Purpose: The majority of nasal bone fractures have been managed by routine procedure of closed reduction and intranasal packing. However, nasal packing can cause nasal injury, hypoxia and patient's discomfort. And, synechiae formation is a frequently occurred after the nasal surgery. Various methods are used to reduce the incidence of synechiae formation. The purpose of this study was to compare routine procedure and nasal packing with reverse "U" shaped silicone sheet with respect to postoperative nasal synechiae formation and final outcome. Methods: We analyzed the medical records of 100 patients with nasal bone fracture who were operated by closed reduction in the last one year. The silicone sheet was designed in reverse "U" fan - shape and inserted between the middle turbinate and the septal wall. Nasal packing was removed at two days after the operation, and silicone sheet was removed at 10 to 14 days. Results: Synechiae in the middle meatus developed in 2 of 75 patients. Although synechiae between the middle meatus and nasal septum occurred in patients, the patients did not complaint of any olfactory disturbance and nasal obstruction. Conclusion: The reverse "U" fan - shape silicone sheet caused less pain for patients and no significant differences in outcome were found. The results of this study suggest that insertion of silicone sheet between the middle meatus and septum can be a useful method in the prevention of intranasal synechiae formation. The reverse "U" silicone sheet is a good alternative for routine packing methods.
Kim, Byung Jun;Lim, Jong Woo;Park, Ji Hoon;Lee, Yoon Ho
Archives of Craniofacial Surgery
/
v.15
no.2
/
pp.82-88
/
2014
Background: The chin shape and position is important in determining the general shape of the face, and augmentation genioplasty is performed alone or in combination with other aesthetic procedures. However, augmentation genioplasty using osteotomy is an invasive and complex procedure with the potential to damage mentalis muscle and mental nerve, to affect chin growth, and prolonged recovery. Our aim was to present our experience with a modified augmentation genioplasty procedure for hypoplastic chins using a Gore-Tex implant. Methods: Two vertical slit incisions were made at the canine level to create a supra-periosteal pocket between the incisions, preserving the periosteum and mentalis muscle. Minimal sub-periosteal dissection was performed lateral to the incisions along the mandibular border. The both wings of implant were inserted under the periosteum to achieve a stable dual plane implantation. Results: In total, 47 patients underwent dual plane chin augmentation using a Gore- Tex implant between January 2008 and May 2013. The mean age at operation was 25.77 years (range, 15-55 years). There were 3 cases of infection; one patient was treated with antibiotics, the others underwent implant removal. Additionally, two patients complained of postoperative parasthesia that spontaneously improved without any additional treatment. Most patients were satisfied with the postoperative outcomes, and no chin growth problems were observed among the younger patients. Conclusion: Dual plane Gore-Tex chin augmentation is a minimally-invasive operation that is simple and safe. All implants yielded satisfactory results with no significant complications such as mental nerve injury, lower lip incompetence, or chin growth limitation.
Background Condylar process fractures account for one-third of all mandibular fractures, and the distal fragment is prone to dislocate to the medial side due to the pulling of the lateral pterygoid muscle. Retromandibular approaches are commonly used, but the intraoperative view becomes limited in medially dislocated fractures. This study summarized a series of cases of retromandibular reduction for medially dislocated condylar process fractures and described our supplementary procedure to realign the dislocated condylar process. Methods Nine patients with medially dislocated condylar process fractures underwent surgical correction from January 2012 to December 2016. In 6 of them, it was possible to realign the fractures with a conventional retromandibular approach, but for 3 cases of severe dislocation to the middle cranial fossa, a supplementary transoral procedure was carried out. The angle difference between the ramus and condyle, ramus height, and maximal mouth opening (MMO) were evaluated. Results All 9 cases were restored to the proper anatomical alignment without any major complications, and postoperative images revealed successful union. The angle difference was $8.94^{\circ}{\pm}4.11^{\circ}$ preoperatively, and $0.99{\pm}0.49^{\circ}$ at the 6-month follow-up. The pretreatment ramus height difference was $6.12{\pm}6.09mm$, and the postoperative difference was $0.18{\pm}0.10mm$. These changes after surgery were statistically significant. The MMO before surgery was $11.44{\pm}3.0mm$, and the postoperative MMO was $37.2{\pm}2.9mm$, reflecting a significant increase after reduction. Conclusions Retromandibular reduction is a useful method in medially dislocated condylar process fractures, and additional transoral assistance should be considered to realign condylar processes that severely dislocate to the middle cranial fossa.
