• Journal of Chest Surgery
• /
• v.30 no.1
• /
• pp.48-54
• /
• 1997

Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

• Journal of International Society for Simulation Surgery
• /
• v.1 no.1
• /
• pp.32-36
• /
• 2014

Reconstruction of the maxilla is quite a difficult challenge for reconstructive surgeons. The maxilla is the most important part of the midface, which contributes to facial esthetics, mastication, swallowing, speech, supporting orbital contents and sinus function. Free fibular flap is most versatile to reconstruct jaw bone because of its adequate length, containing both soft and bony tissues and acceptance of dental implants. In this case report, a reconstruction of the maxilla using free fibular flap and dental implants is described in which rapid prototype was used before surgery to simulate the final prosthetic results.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.21 no.1
• /
• pp.22-26
• /
• 2010

Neuromuscular Disorders Affecting the Larynx are steadily important topics at laryngology. Physiology of larynx is controlled by the frame structure and neuromuscular dynamics to acting on the specialized soft tissue, Therefore, for a proper understanding of the larynx, it is needed the voice and swallowing, a series of prayers on the regulation of neurologic function and the correlation between systemic neuromuscular disease and laryngeal symptoms and clinical knowledge, We described that clinical findings and treatments of the 3 neurological diseases causing dysphonia well (Parkinson's disease, laryngeal tremor, spasmodic dysphonia) and vocal impairments for stoke patients.

• Korean Journal of Bronchoesophagology
• /
• v.17 no.1
• /
• pp.29-34
• /
• 2011

Traditionally, the main strategy of treatment of the head and neck cancer was en bloc resection including adjacent normal tissues through wide incision. However, the procedures may leave severe functional deficit such as swallowing difficulty, aspiration, and wide neck scar. Therefore, many attempts have been made up to minimize these morbidities. Of them, the minimal invasive approach such as transoral laser microsurgery (TLM) and transoral robot surgery (TORS) have been spolighted as a sensible strategy for organ preservation of the head and neck cancer patients. Results of TLM are equivalent to those obtained by conventional surgery, with considerably less morbidity, less hospital time and better postoperative function. Oncologic results of TLM are equivalent to conventional surgery. TORS are safe, feasible, and promising but oncologic safety is not yet verified. This article covers to current application of TLM and TORS, their advantages and limitations, and future direction.

• The Journal of the Korean dental association
• /
• v.56 no.6
• /
• pp.333-338
• /
• 2018

The mouth guard is a device with elasticity to be installed in the oral cavity. It has a function to reduce the trauma in the oral cavity and to protect the teeth and surrounding tissues from trauma. The purpose of mouth guard is to prevent trauma and concussion. It is mandatory to wear a mouthguard in sports where there is a lot of contact and the possibility of trauma or concussion in the mouth area is high. The mouse guard is divided into a stock type, a mouth formed type, and a custom made type according to the manufacturing method. The custom made type is made on the individual dentition model and has excellent retention because of its excellent fit. Also, the effect of trauma prevention is excellent. It is possible to design and adjust by the dentist and reduce the complaint the athlete has about the mouthguard. In this article, the process of making a dentist-customized mouthguard was described.

• Korean Journal of Cleft Lip And Palate
• /
• v.13 no.2
• /
• pp.43-52
• /
• 2010

Intraoral prosthesis (Palatal Augmentation Prosthesis, PAP) may be used to augment swallowing function in patients with dysphagia. PAP can be used to recontour the dimensions of hard palate to fit the tongue following removal of oral cancer. Use of PAP can significantly improve the patient's ability to use the tongue to propel the bolus through the pharynx. The aim of this study is to show the effects of PAP through videofluoroscope in patients with dysphagia. The results were as follows: 1. A decrease in pharyngeal transit time was detected wearing with PAP. 2. Pharyngeal cross area was decreased wearing with PAP. 3. The results indicated PAP may effectively help lingual movement in patients with dysphagia.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.18 no.3
• /
• pp.185-195
• /
• 2002

