• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.34-40
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• 2004

Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.329-337
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• 1993

Improvement of orthognathic surgical techniques make it possible to design esthetic surgical correction for total esthetic face. In order to find the esthetic line which guide esthetic surgical correction in patients of orthognathic surgery, cephalometric soft tissue analysis of esthetic faces were performed. In esthetic Korean young adults, 25 males and 25 females who were within 1 S.D. of E-line, ANB, P/A facial height ratio, were analyzed in natural position keeping their face eye level. 1. Sn position is constant in males and females. The Sn-N'-N' Vertical plane angle is $5.3^{\circ}$ in both sexes. Sn is positioned in front of 5 mm in female 7 mm in male from the N' vertical plane. 2. The Sn-Ls line make constant angle to horizontal plane with $72.5^{\circ}$ in both sexes, which is called "upper esthetic line". The Ls-Pg' line makes constant angle to $72.4^{\circ}$ (range $72.2^{\circ}$ in female to $72.6^{\circ}$ in male), which is called "lower esthetic line". 3. When inter-esthetic line angle (the Sn-Ls line to Ls-Pg' line) has $144.9^{\circ}$, lower third face has esthetic upper and lower lip. 4. In treatment planning, Sn is first corrected in proper position, and then upper and lower esthetic line are established with the angle of 144.9. The maxilla is moved to tangent Ls to the upper esthetic line, and mandible is moved to tangent Li and Pg' to the lower esthetic line, according to the "y"-shaped esthetic lines, then lower third face showes esthetics.

• Archives of Craniofacial Surgery
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• v.21 no.2
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• pp.92-98
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• 2020

Background: Posttraumatic acquired facial deformities require surgical treatment, with options including scar revision, fat grafts, implant insertion, and flap coverage. However, each technique has specific advantages and disadvantages. Methods: From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressed scar) were treated using dermofat grafts from the groin. The harvested dermofat was then inserted into the undermined dead space after the contracture was released, and a bolster suture was done for fixation considering the patient's contour and asymmetry. A modified version of the Vancouver Scar Scale and satisfaction survey were used to compare deformity improvements before and after surgery. Results: In most cases, effective volume correction and an aesthetically satisfactory contour were maintained well after dermofat grafting, without any major complications. In some cases, however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated. A significant difference was found in the modified Vancouver Scar Scale before and after surgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20 points. Conclusion: A dermofat graft with the groin as the donor site can be considered as an effective surgical option that is the simplest and most cost-effective method for the treatment of acquired facial deformities with scar contracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.371-374
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• 1999

The treatment of adults with dentofacial deformities is frequently complicated by existence of discrepancies in transverse dimension. Control of the transverse dimension through surgical technique is now a valuable treatment consideration in non-growing patients. Proper diagnosis of relative and absolute maxillary transverse deficiency is imperative prior to surgical intervention. Therapeutic purpose should be implemented accordingly to facilitate correction of transverse discrepancies concomitant with treatment objectives in sagittal dimension in order to provide the patient with the most stable and functional result possible. Concomitant surgical correction of narrow palate require less treatment time, treatment cost and post-treatment relapse is less than to do only orthodontic therapy. This report is concerned with rapid palatal expansion by a combination of corticotomy and orthodontic treatment.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.565-570
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• 1995

