited our hospital, he had been diagnosed with a cardiac tumor, which was located between the left atrium and posterior aortic root, and which was adjacent to both the aortic and mitral valves. Cardiac transplantation was recommended at the other hospital because of the high risk of cardiac dysfunction induced by both aortic and mitral valvular dysfunction after surgical resection. Based on preoperative transthoracic echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and intraoperative transesophageal echocardiography, we considered it to be a benign tumor. Complete resection was achieved and the pathology confirmed organizing thrombus. We report a case of organizing thrombus mimicking a cardiac tumor, which was located at the mitral-aortic intervalvular fibrosa of the left ventricular outflow tract without any heart disease.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.591-596
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• 2017

Objective : Frameless stereotactic aspiration of a hematoma can be the one of the treatment options for spontaneous intracerebral hemorrhage in the basal ganglia. Postoperative hematoma enlargement, however, can be a serious complication of intracranial surgery that frequently results in severe neurological deficit and even death. Therefore, it is important to identify the risk factors of postoperative hematoma growth. Methods : During a 13-year period, 101 patients underwent minimally invasive frameless stereotactic aspiration for basal ganglia hematoma. Patients were classified into two groups according to whether or not they had postoperative hematoma enlargement in a computed tomography scan. Baseline demographic data and several risk factors, such as hypertension, preoperative hematoma growth, antiplatelet medication, presence of concomitant intraventricular hemorrhage (IVH), were analysed via a univariate statistical study. Results : Nine of 101 patients (8.9%) showed hematoma enlargement after frameless stereotactic aspiration. Among the various risk factors, concomitant IVH and antiplatelet medication were found to be significantly associated with postoperative enlargement of hematomas. Conclusion : In conclusion, our study revealed that aspirin use and concomitant IVH are factors associated with hematoma enlargement subsequent to frameless stereotactic aspiration for basal ganglia hematoma.