• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1204-1208
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• 2000

Objectives : At the closure of the transsphenoidal approach(TSA), the proper sellar floor reconstruction plays an important role in preventing postoperative complications. The septal cartilage, perpendicular plate of nasal septum, and the sphenoid sinus bone are usually used to repair the sellar floor as a bone splint. The authors evaluate the usefulness of a silicone plate as a substitute for bone splint to close a defect of the sellar floor. Materials and Methods : A silicone plate was used to repair the sellar floor in 7 patients with sellar lesions which included four pituitary adenomas, two Rathke's cleft cysts and one metastatic tumor. Among seven cases, five cases underwent a standard TSAs and two received a extended TSAs. The trajectories of the approach were sublabial in four cases and endonasal routes in three cases. The silicone plate for implantation was cut to a size of slightly larger than that of bone window and inserted with a three-pronged fork, and then adjusted precisely. Results : In six patients, there were no complications which related to sellar floor reconstruction. A postoperative cerebrospinal fluid(CSF) rhinorrhea was observed in one patient with pituitary macroadenoma. Conclusions : From the authors' experience, the advantages of the silicone plate are its simplicity of molding to fit any size of sellar floor defects, and easy detection of previously created bone window at reoperation.

• Archives of Craniofacial Surgery
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• v.15 no.3
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• pp.133-137
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• 2014

Reconstruction of a full-thickness alar defect requires independent blood supplies to the inner and outer surfaces. Because of this, secondary operations are commonly needed for the division of skin flap from its origin. Here, we report a single-stage reconstruction of full-thickness alar defect, which was made possible by the use of a nasolabial island flap and septal mucosal hinge flap. A 49-year-old female had presented with a squamous cell carcinoma of the right ala which was invading through the mucosa. The lesion was excised with a 5-mm free margin through the full-thickness of ala. The lining and cartilage was restored using a septal mucosa hinge flap and a conchal cartilage from the ipsilateral ear. The superficial surface was covered with a nasolabial island flap based on a perforator from the angular artery. The three separate tissue layers were reconstructed as a single subunit, and no secondary operations were necessary. Single-stage reconstruction of the alar subunit was made possible by the use of a nasolabial island flap and septal mucosal hinge flap. Further studies are needed to compare long-term outcomes following single-stage and multi-stage reconstructions.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.11-18
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• 2022

Purpose: This study aimed to assess incidental abnormal findings in the paranasal sinuses and anatomical variations of the ostiomeatal complex (OMC) on magnetic resonance imaging (MRI) scans. Materials and Methods: MRI scans of 616 patients (mean age, 44.0±19.4 years) were evaluated. Prior to obtaining the MRI scans, a checklist of patients' clinical symptoms was filled out after obtaining their consent. The Lund-Mackay classification was used to assess the paranasal sinuses and OMC. The prevalence of abnormal findings and their associations with patients' age, sex, and subjective symptoms were analyzed by the chi-square test, independent-sample t-test, and analysis of variance. The level of significance was set at 0.05. Results: Abnormal findings in the paranasal sinuses were detected in 32.0% of patients, with a significantly higher prevalence in males (P<0.05), but no significant association with age (P>0.05). Epithelial thickening and retention cyst were the most common abnormal findings in the paranasal sinuses. According to the Lund-Mackay classification, 93% of the study population had normal sinuses (score<4). Concha bullosa and paradoxical concha were detected in 15.3% and 3.4%, respectively, with no significant association with the presence of septal deviation or Lund-Mackay classification (P>0.05). Conclusion: Considering the relatively high prevalence of abnormal findings in the paranasal sinuses, it appears that clinical symptoms alone are not sufficient to diagnose sinusitis. A more accurate strategy would be to assess radiographic images of the paranasal sinuses and use a classification system. Sinusitis should be suspected in patients receiving a high score in this classification.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.71-83
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• 2001

