• 사상체질의학회지
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• 제10권2호
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• pp.221-270
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• 1998

Objective This research is a study about constitutional diagnosis through the external appearances as a basic principle, and it is for finding shape differences of the ear, eye, nose, mouth according to the Sasang constitution Method We have collected 209 cases of patients of the Sasang Constitutional Department, including employees of the Kyung-Hee Medical Center and took pictures of the frontal view, lateral view, oblique view of face and measured heights, deapth, breadths of ear, eye, nose, mouth with 'The Measurement of R. Martin'. We analyzed shape differences of the face according to the Sasang constitution with certain results Results We got the morphologic characteristics of ear, eye, nose and mouth according to the Sasang constitution as Table 3. -Table 10. Conclusion : 1. The morphologic characteristics of Ear according to the Sasang constitution (1) Morphologic ear length, Physiognomic ear length, Ear lobule length is longer in Taeumin than Soeumin. (2) Physiognomic ear breadth is wider in Taeumin than Soeumin. (3) Physiognomic ear length, lobule length ratio is higher in Taeumin than Soyangin. 2. The morphologic characteristics of Eye according to the Sasang constitution. (1) Inner Palpebral fissure width, 5th Palpebral fissure length, Bizygomatic breadth-Outercanthal distance is the longest in Taeumin (2) Palpebral fissure inclination is widest in Soeumin. (3) Palpebral fissure length is longer in Taeumin than Soeumin. (4) Pupillary diameter ratio is the lowest in Taeumin (5) Palpebral fissure length, width ratio is higher in Soeumin than Taeumin. (6)zygomatic breadth, Bizygomatic breadth-Outercanthal distance ratio is the higher in Taeumin than Soeumin. 3. The morphologic characteristics of Nose according to the Sasang constitution. (1) Nasion depth is deepest in Soyangin. (2) Nasion to pupillary depth is deeper Soyangin than Taeumin. (3) Nasal tip depth, Nostril to Nasalalar depth is deeper Soyangin than Taeumin. (4) Subnasale to Nasalalar depth is the shallowest in Taeumin (5) Nasalalar height is lowest in Soeumin. (6) Nasalalar to Nostril distance is deeper Taeumin than Soeumin. (7) Nasal tip depth, Nasal depth ratio is the highest in Taeumin (8) Nasal depth Nasalalar heightratio is lowest in Soeumin. (9) Midfaceheight, Nasal tip depth ratio is higher Soyangin than Taeumin. 4. The morphologic characteristics of mouth according to the Sasang constitution. (1) Lower mid lip height, Lower philtrum height, Lower quarter lip height, Total middle lip height, Total philtrum height, Total quarter lip height is the shottest in Soyangin. (2) Upper mid lip height, Upper philtrum height is longer in Taeumin than Soyangin (3) Lip inclination is higher in Soeumin than Soyangin. (4) Intercheilion breadth, total height ratio is lowest in Soyangin. (5) Total lip height, Upper philtrum height ratio is higher in Soyangin than Soeumin. (6) Lower lip height Lower quarter lip height ratio is higher in Soyangin than Taeumin. (8) Total lip area is wider in Taeumin than Soyangin.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.351-356
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• 2020

Background: We have devised a novel surgical method, termed as temporalis muscle tendonperiosteum (T-P) compound surgical method, by modifying pre-existing techniques. Our method is characterized by elevation of temporalis muscle tendon and the periosteum of the mandibular ramus as a single compound. Here, we describe the concept and clinical outcomes of our method. Methods: We conducted both a cadaveric study and a clinical study. First, we used four human cadavers (two males and two females) to confirm the anatomy of the temporalis muscle tendon and availability of sufficient length extension through the elevation of the T-P compound. Moreover, we obtained measurements of the mouth angle and the philtrum angle from a total of six patients (two males and four females) and compared them between preoperatively and postoperatively. Results: The mean length of the periosteal portion was measured as 2.43± 0.15 cm (range, 2.2-2.6 cm). There was an improvement in the mouth angle postoperatively as compared with preoperatively (7.2°± 3.0° vs. 14.5°± 4.7°, respectively). Moreover, there was also an improvement in the philtrum angle postoperatively as compared with preoperatively (7.2°± 3.4° vs. 17.2°± 6.5°, respectively). Conclusion: Our method is a simple, minimally-invasive modality that is effective in achieving good clinical outcomes. Its advantages include an ability to achieve a firm extension of the temporalis muscle tendon as well as a lack of requirement for a donor site that may cause complications.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.747-754
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• 2011

