• Archives of Plastic Surgery
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• 제46권1호
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• pp.23-33
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• 2019

Background Venous malformations (VMs) are a common type of vascular malformation. However, their causes and management remain unclear, and few studies specific to VMs of the head and neck have been reported. This study describes our experiences with VMs of the head and neck. Methods This retrospective study included 82 patients who underwent treatment for head and neck VMs, among 222 who visited our vascular anomalies center. Medical records between 2003 and 2016 were reviewed to identify common features in the diagnosis and treatment. The diagnosis of suspected head and neck VMs was based on the results of imaging studies or biopsies, and the VMs were analyzed based on magnetic resonance imaging, computed tomography, and Doppler sonography findings. Results VMs were slightly more common in female patients (59.8%), and 45.1% of patients developed initial symptoms at the age of 10 or younger. Lesions were slightly more common on the right side (47.3%). The main sites involved were the cheek (27.7%) and lip area (25.5%). The muscle layer was commonly involved, in 98.7% of cases. Small lesions less than 5 cm in diameter accounted for 60.8% of cases, and well-defined types were slightly more prevalent at 55.4%. Improvement was observed in 77.1% of treated patients. Conclusions Early and accurate diagnosis and appropriate treatment according to individual symptoms are important for successful treatment of VMs. If treatment is delayed, the lesions can worsen, or recurrence becomes more likely. Therefore, VMs require a multidisciplinary approach for early and accurate diagnosis.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.313-318
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• 2017

Background Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. Methods Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015. Results In total, 190 patients (57 men) with a mean age of 75 years (range, 42-97) were assessed. Overall, 203 NMSCs were diagnosed, including 123 basal cell carcinomas and 80 squamous cell carcinomas. The tumor sites included the nose, cheeks, periorbital area, and lips (n=55, 54, 25, and 20, respectively). We identified 92 T1-stage and 60 T2-stage tumors, and 120 cases were treated with wide surgical resection and 17 cases were treated with radiation therapy at the medical center. Of the 120 cases treated surgically, 69 required reconstructive surgery using a local skin flap, 22 required full-thickness skin grafting, and 12 underwent primary closure. Basal and squamous cell carcinomas recurred in 2 and 1 cases, respectively. Conclusions Compared to the reports from other regions, the average patient age was 10 years higher, with a marked female preponderance. While the proportion of squamous cell carcinoma was higher than in other regions, the tumor distribution and surgical management profiles were similar.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.350-358
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• 2019

Background Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus about the best treatment option. The purpose of this prospective cohort study conducted at a single institution was to evaluate the clinical outcomes and patient satisfaction following a mini-open carpal tunnel release for idiopathic CTS. Methods A total of 72 patients (53 female and 19 male patients; mean age, $57.8{\pm}15.3$ years; range, 24-94 years) had a mini-open carpal tunnel release performed by a single senior surgeon between June 2015 and June 2016. The patients were evaluated preoperatively, and at 3 and 12 months post-intervention. At every follow-up, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and visual analogue scale (VAS) scores for pain and satisfaction were completed. Digital sensibility (using Semmes-Weinstein monofilaments) was assessed and pinch and grip strengths were measured. Results Statistically significant and clinically relevant improvement was found in terms of digital sensibility, grip and pinch strength (except for 2-point pinch), BCTSQ scores and pain scores. The complication rate was minimal, and no major complications occurred. Two patients experienced recurrence. The availability of follow-up records (including patient-reported outcomes, BCTSQ and VAS scores, and the complication rate) at 1-year post-intervention varied between 69% and 74% (50-53 patients) depending on which parameter was assessed. Patient satisfaction was high (mean, $80.9{\pm}26.0$; range, 0-100). Conclusions This study demonstrates that mini-incision carpal tunnel release is clinically effective in the short and long term.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.599-604
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• 2007

Purpose: Blowout fractures of the orbit are common sequelae to blunt facial trauma and now increasing in number due to automobile accidents, violence and industrial disasters. There are some reports of diagnosis and treatment of this fracture, but detailed data provided in overall aspects are very few. We analysed extensive data to provide guide line of blowout fracture patients care. Methods: We retrospectively studied 387 orbital blowout fracture patients who had been followed up at least 3-6 months. Their hospital records were reviewed according to causes, fracture site, operation methods, and follow up results, etc. Results: The ratio of males to females was 7 : 3 and fractures were most often seen in the 20-29 age group. 180(47%) patients had medial orbital wall fractures, 155(40%) patients had floor fractures and 52(13%) patients had a combination of orbital floor and medial wall fractures. The highest associated bone fracture was the nasal bone(37%). The open reduction was done in the 324 patients(83.7%) and insertion materials were used in the 249 patients(77%). Total 45 patients(14%) complained of residual diplopia and 26 patients(8%) kept mild enophthalmos. 24 patients(7%) showed some restriction of extraocular muscle movements. Conclusion: We broadly surveyed the information of blow out fracture patients and believe that this study provides important prognostic information that can be of benefit to both patient and surgeon during preoperative counseling and postoperative analysis of orbital blowout fractures.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.48-52
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• 2017

Background The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. Methods From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients' records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. Results All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. Conclusions Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.

