• Archives of Plastic Surgery
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• 제32권5호
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• pp.645-648
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• 2005

Cutaneous horn is a morphologic designation for a projectile, conical, dense hyperkeratotic nodule that resembles the horn of an animal. The lesion varies in size from only a few millimeters to several centimeters, in color(white or yellowish) and in form (straight, curved, or twisted). It arises from a wide range of epidermal lesions, which include benign lesions, premalignant lesions and malignant lesions. An 83-year-old women came to our clinic with a giant cutaneous horn on the right chin and a small horn on the left upper eyelid. The patient had no palpable cervical lymph node. A wide elliptical skin incision was made and the horn was totally excised. In pathology, the giant cutaneous horn on the right chin revealed a moderately differentiated squamous cell carcinoma with subcutis invasion at its base. "Giant cutaneous horns" have often been associated with invasive squamous cell carcinoma. Cutaneous horns are common lesions usually found on the face, rarely larger than 2 cm. As large cutaneous horns are often associated with underlying malignancy, histopathologic examination of the base of the lesion is necessary to rule out carcinoma and full excision is recommended.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.418-422
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• 2022

Acquired cutis laxa is a rare disease. Owing to few reports on the condition, no statistical data have been produced. Cutis laxa is characterized by drooping skin, caused by decreased levels of dermal elastin, leading to reduced skin elasticity. The disease usually emerges on the neck or trunk and spreads throughout the body; however, it rarely involves the extremities. Moreover, cases localized to the face are rare. The objective of this clinical case report was to highlight this unusual disease in a 24-year-old female, with localization on the face and neck. The patient underwent surgery for treatment of bilateral ear lobe and eyelid skin laxity.

• 대한안과학회지
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• 제59권12호
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• pp.1181-1184
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• 2018

목적: 선천 눈물샘소관 샛길은 드물게 보고되었으며 아직까지 국내에서는 보고된 바 없다. 본 증례에서는 선천 눈물샘소관 샛길을 경험하였기에 이를 보고하고자 한다. 증례요약: 우측 윗눈꺼풀 외측 피부에 위치한 구멍을 통해 투명한 액체 고임을 주소로 생후 3개월 여아가 내원하였다. 재태연령 35주 3일에 태어났으며, 그 외 특이 과거력은 없었고 다른 안과적인 이상은 발견되지 않았다. 내원 당시 우측 상안검 외측에서 무색의 투명한 액체가 고인 직경 약 2 mm 크기의 개구부가 보였으며, 개구부 주변으로 감염을 의심할 만한 소견은 없었다. 눈물고임 증상을 동반한 눈물소관 샛길 소견으로 전신마취하 눈물소관 샛길의 완전절제 및 병리생검을 시행하였으며, 조직학적 소견상 눈물소관 샛길을 진단하였다. 수술 후 우측 윗눈꺼풀 외측 눈물흘림은 호전되었고, 재발 소견은 관찰되지 않았다. 결론: 현재까지 국내에서 보고된 적 없는 선천 눈물샘소관 샛길 및 이의 치료 과정을 경험하였기에 이를 보고하고자 한다.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.119-127
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• 2016

Background: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. Methods: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). Results: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication-oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. Conclusion: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.

• 전자공학회논문지SC
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• 제40권3호
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• pp.189-198
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• 2003

영상 안진기(VOG, Videooculograph)는 전정 안반사의 객관적 평가 방법으로 이용되고 있는 안구 운동 측정 방법 중의 하나이다. 영상 안진기의 핵심 기술은 눈꺼풀이나 속눈셉, 각막 반사, 그리고 눈 깜박임과 같은 영향에 덜 민감하면서 동공의 중점과 회전 운동을 정확하게 찾는 것이다. 회전 운동의 측정에 있어 부정확한 동공의 중점은 부정확한 회전 운동 측정으로 이어지므로 3차원 영상 안진기에서는 중점의 정확한 추정이 매우 중요하다. 이를 위해 잡음에 영향을 적게 받는 동공 중점을 찾는 새로운 알고리즘을 제안하고 알고리즘의 성능에 영향을 주는 인자에 대해 분석하여 최적의 조건을 찾았다. 그리고 제안한 방법을 이용하여 안구의 수평, 수직, 회전 운동, 그리고 동공의 크기 변화를 측정할 수 있는 실시간 3차원 VOG 시스템을 구현하였다.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.10-13
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• 2016

Chromosome 11q13 deletion syndrome has been previously reported as either otodental syndrome or oculo-oto-dental syndrome. The otodental syndrome is characterized by dental abnormalities and high-frequency sensorineural hearing loss, and by ocular coloboma in some cases. The underlying genetic defect causing otodental syndrome is a hemizygous microdeletion involving the FGF3 gene on chromosome 11q13.3. Recently, a new form of severe deafness, microtia (small ear) and small teeth, without the appearance of eye abnormalities, was also reported. In this report, we describe a 1-year-old girl presenting with ptosis of the left upper eyelid, right auricular deformity, high-arched palate, delayed dentition, simian line on the right hand, microcephaly, and developmental delay. In this patient, we identified a deletion in the chromosome 11q13.2-q13.3 (2.75 Mb) region by using an array-comparative genomic hybridization analysis. The deletion in chromosome 11q13 results in a syndrome characterized by variable clinical manifestations. Some of these manifestations involve craniofacial dysmorphology and require a functional workup for hearing, ophthalmic examinations, and long-term dental care.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.80-84
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• 2017

Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema. To the best of our knowledge, our management of the radical vulvectomy defect with a labia majora sharing procedure is novel and has not been previously described. The labia major flap presented in this report is a shared flap; that is, a transposition flap based on the dorsal clitoral artery, which has consistent vascular anatomy, making this flap durable and reliable. This procedure epitomises the principle of replacing like with like, does not interfere with leg movement or patient positioning, has minimal donor site morbidity, and preserves other locoregional flap options for future reconstruction. One limitation is the need for a lax contralateral vulva. This labia majora sharing procedure is a viable option in carefully selected patients.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.168-171
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• 2019

The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

• Parasites, Hosts and Diseases
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• 제58권5호
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• pp.577-581
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• 2020

A 22-year-old Thai man from the Northeast region presented with acute eye swelling, itching, and discharge on his left eye. He was suspected of having gnathostomiasis and treated with albendazole and prednisolone for 3 weeks. Nine months later, he was treated with high-dose oral prednisolone for the preliminary and differential diagnoses with thyroid-associated orbitopathy and lymphoma. He had been administered prednisolone intermittently over a few years. Then he developed a painless movable mass at the left upper eyelid and recurrent pseudotumor oculi was suspected. The surgical removal of the mass was performed. A white pseudosegmented worm revealed a definite diagnosis of ocular sparganosis by a plerocercoid larva. Molecular diagnosis of the causative species was made based on the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Proper technique of extraction and amplification of short fragments DNA from formalin-fixed paraffin-embedded tissue successfully identified parasite species. The result from the sequencing of the PCR-amplified cox1 fragments in this study showed 99.0% sequence homology to Spirometra ranarum. This is the first report of S. ranarum in Thailand.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.603-609
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• 2013

Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.