Purpose: The Abbe flap procedure has been used to correct disharmony of the upper and lower lips as well as for making a philtrum for patients with secondary cleft lip deformities. But the Abbe flap procedure adds two scars in addition to the prior operative scar on the upper lip. This study was conducted to determine the treatment outcomes of esthetic subunit excision of the scar on the philtrum and Abbe flap coverage for correction of cleft lip deformities with photogrammetric analysis. Methods: This study investigated a total of 11 patients with cleft lip deformities who underwent scar excision with Abbe flap coverage, and the patients were followed up for at least 6 months. Under general anesthesia, a mushroom-shaped Abbe flap was drawn on the lower lip with a width of 8 mm and a height 1~2 mm longer than that of the philtral midline. The epidermis and dermis of the scar on the upper lip were excised. In the cases with alar base depression, the orbicularis oris muscle was split vertically and transposed to the alar base. The Abbe flap was harvested as a pedicled flap containing a small amount of muscle and this was rotated 180-degree to be inserted into the upper lip. Mucosa, muscle, subcutaneous tissue and skin were closed in layers. The flap was divided at the 7~14 postoperative day. The postoperative outcomes were evaluated by using photogrammetric analysis. Three indices were measured from the standard clinical photographs taken before and after the surgery. For anthroposcopic assessment, observers described the postoperative outcomes using an ordinary scale method. Results: The postoperative values obtained in the photogrammetric analysis showed improvement as compared with the preoperative ones. Improved anthroposcopic outcomes were also noted. Conclusion: Scar excision and Abbe flap coverage were proven to be effective in improving protrusion and the height of the upper lip, the scar of the upper lip and the symmetry of Cupid's bow and the philtral column, as well as formation of the philtral dimple.

• 대한구순구개열학회지
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• 제3권1호
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• pp.11-16
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• 2000

구순열 수술에서 인중의 해부, 형태, 기능적 재건에 도움을 받고자 상순 및 하순의 전층표본을 가지고 미세구조를 관찰하였으며, 자연스럽고 미적인 인중을 재건하기 위해서는 정상적 근육 부착의 재건과 구륜근 표층의 진피 부속물들의 회복과 장력 없는 상순의 접합, 진피 부속물들을 포함한 인중융기의 두께 회복 및 비탄력성 흉터 조직의 최소화가 필요하다고 사료되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.18.1-18.6
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• 2018

Background: Clefts in newborns are associated with severe morphological and functional impairment. Especially the lip is of importance as if the treatment result is unsatisfactory, it can lead to psychological changes in the patient. Different operative procedures have been developed over the last decades. The aim of the presented study was the comparison of the surgical techniques according to Millard and Pfeifer regarding the temporal development of the postoperative symmetry of the lip height and mouth width. Methods: Digitized photographs of patients from the department of oral and maxillofacial surgery at the University of Göttingen were evaluated from 1979 to 1996. With a video analysis program, the lip height and mouth width were analyzed regarding the symmetry. We demonstrated the symmetry values over a period of 8 years in order to show the influence of growth on postoperative results. Results: The development of the vertical symmetry of the Philtrum and the lip vermillion on the cleft side in comparison to the healthy side behaves differently depending on Pfeifer and Millard. The lip height of the cleft lip was shorter in both techniques than on the healthy side, but Pfeifer's difference was significantly more pronounced. The lip vermillion height on the cleft side was slightly shorter in the Millard group and markedly larger in the Pfeifer group. Both techniques can achieve good symmetry results for the vertical dimension of the lip. According to Pfeifer, the development of the horizontal dimension on the cleft side is bigger within the first 4 years than on the healthy side; according to the Millard technique, the horizontal development is smaller. These differences are greater within the first 6 years and approach between the 6th and 8th year. Conclusions: The Millard technique demonstrates better results concerning the philtrum and vermillion symmetry during growth within the first 6 years. Over the whole study period, growth corrects the philtrum and vermillion symmetry within the Pfeifer group.

• Journal of Chest Surgery
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• 제26권11호
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• pp.886-889
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• 1993

The DiGeorge syndrome is a rare congenital anomaly of absent or hypoplastic thymus and parathyroid glands. Authors experienced a case of DiGeorge syndrome with complex cardiac anomaly. The complex cardiac anomaly was tetralogy of Fallot with origin of the right pulmonaly artery from the posterolateral ascending aorta.His face showed hypertelorism,short philtrum,"fish-like"mouth and micrognathia. This patient underwent total correction of tetralogy of Fallot and end-to-side anastomosis between right pulmonaly artery and side of main pulmonaly artery. He expired on postoperative second day due to right heart failure and hypoxia.d hypoxia.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.542-545
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• 2013

