• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권3호
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• pp.146-152
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• 2024

Objectives: This prospective observational study aimed to assess the clinical outcomes of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer. The study described the frequencies and types of procedures for securing the airway and the duration and types of postoperative ventilatory support. We compared the findings with those of the TRACHY study. Patients and Methods: One hundred patients undergoing oral cavity oncological surgeries were included. Airway assessment included inter-incisor gap, Mallampati class, neck movements, and radiological features. Surgical parameters, postoperative ventilatory support, and complications were documented. Results: The buccal mucosa was the most common cancer site (48.0%), and direct laryngoscopy was deemed difficult in 58.0% of patients. Awake fibreoptic intubation or elective tracheostomy was required in 43.0% of cases. Thirty-three patients were extubated on the table, and 34 patients were successfully managed with a delayed extubation strategy. In comparison with the TRACHY study, variations were observed in demographic parameters, tumour characteristics, and surgical interventions. Our mean TRACHY score was 1.38, and only five patients had a score ≥4. Prophylactic tracheostomy was performed in 2.0% of cases, in contrast to the TRACHY study in which 42.0% of patients underwent the procedure. Conclusion: The study emphasizes the challenges in airway management for oral cavity cancer surgery. While prophylactic tracheostomy may be necessary in specific cases, individualized approaches, including delayed extubation, are preferrable to maximize safety. Our findings contribute to better understanding and managing perioperative challenges in oral cancer patients and highlight the need for personalized strategies. Scoring systems like TRACHY should not be accepted as universally applicable.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.433-438
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• 2018

Background: Cervical foraminal stenosis (CFS) is one of the degenerative changes of the cervical spine; however, correlations between the severity of stenosis and that of symptoms are not consistent in the literature. Studies to date on the prevalence of stenosis are based on images obtained from the departments treating cervical lesions, and thus patient selection bias may have occurred. The purpose of this study was to investigate the prevalence of CFS according to the site, extent, and morphology of stenosis using cervical computed tomography (CT) images obtained from patients who were visiting not because of symptoms related to the cervical spine, cervical pain, or upper limb pain. Methods: Among patients who underwent CT from January 2016 to March 2016 for reasons other than cervical spine symptoms, a total of 438 subjects were enrolled, and 2,628 cervical disc images (C4-5, C5-6, and C6-7; left and right sides) were examined. Three orthopedic surgeons performed two measurements each at 4-week intervals. Values were used for analysis if matched by more than two surgeons; if no match was found, the median values were used for analysis. The left and right sides on the same axial image were independently classified. Results: Left C5-6 stenosis was most common (24.66%) among patients. At the left C6-7, there were 20 focal types and 33 diffuse types. At bilateral C4-5 and right C6-7, the focal type was more common, whereas at bilateral C5-6 and left C6-7, the diffuse type was more common. Age and the severity of stenosis showed statistically significant correlation at all cervical levels. Conclusions: The prevalence of CFS was highest at the C5-6 level (19.06%). Compared to other levels, focal stenosis was more frequent at C4-5 and diffuse stenosis was more common at C5-6. At C6-7, the incidence of focal stenosis was higher on the right side and that of diffuse stenosis was higher on the left side.

• Imaging Science in Dentistry
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• 제42권4호
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• pp.243-247
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• 2012

Purpose: This study was performed to compare the inverted digital images and film-based images of dry pig mandibles to measure the periodontal bone defect depth. Materials and Methods: Forty 2-wall bone defects were made in the proximal region of the premolar in the dry pig mandibles. The digital and conventional radiographs were taken using a Schick sensor and Kodak F-speed intraoral film. Image manipulation (inversion) was performed using Adobe Photoshop 7.0 software. Four trained examiners made all of the radiographic measurements in millimeters a total of three times from the cementoenamel junction to the most apical extension of the bone loss with both types of images: inverted digital and film. The measurements were also made in dry mandibles using a periodontal probe and digital caliper. The Student's t-test was used to compare the depth measurements obtained from the two types of images and direct visual measurement in the dry mandibles. A significance level of 0.05 for a 95% confidence interval was used for each comparison. Results: There was a significant difference between depth measurements in the inverted digital images and direct visual measurements (p>|t|=0.0039), with means of 6.29 mm ($IC_{95%}$:6.04-6.54) and 6.79 mm ($IC_{95%}$:6.45-7.11), respectively. There was a non-significant difference between the film-based radiographs and direct visual measurements (p>|t|=0.4950), with means of 6.64mm($IC_{95%}$:6.40-6.89) and 6.79mm($IC_{95%}$:6.45-7.11), respectively. Conclusion: The periodontal bone defect measurements in the inverted digital images were inferior to film-based radiographs, underestimating the amount of bone loss.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권5호
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• pp.299-310
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• 2012

Purpose: The purpose of this study was to evaluate the histological healing process of 3 different types of xenogenic tooth bone graft material and xenogenic bone graft material. Methods: Three types of human tooth bone graft material (chips, crowns, and roots) and BioOss (Geistlich Pharma AG, Wolhausen, Switzerland) was filled at the preformed 4 round-shaped calvarial bone defects of beagle dogs. The beagles were sacrificed at 2, 4, 8, and 12 weeks, respectively, for radiological and histological evaluation. Results: Increased strength and radiopacity were detected in all graft material groups in time-dependent manner. New bone was formed and matured surrounding the graft material histologically. Also, a new bone was directly integrated with graft material. Conclusion: It was expected that newly developed tooth bone graft material would show good bone healing capacity if it was used as a graft material for the restoration of bony defect.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.723-731
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• 2006