Seventy-three patients with isolated total anomalous pulmonary venous connection the patients associated with other major cardiac anomalies such as single ventricle, DORV[Double Outlet Right Ventricle and large VSD[Ventricular Septal Defect were excluded were underwent surgical repair from January 1980 through October 1993. There were 45 boys and 28 girls. The mean age at operation was 19.9 months[range 6 days to 24 years and mean body weight was 7.1kg[range 2.6kg to 45kg . The anomalous locations of connection were supracardiac in 38, cardiac in 21, infracardiac in 5, and mixed in 9. In 38 patients[52% , the venous drainage was obstructed. The obstruction ratios according to the connection type were as follows: 53%[28/38 in supracardiac, 52%[11/21 in cardiac, 100%[5/5 in infracardiac, 22%[2/9 in mixed type. The associated cardiac anomalies were persistent left SVC[2 , tricuspid valve regurgitation[3 , cor triatriatum[1 , and mitral cleft[1 . And associated noncardiac anomalies were imperforate anus[1 and Neil Weightman syndrome[1 . The operative mortality was 23%. The causes of death were pulmonary hypertensive crisis, perioperative myocardial failure, pneumonia with sepsis, arrhythmia and etc. The statistically significant factors in postoperative mortality were the pulmonary venous obstruction and age [p<0.01 . The operative mortality was high in groups of age under 1 month and pulmonary venous obstruction. The mean follow-up was 27.1 months. There were two late deaths. The first patient was three months old boy with supracardiac type and severe obstructive symptoms. The postoperative echocardiography was showed anastomotic stenosis and reoperations were performed twice but the patients expired due to pneumonia and sepsis. The second patient was three month old boy with supracardiac type and total correction was done and was doing well postoperatively. Eight years later, he expired suddenly due to arrhythmia. But all the other patients were in NYHA Fc I and received no medications. The 5-year survival rate excluding early expired patients is 97.1 $\pm$ 0.03 %. In conclusion, although the operative mortality of total anomalous pulmonary venous connection was relatively high compared to other major cardiac anomalies, we could expect excellent long-term results by early surgical correction.

• Archives of Plastic Surgery
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• v.47 no.4
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• pp.317-323
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• 2020

Background Microtia with constricted features is characterized by a short helical length of variable severity, upper antihelical or scaphal deficiency, and a downfolded upper ear. No consensus has been reached regarding the most appropriate surgical method for this condition. In this study, we aimed to introduce a simple and safe surgical method for the correction or reconstruction of upper helix ear deformities. Methods Between February 2011 and June 2014, eight patients with microtia with constricted upper helix ear deformity underwent reconstruction of the ear deformity. The upper ear helical framework was constructed by carving and curving the eighth rib cartilage harvested from the ipsilateral chest wall, covering this cartilage with a superficial temporal fascial flap, and adjusting the skin graft to align with the ear contour. To evaluate their satisfaction, patients were asked to complete a questionnaire regarding ear shape, symmetry, position, color, and overall outcome scored on a 5-point scale at 12 months postoperatively. Results None of the patients experienced severe complications in the reconstructed ear. The preoperative and postoperative vertical ear length ratios were 0.88 and 1.02, respectively. And the mean patient satisfaction scores for shape, symmetry, position, color, and overall outcome were 4.2, 4.5, 4.7, 4.4, and 4.6 out of 5 points, respectively. All patients expressed a high level of satisfaction at 12 months postoperatively. Conclusions Our technique provides a good alternative method for the reconstruction of moderate constricted upper helix ear deformities in patients who meet the surgical indications with satisfactory outcomes and few complications.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1202-1206
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• 1996

Ebstein's anomaly is an unusual and a rare congenital cardiac malformation but characteristic abnormality of the development of the tricuspid valve, right atrium and ventricle. The characteristic findings are a displaced tricuspid valve with a septal leaflet spiralling into the right ventricle. The surgical correction is variable and are left unsolved problem in surgical treatment of anomaly. Between January 1988 ＆ December 1995, we experienced 11 cases of Ebstein's anomaly and associated cardiac anomalies are ASD, PFO, ASD with VSD. The typically displaced tricuspid valve leaflet was found in all cases. In the NYHA functional classification, three were in class II, seven were in class III, and one was in class IV. Nine patients were operated by tricuspid annuloplasty ＆ plication with Danielson's method and two patients were done by tricuspid valve replacement with plication, and in all cases associated anomaly was corrected. Postoperatively, five patients suffered from complication - low cardiac output syndrome, arrhythmia and wound infection. There was no operative mortality and the postoperative courses were relatively good conditions with more improvement of symptoms.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.16-22
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• 2019

