• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.329-335
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• 2009

Objective : Determining language lateralization is important for the presurgical evaluation of patients with medically intractable epilepsy. The Wada test has been the gold standard for lateralization of language dominance before epilepsy surgery. However, it is an invasive test with risk, and have some limitations. Methods : We compared the volumetric analysis with Wada test, and studied the clinical potential of volumetric analysis to assess language laterality in large surgical candidates with temporal lobe epilepsy (TLE). To examine the efficacy of volumetric analysis to determine language lateralization during presurgical evaluation, we compared the volumetric analysis of the bilateral planum temporale with the results of Wada test in 59 patients with chronic intractable TLE (rTLE, n=32; lTLE, n=27) who underwent epilepsy surgery. We measured the gray matter volumes of planum temporale (PT) of each patients using the VoxelPlus2 program (Mevisys, Daejeon, Korea). Results : Overall congruence of the volumetric analysis with the Wada test was 97.75% in rTLE patients and 81.5% in lTLE patients. There were more significant leftward asymmetry of the PT in rTLE patients than lTLE patients. In lTLE patients, relatively high proportion (37%) of the patients showed bilateral or right hemispheric language dominance. Conclusion : These results provide evidence that the volumetric analysis of the PT could be used as an alternatives in language lateralization. Also, the results of the Wada test suggested that there was considerable plasticity of language representation in the brains of patients with intractable TLE and it was associated with an earlier age of brain injury.

• Journal of Oral Medicine and Pain
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• v.40 no.3
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• pp.115-123
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• 2015

Purpose: The aim of this study was to elucidate the coordination patterns of the sternocleidomastoid and posterior cervical muscles in response to symmetrical and asymmetrical jaw functions in normal adults. Methods: Twenty-seven healthy volunteers (8 females, 19 males; mean age, $30.4{\pm}2.5$ years) participated in this study. Surface electromyography (EMG) was used to record activities in the masseter, suprahyoid, sternocleidomastoid, and posterior cervical muscles at rest and during maximum tooth clenching, biting of a cotton roll with the anterior teeth, unilateral biting of a cotton roll with the posterior teeth, bilateral biting of cotton rolls with the posterior teeth, and jaw opening while seated. Normalized amplitude, activity indices, and asymmetry indices were compared between the muscles and the jaw tasks. Results: During symmetrical jaw functions (e.g., tooth clenching, biting with the anterior teeth, bilateral biting with the posterior teeth, jaw opening), the sternocleidomastoid and posterior cervical muscles showed elevated EMG amplitudes compared with the resting condition. The co-activation pattern of the sternocleidomastoid muscle was more pronounced than those of the posterior cervical muscles during these tasks. During asymmetrical jaw functions (e.g., unilateral biting with the posterior teeth), the ipsilateral sternocleidomastoid and masseter muscles showed higher contraction activity than did the contralateral muscles, but the contralateral posterior cervical muscles were more active than the ipsilateral muscles. Conclusions: The sternocleidomastoid and posterior cervical muscles were shown to be co-activated and coordinated anteroposteriorly or bilaterally according to symmetrical or asymmetrical jaw function. These results suggest an integrated neural control mechanism for the jaw and neck muscles, and provide further evidence supporting the intimate functional coupling between the trigeminal and cervical neuromuscular systems.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.11-22
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• 2005

There ate anteroposterior$\cdot$vertical maxillary underdevelopment, transverse maxillary deficiency and wide cleft alveolus$\cdot$oroanual fistula among cleft lip ant palate related maxillary deformities. For treatment of these deformities, ones have used conventional treatment methods, there were often unsatisfactory results to patients and operators both. Since llizarov introduced effective technique of bone lengthening and augmentation for a variety of limb defotmities, application of distraction osteogenesis on maxillofacial area has been used to solve those disadvantages of conventional methods. Authors introduced following three cases about use of distraction osteogenesis. The first case is the application of RED(rigid external distraction) II system for the treatment of the anteroposterior$\cdot$vertical maxillary hypoplasia after several times of surgery and end of development in bilateral cleft lip and palate patient. The second case is the application of the USPD(unilateral segmental palatal distraction) for the resolution of the unilateral posterior crossbite and transverse dental arch asymmetry after alveolorraphy in growing unilateral cleft lip and palate patient. The third case is the application of transport distraction osteogenesis far closure of the wide clef alveolus and oroantral fistula in growing bilateral cleft lip and palate patient. There were satisfactory results in these cases. Particularly, in comparison with the decreases of relapse rates, the reduction of the hospitalization time and post-operative discomfort owing to minimal surgical intervention.