Ho Yoon Jeong;Taewoo Kang;Heeseung Park;Kyoung Eun Kim;Su Bong Nam;Ju Young Go;Seong Hwan Bae
Archives of Plastic Surgery
/
v.51
no.1
/
pp.62-66
/
2024
Gestational gigantomastia is characterized by the rapid growth of breasts during pregnancy. The treatment method of gestational gigantomastia is unclear; if the medical treatment is ineffective, surgery is considered. However, sufficient research on which method is best to perform breast reconstruction for the gestational gigantomastia patient has not yet been conducted. Our patient was young and had aesthetic needs; thus, we did not recommend modified radical mastectomy. However, it was difficult for the patient to consider active reconstruction using an implant or autologous tissue because of the expected complications and economic problems. The patient had a thin body shape and very large breasts compared with the trunk. Therefore, breast volume was not significantly required after reconstruction. Additionally, we expected that a considerable portion of skin would remain after mastectomy as a tubular-shaped breast. It was expected that the Goldilocks technique would be sufficient to meet the patient's volume needs. Therefore, we proceeded with total mastectomy and reconstruction using the Goldilocks procedure. No complications were recorded after the operation; most of the patient's discomfort was resolved, and the shape and size of the breasts were satisfactory.
Choi, Eui Chul;Kim, Jun Hyuk;Nam, Doo Hyun;Lee, Young Man;Tak, Min Sung
Archives of Craniofacial Surgery
/
v.11
no.1
/
pp.53-57
/
2010
Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.
Purpose: A lower facial contouring surgery has become a commonly performed procedure in Asia. Currently, mandibular angle sagittal ostectomy and botulinum toxin type A treatment are main procedures for aesthetic correction of a broad lower face. There are a few date to show the differences in the mandibular contouring changes between mandibular angle splitting ostectomy and botulinum toxin type A treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective for evaluation of facial contour analysis. This study was designed specifically to compare the changes in lower face width after two different forms of lower facial contouring procedure using facial golden mask. Methods: Seventeen patients, aged 18 to 55 years (mean, 28.6 years), 15 women and 2 men, consented to the study and receive a contouring procedure of lower face. The patients were classified in to 2 groups. In group A, the sample consisted of 10 patients with a prominent squared mandibular angle and mandibular angle splitting ostectomy was performed. In group B, the sample consisted of 7 patients with masseteric hypertrophy and botulinum toxin type A treatment was performed. Photographs of the face were taken to record the facial change at preoperative and postoperative. The postoperative photographs were taken to considered maximal effect at 2 years after surgery in group A and 4.8 months after treatment in group B. The authors applied the facial golden mask to preoperative and postoperative photographs and horizontal ratio, which compares facial width with golden mask width, were calculated. We made an analysis of the result of horizontal ratio using SPSS. Results: Overall average horizontal ratio of pre- and postoperative photos of group A were 1.24 and 1.11, whereas overall average horizontal ratio of pre- and postoperative photos of group B were 1.19 and 1.12. The horizontal ratio decreased 10.24% in group A and 5.93% in group B. There was a statistically significant change in before and after treatment, but there was no significant change in comparing the group A and group B. Conclusions: The result from this study suggest that mandibular angle sagittal ostectomy and botulinum toxin type A treatment showed relatively satisfactory clinical effects on lower facial contouring treatment. There was no statistical significant difference within two lower facial contouring treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective, so we think that facial golden mask is a good method for evaluation of lower facial contouring treatment.