Purpose This article describes the historic and clinical aspects of the determination of the vertical dimension of occlusion and the synoptic procedure of the determination of the vertical dimension of occlusion in complete denture. The determining procedure of the susceptible vertical dimension of occlusion is one of the most important steps in construction of complete denture and prosthodontic treatment. It is considered essential for the improvement and the recovery of facial esthetics and stomatognathic functions. Results Several methods have been suggested for measurement of the vertical dimension of occlusion in the construction of complete denture and the prosthodontic rehabilitation. These range from pre-extraction records to the use of physiologic rest position, swallowing, phonetics, esthetics and facial proportion, etc. But, there is no universally accepted or completely accurate method. There seems to be no significant advantages of one technique other than those of cost, time and equipment requirements, and seems to be in controversial in determining the vertical dimension. Conclusion The vertical dimension of occlusion should be determined and reinspected carefully by dentist for a successful prosthesis with several methods. The more investigations are necessary for more objective and scientific techniques in determining the vertical dimension of occlusion.

• The Korean Journal of Rehabilitation Nursing
• /
• v.5 no.1
• /
• pp.38-48
• /
• 2002

The purpose of this study is to identify the effects of a nursing intervention using sensory stimulation in dysphagic patients. Quasi-experimental with a nonequivalent control group pretest-posttest design was used. 15 patients of each group were assigned for this study, who were hospitalized in the oriental medicine hospital of K. University. Specific stimulation plans were devised based on a dysfunctional area of the subjects. For each modality, subjects were systematically stimulated for 30 minutes, in the experimental group prior to each meal and 3 times per day for a week. The data were analyzed by SPSS PC program using $X^2$-test, Wilcoxon Signed Rank test and Mann-Whitney U test. The results of this study are as follows : 1. The tongue control score of the experimental group is greater than that of the control group(u=52.0, p=.007). 2. The score of chewing ability, lip control, swallowing ability of the experimental group is greater than that of the control group. But no difference is statistically seen between the experimental group and control group. Therefore, this study shows that sensory stimulation using icing, quick stretch, etc., was effective in improving or oropharyngeal function in patients with dysphagia.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.2
• /
• pp.225-230
• /
• 1999

The labiomandibulotomy approch to the oral cavity and oropharygeal region was first described by Roux in 1836 and become popular for oral and oropharyngeal tumors in cases where there are no clinical and radiological signs of mandible invasion. Anterior labiomandibulotomy and swing procedure provides excellent access and facilitate a mandibular resection and subsequent repair. In last two years, 8 cases of oral and oropharyngeal tumors were treated by this approach at the Dept. of Oral & Maxillofacial Surgery, Holy Family Hospital, Catholic University of Korea. And we analyzed postoperative complications as well as functional evaluations, and the results were as follows; In 4 cases, marginal mandibulectomy were combined with labiomandibulotomy and in case of malignancies, neck dissection was performed simultaneously. In almost case, plate and miniscrew fixation was used for osteotomy sites. Histologic evaluation of the resection margins of the specimens revealed tumor free in all cases. The postoperative complications were occured in 3 cases, one case of nonunion, one case of orocutaneous fistula, and one case of wound dehisence. Occlusal stability, jaw movement and swallowing function were acceptable postoperatively in 3 months. From above results, we concluded that, this approach not only provides wide exposure, permitting radical removal of benign and malignant lesions but also preserves function with minimal complications.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.546-551
• /
• 2006

Purpose: The reconstruction of oropharyngeal defect after cancer surgery is very difficult because of their complicated structure and the functional importance to prevent velopharyngeal incompetence. In this article we investigated affecting factors of velopharyngeal function after reconstruction and a fundamental rule of reconstruction for saving their functions such as swallowing, speeching and breathing. Methods: We classified 18 patients into three group under Kimata's grouping. Type I defect(6 patients) was healed by primary closure or secondary intention. In Type II or III defect, two operation methods were used - the folded flap(8 patients) and modified Gehanno method(4 patients), which include a lateral-posterior pharyngeal rotation-advancement flap. We evaluated wound dehiscence between the flap and the soft palate, speech intelligibility using Hirose's method, regurgitation during oral feeding, and hypernasality. Results: Most of type I or II defects patients recovered satisfactory velopharyngeal function. But, in patients with type III defects we found wound dehiscence, worse speech function, and common velopharyngeal incompetence. Conclusion: The large defect size and presence of wound dehiscence are major factors of postoperative velopharyngeal function. We conclude that folded flap or modified Gehanno method is a good reconstructive operation method for broad contact between the flap and defect site, preventing wound problem.