• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.433-442
• /
• 2010

Purpose: Many authors reported about the posttraumatic nasal aesthetic complications. However, the studies for functional or intranasal complications are not enough yet. We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae, and the synechiae formation was a frequently occurred after the nasal bone reduction. And then, the aim of this study is to identify the usefulness of the treatment of intranasal synechiae. Methods: We reviewed the data from 10 patients with symptomatic intranasal synechiae from June 2007 to June 2009. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We studied 10 patients with intranasal synechiae who had persistence postoperative symptoms. We studied the patients who were operated by removal of synechiae and ancillary surgical treatments in the last two years. Results: In the previous report, the incidence of intranasal synechiae was 15% (n=62) and symptomatic synechiae was 16% (10/62). We classified the nasal bone fracture according to Stranc classification. In this paper, the incidence of treated intranasal synechiae was 13% (2/15) in Frontal Impact (FI) Type I, 11% (2/18) in FI Type II, 100% (2/2) in FI Type III, 0% (0/2) in Lateral Impact (LI) Type I, 25% (3/12) in LI Type II, and 33% (1/3) in LI Type III, respectively. After removal of synechiae, all patients improved nasal obstruction and little improved olfactory disturbance. Conclusion: Simple removal of synechiae by scissors improved postoperative symptoms and complications such as nasal obstruction and olfactory dysfunction. After removal of synechiae, all patients improved nasal obstruction, however, little improved anosmia. So, we thought that olfactory dysfunction may result in many intranasal factors. First of all, education of delicate procedure regarding this subject should be empathized accordingly.

• Archives of Plastic Surgery
• /
• v.36 no.2
• /
• pp.242-246
• /
• 2009

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.

• Archives of Plastic Surgery
• /
• v.36 no.2
• /
• pp.188-193
• /
• 2009

Purpose: Several authors reported about the post - traumatic nasal aesthetic complications. However, the study for functional or intra - nasal complications has been reported not enough. The aim of this study is to observe the incidence of intranasal synechia. Methods: We reviewed the data from 401 consecutive patients with nasal bone fracture from september 2006 to December 2007. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We classified the nasal bone fracture according to the anatomy and severity of fracture. Type I is nasal tip fracture(15%, n = 59), Type II is simple lateral without septal injury(38%, n = 152), Type III is simple lateral with septal injury(23%, n = 92), Type IV is closed comminuted(20%, n = 82), Type V is open comminuted or complicated(4%, n = 16). We studied 98 patients with nasal bone fracture who had postoperative symptoms or undergone postoperative endoscopic evaluation. And then we evaluated the postoperative endoscopic finding and nasal synechal formation after operation. Results: The incidence of intranasal synechiae was 15%(n = 62). According to the endoscopic findings, the incidence of intranasal synechiae was 10%(n = 6) in Type I, 8%(n = 12) in Type II, 16%(n = 15) in Type III, 24%(n = 20) in Type IV, and 56%(n = 9) in Type V. Additionally, the incidence of subjective nasal obstruction and olfactory dysfunction is 18%(n = 72) and 13%(n = 51). But the incidence of symptomatic synechiae of nasal obstruction and olfactory dysfunction is 92%(57/62) and 55%(34/62). Conclusion: We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae. Based on the results of this study, intranasal synechiae really caused airway obstruction(92%). Our data showed significant relationship between intranasal synechiae and severity of the fracture, because of increasing mucosal handling and destructive closed reductional procedures. First of all, education of delicate procedure regarding this subject should be empathized accordingly.

• Archives of Craniofacial Surgery
• /
• v.9 no.1
• /
• pp.41-44
• /
• 2008

Cleft palate and congenital alveolar synechia is a rare syndrome. Only eight cases have been previously reported. It consists of a spectrum of facial anomalies always including cleft palate and congenital alveolar synechiae without other abnormalities. This report described an unusual case of congenital alveolar synechial band spanning posterior alveolar of the two jaws with cleft palate. Previously reported cases showed bilaterally or anteriorly located fibrous band. In our department, a new born revealed unilateral posterior synechia. Under brief intravenous sedation, synechium was divided using bipolar diathermy in the nursery at 3 days of age because of poor feeding. This division allowed full jaw opening after brief passive exercise. The patient is growing and maturing as expected with no complications. This patient is supposed to be the first reported case of isolated unilateral alveolar synechium combined with cleft palate in the worldwide.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.8.1-8.4
• /
• 2016

Congenital alveolar synechiae is a rare anomaly mostly presenting in association with cleft palate. Owing to reduced mouth opening, feeding difficulties, and compromised airway in extreme cases along with presentation in early neonatal period, these patients present unique challenges to the surgeon as well as the anesthetist. Here, we discuss the surgical and anesthetic management of this entity in a 12-month-old female child.