Kim, Byung Jun;Choi, Jun Ho;Kim, Tae Hoon;Jin, Ung Sik;Minn, Kyung Won;Chang, Hak
Archives of Plastic Surgery
/
v.41
no.6
/
pp.702-708
/
2014
Background Lower abdominal soft tissue transfer is the standard procedure for breast reconstruction. However, abdominal wall weakness and herniation commonly occur postoperatively at the donor site. To reduce the morbidities of the donor site, the superficial inferior epigastric artery (SIEA) flap was introduced, but inconsistent anatomy of the SIEA has reduced its utility. In the present study, the anatomy of the superficial inferior epigastric vessels in Korean women was determined with regards to breast reconstructive surgery. Methods The vascular anatomies of the SIEA and superficial inferior epigastric vein (SIEV) were evaluated on 32 breast cancer patients receiving free transverse rectus abdominis musculocutaneous flap reconstruction after mastectomy. The existence, pulsation, location, external diameter, and depth of the SIEA and SIEV were measured at the lower abdominal incision level. Results SIEA and SIEV were present in 48/64 (75.00%) and 63/64 (98.44%) hemi-abdomens, respectively. Pulsation of the SIEA was found in 44/48 (91.67%) cases. The mean locations of SIEA and SIEV were +5.79 (${\pm}12.87$) mm, and -8.14 (${\pm}15.24$) mm from the midpoint between the anterior superior iliac spine and symphysis pubis, respectively. The mean external diameters of SIEA and SIEV were 1.20 (${\pm}0.39$) mm and 1.37 (${\pm}0.33$) mm, and they were found at a mean depth of 9.75 (${\pm}2.67$) mm and 8.33 (${\pm}2.65$) mm, respectively. Conclusions The SIEA was absent in 25% of Korean women and had a relatively small caliber. Therefore, careful preoperative assessment of the lower abdominal vasculature is required to achieve successful breast reconstruction using SIEA flaps.
Kim, Sang Bum;Won, Chang Hoon;Dhong, Eun Sang;Han, Seung Kyu;Park, Seung Ha;Kim, Woo Kyung;Kim, Young Jo;Lee, Byung Il
Archives of Plastic Surgery
/
v.32
no.3
/
pp.327-334
/
2005
This study was designed to investigate the effect of the surgical delay in the prefabricated cutaneous flap. Abdominal skin flaps (n=40), $4.5{\times}6.0cm$ in size, were created by the subcutaneous implantation of a saphenous vascular tissue in the male Sprague-Dawley rats. In the groups 1 and 2, the pedicle was skeletonized. In the groups 3 and 4, perivascular muscle cuff or gracilis fascia was retained, respectively. Six weeks later, each flap was elevated as an island flap and reposed in place. All flaps of the group 2 had a 72-hours of delay period. Five days after the flap repositioning, estimation of flap viability, microangiographies, and histological evaluation of vessel development were performed. The groups 2 and 3 showed higher viability in flap survival. The dilated choke vessels and fully developed vascular network were observed in the flap of the group 2, but not typically seen in the other groups. New vessels around the implanted pedicle were more developed in the group 2. Amount of the vessels in the mid-portion of the flap was significantly increased in the groups 2 and 4. In conclusion, the delay procedure enhanced the viability, and its effect was dependent on the new vessel formation around the implanted pedicle.
Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.
Yun, Tae Kyoung;Yoon, Eul Sik;Ahn, Duck Sun;Park, Seung Ha;Lee, Byung Il;Kim, Hyon Surk;You, Hi Jin
Archives of Plastic Surgery
/
v.42
no.6
/
pp.769-775
/
2015
Background The radial forearm flap is a versatile, widely used flap. However, the possibility of donor site complications has led to concern over its use. Some surgeons prefer using other flaps whose donor sites can be closed primarily with less morbidity, including avoiding unpleasant scarring. However, in our experience, donor site stability of the radial forearm flap can be reliably achieved by using well-implemented specific procedures. Here, we present a collection of donor site cases of the radial forearm flap and investigate factors that affect the aesthetic results as the basis for a reference for selecting a radial forearm flap. Methods In this retrospective study, we reviewed 171 cases in which a radial forearm flap was used for free tissue transfer after resecting head and neck cancer. We focused on donor site morbidity rates. Each operation involved a detailed procedure designed to minimize donor site morbidity. Moreover, statistical investigations were conducted for 22 cases to determine factors affecting the scar appearance. Results Only one case developed total skin graft necrosis as a major complication. Scar-related aesthetic results were acceptable, and the body-mass index, body weight, diabetes, and cardiac problems were significant factors related to the appearance of scars. Conclusions Performing the radial forearm flap using a well-implemented detailed technique helps achieve acceptable donor site morbidity results. The aesthetic results were more promising for patients without excess body weight, diabetes, or cardiac problems. Therefore, anxiety about donor site morbidity should not be a reason to avoid selecting the radial forearm flap in suitable patients.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.