• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.250-255
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• 1998

The purpose of this study was to evaluate the histologic change of the inferior alveolar nerve according to distraction amount following mandibular lengthening. Seven rabbits weighing about 2 kg were used. Corticotomy was performed on the mandibular body anterior to the right first premolar region and unilateral external fixation device was placed. Every effort was made to preserve the inferior alveolar nerve during the corticotomy. The rabbits were then allowed to heal for 7 days without distraction of the device. The mandible was lengthened 0.36 mm/day, 0.76 mm/day, or 1.0 mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 14-day-consolidation period was allowed. After consolidation, rabbits were sacrificed, and histologic examination of the inferior alveolar nerve was performed. The results obtained were as follows : 1. In the control group, normal trifascicular pattern of inferior alveolar nerve was observed. Epineurium, perineurium, endoneurium, and axon with myelin sheath were observed in normal appearance. 2. In 0.36 mm/day distraction group, the trifascicular pattern was normally shown, and there was no destruction in epineurium, perineurium, and endoneurium. The mild changes including myelin attenuation, axoplasmic swelling and darkening were observed. 3. In 0.72 mm/day distraction group, it was possible to differentiate the epineurium from the perineurium. Two normal fascicles and one injuried fascicle were observed with a partially destructed perineurium. Most of the axons had axoplasmic swelling and darkening. 4. In 1 mm/day distraction group, it was difficult to differentiate the nerve structures such as fascicles, epineurium, perineurium, and endoneurium. The axons were severely destroyed, except few which showed decreases in size and changes in shape. Some collagen matrices were observed around the axons. These results suggest that the higher the distraction amount, the more severe the injury to the inferior alveolar nerve, fascicles, axons. Although distraction osteogenesis may be useful, the amount of distraction should be carefully selected.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.365-369
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• 2010

Objective : There has been inconsistency about definition of the temporal stem despite of several descriptions demonstrating its microanatomy using fiber dissection and/or diffusion tensor tractography. This study was designed to clarify three dimensional configurations of the temporal stem. Methods : The fronto-temporal regions of several formalin-fixed human cerebral hemispheres were dissected under an operating microscope using the fiber dissection technique. The consecutive coronal cuts of the dissected specimens were made to define the relationships of white matter tracts comprising the temporal stem and the subcortical gray matters (thalamus, caudate nucleus, amygdala) with inferior limiting (circular) sulcus of insula. Results : The inferior limiting sulcus of insula, limen insulae, medial sylvian groove, and caudate nucleus/amygdala were more appropriate anatomical structures than the roof/dorso-lateral wall of the temporal horn and lateral geniculate body which were used to describe previously for delineating the temporal stem. The particular space located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus could be documented. This space included the extreme capsule, uncinate fasciculus, inferior occipito-frontal fasciculus, anterior commissure, ansa peduncularis, and inferior thalamic peduncle including optic radiations, whereas the stria terminalis, cingulum, fimbria, and inferior longitudinal fiber of the temporal lobe were not passing through this space. Also, this continued posteriorly along the caudate nucleus and limiting sulcus of the insula. Conclusion : The temporal stem is white matter fibers passing through a particular space of the temporal lobe located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus. The three dimensional configurations of the temporal stem are expected to give the very useful anatomical and surgical insights in the temporal lobe.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.783-787
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• 2015

This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.464-473
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• 2006

Purpose: This study was performed to evaluate relationship between the inferior alveolar nerve injury and the findings of panoramic and tomographic images for preventing inferior alveolar nerve injury after the 3rd molar extraction. Material and Method: From April, 2005 to June, 2005, The 190 patients who visited in the Department of Oral and Maxillofacia Surgery, Chonnam National University Hospital and the panoramic radiographies were taken for extraction of the mandibular third molar, was selected. Among 215 mandibular third molars, Scanora tomographic imagings were taken in the 90 teeth which were overlaped to the mandibular canal in the panoramic imagies. In panoramic radiographies, the angulation, the level, the root morphology, and the superimposition sign of the mandibular third molars with the mandibular canal were evaluated. In the tomographic radiographies, the location and distance of the mandibular third molar from the canal were also evaluated. The relationships between these findings and the inferior alveolar nerve injury were examined. Results: In the panoramic findings, the inferior alveolar nerve injuries were occurred in the darkened roots (5 molars, 7%), the uncontinuous radiopaque image (3 molars, 7%), and the depositioned mandibular canal (2 molars, 10%). In the tomographic findings of 90 molars, 20 molars also had the superimposition imagies. Five molars in those molars (25%) had the inferior alveolar nerve injury after extraction. There were 10 patients who had the inferior alveolar nerve injury. The sensory was began to be recovered in 9 patients, except 1 patient, within 2 weeks, then fully recovered within 3 months. Conclusion: These results indicate that the depth mandibular third molar and the superimposition sign may be related with the risk of the inferior alveolar nerve injury after extraction.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.933-948
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• 1996