Background The aims of alveolar bone grafting are closure of the fistula, stabilization of the maxillary arch, support for the roots of the teeth adjacent to the cleft on each side. We observed nostril base augmentation in patients with alveolar clefts after alveolar bone grafting. The purpose of this study was to evaluate the nostril base augmentation effect of secondary alveolar bone grafting in patients with unilateral alveolar cleft. Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bone grafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 were reviewed. Preoperative and postoperative worm's-eye view photographs and reconstructed three-dimensional computed tomography (CT) scans were used for photogrammetry. The depression of the nostril base and thickness of the philtrum on the cleft side were measured in comparison to the normal side. The depression of the cleft side pyriform aperture was measured in comparison to the normal side on reconstructed three-dimensional CT. Results Significant changes were seen in the nostril base (P=0.005), the philtrum length (P=0.013), and the angle (P=0.006). The CT measurements showed significant changes in the pyriform aperture (P<0.001) and the angle (P<0.001). Conclusions An alveolar bone graft not only fills the gap in the alveolar process but also augments the nostril base after surgery. In this study, only an alveolar bone graft was performed to prevent bias from other procedures. Nostril base augmentation can be achieved by performing alveolar bone grafts in children, in whom invasive methods are not advised.

• 사상체질의학회지
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• 제24권3호
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• pp.60-68
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• 2012

Objectives Sasang Constitution (SC) is determined by various physical and psychological attributes. Recently, skin properties have been used effectively to describe SC types in clinics. In this paper, we investigated the constitution dependence of skin elasticity and skin perspiration by using quantitative measurement devices. Methods The skin elasticity of forearm and the skin perspiration of forehead and philtrum were measured in 223 elderly female subjects. To determine the subject's constitution, we adopted the classification results from a newly developed diagnostic tool. For the clarity of constitution, we excluded low-scored subjects in their SC classification. Results & Conclusions As a result, the elasticity hysteresis of forearm (EHFa) of Taeum-in group was significantly less than the EHFa of Soeum-in group. Soeum-in group has high perspiration difference between philtrum and forehead (Diff.PhFh) compared to Taeum-in group in a significance level of .05. Taeum-in and Soeum-in group were significantly classified by EHFa and Diff.PhFh using a Support Vector Machine.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.11-21
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• 2012

Purpose: Mulliken's method allows for normal nasal and lip growth, which in turn forms a natural shape of the philtrum. Therefore, we used a modified Mulliken's method to correct unilateral and bilateral cleft lip nasal deformities and followed the patients for 10 years. Methods: Ninety-one patients, who had undergone repair of unilateral and bilateral cleft lip and nasal deformity simultaneously using Mulliken's method during the time period from June 1997 to June 2009, were enrolled into this study. To follow-up of the growth of the lips and nose after the operation, the following 5 anthropometric measurements were analyzed: nasal tip protrusion, columellar length, upper lip height, cutaneous lip height, and vermilion mucosa height. Results: Using this method, we obtained a result that there was no significant difference in the development of the lip compared to the normal control group, and that the bilateral cleft lip patients' nasal projection and columellar length was shorter than that in normal persons. Both measures were statistically significant. Conclusion: Mulliken's method is a superb surgical technique, which enables the normal development of the nose and lip, which further allows for the innate philtrum appearance. The author's result does not seem to be meaningful, because the normal rate of nasal growth is slow before adolescence; however, we recommend additional follow-up and accordant treatment, if needed, once the nasal growth is complete.

• 한방안이비인후피부과학회지
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• 제22권1호
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• pp.157-171
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• 2009

Objective : The face is very important for human communication. So facial palsy patients experience not only physical disturbances but also serious emotional stress. Therefore the focus of treatment must be to not only aid the recovery of objective symptoms but also the improvement of subjective quality of life. However there has not been enough Oriental Medical study in this field until now. Thus this study was begun to suggest a useful index for the treatment of facial palsy. Methods : Grade of paralysis, sequelas, and quality of life were used for evaluation. To evaluate Grade of paralysis, House-Brackman Grade was used as the Gross scale and Kim's Grade was used as the Regional scale. Sequelas were evaluated by muscle contraction, synkinesis, NA, and grade of philtrum tilt. Quality of life was evaluated by SF-36v2, Facial Disability Index, and Vas. Results & Conclusion : 1. The change of grade of paralysis between the early and the present time reveals remarkable improvement statistically. 2. There was a remarkable improvement in all parts of quality of life except several areas of SF-36(RP, RE, MH, VT) 3. In only PF(Physical Function) of FDI, quality of life increased remarkably according to the improvement of grade of paralysis. 4. There is the positive relationship among Kim's grade, HB grade and Synkinesis 2. 5. Synkinesis among sequelas has the greatest effect on quality of life. And muscle contraction, change of NA, and grade of philtrum tilt also affect quality to some extent. 6. There was no remarkable relationship between the period of illness and change of quality of life. 7. Change of NA is shown after 3 months of illness and synkinesis becomes worse after 6 months of illness.