• Journal of Oral Medicine and Pain
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• 제33권4호
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• pp.295-303
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• 2008

목적: 혀의 해부학적 위치에 따른 촉각식별능의 차이를 조사하고 이것과 심상유두의 개수 사이에 관련성이 있는지의 여부를 확인하기 위해서 본 연구를 시행하였다. 방법: 현재 복용 중인 약물이 없고, 과거 장기간 약물을 복용한 경험이 없었으며, 전신질환이 없는 건강한 남녀 13명(평균 연령 $30{\pm}3$세)을 대상으로 혀의 수초성 $A{\delta}$ 섬유와 무수초성 C 섬유와 관련한 촉각식별능을 알아보기 위해서 Castroviezo $caliper^{(R)}$를 이용한 두점식별검사를 실시하였다. 심상유두의 개수는 methylene blue로 혀를 염색해서 심상유두를 확인하여 개수를 세었다. 결과: 1. 혀의 전방부와 후측방부위의 심상유두개수를 세어 본 결과, 남자는 전방과 후측방이 각각$51.69{\pm}14.15$개, $12.92{\pm}6.13$개였으며, 여자는 $58.85{\pm}13.56$개, $16.23{\pm}6.38$개였다. 남녀 모두 후측방에 비해 전방부에서 유두의 개수가 3배 이상 많은 것을 관찰할 수가 있다. 2. 두 점으로 식별해내는 최소한의 거리는 전방에서 평균 $1.91{\pm}0.74mm$였으며, 성별에 따라 나눠 다시 분류했을 때, 남자의 인식 역치가 높은 것으로 관찰되었으나, 성별에 따른 통계적 유의성은 나타나지 않았다. 3. 두점식별거리를 기준으로 네 개의 그룹으로 나누었을 때, 거리가 증가할수록 심상유두의 개수가 감소하는 경향을 보였다. 그러나, 두점인지역치와 심상유두의 개수 간에 통계적 유의성은 없었다.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.173-181
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• 2011

Purpose: Masseter muscle is an important muscle of mastication. Because it has a great influence on the shape of low facial contour, patients who have masseteric hypertrophy show square-shaped jaw appearance. As aesthetic procedures for the reduction of the masseter muscle volume, radiofrequency ablation or botulinum toxin injection is at the center of attention. Authors studied the anatomical measurement of the thickness and width of masseter muscle and the surface mapping of the maximal thickness point using computed tomography (CT) scan to identify the useful guide for the injection of botulinum toxin in masseteric hypertrophy patients. Methods: We analyzed 2 mm-thickness OMU (ostiomeatal unit) CT of 112 normal people (224 masseter muscles) taken from June 2009 to May 2010. First, we measured the thickness, width and depth of the masseter muscle from the skin surface and analysed each by side, sex and age, respectively. The distribution of the thickness of the muscle and the correlation of thickness and width of the muscle were studied also. Second, we underwent surface mapping of the maximal thickness point using CT analysis by means of checking the vertical and horizontal distance from the angle of the mandible. Results: The average thickness and width of the masseter muscle was 17.73 mm and 40.78 mm in the male patients and were 14.33 mm and 37.42 mm in the female patients. Statistically, both figures of the male patients were larger than those of the female patients. However, the depth of the muscle from the skin surface in female patients (7.37 mm) was larger than that of the male patients (6.15 mm). There were no statistical difference in side or age. The width and thickness of the masseter muscle were in the positive correlation. The location of maximal thickness point of the masseter muscle was 27.77 mm vertically and 27.68 mm horizontally in the male patients, and 25.19 mm vertically and 25.42 mm horizontally in the female patients from the angle of mandible. Conclusion: We were able to present statistical evidence of the diagnosis and treatment of the masseteric hypertrophy regarding the anatomical measurements such as the thickness and width. And the maximal thickness point of the masseter muscle may be a useful guide for the clinical procedures of botulinum toxin injection.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.147-154
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• 2006

Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.93-96
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• 2011

Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권3호
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• pp.193-203
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• 2001