• 한국도서관정보학회지
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• 제42권4호
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• pp.5-29
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• 2011

본 연구에서는 현재 한국 문헌정보학과에 개설된 교과목들의 현장필요성을 평가하고 교과과정의 개선방향을 모색하고자 하였으며, 현장사서들을 대상으로 현재의 교과목운영에 대한 만족도 조사를 기반으로 구체적으로 필수 또는 핵심과목, 그리고 선택과목으로 나누어 제안하였다. 필수과목으로 사서실습, 문헌정보학개론, 정보조직학(분류목록), 정보조사 제공론, 도서관경영론, 정보검색론 등 6개 과목, 핵심과목으로 정보자료분류목록실습, 주제별정보원(참고정보원), 장서개발론, 디지털도서관론, 서지학개론, 기록관리학개론 등 6개 과목, 나머지 과목은 학교의 상황 및 교수진의 구성에 따라 선택과목으로 개설할 것을 제안한다. 또한 교육방법으로 사서실습 및 현장답사를 통한 교육, 발표 및 토론위주 교육을 제안하며, 문헌정보학 교육과정의 내실화를 위해 중요한 것은 교육주제의 최신성, 교육내용의 전문성, 교육자의 전문성 및 자질, 교육교재의 전문성, 담당과목과 담당교수의 전공상관도 제고 등이다.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.22-28
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• 2012

Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

• Archives of Plastic Surgery
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• 제42권2호
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• pp.201-206
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• 2015

Background Although plastic surgeons daily encounter various facial tumors in the field, reports limited on face are scarce. In our study, we want to provide basic epidemiologic data to help clinicians to decide the proper management for their patients. Methods We retrospectively reviewed the medical records of patients including age and gender, location and size of the tumor, histopathologic result, recurrence, type of anesthesia and any associated disorders who had undergone a surgical removal of their facial tumors and received the histopathologic report in the same institution between January 2009 and October 2012. Results One hundred eighty-nine patients with 203 non-melanocytic benign tumors were included. The most frequent site of tumors was the central subunit of the forehead, followed by the lateral subunit of the cheek and the auricular unit. Of 36 different histopathologic results, the epidermal cyst was most frequent, followed by lipoma, pilomatricoma and osteoma. Statistical analysis showed that males were dominant in the epidermal cyst and lipoma groups. While, females were dominant in the osteoma and pilomatricoma groups. No associations were found between lesions and other diseases. Conclusions Our study is the at most specific and concentrated study on non-melanocytic benign tumors of the face. We expect the epidemiologic data of our study may help plastic surgeons who are confronted with so many facial lesions in the field to decide on the most proper management for their patients.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.345-351
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• 2012

Background Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. Methods Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. Results The mean follow-up period was 11.8 months and the mean operation time for reconstruction was $8.4{\pm}3.36$ hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. Conclusions The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

• 대한두개안면성형외과학회지
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• 제15권1호
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• pp.14-21
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• 2014

Background: There are several options for replacement of the dermal layer in fullthickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools. Methods: We retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft. We examined graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Nine months after surgery, we compared the skin qualities of CGDerm graft group (n=25), AlloDerm graft group (n=8) with skin graft only group (n=23) each other using the objective and subjective measurements. Results: The average of graft survival rate was 93% for CGDerm group, 92% for AlloDerm group and 86% for skin graft only group. Comparing CGDerm grafted skin to the surrounding normal skin, mean elasticity, hydration, and skin barrier values were 87%, 86%, and 82%, respectively. AlloDerm grafted skin values were 84%, 85%, and 84%, respectively. There were no statistical differences between the CGDerm and AlloDerm groups with regard to graft survival rate and skin functional analysis values. However, both groups showed more improvement of skin quality than skin graft only group. Conclusion: The new dermal substitute (CGDerm) demonstrated comparable results with regard to elasticity, humidification, and skin barrier effect when compared with conventional dermal substitute (AlloDerm).