• Korean Journal of Applied Biomechanics
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• v.28 no.3
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• pp.175-180
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• 2018

Objective: Anterior cruciate ligament reconstruction (ACLR) has been considered the primary treatment for anterior cruciate ligament (ACL) injured patient. However, there is little biomechanical evidence regarding bilateral knee joint biomechanics during landing and cutting task after ACLR. Method: Eighteen females with ACLR participated in this investigation. Double leg jump landing (DLJL) and single leg jump cut (SLJC) biomechanics were assessed. Results: During DLJL, the healthy knee showed greater knee valgus angle at initial contact ($^{\circ}$) compared to the injured knee (Injured: $2.93{\pm}2.59$, Healthy: $4.20{\pm}2.46$, t=2.957, p=0.009). There was a significant difference in anterior tibial shear force ($N{\times}N^{-1}$) with greater in the injured knee (Injured: $1.41{\pm}0.39$, Healthy: $1.30{\pm}0.35$, t=2.201, p=0.042). During SLJC, injured knee showed greater knee extension moment ($N^*m{\times}[N^*m]^{-1}$) compared to healthy knee (Injured: $0.51{\pm}0.19$, Healthy: $0.47{\pm}0.17$, t=2.761, p=0.013). However, there was no significant differences between the knees in the other variables. Conclusion: ACLRfemales exhibited a greater knee valgus angle at initial contact and lesser anterior tibial shear force on the healthy knee during double leg jump landing. In addition, ACLR females showed a greater knee extension moment on the injured knee during single leg jump cut.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.373-381
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• 2021

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.43.1-43.4
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• 2016

Background: Supernumerary nostril is a congenital anomaly that contains additional nostril with or without accessory cartilage. These rare congenital nasal deformities result from embryological defects. Since 1906, Lindsay (Trans Pathol Soc Lond. 57:329-330, 1906) has published the first research of bilateral supernumerary nostrils, and only 34 cases have been reported so far in the English literature. Case presentation: A 1-year-old female baby was brought to our department group for the treatment of an accessory opening above the left nostril which had been presented since her birth. Medical history was non-specific and her birth was normal. The size of a supernumerary nostril was about 0.2 cm diameter and connected to the left nostril. The right one was normal. Minimal procedure was operated for the anomaly. After 1 year, rhinoplasty was performed for the nostril asymmetry. Conclusions: At 1 year follow-up, the functional and cosmetic result was satisfactory. In this case, it is important that we have early preoperative diagnosis. Also, it is desirable that we should perform a corrective surgery as soon as possible for the patient's psychosocial growth.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.21.1-21.3
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• 2019

Background: Treatment planning the correction of a transverse maxillary occlusal plane cant often involves a degree of qualitative "eyeballing", with the attendant possibility of error in the estimated judgement. A simple chair side technique permits quantification of the extent of asymmetry and thereby quantitative measurements for the correction of the occlusal plane cant. Methods: A measuring instrument may be constructed by soldering the edge of a stainless steel dental ruler at 90° to the flat surface of a similar ruler. With the patient either standing in natural head position, or alternatively seated upright in the dental chair, and a dental photographic retractor in situ, the flat under-surface of the horizontal part of this measuring instrument is placed on a unilateral segment of a bilateral structure, e.g. the higher maxillary canine orthodontic bracket hook. The vertical ruler is held next to the contralateral canine tooth, and the vertical distance measured directly from the canine bracket to the flat under-surface of the horizontal part of the measuring instrument. Results: This vertical distance quantifies the overall extent of movement required to level the maxillary occlusal plane. Conclusions: This measuring instrument and simple chair side technique helps to quantify the overall extent of surgical levelling required and may be a useful additional technique in our clinical diagnostic armamentarium.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.99-106
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• 2017

Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

• Journal of Korean Neurosurgical Society
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• v.47 no.6
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• pp.424-427
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• 2010

Objective : Chronic subdural hematomas (CSDH) are more common on the left hemisphere than on the right. We verified this left predilection of CSDH and tried to explain the reason for this discrepancy. Methods : We investigated the laterality of CSDH in 182 patients who were treated from January 2005 to December 2009. We examined the symmetry of the cranium and the location of the lesion. Results : CSDH was more common on the left-side. The cranium was symmetric in 63 patients, asymmetric in 119 patients. The asymmetric crania were flat on the right-side in 77 patients, on the left-side in 42 patients. The density of the CSDHs was hypodense in 29 patients, isodense 132 patients, and the others in 21 patients. Bilateral hematomas were more common in the hypodense group. In the right flat crania, the hematoma was more commonly located on the opposite side of the flat side. While in the left flat crania, the hematoma was more common on the same side. Conclusion : CSDHs occurred more frequently on the left side. The anatomical asymmetry of the cranium influences the left predilection of CSDH.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.291-300
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• 2012

The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.