• Archives of Plastic Surgery
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• 제46권6호
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• pp.572-579
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• 2019

Background Even with satisfactory anastomosis technique and adequate experience of the surgeon, flap loss due to thrombosis can still occur due to the patient's underlying condition. Patients with hypercoagulability due to etiologies such as malignancy, hereditary conditions, and acquired thrombophilia are among those who could benefit from free flap procedures. This review aimed to evaluate the risk of free flap thrombosis in patients with hypercoagulability and to identify the most effective thromboprophylaxis regimen. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The PubMed, Embase, and Cochrane Library databases were explored. Types of free flaps, types of hypercoagulable states, thrombosis prevention protocols, thrombosis complication rates, and flap vitality outcomes were reviewed. Samples from the included studies were pooled to calculate the relative risk of free flap thrombosis complications in patients with hypercoagulability compared to those without hypercoagulability. Results In total, 885 articles underwent title, abstract, and full-text screening. Six articles met the inclusion criteria. The etiologies of hypercoagulability varied. The overall incidence of thrombosis and flap loss in hypercoagulable patients was 13% and 10.3%, respectively. The thrombosis risk was two times higher in hypercoagulable patients (P=0.074) than in controls. Thromboprophylaxis regimens were variable. Heparin was the most commonly used regimen. Conclusions Hypercoagulability did not significantly increase the risk of free flap thrombosis. The most effective thromboprophylaxis regimen could not be determined due to variation in the regimens. Further well-designed studies should be conducted to confirm this finding.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권5호
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• pp.353-357
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• 2002

Pigmented villonodular synovitis(PVNS) usually presents as a benign proliferative monoarticular arthritis that affects the knee in 80% of cases, followed in frequency by the hip, ankle, and calcaneocuboid joint. PVNS rarely affects temporomandibular joint area. Patients typically complain of pain, locking, and recurrent swelling. Tumor progression limits the range of movement of the joint and causes it to become stiff and firm. Sometimes a palpable mass can be appreciated. Aggressive form of PVNS invades into adjacent bones and soft tissues, is confused with other types of neoplasia. Here we report 2 cases of the PVNS on a temporomadibular

• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.177-186
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• 2003

교통사고의 증가로 심한 경골 고평부 골절이 점진적으로 증가되는 양상이며, 경골 고평부 골절 후 동반손상의 적절한 치료, 해부학적 정복 및 견고한 고정, 조기 관절운동이 좋은 예후를 보이며 외상성 관절염을 줄일 수 있을 것으로 사료된다.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.3-9
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• 2023

Background In breast reconstruction, synthetic meshes are frequently used to replace acellular dermal matrix (ADM), since ADM is expensive and often leads to complications. However, there is limited evidence that compares the types of substitutes. This study aimed to compare complications between materials via a network meta-analysis. Methods We systematically reviewed studies reporting any type of complication from 2010 to 2021. The primary outcomes were the proportion of infection, seroma, major complications, or contracture. We classified the intervention into four categories: ADM, absorbable mesh, nonabsorbable mesh, and nothing used. We then performed a network meta-analysis between these categories and estimated the odds ratio with random-effect models. Results Of 603 searched studies through the PubMed, MEDLINE, and Embase databases, following their review by two independent reviewers, 61 studies were included for full-text reading, of which 17 studies were finally included. There was a low risk of bias in the included studies, but only an indirect comparison between absorbable and non-absorbable mesh was possible. Infection was more frequent in ADM but not in the two synthetic mesh groups, namely the absorbable or nonabsorbable types, compared with the nonmesh group. The proportion of seroma in the synthetic mesh group was lower (odds ratio was 0.2 for the absorbable and 0.1 for the nonabsorbable mesh group) than in the ADM group. Proportions of major complications and contractures did not significantly differ between groups. Conclusion Compared with ADM, synthetic meshes have low infection and seroma rates. However, more studies concerning aesthetic outcomes and direct comparisons are needed.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.92-96
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• 2017

Background: All nasal bone fractures have the potential for worsening of olfactory function. However, few studies have studied the olfactory outcomes following reduction of nasal bone fractures. This study evaluates posttraumatic olfactory dysfunction in patients with nasal bone fracture before and after closed reduction. Methods: A prospective study was conducted for all patients presenting with nasal bone fracture (n=97). Each patient consenting to the study underwent the Korean version of Sniffin' Sticks test (KVSS II) before operation and at 6 month after closed reduction. The nasal fractures were divided according to the nasal bone fracture classification by Haug and Prather (Types I-IV). The olfactory scores were compared across fracture types and between preoperative and postoperative settings. Results: Olfactory dysfunction was frequent after nasal fracture (45/97, 46.4%). Our olfactory assessment using the KVSS II test revealed that fracture reduction was not associated with improvements in the mean test score in Type I or Type II fractures. More specifically, the mean posttraumatic Threshold, discrimination and identification score decreased from 28.8 points prior to operation to 23.1 point at 6 months for Type II fracture with septal fracture. Conclusion: Our study has revealed two alarming trends regarding post-nasal fracture olfactory dysfunction. First, our study demonstrated that almost half (46.4%) of nasal fracture patients experience posttraumatic olfactory dysfunction. Second, closed reduction of these fractures does not lead to improvements olfaction at 6 months, which suggest that olfactory dysfunction is probably due to factors other than the fracture itself. The association should be further explored between injuries that lead to nasal fracture and the mechanism behind posttraumatic olfactory dysfunction.

