• Archives of Plastic Surgery
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• v.36 no.1
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• pp.24-28
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• 2009

Purpose: As a recipient vessel, internal mammary vessels have many advantages for microvascular reconstruction of the breast. But the approach is time consuming and results in large morbidities. However, the perforating branches of the internal mammary vessels can be used to minimize such demerits. The purpose of this cadaver study is to clarify the location and diameter of the perforating branches of internal mammary vessels and to prove they are safe and reliable recipient vessels. Methods: We studied 11 formalin - fixed cadavers and dissected their anterior chests bilaterally. The chests were exposed using midline presternal incisions. We dissected and found all perforators at subfascial planes under loupe magnification. The number, external diameter, and the distance from the midline were measured. Result: The mean external diameter of the arterial perforators was 1.32 mm and the mean external diameter of the venous perforators was 1.48 mm. The largest arterial and venous perforators were most frequently found in the second intercostal space. The mean distance from the midline to the perforator was evaluated; the artery averaged 1.95 cm and the vein averaged 2.08 cm. Conclusion: This study will be helpful when using the internal mammary perforating vessels as a recipient vessel during breast reconstruction.

• Advances in pediatric surgery
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• v.9 no.2
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• pp.117-120
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• 2003

Anal canal duplications occurring in a pair of 4 month-old healthy female twins are presented. The openings were located in the posterior midline of the anus since birth without a history of perianal abscess or swelling. Excision of the duplicated anal canals was performed using posterior sagittal approach. Although the anal canal duplication occurs predominantly in female, to our knowledge, this is the first case of anal duplication in a monozygotic female twins reported.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.714-716
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• 2005

In an extremely enlarged right heart, the repeated midline sternotomy was considered to involve the risk of massive hemorrhage. A right thoracotomy provides a convenient and safe way to approach the tricuspid valve in patient who have had previous heart surgery through a midline sternotomy.

• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.178-181
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• 2011

Congenital anomalies in arches of the atlas are rare, and are usually discovered incidentally. However, a very rare subgroup of patients with unique radiographic features is predisposed to transient quadriparesis after minor cervical or head trauma, A 46-year-old male presented with a 2-month history of tremor and hyperesthesia of the lower extremities after experiencing a minor head trauma. He said that he had been quadriplegic for about 2 weeks after that trauma. Radiographs of his cervical spine revealed bilateral bony defects of the lateral aspects of the posterior arch of C1 and a midline cleft within the anterior arch of the atlas. A magnetic resonance imaging revealed an increased cord signal at the C2 level on the T2-weighted sagittal image. A posterior, suboccipital midline approach for excision of the remnant posterior tubercle was performed. The patient showed significant improvement of his motor and sensory functions. Since major neurologic deficits can be produced by a minor trauma, it is crucial to recognize this anomaly.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.27-31
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• 2020

The midline nasal dermoid cysts are rare congenital neoplasms, which are diagnosed frequently in childhood. Masses are often noticeable at birth gaining size over time with recurrent infections and usually arise from the nasal cavity or lower 1/3 of the nasal dorsum. CT scan as the primary investigation is helpful to determine accurately the size and extent of the lesion as well as the integrity of adjacent bony structures. MRI scan is recommended to rule out an intracranial extension or sinus tracts. Treatment of choice is the complete surgical excision preserving the cyst wall. Here in, we present an unusual case of nasofrontal dermoid cyst in a 19-year-old boy without radiographic evidence of transcranial extension. In this case, we surgically removed nasofrontal dermoid cyst via transcolumellar approach. We also corrected saddle nose deformity after mass removal. Therefore, in this case, we experienced a successful case in which the nasofrontal dermoid cyst was totally removed without facial scar and deformity.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.739-743
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• 2005

Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.109-115
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• 2015

