• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.432-439
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• 2012

Purpose: The aim of this study was to investigate the blood supply to the maxillary sinus in Koreans using computed tomography of the lateral wall of the sinus, and to analyze the data according to demographic data, and to compare our results with previously published research. Methods: One hundred and three patients (males 51, females 52) who visited the dental clinic were evaluated. We investigated the canals with cone-beam computed tomography, and measured the diameter and length from the bony notch of the vascular canal at the lateral wall of the sinus to each of the reference planes. Results: Most types of vascular canal were type I & II (total 72.2%) which were driving through inside the sinus wall. Type IV, V were frequently investigated in 1st premolar and 2nd molar. Mean height; from anterior nasal spine-posterior nasal spine plane to vascular canal was 5.56 mm in 1st premolar, 2.11 mm in 2nd premolar, 0.98 mm in 1st molar, 4.32 mm in 2nd molar; from the basal layer of the sinus was 4.93 mm in 1st premolar, 5.00 mm in 2nd premolar, 6.05 mm in 1st molar, 7.91 mm in 2nd molar; and from alveolar crest, 20.80 mm in 1st premolar, 16.57 mm in 2nd premolar, 14.01 mm in 1st molar, 16.17 mm in 2nd molar. The mean height of the vascular canal of each reference plane showed no significant difference between sex, site (left or right) and age. The mean diameters of the canals were 1.76 mm in male, and 1.50 mm in female. Diameter decreased with age, and tooth site (from 1st premolar to 2nd molar). Conclusion: These results show that the mean diameter of the vascular canal of the maxillary sinus varies according to age, sex, and tooth site, but that the mean height of canal had no significant difference based on these three factors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.4
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• pp.278-286
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• 2011

Introduction: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. Materials and Methods: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. Results: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. Discussion: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.140-150
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• 2005

Maxillary sinus lifting procedure and bone grafting are used to reconstruct atrophic maxillae. These procedure are usually followed by the placement of endosseous dental implants. Different materials and techniques can be used for sinus bone grafting. Platelets are known to contain various growth factors involved in the repair of the vasculature and tissues, and it is known that the specialized platelet secretory granules, the alpha granules, contain platelet derived growth factor(PDGF), transforming growth factor-beta(TGF-beta), insuline like growth factor-I(IGF-I), epidermoid growth factor(EGF), and others. This study was to evaluate the effect of PRP on bone formation in a sinus bone grafting. Twelve rabbits were included in this randomized, blinded, prospective pilot study. In experimental group, sinus bone grafting with autobone and platelet rich plasma. In control group, sinus bone grafting with only autobone. Rabbits were sacrificed at 2nd, 4th, 8th, 12th weeks postoperatively. Clinical and radiographic tests, histological analysis were conducted to compare both sides. In clinical examination, there in no significant difference between experimental group and control group. But, in radiographic examination, a distinct incresed in the radiopaque of the PRP experimental group at 2nd and 4th weeks. The histologic examination revealed that more new bone formation and osteoblast activity were seen in experimental group at 2nd and 4th weeks. In conclusion, PRPs action in sinus bone grafting had a capacity of increased new bone formation in a early bone healing stage.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.376-381
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• 1999

A variety of materials and procedures such as sinus floor elevation, sinus-lift graft, inlay bone graft using Le Fort I osteotomy, and onlay graft have been used to create adequate bone volume in the maxillary sinus for placement of endosseous implants in the posterior atrophic maxilla. Because of the frequent lack of bone in the posterior maxilla, sinus lift procedure has become a commonly practiced treatment modality. The 138 endosseous implants of 36 patients with sinus augmentation procedures performed in Korea University Hospital from January 1991 to December 1998 were summarized and analysed. The result of this study were as follows: 1. Age ranged from 39 to 57, with a mean of 50.7. 2. The mean survival rate for 138 implants with maxillary sinus lift procedure was 80.4%. 3. There was no corelationship between the fixture length, width and the survival rate. 4. The result showed that the healing period for 8-12 months was necessary if the residual alveolar bone height was less than 5mm. 5. Autogenous iliac corticocancellous block graft showed the most favorable survival rate(95%).

