• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.78-83
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• 2015

Squamous cell carcinoma (SCC) is the most common malignant tumor in the oral cavity, and it accounts for about 90% of all oral cancers. Several risk factors for oral SCC have been identified; however, SCC associated with odontogenic keratocysts have rarely been reported. The present study describes the case of a 36-year-old man with SCC of the right ramus of the mandible, which was initially diagnosed as a benign odontogenic cyst. He underwent enucleation at another hospital followed by segmental mandibulectomy and fibular free flap reconstruction at our institution. In this case, we introduce a patient with oral cancer associated with odontogenic cyst on the mandible and report a satisfactory outcome with wide resection and immediate free flap reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.44-48
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• 2011

Maxillary defects are inherently complex because they generally involve more than one midfacial component. In addition, most maxillary defects are composite in nature, and often require bony support, as well as a mucosal lining for reconstruction. Therefore, midfacial bone and soft tissue defects present a unique challenge because they require a complex arrangement of tissues in a relatively limited space. This might be difficult to achieve only with free osteocutaneous flaps. The use of bone grafts allows greater flexibility in a reconstruction but is limited by graft resorption. We report a case of a patient reconstructed with a lateral arm free flap, iliac bone graft, sagital split ramus osteotomy for the reconstruction of a right maxillary defect zygomatico-maxillary defect caused by a zygomatico-maxillary malignant tumor resection.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.140-147
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• 2012

Microvascular reconstruction, in the oral and maxillofacial regions, is a widely accepted as the best way to overcome the complex oral cavity defects. Many patients requiring composite reconstructions have been treated previously with radiation therapy, chemotherapy, selective and/or functional neck dissection or any of these combinations. In many cases of these patients, inadequate neck vessels for the microanastomosis of free flap are available, due to a lack of recipient vessels in the neck, poor vessel quality or vessel caliber mismatch. To achieve a tension-free anastomosis, vein grafting must be considered to span the vessel gap between the free flap pedicle and the recipient neck vessels. Although most microsurgeons believed that interpositional grafts are to be avoided due to vessel thrombosis and increased number of necessary microanastomosis, we, authors have some confidence of equivalency between reconstruction with and without interpositional saphenous vein graft. The great saphenous vein, also known as the long saphenous vein, is the large subcutaneous superficial vein of the leg and thigh. It joins with the femoral vein in the region of femoral triangle at the saphenofemoral junction, and coursed medially to lie on the anterior surface of the thigh before entering an opening in the fascia lata, called the saphenous opening. For a better understanding of the great saphenous vein graft for the interpositional vessel graft in the oral cavity reconstructions, and an avoidance of any uneventful complications during these procedures, the related surgical anatomies with their harvesting tips are summarized in this review article in the Korean language.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.6
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• pp.266-271
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• 2014

Objectives: The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects. Materials and Methods: We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT). Results: Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages ($9.25{\pm}5.10months$), plate fracture was the most common complication, but in the later stages ($35.75{\pm}17.00months$), screw loosening was the most common complication. Conclusion: It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.3
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• pp.216-223
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• 2021

Preoperative patient analysis for oral cancer involves multiple considerations that are based on multiple factors; these include TNM stages, histopathologic findings, and adjacent anatomical structures. Once the decision is made to excise the lesion, the margin of dissection and its extent should be considered along with the best form of reconstruction and airway management. Treatment methods include surgical resection, radiotherapy, and chemotherapy. Although the combined method of treatment is controversial, surgical resection is considered predominantly, and immediate reconstruction after surgical resection follows. The choice of treatment is dictated by the anticipated functional and esthetic results of treatment and also by the availability of a surgeon with the required expertise. Segmental mandibulectomy with primary reconstruction has been shown to have advantages in both functional and esthetic results. A 52-year-old male patient with basaloid squamous cell carcinoma of the floor of the mouth, and the anterior portion of the mandible was treated with surgical procedures that included segmental mandibulectomy with both supraomohyoid neck dissection (SOHND) at Levels I-III and mandible reconstruction with a left fibula free flap. A 55-year-old male patient with clear cell odontogenic carcinoma of the oral cavity underwent segmental mandibulectomy with both SOHND at Levels I-III and mandible reconstruction with a left fibula free flap. The purpose of this study was to review the anatomic and functional results of patients after immediate reconstruction with a fibula free flap following resection of carcinoma in the anterior portion of the mandible and floor of the mouth.

• Journal of International Society for Simulation Surgery
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• v.3 no.1
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• pp.12-15
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• 2016

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.7.1-7.5
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• 2018

Background: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. Case presentation: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. Conclusion: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.4
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• pp.361-365
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• 2007

The reconstruction of perioral defects following resection of cancer on the perioral region has been a challenge for oral and maxillofacial surgeons. Surgical management of oral squamous cell carcinoma (SCC) typically involves resection of the carcinoma with a 1cm margin of normal appearing tissue. A large surgical defect is often encountered. The goals of perioral reconstruction are esthetics and function, with oral competence and good lip control. Abbe described the operation that bears his name in 1898, when he reported on the repair of a "conspicuous deformity" in a 21-year-old man born with bilateral cleft lip and palate. Since that time, Abbe flap reconstruction has been used more frequently for repair following resection of malignancies. Large defects of the lips have been repaired with recent modifications of the Abbe flap. The technique has been popularized by Estlander for reconstruction of the lower lip. We have treated 70-year-old male patient with SCC on lower lip using Abbe-Estlander flap. Postoperatively the results showed good prognosis. So we report the result of its treatment and case with review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.93-101
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• 2011

Reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. The radial forearm free flap (RFFF) is a thin, pliable soft tissue flap with large-caliber vessels for microvascular anastomosis. Its additional advantages include consistent flap vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with a tumor resection. For a better understanding of RFFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of RFFF in the Korean language.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.343-348
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• 2012

Treatment of hemifacial atrophy is a challenge for oral & maxillofacial surgeons. The surgical approach basically focused on skeletal correction so that the overlying soft tissues can be improved by the osseous change of the skeleton. However, the treatment ends up with insufficient soft tissue mophology in most cases even after skeletal correction. Therefore comprehensive hard and soft tissue reconstruction is needed for treating the hemifacial atrophy. In this case report, we experienced a successful result after combined orthognathic and microvascular adipofascial flap reconstruction for hemifacial atrophy patient.