Orthognathic surgery of the mandibular prognathism and the retrognathism is tend to be performed on the mandibular ramus to prevent inferor alveolar nerve injuries. The purpose of this study is to find a safe and accurate reference point on mandibular ramus for orthognathic surgery by comparative anatomical study of dentofacial deformity patients. We use 38 Korean Cadavers with normal occlusion(Group 1), 3-dimensional simulation of computerized tomogram of 23 patients with retrognathism (Group 2), 27 patients with mandibular prognathism (Group 3). Following results are obtained : 1. The maximum thickness of the mandibular ramus is $8.78{\pm}1.15mm$ for Group 2, $7.61{\pm}1.26mm$ for Group 1, $6.95{\pm}0.82mm$ for Group3 respectively (P=0001). The minimum thickness is $5.51{\pm}1.08mm$ for Group 1, $5.06{\pm}0.40mm$ for Group 2, $4.56{\pm}0.78mm$ for Group3, respectively (p=0.0001). But, the thickness at the level of 5mm above the lingular is $0.78{\pm}0.65mm$ for Group 2, $5.63{\pm}1.28mm$ for Group 1, $5.32{\pm}0.91mm$ for Group 3, respectively. There is no significant difference between these groups(P=0.0510). 2. The horizontal location from the midwaist point to lingular is $0.18{\pm}1.57mm$ for Group 1, $0.69{\pm}1.33mm$ for Group 2, $0.66{\pm}1.66mm$ for Group 3, and there is no significant difference between these groups(p=0.0835). But the vertical location from the midwaist point to lingular is $1.45{\pm}2.64mm$ for Group 1, $0.63{\pm}1.44mm$ for Group 2, $0.34{\pm}1.81mm$ for Group 3, and there is significant difference between these groups(p=0.0030). 3. The horizontal location from the midwaist point to mandibular foramen is $0.29{\pm}1.75mm$ for Group 1, $0.63{\pm}1.44mm$ for Group 2, $0.34{\pm}1.81mm$ for Group 3, and there is no significant difference between these groups(p=0.5403). But the vertical location from the midwaist point to mandibular foramen is $-3.33{\pm}4.43mm$ for Group1, $-4.79{\pm}2.26mm$ for Group 2, $-6.06{\pm}2.99mm$ for Group 3, and there is significant difference between these groups(P=0.0001). 4. The horizontal length from the disto-buccal cusp tip of mandibular second molar to lingula is $30.97{\pm}4.17mm$ for Group 3, $28.29{\pm}2.65mm$ for Group 1, $25.48{\pm}0.77mm$ for Group 2 (p=0.0000), and also vertical length is $7.72{\pm}3.22mm$ for Group 3, $6.38{\pm}1.83mm$ for Group 1, $5.89{\pm}2.30mm$ for Group 2 (P=0.0014). 5. The location of lingular is 0.50 from anterior border of mandibular ramus in all groups, if it assumed the length from anterior border to posterior border is 1. And it is almost 0.33 from the sigmoid notch, if it assumed the length from sigmoid notch to antegonial notch is 1. 6. In Group 1, Antilingular prominence is located on ($1.12{\pm}1.43mm,\;4.01{\pm}2.36mm$) from the midwaist point, and there is no correlation between antilingular prominence and lingular, mandibular foramen.

• 치과방사선
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• 제22권2호
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• pp.259-269
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• 1992

