• 대한기관식도과학회지
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• 제15권2호
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• pp.19-23
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• 2009

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.27-34
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• 2006

After orthognathic surgery in skeletal class III patients, the hyoid bone position and the upper airway dimension could be changed due to mandibular setback. There has been many studies about airway dimension of the patients with skeletal class II malocclusion or obstructive sleep apnea. but not with skeletal class III. The purpose of this study was to examine the change of position of the hyoid bone and the consequent change of airway space as the result of retrusion of mandible after orthognathic surgery in skeletal Cl III malocclusion patients. It is also to apply this results in predicting, diagnosing and treating the subsequent obstructive sleep apnea. Forty patients who were diagnosed as skeletal Cl III maloccusion, received orthoganthic surgery of both jaws including mandibular setback, and were followed up post-operatively for more than 6 months were selected. There were 10 male patients 30 female patients. The preoperative and postoperative lateral cephalograms were traced and the distances and angles were measured. The nasopharyngeal space increased postoperatively while the oropharyngeal space decreased. Except for the change of oroparyngeal space, the changes in male patients were greater than female patients. The hyoid bone moved in the posterior-inferior direction, and the change was greater in males than in females. If the postoperative mandibular setback is great, then a significant decrease of airway space and posterior and inferior movement of the hyoid bone were observed. This can result in symptoms related to obstructive sleep apnea. This result should be considered in the diagnosis and treatment planning of orthognathic surgery patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.237-245
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• 2004

왜소악, 설하수, 구개열의 세 가지 특징적 증상과 더불어 간헐적인 청색증, 흉곽의 함몰, 기도 폐색에 의한 호흡 곤란과 수유곤란 등의 임상소견을 나타낸 3례의 Pierre Robin sequence 환아에서, 혀의 위치를 교정하기 위한 구강저골막하박리술과 혀를 전방으로 위치시켜 호흡 곤란과 기도 폐색을 예방하기 위한 설구순접합술과 동시에 시행하고 약 1년 경과 후 설구순분리술을 시행한 결과 호흡 곤란과 수유장애의 해소, 혀의 전방 재위치, 체중 증가 및 하악골의 성장 증진 등 만족할 만한 결과를 얻었다. 구강저골막하박리술과 구순접합술 동시 시술은 Pierre Robin sequence 환아에서 기도 폐색의 외과적 치료를 위한 간단하고도 신뢰할만한 방법이라고 사료된다.

• 대한기관식도과학회지
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• 제4권2호
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• pp.235-239
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• 1998

Warfarin sodium is a widely used oral anticoagulant and it sometimes causes hemorrhage in various sites such as traumatic or operative wounds, urologic organs, gastrointesitnal tract and subcutaneous tissues. Warfarin induced hemorrhage in upper respiratory tract causing upper airway obstruction is extremely rare. Despite the life-threatening nature of this complication, the symptoms are obscure like sore throat or hoarseness, suggesting infection and early diagnosis can be delayed. Careful medical history is emphasized When bleeding is observed, the patient should be admitted for close observation and prompt treatment. Recently we have exrperienced a case of laryngeal and upper tracheal submucosal hemorrhage induced by long term warfarin in 64 years old mm. We described the case with a review of the literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권4호
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• pp.232-236
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• 2022

A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권6호
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• pp.457-464
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• 2022

Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권4호
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• pp.460-467
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• 2008

Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.

• 대한치과교정학회지
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• 제37권3호
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• pp.192-203
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• 2007