The purpose of this study was to Prove that the medial edge epithelial cells covering the secondary palatal shelves were removed by apoptosis during palatal fusion. 12 mature female rats (Suprague-Dawley) were mated overnight with male rats and sacrificed on days 15.0, 16.5, 16.75, 17.0 of pregnancy. The embryos were removed from the uterus and the heads were embedded in paraffin. The paraffin blocks were sectioned and the sections were undergone H-E staining for general histologic feature and TdT staining for detection of apoptotic cells. The obtained results were as follows. k. In the section of 16.0 and 16.5 day embryos, the palatal shelves were prior to contact and no apoptotic cells wereobserved in the medial edge epithelium. At the initial contact of Palatal shelves, there was a few apoptotic cells in the fusing epithelium. 2. In the 16.75 day embryos, the samples that epithelial seams did not lost there continuity, apoptotic cells were rarely seen at the midline epithelial seam. In contrast, a lot of apoptotic cells were observed at epithelial triangles and the junction between palatal shelves and nasal septum. 3. In the 16,75 day embryos, the samples that epithelial seams lost their continuity and disrupted to epithelial islands, large number, of apoptotic cells were observed at epithelial islands and epithelial triangles. Some apoptotic cells were also observed at the oral, nasal epithelium near the midline. 4. In the 17.0 day embryos, most of epithelial islands were disappeared and mesenchymal confluence was achieved. Apoptotic cells were rarely observed in the mesenchymal tissue which replaced epithelial islands, but there were some apoptotic cells at the epithelial triangles, oral and nasal epithelium. From the results of the study, it was revealed that medial edge epithelial cells of fusing palate were removed by apoptosis. Apoptotic cells were found mainly in the disappearing midline epithelial seam and the oral and nasal epithelial triangles at some late stages of palatal fusion.

• The Journal of Korean Medicine
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• v.21 no.3
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• pp.149-165
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• 2000