Background Various surgical techniques have been used to correct Tessier number 7 craniofacial cleft, which involves macrostomia, ear deformity, and hemifacial microsomia. To achieve symmetrical and satisfactory results in patients with macrostomia, the authors performed a 1-mm medial overcorrection on the cleft side and evaluated the results of this procedure. Methods A retrospective medical record review of patients diagnosed with Tessier number 7 craniofacial cleft from March 1999 to February 2017 was performed. Using clinical photographs, outpatient clinic records, and operative records, information was recorded regarding concurrent congenital anomalies, postoperative complications, and follow-up. Using Photoshop CS2, the length of both sides of the lip was compared. The ratio of these lengths was calculated to evaluate lip symmetry. Results Of the patients treated at the Department of Plastic and Reconstructive Surgery at Kyungpook National University Chilgok Hospital, 11 (male-to-female sex ratio, 7:4) were diagnosed with Tessier number 7 craniofacial cleft. Concurrent congenital anomalies included skin tag, hemifacial microsomia, and cleft palate. The mean duration of follow-up was $78.273{\pm}72.219$ months and the mean ratio of the lengths of both sides of the lip was $1.048{\pm}0.071$. Scar widening occurred as a postoperative complication in some patients. No cases of wound infection, bleeding, or wound dehiscence occurred. Conclusions For the successful correction of macrostomia, plastic surgeons should consider both functional and aesthetic problems of the lip. Adequate repair of the orbicularis oris muscle, skin closure with Z-plasty, and medial overcorrection of the neo-oral commissure led to good results in our patients.

• Archives of Plastic Surgery
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• v.49 no.4
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• pp.510-516
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• 2022

Background Surgical correction of bilateral cleft lip deformities remains one of the most challenging areas in facial plastic surgery. Many surgical techniques and conservative devices have been offered for the early management of bilateral cleft lip in infants. The purpose of this study was to evaluate the effect of lip adhesion on the lip and nose of patients with bilateral cleft lip. Methods A retrospective review of 13 patients with bilateral cleft lip was performed and compared with age-matched noncleft children. Patients underwent lip adhesion at a mean age of 2.8 months, and cheiloplasty at 6.6 months of age using a modification the Mulliken method. Secondary rhinoplasty was performed at the age of 6 in 13 patients. The surgical results were analyzed using photographic records obtained at the age of 1 and 7 years. Twelve length measurements and one angle measurement were obtained. Results All measurements were not statistically different from those of the noncleft age-matched control group at the age of 1. At 7 years of age, upper lip height and vermilion mucosal height were shorter (p < 0.05) than in the control group. Nasal tip protrusion and the nasolabial angle were greater (p < 0.05) than in the control group. Conclusion Lip adhesion followed by secondary rhinoplasty resulted in an acceptable lip and nasal appearance. Although nasoalveolar molding is now widely used, lip adhesion can be an appropriate alternative if an orthodontist is not available due to geographical or economic constraints.

• Journal of Veterinary Clinics
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• v.39 no.1
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• pp.1-8
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• 2022

The current, retrospective study aimed to assess the short-term prognosis and postoperative complications associated with the surgical correction of elongated soft palate using harmonic scalpel and to compare the postoperative complications associated with the application of harmonic scalpel and traditional surgery using Metzenbaum scissors. Harmonic scalpel was used to perform staphylectomy in 21 dogs. A total of ten dogs underwent sacculectomy; six dogs with harmonic scalpel and four dogs using Metzenbaum scissors. Stenotic nares were corrected by wedge resection. Postoperative complications were recorded through monitoring and radiographic examinations. Telephone interviews were conducted on the first, third, and seventh day after discharge and continued until the resolution of postoperative complications. Postoperative edema at the surgical site was identified and mitigated within a day or two. Snoring and dyspnea improved dramatically in the group that underwent staphylectomy alone. Moreover, three dogs presented with postoperative gastrointestinal complications, especially retching. The symptoms persisted for seven days and ten days in two dogs that underwent sacculectomy with harmonic scalpel and for two days in one dog that underwent sacculectomy with Metzenbaum scissors. The clinical signs and symptoms of brachycephalic syndrome disappeared without recurrence. Harmonic scalpel provides a hemostatic effect during staphylectomy, is convenient, and does not cause postoperative complications. Conversely, the use of harmonic scalpel during sacculectomy necessitated a longer period for the resolution of complications without any significant hemostatic efficacy, compared to traditional surgery.