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.128-130
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• 2007

Purpose: Pnumosinus dilatans is a rare disease that one or more of the paranasal sinuses are dilatated without functional alteration. The most frequently involved sites are frontal and sphenoid sinus. Facial asymmetric contour is the most common signs and nasal obstruction and pain may be combined. The purpose of reconstruction of pneumosinus dilatans is two-fold, to re-establish a permanent pressure equilibrium of sinus and to correct the possible facial deformities. Methods: We present a case of a 24-year-old female with a 7-year history of protrusion of right malar region. Plane radiography and computed tomography detailed an abnormal expansion of the right maxillary sinus without thinning of bony wall, leading to diagnosis of maxillary pneumosinus dilatans. Surgical decompression and maxilloplasty were achieved by ostectomy of anterior wall of maxillary sinus and repositioning of removed bony fragment with miniplate. Results: Post operative course was uneventful without complication and malar height became symmetric by physical and radiologic examination. Conclusion: We corrected successfully pneumosinus dilatans of maxillary sinus by surgical decompression and maxilloplasty. For this case, we reviewed literature related to this topic.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.827-830
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• 2010

Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.2
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• pp.300-316
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• 1995

Methods for restoring the posterior portion of the maxilla with delayed and simultaneous sinus lift, composite graft and placement of TPS cylinder and screw type implants are presented. Sinus grafting is needed because of minimal remaining alveolar bone and supporting posterior maxillary portion, The composite graft material uses a combination of autogeneous bone from tuberosity, dimeneralized freeze dried allogenic bone and hydroxylapatite with saline. Since 1991, feb, 1 sinus graft with delayed implantation of 3 cylinder implants and 5 sinus grafts with simultaneous placement of 4HA coated screw typed, 8 TPS cylinder typed implants have been performed for 6 patients. None of the 15 restored implants have been lost, Temporization of prosthesis was done about 2-5 months before final prosthetic work, None of them shows any severe complication.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.43-49
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• 1979

This is a case report of surgically treated rupture of Valsalva Sinus aneurysm combined with VSD. He has been relatively healthy until about one month before admission, when during bath, he felt abruptly palpitation, left chest pain and exertional dyspnea. These symptoms have progressed. On admission, thrill was palpable and continuous machinery murmur was audible on 2nd and 3rd intercostal space along the left sternal border. A rupture of Valsalva`s sinus aneurysm was confirmed by aortography and echocardiography but a small VSD was found by cardiotomy in open heart surgery. On 11th Sep. 1978, open heart surgery was performed. Valsalva`s sinus aneurysm came out from right coronary aortic sinus and ruptured into the right ventricle. It sized 1.2X1.5X1.5 cm. Ruptured opening was noted on apex of aneurysm [0.8X0.8cm], VSD [1. 0X0. 3cm in size] was just below the aortic annulus. The aneurysmal sac was removed on neck. After that, VSD and aneurysmal orifice were closed together with interrupted mattress sutures on same plane. The postoperative course was uneventful and discharged three weeks after open heart surgery.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.687-692
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• 1989

Aneurysm of the sinus of Valsalva is an uncommon cardiac anomaly, usually congenital in origin, which may occur as an isolated defect or in conjunction with other cardiac malformation. This report is a case of a ruptured sinus of Valsalva aneurysm with ventricular septal defect in a 18-year-old female patient who complained progressive exertional dyspnea. She underwent operative management using total cardiopulmonary bypass. The fistula originated from the right coronary sinus and ruptured into the right ventricle and coexistent lesion was supracristal ventricular septal defect. The repair was done through aortic and right ventricular approach. The ruptured sinus of Valsalva was closed with pledget suture and the ventricular septal defect was closed with patch. The postoperative result was good.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.655-660
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• 1989

The unroofed coronary sinus syndrome is a spectrum of cardiac anomalies in which part or all the common wall between the coronary sinus and the left atrium is absent. This defect is part of a developmental complex which includes absence of the coronary sinus and termination of a persistent left superior vena cava in the left atrium. Recognition of this complex is important so that interruption or diversion of the left superior vena cava may be done to prevent subsequent central nervous system complications. Surgical correction uses an intraatrial baffle to divert flow from the left superior vena cava to right atrium and to close the atrial septal defect. This report describes a 7 years old female patient in whom the left superior vena cava was identified preoperatively and the complex [unroofed coronary sinus syndrome, common atrium, mitral valve cleft] recognized at the time of operation. Surgical correction, following repair of cleft mitral valve, utilized a Dacron patch baffle to route the left caval blood to the right atrium and included closure of the atrial septal defect