As recent developments of Immunology and Nuclear medicine, serum IgE and IgG values are helpful in the diagnosis and evaluation of the therapeutic effects of nasal allergies. But in Korea, air pollution and the increased use of food additives have become leading factors in nasal allergies, It seems to be induced by environmental change, especially industrialization and urbanization, so allergic rhinitis in our environment has changed in accordance with the changes made in the living environment. Therefore this study is attempted in order to observe a clinical analysis which places more importance on allergic rhinitis. We studied 200 patients who had visited Kyunghee Oriental Medical Center with allergic rhinitis from January 1, 1999 to December 31, 1999 The results were as follows: 1. The sex distribution was 114 males(57%) and 86 females(43%). In age distribution, the average age was 25. In males, ages ranged from 3 to 66 years old and the average was 23.81. In females, ages ranged from 4 to 67 years old and the average was 28.57. The peak age was 30～39 years old(24%); under 9 years old and 10～19 years old were each 18%; 20～29 years old was 22%; 40～49 years old was 11 %; over 50 years old 6.5%. The gulf between males and females showed a statistically significant difference(P<0.025). 2. In the age of onset, male' s maximum was 62.5, minimum was 0.25; female s maximum was 59.5, minimum was 0.2. Under 9 years old was the most with 34%(male 24%, female 10%), 10～19 years old was 18%, 20～29 years old was 22.5%, 30～39 years old was 13.50%, over 40 years old was 12%, The gulf between males and females were showed statistically significant difference.(p<0.014) 3. The average duration of the disease was 5.67 years. In male and female, the maximum was 30, the minimum was 0.05; under 5 years old was the most with 62%(male 34.50%, female 27.50%); 6～10 years old was 23%. So, under 10 years old was 85%. There was no statistically significant difference in the duration of disease. 4. Regarding type of residence, 47.50% of patients with allergic rhinitis lived in apartments, 52.50% lived in houses. In males, 29.50% lived in apartments, 27.50% lived in houses. In females, 18% lived in apartments, 25% lived in houses. There was no statistically significant difference in the residence by T-test and chi-test. 5. In the distribution of season, spring is the most with 29.5% of patients, winter 28%, fall 25.5%, and summer 17%. But there was no statistically significant difference. 6. After observing 200 patients with allergic rhinitis, classifying main symptoms into 5 types, sneezing was the main symptom in 177cases(88.50%), nasal obstruction in 176cases(88%), rhinorrhea in 169cases(84.5%), post nasal discharge in 87cases(43.50%), and itching in I04cases(52%). The Cumulus ration is 98.50% and symptoms overlapped with an average 3.57±0.1 times but in an analysis of variance of these symptoms, the gulf between males and females was not recognized as statistically significant by T-test and ANOVA. 7. Patients whose families have allergic diseases account for 90 cases(45%) : 49cases(24.50%) male and 41cases(20.50%) female. There were 4 cases (71.11 %) whose families have allergic rhinitis, 9cases(10%) of asthma, and 7.78% with allergic dermatitis. There were 61 (67.80%) cases of patients whose parents have allergic diseases; cases wherein the patient s child had allergic diseases numbered 13 (14.45%); and cases with a sibling with allergic diseases totalled 16cases (17.80%). There was no statistically significant difference in allergic disease regarding sex, parents, or siblings by chi-test. 8. Blood type: For males, type A is the most common, with 37cases(18.5%), followed by type B with 32cases(16%), type O 28cases(l4%) and type AB 13cases(6.5%). For females, type B is the most common, with 30cases(15%), followed by type O with 23cases(l1.5%), type A with 18cases(9%) and type AB with 13cases(6.5%). There was no statistically significant difference in blood type by chi-test. 9. In the selection of prefered food, most patients prefer cool food, with 98 such cases(49%), tepid food in 54cases(27%) and warm food in 48cases(24%). These showed a statistically significant difference in the selection of prefered food between males and females by chi-test(p<0.009). 10. The state of Past History was classified into II types. chronic hypertrophic rhinitis is the most common with 11cases (18.64%), tonsil and adenoid hypertrophy is 8cases(l3.56%), sinusitis is 6cases(10.17%), nasal septum deviation is 4cases, nasal polyp is 2cases, others are 10cases(l6.95%). No statistically significant difference in past history between males and females was shown, but a statistically significant difference was shown when males and females were compared with total cases by T-test(p<0.002, P<0.0008). 11. Regarding complications, 37 patients (28.91%) had sinusitis: 22cases(17.19%) in male, 15cases(11.72%) in female. Chronic hypertrophic rhinitis was found in 15cases(11.72%). Others are under 10%. There was no statistically significant difference in the type of complications between males and females, but a statistically significant difference was shown when males and females were compared with total cases by T-test(P<0.00l, P<0.007). 12. In the treatment, medication was used 1691 times, an average of 2.58 times. No.34 was used 370 times for 124 cases, an average of 2.98 times. No. 152 was used 318 times for 106 cases, an average of 3.00 times. No.151 was used 307 times for 97cases, an average of 3.16 times. No. 31 was used 117 times for 33 cases, an average of 3.55 times. No 25 was used 116 times for 33 cases, an average of 3.52 times. 13. In the duration of treatment, the most frequent is 1 week(69cases, 34.50%), the maximum is 20weeks, and the minimum is 1week. A treatment period of 2～3 weeks accounted for 32% of cases, a period of 4～5weeks accounted for 13.5%. The gulf between males and females showed a statistically significant difference in the duration of treatment.(p<0.01). There was a statistical significance when the males were compared with total cases by ANOVA(P<0.03). 14. A comparison between before-treatment and after-treatment showed a statistically significant difference in treatment by T-test (p<0.01) and F-test (p<0.0058).

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.189-196
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• 1992

Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.1
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• pp.13-26
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• 2001

