• Archives of Plastic Surgery
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• 제43권3호
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• pp.265-271
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• 2016

Background Reconstruction of orofacial soft tissue defects is often challenging due to functional and aesthetic demands. Despite advances in orofacial soft tissue defect reconstruction using free flaps, locoregional flaps still remain an important option, especially in health resource-depleted environments. This retrospective study highlights our experiences in oral and maxillofacial soft tissue reconstruction using locoregional flaps. Methods A twenty-three years retrospective analysis of all patients managed in our department was undertaken. Information was sourced from patients' case notes and operating theater records. Data was analyzed using SPSS ver. 16 (SPSS Inc.) and Microsoft Excel 2007 (Microsoft). Results A total of 77 patients underwent orofacial soft tissue defect reconstruction within the years reviewed. Males accounted for 55 (71.4%) cases and trauma was the main etiological factor in 45 (58.4%) of the patients treated. When sites of defect were considered, the lip, 27 (32.1%), was the most frequent site followed by the nose, 17 (20.2%). Forehead flap, 51 (59.3%), was the most commonly used flap. Complications noted were tumor recurrences at the recipient bed in 3 (3.9%) cases, tumor occurrence at the donor site in 1 (1.3%) case and postoperative infection in 11 (14.3%) cases. Conclusions Locoregional flaps still have an important role in the rehabilitation of patients with orofacial soft tissue defects. They remain a vital tool in the armamentarium of the reconstructive surgeon, especially in health resource-depleted environments where advanced reconstructive techniques may not be feasible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권3호
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• pp.305-318
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• 1991

Reconstructive techniques of orofacial defects are very varied. In recent years, myocutaneous flaps, in particular the pectoralis major or latissimus doris myocutaneous flap have achieved popularity. In 1983, Soutar et. al. used the forearm free flap that had been developed in in China and popularised the radial forearm fasciocutaneous flap to reconstruct defects in the orofacial region. This paper presents the authors experience with 10 consecutive patients in which 12 flaps were used either as a fascioncutaneous flap or as a composite flap incorporating part of the radius. Some literatures were reviewed and the clinical results were discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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• pp.248-255
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• 2013

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.21.1-21.5
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• 2018

Background: The purpose of this study was to evaluate the clinical outcomes of treatment of non-odontogenic atypical orofacial pain using botulinum toxin-A. Methods: This study involved seven patients (seven females, mean age 65.1 years) who had non-odontogenic orofacial pain (neuropathic pain and atypical orofacial pain) and visited the Seoul National University Bundang Hospital between 2015 and 2017. All medication therapies were preceded by botulinum toxin-A injections, followed by injections in the insignificant effects of medication therapies. Five of the seven patients received intraoral injections in the gingival vestibule or mucosa, while the remaining two received extraoral injections in the masseter and temporal muscle areas. Results: In five of the seven patients, pain after botulinum toxin-A injection was significantly reduced. Most of the patients who underwent surgery for dental implantation or facial nerve reconstruction recovered after injections. However, the pain did not disappear in two patients who reported experiencing persistent pain without any cause. Conclusions: The use of botulinum toxin-A for the treatment of non-odontogenic neuropathic orofacial pain is clinically useful. It is more effective to administer botulinum toxin-A in combination with other medications and physical therapy to improve pain.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.230-236
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• 2014

Esthetic reconstruction of cleft lip nose deformity is a challenging task in surgical management of patients with orofacial cleft. The author reconstructed cleft lip nose deformity effectively using autogenous auricular cartilage and a relatively new graft material of porcine dermal collagen, $Permacol^{TM}$. After correction of the deformed lower third of the nose with patient's auricular cartilage, we applied $Permacol^{TM}$ to augment the entire nasal dorsum. Three patients were treated and followed for up to five years. All patients improved in nose aesthetics without any inflammatory or immunogenic reaction. The author suggests that the use of $Permacol^{TM}$ for nasal profile augmentation in the treatment of cleft lip nose deformity is an alternative surgical strategy with minimal surgical invasiveness. The author report long-term experience with combined use of auricular cartilage and $Permacol^{TM}$ in nasal reconstruction for cleft lip nose deformity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.1-16
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• 1996