Background: This study sought to determine safe ranges of oblique angle, skin entry point and needle length by reviewing computed tomography (CT) scans and to evaluate the usefulness of a bent tip needle during celiac plexus block (CPB). Methods: CT scans of 60 CPB patients were reviewed. Image of the uppermost margin of L2 vertebral body was used to measure the minimal and maximal oblique angles and the distances from the midline to skin puncture point. The imaginary needle trajectory distance was calculated by three-dimensional measurement. When the procedure was performed by using a $10^{\circ}$ bent tip needle under a $20^{\circ}$ oblique X-ray fluoroscopic view, the distance (GF/G'F) from the midline to the actual puncture site was measured. Results: The imaginary safe oblique angle range was $26.4-34.2^{\circ}$ and $27.7-36.0^{\circ}$ on the right and left, respectively. The distance from the midline to skin puncture point was 6.1-7.6 cm on the right and 6.3-7.6 cm on the left. The needle trajectory distance at minimal angle was 9.6-11.6 cm on the right and 9.5-11.5 cm on the left. The distance of GF/G'F was 5.1-6.5 cm and 5.0-6.4 cm on the right and left, respectively. All imaginary parameters were correlated with BMI except for GF/G'F. All complications were mild and transient. Conclusions: We identified safe values of angles and distances using a straight needle. Furthermore, using a bent tip needle under a $20^{\circ}$ oblique fluoroscopic view, we could safely perform CPB with smaller parameter values.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.77-87
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• 2010

Skeletodental asymmetries are common and asymmetric orthodontic treatments are very difficult to correct successfully. The cause of asymmetries can be the skeletal asymmetry, dental, or functional, or combinations of these causes. Skeletodental asymmetries can be the result of congenital factors, such as hemifacial microsomia and environmental factors, such as trauma. Optimal treatment outcome of the severe facial asymmetry requires the orthognathic surgery. Mild asymmetry problem can be treated by only orthodontic treatment. The orthodontic treatment of asymmetry is usually difficult. Facial asymmetry orthodontic treatment are primarily based on proper diagnosis and careful treatment planning. Side effects of asymmetric elastic to treat midline discrepancies are canted occlusal plane, tipped incisors and unesthetic results. In the management of dental arch asymmetries, the clinician should select the appropriate force system and the appliance design necessary to address the asymmetry while minimizing undesirable side effects. This report presents treatment strategies for the treatment of skeletodental asymmetry. In this case report, the clinical case with midline discrepancies treated by optimal mechanics is described. Through diagnosis and strategic treatment mechanics can obtain proper midline correction with minimal side effects.

• Journal of Chest Surgery
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• v.54 no.4
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• pp.314-318
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• 2021

In this paper, I present the technique of subxiphoid single-port video-assisted thoracic surgery (VATS) thymectomy for thoracic surgeons to perform this procedure safely. This procedure is indicated for all anterior mediastinal masses and may be extended to lung cancer. The patient is placed in the lithotomy position, and the operator should be on the midline. Below the xiphoid process, a skin incision is made 4-5 cm horizontally at a single thumb's width down. Under two-lung ventilation, CO₂ is insufflated, maintaining 10 mm Hg. The fat tissue and thymic tissue are all resected from the sternum and pericardium between both phrenic nerves using an articulated grasper and an energy device. After retrieval of the mass with a wrap bag, a Jackson-Pratt drain is inserted instead of a chest tube. One of the advantages of this procedure is less postoperative pain than intercostal VATS. The subxiphoid approach can be used for bilateral pneumothorax, bilateral pulmonary metastasectomy, and simple lobectomy for both upper lobes and the right middle lobe.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.648-651
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• 2022

Nasal dermoid cysts are rare congenital anomalies that affect one in 20,000 to one in 40,000 individuals. Herein, we report a case of an initially misdiagnosed nasal dermoid cyst with intracranial extension. Among nasal dermoids, the lesion of the nasal tip is considered uncommon. Therefore, this should always be considered as a differential diagnosis of midline nasal masses, and a proper diagnostic approach should be taken.