• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.133-138
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• 1998

Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.18.3-19
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• 1983

Choanal atresia, described first by Johann Roedere (1755) is an obstruction between the nasal cavity and nasopharyngeal vault, and the diagnosis and treatment were developed because of severity of the disease. Embryologically, incomplete development of olfactory pit, or failure of nasobuccal membrane to rupture, or persistent remaining of buccopharyngeal membrane, etc, all forms the congenital choanal atresia. And the acquired type was the result from syphilis or diphtheria with a resultant stenosing cicatrix and after the inexpert surgery and the trauma. Multiple abnormalities may be present particularly affecting the head, the heart and the alimentary system in the congenital type. The operative technique employed would depend upon the type of obstruction(whether membranous or bony), the age of the patient, and the presence or absence of any associated pathologic condition. Since Emmert (1853) first tried blind puncture of the atretic plate with the trocar, other surgical techniques have been introduced over the years for the correction of choanal atresia, which were the transnasal, transpalatal, transantral and the transseptal approach. Among them, transpalatal approach was proved to be a popular technique, that it provides a direct route, thus permitting an exact reconstruction and low restenosis rate. Recently, we have experienced two cases of choanal atresia and treated successfully with transpalatal approach, so authors report these cases with a review of the literature.

• The korean journal of orthodontics
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• v.34 no.5 s.106
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• pp.458-464
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• 2004

Anchorage plays an important role in orthodontic treatment especially in the maxillary arch. In spite of many efforts for anchorage control. it was difficult for clinicians to predict the result of treatment because most of the treatment necessitated an absolute compliance of patients, But recently, skeletal anchorage has been used widely because it does not necessitate patient compliance but produces absolute anchorage. In addition titanium miniscrews have several advantages such as ease of insertion and removal. possible immediate leading and use in limited implantation spaces. In this case, a skeletal Class I bialveolar protrusion Patient was treated with standard edgewise mechanics using indirect active P.S.A. (palatal skeletal anchorage). The miniscrews in the paramedian area of the hard palate provided anchorage for retraction of the upper anterior teeth and remained firm and stable throughout treatment This indicates that the PSA can be used to reinforce anchorage for orthodontic treatment in the maxillary arch Consequently, this new approach can help effective tooth movement without patient compliance, when used with various transpalatal arch systems.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.23.2-23
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• 1987

저자들은 1977년부터 1986년까지 10년동안 서울대학병원 이비인후과에서 유년기성 비인강 혈관섬유종의 진단하에 치료받았던 27명의 환자에 대해 임상적 조사를 시행하여 다음과 같은 결과를 얻었다. 1) 남녀비율은 전례에서 남성이었으며 연령은 9세∼22세의 분포를 보였고 16∼17세가 가장 많았다. 2) 주증상으로는 전례에서 비출혈을 동반하는 비폐색증을 보였으며 편측인 례가 7례였다. 3) 종양의 크기는 21례에서 비인강 및 비강내에 국한되어 있었고, 4례에서 익상상악와, 2례에서 두개내 침습을 보였다. 4) 종양의 혈액공급은 동측의 내상악동맥에서 이루어지는 경우가 27례, 동측의 상행인두동맥이 13례, 양측에서 이루어지는 경우가 9례 있었다. 5) 치료는 23례에서 수술적 요법을, 4례에서 방사선치료를 시행하였다. 수술적 요법 23례중 11례 에서 경반구개제거술(hemipalatal approach), 8례에서 경전구개제거술(transpalatal appoach), 2례에서 경전구개 및 경상악동제거술(transantral approach), 2례에서 외비절제술(lateral rhinotomy approach)에 의해서 종양을 적출하였다.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.191-197
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• 1984

Nasopharyngeal angiofibroma is a relatively rare, but is a well known tumor that occurs almost in male, most frequently during the adolescent stage. Its character is histologically benign but clinically malignant because of locally invasive character to the adjascent structures, massive bleeding tendency during surgical procedure and high recurrence rate after treatment. Recently many advancements in diagnostic method and surgical technique has reached satisfactory result in treating this difficult tumor. The authors present a case of nasopharyngeal angiofibroma in 16 years old male patient, who was received surgical removal of the tumor through the transpalatal approach after full diagnostic evaluation and preoperative hormonal therapy.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.172-176
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• 1999

Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.