There are various defects caused by trauma or resection of maignant tumor in the orofacial region, which can be reconstructed with various regional and pararegional flaps. Among these defects, it is very difficult to reconstruct palatal and midfacial defects after maxillectomy and patients have problems in speaking and swallowing of food. Therefore it is very important for surgeons to reconstruct these defects functionally and esthetically and to return the patients to the normal social activity. These defects are usually obturated with prosthodontic appliances to assist the phonation and swallowing. But nowadays surgical reconstruction by various flaps was considered and performed for better rehabilitation. For this purpose the forehead flap, the nasolabial flap, the tongue flap, the sternocleidomastoideous flap, the temporal flap, the latissimus dorsi flap, the scapular flap etc. are used. We reconstructed small-sized plalatal defects with tongue flap, medium-sized palatal and maxillary defects after maxillectomy with temporal myofascial flap and large midfacial defects including eyeball exenteration with latissimus dorsi myocutaneous flaps. Here we are to report 5 cases of these flaps used for the reconstruction of palatal and midfacial defects and consider the versatility, reliability and limitation in use of these flaps.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.518-523
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• 2021

Epignathus is a rare congenital orofacial teratoma that arises from the sphenoid region of the palate or the pharynx. It occurs in approximately 1:35,000 to 1:200,000 live births representing 2% to 9% of all teratomas. We present the case of a newborn of 39.4 weeks of gestation with a tumor that occupied the entire oral cavity. The patient was delivered by cesarean section. Oral resection was managed by pediatric surgery. Plastic surgery used virtual 3-dimensional models to establish the extension, and depth of the tumor. Bloc resection and reconstruction of the epignathus were performed. The mass was diagnosed as a mature teratoma associated with cleft lip and palate, nasoethmoidal meningocele that conditions hypertelorism, and a pseudomacrostoma. Tridimensional technology was applied to plan the surgical intervention. It contributed to a better understanding of the relationships between the tumor and the adjacent structures. This optimized the surgical approach and outcome.

• Journal of Oral Medicine and Pain
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• 제24권1호
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• pp.69-80
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• 1999

OBJECTIVES: This study was designed to measure the minimal cross-sectional areas and volumes of the pharynx in snoring patients and normal subjects and to see if there is an increase in the minimal cross-sectional areas and volumes of the pharynx with advancement of the mandible. METHODS: The pharyngeal computed tomography and 3-dimensional reconstruction were used to measure the cross-sectional areas and volumes of the nasopharynx, oropharynx, and hypopharynx with the jaw in normal position and in protrusive position in 7 patients with snoring and 7 control subjects while they were awake. RESULTS: The oropharynx was revealed to have the most narrow site in the pharynx and there was a tendency for the snorers to have a smaller nasopharyngeal and oropharyngeal cross-sectional area than normal subjects but not statistically significant. There were no significant differences in the volumes of the nasopharynx and oropharynx between the two groups. With advancement of the jaw the minimal cross-sectional area of oropharynx was significantly increased, and the volume was also increased but not significantly. The minimal cross-sectional areas and volumes of nasopharynx as well as hypopharynx were not significantly influenced by the advancement of the mandible. CONCLUSIONS: There was a tendency for snorers to have a smaller oropharynx than normal subjects and the oropharyngeal lumen was increased with the advancement of the mandible in both snorers and normal subjects.

• 대한치과교정학회지
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• 제28권6호
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• pp.893-904
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• 1998

교정적으로 치료할 수는 있지만 많은 노력을 필요로 하는 부정교합들이 존재한다. 특히, 전방 개교는 치료하기 어렵고, 많은 경우 외과적 수술을 동반하여야 한다. 이러한 문제를 해결하기 위해, 여러 치료기전에 대한 연구가 소개되었다. 제안된 치료기전들은 직접, 간접적으로 근신경계와 형태학적인 특징과 원인적 혹은 환경적 요소에 기초를 둔다. 성장 변이에 따라 안모의 수직 관계는 증가하나, 적절한 치아치조 보상기전으로 정상교합 관계가 유지된다. 그러나, 부적절하거나, 부정적인 치아치조 보상기전이 일어나는 경우 개교가 발생할 수 있다. 골격 부조화가 너무 심해 교정치료만으로 해결되기 어렵다면, 악구강계의 기능과 심미를 증진시키기 위하여 수술이 행해져야만 한다. 그러나, 많은 경우 적절한 진단과 치료계획으로 주어진 골격패턴에 알맞게 교정 치료를 변형시키면, 만족스런 결과를 얻을 수 있다. Multiloop Edgewise Arcgwire(MEAW) 기법은 주로 치아치조 영역에서 치료 변화가 일어나며, 자연적인 치아치조 보상기전과 상당한 유사성을 보인다. 다시 말해서 MEAW기법은 교정의가 자연적인 치아치조 보상을 교정적으로 유도한다고 할 수 있다. 골격 패턴에 알맞은 교정적인 치아치조 보상으로 개교를 치료했다고 해도, 자연적인 치아치조 보상을 억재해왔던 원인요소가 남아 있다면, 재발이 일어난다. 원인요소는 초진시 진단되고 치료와 보정시기에도 고려되어야한다.