The purpose of this study was to examine the anatomic structures of the mandible-inferior alveolar canal, mental foramen, mental canal-with panoramic radiography and conventional tomography and to compare both radiographic techniques in conjunction with endosseous implants. In this study 14 adult dentulous mandibles -27 cases of right and left side of mandibles- were examined and the results were as follows. 1. The distance between superior border of the inferior alveolar canal and the alveolar ridge crest showed a decreasing tendency from the mental foramen to 4cm posterior to the mental foramen. 2. The mean diameter of the inferior alveolar canal was $4.11{\pm}0.50mm$ with panoramic radiography and $3.29{\pm}0.59mm$ with conventional tomography. 3. The inferior border of the inferior alveolar canal and inferior border of the mandible was closest at 2cm posterior to the mental foramen but it was not statistically significant. the mean distance was $1l.64{\pm}2.95mm$ in panoramic radiography and $1l.68{\pm} 2.91mm$ in conventional tomography. 4. The inferior alveolar canal located lingually in bucco-lingual direction 16%(mental foramen), 54%(lcm posterior to the mental foramen), 68%(2cm posterior to the mental foramen), 50%(3cm posterior to mental foramen), 55%(4cm posterior to the mental foramen). 5. Mean length of the anterior loop of the mental canal was 2.73mm, and the loop below 2mm was 35% and 15% of mental canal was invisible in panoramic radiography. 6. The minimum interforaminal distance was 56.7mm, the maximum distance was 73.2mm and the mean distance was 66.42mm in panoramic radiography. 7. The mean distance between midpoint of the mental canal and alveolar ridge crest was 16.24mm and the mean buccolingual angulation of the mental canal was $52.98^{\circ}$ in conventional tomography. 8. In comparison of panoramic radiography and conventional tomography, inferior alveolar canal is better visualized with conventional tomography than panoramic radiography from the mental foramen to the 2cm posterior to the mental foramen, while visiblity of conventional tomography prominently decreased in 4cm posterior to the mental foramen and alveolar ridge crest is better visualized with panoramic radiography than conventional radiography at the mental foramen and at 4cm posterior to the mental foramen. In radiologic examination of anatomic structures of the mandible for endosseous implants, panoramic radiography and conventional tomography can be effectively used when it is used to overcome the anatomic limitations.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.729-734
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• 2007

Purpose: The operative treatment for blow-out fracture involves restoration of intra-orbital soft tissue and bony structural integrity. There are several methods for reconstruction of inferior blow out fracture. We report reduction of inferior blow-out fracture with urinary balloon catheter in comparison with $Medpor^{(R)}$ using group to complication rate. Methods: A retrospective study was performed on 67 patients who underwent inferior orbital blow-out fracture reconstruction with $Medpor^{(R)}$ implant or urinary balloon catheter following between 2003 and 2006. Hospital records were reviewed especially for preoperative and postoperative enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia between $Medpor^{(R)}$ implant group and balloon catheter using group. Results: There was no significant statistical difference between both groups on incidence of postoperative complications of enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia. Postoperative infection, ectropion were absent in both groups.Conclusion: The use of urinary balloon catheter is simple, fast and inexpensive. Urinary balloon catheter is an alternative and reliable use for reduction of inferior orbital blow-out fracture.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.6 no.1
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• pp.19-26
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• 2011

Objectives : The purpose of this study is to research the necessity of sacral base X-ray that Barge insisted. Methods : I have done a comparative analysis in side of short leg and side of sacral inferior with sacral base X-ray and pelvis A-P Xray pictures of 42 patients with lower back pain from December 1, 2010 to March 31, 2011. Results : Even though most of the subjects in study were male, 36 people had plateau of sacral base and 29 people had symmetry in sacral base X-ray. There was no statistical significance in the side of short leg and side of sacral base inferior in Sacral base X-ray, but there was a statistical significance in pelvis A-P x-ray. 22 people had same side of short leg and side of sacral base inferior in sacral base X-ray and pelvis A-P X-ray and 14 people didn't. 29 people had same side of sacral base inferior in sacral base X-ray and pelvis A-P X-ray and 13 people didn't. Conclusions : According to the result of the study, sacral base X-ray is necessary for correct sacral base inferior analysis.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.1-6
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• 2016

Purpose: The external ear is a common area of trauma on the body prone to exposure of ultraviolet light, which can lead to skin cancer. Thus, variable techniques have been developed and used for reconstruction of the external ear. The aim of this study is to review the surgical method, its area of application, as well as advantages and pitfalls of reconstruction of the external ear with inferior based retroauricular flaps. Materials and Methods: Eight patients underwent external ear reconstruction with inferior based retroauricular flap for external ear defects in our institute from September 2012 to June 2015. According to the area of the defect, patients were classified as middle 1/3 (n=4), inferior 1/3 (n=2), superior auroculo-cephalic sulcus (n=1), and external auditory canal (n=1). Results: All of the flaps survived the operation and there was no marginal necrosis. Mean size of the defect was $2.8{\times}1.8cm$ and mean size of the retroauricular flap was $5{\times}2cm$. For insetting of the flap, a subcutaneous tunneling technique was used in 6 cases and rotation without subcutaneous tunneling was used in 2 cases. Transient paresthesia occurred in 3 cases. Two cases recovered within 3 months but one case did not recover until 6 months. Conclusion: The inferior based retroauricular flap is an available technique in external ear reconstruction with one stage operation.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.63-67
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• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• Imaging Science in Dentistry
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• v.36 no.2
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• pp.81-88
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• 2006

Purpose : To review developmental salivary gland defect based on 12 reported cases and literature, and to guide radiographic diagnosis of this entity. Materials and Methods : The 12 cases of developmental salivary gland defect of Chosun University Dental Hospital in the last 4 years were analyzed and compared with previous reported cases. Result : 11 of the 12 cases were found in men, indicating a very strong male predilection. The peak age was in the 6th decade. These defects were situated just above or at the inferior border of mandible between the first molar and the mandibular angle, and always Inferior to the mandibular canal. Only one case was superimposed with the mandibular canal, 6 cases were superimposed with the inferior border of the mandible. Conclusion : Characteristically, these defects had a special radiographic features such as ovoid shaped well-defined radiolucency located just above or at the inferior border of the mandible between the first molar and the mandibular angle, and always inferior to the mandibular canal. The recognition of these radiographic features were diagnostically valuable.