• Korean Journal of Cleft Lip And Palate
• /
• v.4 no.1
• /
• pp.45-53
• /
• 2001

Congenital craniofacial disorders represent approximately 20% of all birth defects, One of these disorders is syngnathia, Congenital fusion of the maxilla and mandible is rare and can present in a wide range of severity from single mucosal band(synechiae) to complete bony fusion(syngnathia), Syngnathia, congenital bony fusion of the mandible and maxilla, is even less common than synechiae, with only 25 cases reported in the literature, Most of them have presented as an incomplete, unilateral fusion, We report a case of unilateral bony fusion of the maxilla, mandible, and zygomatic arch, Details of operative management and follow-up data are presented with review of literature.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.1
• /
• pp.22-26
• /
• 2007

상악과 하악이 선천적으로 붙어서 태어나는 선천성 유합증은 드문 선천성 기형으로 단순히 점막이 붙은 점막유합증에서 악골이 붙은 골유합증까지 다양하게 나타난다. 이중 상악골과 하악골의 골자체가 붙는 골유합증은 아주 드물어서 현재까지 26증례만 보고되고 있는데, 보고된 대부분의 증례는 편측에만 발생하는 불완전형으로 알려져 있다. 7세 된 여아환자가 인디아의 GSR 병원에 입이 벌어지지 않는다는 주소로 내원하였는데 환아의 턱은 완전히 움직이지 않았으며, 2-3 mm 정도 벌어지는 앞니부위에서는 2.5 cm 폭경의 3.0 mm 두께의 단단한 치조점막이 관찰되었다. 전기메스로 전방부의 부착성 섬유밴드를 잘라준 후 즉각적인 개구정도는 16 mm 정도까지 가능하여 구강으로의 기관삽관이 가능하였다. 삽관후 양쪽 후방부 협측점막의 두꺼운 밴드들을 모두 제거하여 개구량을 33 mm까지 증진시킨 후 수술을 종결하였다. 환아의 보호자에게 거즈 블록과 설압자를 이용하여 개구 연습을 능동적으로 시키도록 강조하여 교육하였으며 술후 16개월 경과시까지 특별한 합병증이나 개구량 감소는 관찰되지 않았다. 독립적으로 발생한 선천성 치조점막 유합증 환자에서 비정상적으로 커져있는 과두와 설골이 관찰되었는데, 설-하악 구조의 비정상적인 발육에 기인하여 지속적인 비정상적 운동으로 인한 이차적인 치은과 협점막의 섬유성 부착이 생긴 것으로 추측되었다. 이에 마취과와의 효율적인 협진으로 기관절개술 등의 부가적인 마취방법 없이 효과적으로 치료할 수 있었다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.1
• /
• pp.11-15
• /
• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• Journal of Veterinary Clinics
• /
• v.14 no.2
• /
• pp.141-146
• /
• 1997

This study was performed to investigate the ophthalmic diseases in 269 Holstein dairy cattle of 10 farms in Kyunggido, Korea. The acerage prevalence rate of ophthalmec diseases was 25.7%, ranging of from 4.8% to 47.6%. The highest incidence age was between 3 and 4 years old, 41.9% and then in order of between 5 and 6 years, between 2 and 3 years, over 6 years, between 4 and 5 years, between 1 and 2 years, and up to 1 year were shown the incidence of 33.3%, 29.4%, 27.7%, 23.8%, 19.8% and 12.5%, respectively. The prevalence rate of cataracts was higher than any other ophthalmic diseases, 10.4% and then in order of chorioretinitis, iris posterior synechiae, corneal scar, conjunctivitis, blindness, third eyelid carcinoma and globe anomaly were diagnosed as the incidence of 4.1%, 3.0%, 1.7%, 1.3%, 0.4%, 0.2% and 0.2%, respectively.

• Korean Journal of Fisheries and Aquatic Sciences
• /
• v.46 no.6
• /
• pp.923-929
• /
• 2013

Black seabream juveniles Acanthopagrus schlegelii held at $20^{\circ}C$ were exposed to formalin at concentrations of 50 to 400 ppm, and tolerance values were determined by calculating median lethal concentration values (LC50) through probit analysis. The 12-, 24, 48, 72- and 96-h LC50 values for formalin were 297, 233, 171, 162 and 157 ppm, respectively. The histological effects of formalin on gill and liver tissues in this fish were determined. No histological effects were observed in the control group. The intensity of cell damage increased with the concentration of, and duration of exposure to, formalin. Hyperplasia, separation and epithelial necrosis, epithelial lifting, lamellar synechiae and collapsed lamellae were observed in gill tissues exposed to formalin. Hepatic lesions in liver tissues of fishes exposed to formalin were characterized by cloudy swelling of hepatocytes, necrosis, cytoplasmic vacuolization, deposition of pigments, spongiosis hepatis, nuclear hypertrophy, dilation of sinusoids and bile stagnation. The LC50 values and histological results obtained in this study will aid in designing treatment regimens to minimize toxic side effects and increase efficacy.