• Advances in pediatric surgery
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• 제6권1호
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• pp.40-44
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• 2000

Congenital esophageal stenosis (CES) is a narrowing of the esophageal lumen from birth. Three types of CES have been described; tracheobronchial remnants (TBR), membranous web (MW), and fibromuscular stenosis (FMS). We reviewed the clinical features and the surgical outcome of 14 patients, pathologically confirmed as CES. Nine patients had TBR, 3 FMS, and 2 MVV. The mean age at operation was 3.8 years. Five patients were boys and 9 girls. Four patients had other congenital anomalies. Segmental resection of the lesion and end to end anastomosis was utilized in all cases except one who underwent myotomy. The stenotic segment was located at the distal esophagus in all patients. There were 8 complications in 6 patients, but no mortality. The mean follow-up period was 68 months. There were no feeding problems but 3 patients had minor gastroesophageal reflux. Our result indicates that segmental resection and anastomosis is a satisfactory surgical procedure in the management of CES.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.29.1-29.7
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• 2020

Background: Microvascular reconstruction is the treatment of choice after oral cancer ablation surgery. There are few published studies of free flap survival among Korean populations. This study aimed to determine the survival rate after 121 consecutive cases of maxillofacial microvascular reconstruction and to analyze the complications associated with microsurgery. Methods: This study included consecutive patients who underwent microsurgical reconstruction with free flaps, from January 2006 through September 2019, performed by a single surgeon at the oral and maxillofacial surgery department of a tertiary medical center. A total of 121 cases were reviewed retrospectively. The flap survival rate, flap type, radiotherapy history, complications, and treatment results were analyzed. Results: Four different flap types were used for microvascular reconstruction: radial forearm (n = 65), fibula (n = 34), latissimus dorsi (n = 21), and serratus anterior muscle with rib bone free flap (n = 1). Total necrosis of the flap was found in four cases (two latissimus dorsi flaps and two fibular flaps). The free flap survival rate was 97.5%. Nineteen patients received radiotherapy before surgery, and none of them experienced flap failure. The mean operation time was 334 ± 83.1 min, and the mean ischemic time was 48.9 ± 12.7 min. Conclusions: The success rate was reliable and comparable with previous studies. The success rate was not affected by radiation therapy. Free flaps can be safely used even after radiation treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.125-134
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• 1996

Mucoepidermoid carcinomas, first reported by Volkman(1895), form 6% to 9% of all salivary tumors. Two thirds affecting the parotid gland and the remaining third, the minor glands. As we could know from its name, mucoepidermoid carcinomas originate from ductal epithelium including squamous, mucous-secreting, and undifferentiated intermediate cells. Histologically, it is classified as well-differentiated (low grade), moderately-differentiated(intermediate grade), and poorly-differentiated (high grade) types and the treatment method and prognosis are influenced from its histological grade. We have experienced two cases of mucoepidermoid carcinoma treated surgically with good results and now would like to report these with review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권3호
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• pp.229-236
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• 2006

The biologic principle of guided bone regeneration(GBR) has been studied extensively in hopes of regenerating alveolar bone. Various materials have been utilized as regenerative membranes and grafting materials in implant surgery. To improve the ability of membranes, several types of membrane have been developed. Various materials have been utilized as regenerative membranes; however, all materials have disadvantages, and the ideal membrane material is yet to be identified. In these cases, a homologous gelatinized bone matrix(GBM) were used as a regenerative material in conjunction with the placement of endosseous root implants. 22 patients participated in this study, and 42 implants were inserted. The result of 1st operative surgery was uneventful, inflammatory reaction and dehiscences were not observed except for only one case. After the final protheses, all implants were functioning successfully. The major advantages in the use of GBMs for guided bone regeneration are of very wide application such as membrane and graft material, and that a second procedure to remove the material is not necessary, and the GBMs are accepted by the surrounding tissues without complications. The purpose of this study was to observe the usefulness of GBMs in dental implant surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권4호
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• pp.363-367
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• 2011

Genioplasy with osteotomy is a flexible and useful procedure. However, osteotomy can cause different types of morbidity. Chin augmentation with porous polyethylene ($Medpor^{(R)}$) has become popular in the recent years. Porous polyethylene ($Medpor^{(R)}$) is an excellent biomaterial for reconstructing facial deformities. $Medpor^{(R)}$ has a porous architecture, which prevents capsule formation and decreases the degree of foreign-body reaction. In addition, it can be easily cut with scissors and molded, and it also maintains its shape. We report here on a satisfactory case of chin augmentation with using porous polyethylene ($Medpor^{(R)}$).