• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.79-86
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• 1989

The is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans- and extra-oral approach. Among 92 sites of mandibular fractures, 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was Symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

• The Journal of the Korean dental association
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• v.54 no.12
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• pp.1045-1054
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• 2016

Purpose : Aim of this study is to describe and compare clinical results and complications epending on the surgical approaches for the mandibular subcondyle fracture Materials and methods : The patients who had been diagnosed as the mandibular subcondyle fracture and underwent open reduction and internal fixation from May 2009 to December 2014 were included. They were divided into two groups depending on the surgical approaches; endoscopically assisted transoral approach and retromandibular approach. Association between the preoperative fracture classification and post-operative results was reviewed depending on the surgical approaches. Results : The number of patients selected in this study was 33. Eighteen patients (male 7, female 11) underwent open reduction and internal fixation via retromandibular approach and fifteen patients (male 12, female 3) underwent open reduction and internal fixation via endoscopically assisted transoral approach. The mean age, follow up period, and operation time were $44.29{\pm}15.19years$, $9.97{\pm}7.82months$, and $161{\pm}89.44minutes$. Post-operative results were all "good" state in the retromandibular approach group regardless of the fracture classification but two patients in the endoscopically assisted transoral approach group underwent re-operation due to "poor" results. The fracture types of two were classified as displacement and lateral override at the same time. There was no statistically significant difference between two groups. Three patients in the retromandibular approach group had experienced facial nerve palsy (17%) temporarily. No one showed malocclusion in this study. There was no significant difference on the complications such as temporomandibular disorder, local infection, and condyle resorption depending on the surgical approaches. Conclusion : In this study, there was no significant difference on the complications between the two groups but retromandibular approach has advantage over endoscopically assisted transoral approach in case of the severely displaced subcondyle fracture.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.1-5
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• 2015

The role of transoral robotic surgery in the treatment of upper aerodigestive tract tumor has expanded in recent. Since the approval of the da Vinci system, the number of transoral robotic surgery has increased significantly. The main indications of transoral robotic surgery are tumors of oropharynx, hypopharynx, and larynxs. Transoral robotic surgery is a minimally invasive surgical approach that offers surgical access to the laryngopharynx without the morbidity of open surgeries while achieving excellent oncologic and functional outcomes. The appropriate application of transoral robotic surgery is still being investigated and previous studies supports transoral robotic surgery as a viable option in the management of upper aerodigestive tract tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.111-116
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• 2022

Retropharyngeal schwannoma is rare. To the best of our knowledge, only 18 cases have been published in the English literature. Complete surgical excision is the treatment of choice for schwannomas. Transoral approaches have been applied for smaller lesions, and external cervical approaches are preferred for larger and more complex lesions. In this report, we present a case of large retropharyngeal schwannoma that was excised using an endoscopic-assisted transoral approach with palatal splitting. Postoperative functional and oncologic outcomes were satisfactory with no reported intraoperative/postoperative complications.

• Korean Journal of Bronchoesophagology
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• v.16 no.1
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• pp.27-32
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• 2010

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.144-150
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• 2016

Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.43-48
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• 2010

The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.74-77
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• 2015

A lingual thyroglossal duct cyst(LTGDC) is a rare congenital anomaly that account for only 0.5% to 2% of total thyroglossal duct cyst. LTGDC is frequently associated with respiratory problem in infants and pharyngeal foreign body sensation or dysphagia in adults. Because of its location and characteristics, lingual thyroid, dermoid cyst, and vallecular cyst should be included in differential diagnosis. Standard treatment for thyroglossal duct cyst is sistrunk's operation, but in terms of LTGDC, because of its location and cosmetic reasons, different kinds of treatments such as electrical cauterization, $CO_2$ laser, Robort surgery via transoral approach have been introduced. Recently authors encountered 21 years old woman with LTGDC and the mass was removed successfully via transoral approach using $CO_2$ laser. We report the clinical course with review of the literature.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.214-216
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• 2008

Parapharyngeal space tumors are extremely rare accounting for about 0.5% of all head and neck tumors and treat mostly by surgical removal. Due to their inherent location, they present with varied non-specific signs and symptoms, resulting in a delay in diagnosis and unnecessary procedures, such as a 'tonsillectomy' or 'incision and drainage' of a 'quinsy'. We recently confirmed a case about a the neurilemnoma on parapharyngeal space during tonsillectomy. To present our experience with the transoral approach for parapharyngeal space tumor and describe our technique for removal of these neoplasms. Although parapharyngeal space tumours are uncommon, recognizing them would enable the correct sequence of investigations, instead of unnecessary procedures resulting in an increased morbidity for the patient.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.379-388
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• 2000

Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.