Cleft lip and/or palate is the congenital orofacial malformation most commonly occurred in humans, The disease is multifactorial and is probably caused by genetic and/or environmental factors, So, there are many problems in research concerning etiology and in treatment of the disease, Even the most practiced and sophisticated methods of surgical repair are necessarily followed by scar contraction and fibrosis, which result in skeletal defects, dental abnormalities, cosmetic disfigurement, and speech impairment, As a result, Fetal surgery can be considered but practiced rarely when the deformity is not fatal to life, And treatment of cleft palate is performed in the form of medicine projection into uterus in animal experiments, Many studies show that growth factor and its receptor emerge from the developing palate; and the epidermal growth factor receptors have a important role in craniofacial development and in palatal fusion, The palatal morphogenesis of the avine is different from the mammal's; it takes the form of physiologic cleft palate, Recently, cleft palate fusion experiment was performed when the avine were in the period of palate formation through the exogenous TGF-β3 addition, and it showed that the exogenous TGF-β3 makes fusion of divided palate through certain process when cleft palate is occurred in palatal formation, In this study, I had the conformation of the fusion of cleft palate through the addition of TGF-β in case of chicken embryo, and observed the effect of TGF-β in EGF receptor distribution, And the following is the results of this study, 1. In case of the TGF-βl and β3 addition group, there was the decrease of EGFR(Epidermal Growth Factor Receptor) immunoreactivity in mesenchymal cells beneath the medial edge epithelium and also in epithelial mesenchymal interface which is between medial edge epithelium and nasal septum in 72 hours, 2, The immunoreactivity of the control group resembles that of normal chicken embryo palate in development, 3. In the view through fluorescence confocal microscopy, there was confluence in TGF-β3 addition group, This shows that the confluence induced by exogenous TGF-β3 is related to EGFR expression in palate of chicken embryo, which is a physiologic cleft palate model.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.2
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• pp.352-360
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• 1997

It has been reported that There is a relatively high incidence of congenital cleft lip and palate among congenital anomalies. Children with the cleft lip and palate confront various problems ranging from feeding difficulties as infants to frequent ear infections, compromised speech, aberrant dentofacial development, malocclusion and esthetic impairment with its unfavorable effects on the psychosocial adaptation of the individual. Management of these patients is a process that starts in infancy and continues on into adulthood. Through a team approach, professionals from various fields convene to assess the needs of the child and to assist the parents in dealing with the situation. A pediatric dentist, one of the team, must advise the parents the way of feeding or make an obturator for normal feeding and weight gain of infants with cleft lip and/or palate. An obturator can aid nursing, stimulate orofacial development, help develop the palatal shelves, prevent tongue distortions, prevent nasal septum irritation, decrease chance of ear infections, expand collaped maxillary segments, constrict the expanded anterior part of the maxilla, reposition the premaxilla, and help the parents psychologically. Three cases of infants with cleft lip and palate were managed with the obturator at the Dept. of Pediatric Dentistry, Kyung Hee University. In all cases, infants showed normal feeding and weight gaining after the insertion of the obturator.

• Journal of Biomedical Engineering Research
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• v.23 no.2
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• pp.147-153
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• 2002

The purpose of this study was to evacuate the effect of different types of Poly(lactic-co-glycolic acid) (PLGA) scaffolds on the formation of human auricular and septal cartilages. All of the scaffolds were formed in a tubular shape for potential application for artificial trachea or esophagus with either 110,000 g/mol PLGA. 220,000 g/mol PLGA. or a combination of both. In order to maintain the tubular shape in vivo, two methods were used. One method was inserting polyethylene tube at the center of scaffolds made of 110,000 g/mol PLGA. The other method involved combination of the two different molecular weight PLGA's. The inner surface of tubular shaped scaffold made with 110,000 g/mol PLGA was coated with 220,000 9/mol PLGA to give more mechanical rigidity. Elastic cartilage was taken from the ear of a patient aged under 20 nears old and hyaline cartilage was taken from the nasal septum. The chondrocytes were then isolated. After second passage, the chondrocytes were seeded on the PLGA scaffolds followed by in vitro culture for one week. The cells-PLGA scaffold complex were implanted subcutaneously on the back of nude mice for 8 weeks. The tissue engineered cartilages were separated from nude mice and examined histologically after staining with the Hematoxylin Eosin. The morphology of the scaffolds were examined by scanning electron microscopy. The pores were well formed and uniformly distributed in the various PLGA scaffolds. After 8 weeks in vivo culture, cartilage was well formed with 110,000 g/mol PLGA. however lumen had collapsed. In contrast. a minimal amount of neocartilage was formed with 220,000 g/mol PLGA, while the architecture of scaffold and lumen were well preserved. Elastic cartilage formed more neocartilage than hyaline. Hyaline and elastic neocartilage were well formed on 110,000 g/mol PLGA with the polyethylene tube, exhibiting mature chondrocytes and preservation of the tubular shape. It was found that 110,000 g/mol PLGA was more appropriate for cartilage formation but higher molecular weight polymer was necessary to maintain the three dimensional shape of the scaffold.