The author has examined the abnormalities in panoramic radiographs of 668 edentulous patients. The distribution, type, incidence, and location of all abnormalities were analized, and the distances between alveolar crest and anatomical structures were measures. (Maxillary measurements were performed between alveolar crest and lower margin of the maxillary sinus and mandibular measurements between alveolar crest and upper edge of the mental foramen.) The obtained results were as follows: 1. Of the 668 panoramic radiographs examined, 103(15.4%) showed one or more abnormalities. 2. The incidence of abnormalities was decreased by years, which was 22.0% in 1970's and 16.8% in 1980's and 12.1 % in 1990's. 3. The distribution of abnormalities as follows; 43 (40.2%) superficial root fragments, 24(22.4%) impacted teeth, 9(8.4%) imbedded root fragments, 7 (6.5%) cysts, 7(6.5%) fractures, 5(4.7%) foreign bodies, 5(4.7%) abnormal radiolucencies, 4(3.7%) abnormal radiopacities, 2(1.9%) bony defects, 1(0.9%) tumor. 4. In the location of abnormalities, 42 cases (35.3%) were in the maxillary posterior region, 26 cases(21.8%) were in the maxillary anterior region, 20 cases(24.4%) were in the mandibular posterior region and 18 cases(15.1%) were in the mandibular anterior region. 5. In the distance between alveolar crest and maxillary sinus, 109 cases(9.7%) were below 0.5㎜, 757 cases(67.6%) were between 0.5㎜ and 10㎜, 254 cases(22.7%) were above 10㎜. In the distance between alveolar crest and mental foramen, 73 cases (8.8%) were below 0.5㎜, 501 cases (60.7%) were between 0.5㎜ and l0㎜ and 252 cases(30.5%) were above 100㎜.

• Archives of Plastic Surgery
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• 제45권5호
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• pp.411-417
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• 2018

Background Accessory auricles (AAs) are common congenital anomalies. We present a new classification according to location and shape, and propose a system for coding the classifications. Methods This study was conducted by reviewing the records of 502 patients who underwent surgery for AA. AAs were classified into three anatomical types: intraauricular, preauricular, and buccal. Intraauricular AAs were divided into three subtypes: intracrural, intratragal, and intralobal. Preauricular AAs were divided into five subtypes: precrural, superior pretragal, middle pretragal, inferior pretragal, and prelobal. Buccal AAs were divided into two subtypes: anterior buccal and posterior buccal. AAs were also classified according to their protrusion pattern above the surrounding surface: pedunculated, sessile, areolar, remnant, and depressed. Pedunculated and sessile AAs were subclassified as spherical, ovoid, lobed, and nodular, according to their body shape. Cartilage root presence and family history of AA were reviewed. A coding system for these classifications was also proposed. Results The total number of AAs in the 502 patients was 1,003. Among the locations, the superior pretragal subtype (27.6%) was the most common. Among the protrusion patterns and shapes, pedunculated ovoid AAs were the most common in the preauricular (27.8%) and buccal areas (28.0%), and sessile lobed AAs were the most common in the intraauricular area (48.7%). The proportion of AAs with a cartilage root was 78.4%, and 11% of patients had a family history. The most common type of preauricular AA was the superior pretragal pedunculated ovoid AA (13.2%) with a cartilage root. Conclusions This new system will serve as a guideline for classifying and coding AAs.

• The Korean Journal of Pain
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• 제23권4호
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• pp.242-246
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• 2010

Background: The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medical to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ipsilateral cornu. After that, one point on the line, which is 1.5 cm cephalad to the level of the PSIS, is considered as the needle entry point. The purpose of this study was to analyze the location of needle entry point and palpated PSIS in S1NRB. Methods: Fifty patients undergoing C-arm guided S1NRB in the prone position were examined. The surface anatomical relationships between the palpated PSIS and the needle entry point were assessed. Results: The analysis revealed that the transverse and vertical distance between the needle entry point and PSIS were $28.7{\pm}8.8mm$ medially and $3.5{\pm}14.0mm$ caudally, respectively. The transverse distance was $27.8{\pm}8.3mm$ medially for male and $29.5{\pm}9.3mm$ medially for female. The vertical distance was $1.0{\pm}14.1mm$ cranially for male and $8.1{\pm}12.7mm$ caudally for female. Conclusions: The needle entry point in S1NRB is located on the same line or in the caudal direction from the PSIS in a considerable number of cases. Therefore previous recommended methods cannot be applied to many cases.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.571-575
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• 2014

Background Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation. Methods Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes. Results A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.

• 대한두개안면성형외과학회지
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• 제22권5호
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• pp.268-275
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• 2021

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features. Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients' baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence. Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity. Conclusion: Nasal reconstruction techniques applied considering Asians' facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.