본 연구는 비폐쇄를 보이는 III급 부정교합아동에서, 기도 공간의 형태와 안모 골격 형태 사이의 상관관계를 평가하였다. III급 부정교합을 보이며, 비폐쇄 소견을 보여 이비인후과로 의뢰된 환아 100명의 초진 측모 두부 규격 방사선 사진에서 상 인두기도 공간(upper PAS), 하 인두기도 공간(lower PAS), 편도의 크기, 구개-혀 공간을 측정하여 기도 공간 형태를 분석하였으며, 통상적인 계측점을 사용하여 안면 골격 분석을 시행하여 기도 공간 형태 계측항목과 안면 골격분성 항목간의 상관관계를 연구하여 다음과 같은 결과를 얻었다. Upper PAS는 ramal height, SNA, SNB, PFH, FHR, facial plane angle 항목과 양의 상관관계를 보였으며, saddle angle, articular angle, gonial angle의 sum, SN-GoGn, Y-axis to SN, FMA 항목과 음의 상관관계를 보였다. Lower PAS는 genial angle, FMA와 양의 상관관계를 보였으며, articular angle, facial depth, PFH, FHR와 음의 상관관계를 보였다. 편도의 크기는 PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH, AFH와 양의 상관관계를 보였다. 구개-혀 공간은 saddle angle, articular angle, genial angle의 합, facial length, AFH, FMA, LFH와 양의 상관관계를 보였으며, IMPA, overbite와 음의 상관관계를 보였다.

• 한국임상수의학회지
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• 제31권2호
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• pp.102-107
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• 2014

본 연구는 한국마사회 동물병원에서 시행한 전신마취 결과를 분석하고 마취 중 후에 발생한 사망률에 영향을 미치는 인자를 찾기 위하여 실시되었다. 총585두의 환마에서 전신마취가 실시되었으며, 수술의 빈도는 정형외과 수술(410)이 가장 많이 실시되었고, 산통 수술(85), 호흡기 수술(45) 순이었다. 585두 중 20두가 마취 중 후에 죽거나 안락사 되었다. 20두 중 14두는 산통 수술을 받았고, 3두는 정형외과 수술, 3두는 호흡기 수술을 받았다. 세부 사망원인으로는 산통 수술에서는 장파열, 호흡기 수술에서는 기도폐색이었다. 정형외과 수술에서는 근육병증, 재골절, 제엽염이 안락사의 원인이었다. 결과적으로 산통 수술과 호흡기 수술 후의 사망률은 정형외과 수술 후보다 높게 나타났다 (p < 0.01). 이상의 결과로부터, 산통수술을 받는 말의 사망률이 가장 높은 것을 확인하였으며, 그 원인은 예후불량에 의한 안락사이었다. 말의 마취 전후 사망률을 낮추기 위하여, 산통 수술을 받는 말은 수술 전후의 집중 관리가 필요하고, 호흡기 수술을 받는 말은 회복 중 주의 깊은 관찰이 추천된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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• pp.211-220
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• 2013

Purpose: The purpose of this study was to compare the changes in the pharyngeal airway space, tongue and hyoid bone positions according to the orthognathic surgical methods of mandibular prognathism. Methods: The subjects included 30 patients (16 males, 14 females) with the skeletal class III malocclusion. Group 1 (10 patients) underwent bilateral sagittal split ramus osteotomy (BSSRO) only; group 2 (10 patients) underwent BSSRO with genioplasty; and group 3 (10 patients) underwent BSSRO, Le Fort I osteotomy. We measured the lines between the selected upper air way, hyoid bone and tongue landmarks on the lateral cephalometric x-ray films of skeletal class III. The measurements were made preoperation, within 1 week after the operation, 3~6 months after the operation and 1 year after the operation. We compared and analyzed the measurements with matched paired t-test and independent samples t-test. Results: There were no postoperative changes in the nasopharyngeal airway space in group 3. The measurements of group 3 also increased during the follow-up period as compared to the preoperative measurements. In group 1, 2 and 3, the immediate postoperative oropharyngeal and hypopharyngeal airway spaces were decreased. In the following period, the hypopharyngeal airway space returned to the preoperative positions, but the oropharyngeal airway space was not significantly changed. The upper and lower tongue was posteriorly repositioned immediately after the surgery. During the follow-up period, the lower tongue position returned to the preoperative position, and the upper tongue position was not significantly changed. Immediately after the surgery, the B point was moved to the posterior position, and a slight anterior advancement was found in the follow-up period. Conclusion: Patients who received the mandibular setback surgery showed a decrease in the posterior airway space, and those who underwent maxillary advancement showed a significant increase of the nasopharyngeal airway space, which remained stable during the evaluation period. The change of the airway space, position of the hyoid bone and tongue did not differ according to the presence or absence of genioplasty.