Purpose: Collagen is the principal structural biomolecule in cartilage extracellular matrix, which makes it a logical target for cartilage engineering. In this study, porous type I collagen scaffolds were cross-linked using dehydrothermal(DHT) treatment and/or 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide(EDC), in the presence and absence of chondroitin-6-sulfate(CS) for cartilage regeneration. Methods: Cartilage defects were created in the proximal part of the ear of New Zealand rabbits. Four types of scaffolds(n=4) were inserted. The types included DHT cross-linked(Group 1), DHT and EDC cross- linked(Group 2), CS added DHT cross-linked(Group 3), and CS added DHT and EDC cross-linked(Group 4). Histomorphometric analysis and cartilage-specific gene expression of the reconstructed tissues were evaluated respectively 4, 8, and 12 weeks after implantation. Results: The largest quantity of regenerated cartilage was found in DHT cross-linked groups 1 and 3 in the 8th week and then decreased in the 12th week, while calcification increased. Calcification was observed from the 8th week and the area increased in the 12th week. Group 4 was treated with EDC cross-linking and CS, and the matrix did not degrade in the 12th week. Cartilage-specific type II collagen mRNA expression increased with time in all groups. Conclusion: CS did not increase chondrogenesis in all groups. EDC cross-linking may prevent chondrocyte infiltration from the perichondrium into the collagen scaffold.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.553-558
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• 2012

Purpose: This article reviews a few of the commonly used types of vascularized osseous free flaps in maxillofacial reconstruction, which still represents the gold standard of restoration. We also discuss the developing concepts in maxillofacial reconstruction. Recent findings: Most of the literature reconfirms the established patterns of reconstruction with the aid of vascularized osseous free flaps. This method of free-tissue transfer is also feasible in cases of osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaw. These flaps are also suitable for prosthetic restoration using osseointegrated dental implants. Summary: Vascularized osseous free flaps still remain the standard of care. Improvements upon the free-tissue transfer method employing vascularized osseous free flaps, such as distraction osteogenesis, tissue engineering, and imaging techniques, currently require further development, but these technologies could lead to improved outcomes of maxillofacial reconstruction in the near future.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.23-33
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• 2019

Background Venous malformations (VMs) are a common type of vascular malformation. However, their causes and management remain unclear, and few studies specific to VMs of the head and neck have been reported. This study describes our experiences with VMs of the head and neck. Methods This retrospective study included 82 patients who underwent treatment for head and neck VMs, among 222 who visited our vascular anomalies center. Medical records between 2003 and 2016 were reviewed to identify common features in the diagnosis and treatment. The diagnosis of suspected head and neck VMs was based on the results of imaging studies or biopsies, and the VMs were analyzed based on magnetic resonance imaging, computed tomography, and Doppler sonography findings. Results VMs were slightly more common in female patients (59.8%), and 45.1% of patients developed initial symptoms at the age of 10 or younger. Lesions were slightly more common on the right side (47.3%). The main sites involved were the cheek (27.7%) and lip area (25.5%). The muscle layer was commonly involved, in 98.7% of cases. Small lesions less than 5 cm in diameter accounted for 60.8% of cases, and well-defined types were slightly more prevalent at 55.4%. Improvement was observed in 77.1% of treated patients. Conclusions Early and accurate diagnosis and appropriate treatment according to individual symptoms are important for successful treatment of VMs. If treatment is delayed, the lesions can worsen, or recurrence becomes more likely. Therefore, VMs require a multidisciplinary approach for early and accurate diagnosis.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.122-127
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• 2017

Castleman's disease (CD) is an uncommon benign lymphoproliferative disorder of unknown etiology. Histopathologically, it is divided into three types: hyaline-vascular, plasma cellular, and multicentric CD. The mass usually presents asymptomatically; however, it can cause non-specific symptoms such as fever and fatigue. Although CD can be found wherever lymph nodes are present, 75% of cases are reported in the mediastinum, and occurrence in the head and neck is rare. Herein, we report a rare case of CD presenting as a superficial mass in the temporal region. To the best of our knowledge, this is the first report of temporal CD in Korea involving a young patient.

• 대한두개안면성형외과학회지
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• 제22권6호
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• pp.337-340
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• 2021

Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.

• Journal of Chest Surgery
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• 제9권2호
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• pp.276-286
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• 1976

Coarctation of the aorta is an important congenital cardiovascular defect,. which occurs in a significant number of persons. The basic anatomic defect is a localized deformity of the media, manifested by two types of strictures in the aorta: "true" coarctation and tubular hypoplasia. The zone of coarctation is characteristically located distal to the origin of left subclavian artery at or just beyond the insertion of the ligamentum arteriosum. It shortens life if untreated, but it can be corrected to render the patient functionally normal. Here we have a 2-year operative experiences with 3 cases of the aortic coarctation, two of hypoplastic type and one of postductal type, at age of 17 to 19 year old Korean, operated in 1965 and l968 at the National Medical Center. The purposes of this report are to describe the immediate and late effect of surgery, histopathologic bases and the rarity of this lesions in Korea.