• Title/Summary/Keyword: 구강악안면

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SOLITARY PLASMACYTOMA OF THE MAXILLOFACIAL REGION (악안면 영역에 발생한 경조직 및 연조직의 고립 형질세포종)

  • Kim, Il-Kyu;Kim, Jae-Woo;Kim, Ju-Rok;Kwak, Hyun-Jong;Chang, Kem-Soo;Park, In-Suh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.3
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    • pp.235-240
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    • 2006
  • Solitary plasmacytoma is a rare malignant neoplasm that originate in immunoglobulin-producing plasma cell. Solitary bone plasmacytoma can be found at any site throughout the skeleton and in most cases eventually progresses to multiple myeloma, of which it is thought to be an unusual presentation. On the other hand, extramedullary plasmacytoma has a tendency to occur in the head and neck region, mainly in association with the upper air passages. Incisional biopsy is the primary approach to make a definitive diagnosis, and immunohistochemical staining can be very helpful in understanding the nature of these tumors. We report a 66 years old patient with solitary bone plasmacytoma and a 36 years old patient with solitary extramedullary plasmacytoma with literatures review.

EFFECTS OF MULTIMODAL TREATMENT FOR THE MAXILLARY CANCER (상악암에 대한 병용요법의 효과)

  • Kim, Yong-Gak;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.54-60
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    • 2001
  • The treatment of maxillary cancer has been commonly performed by the surgery and radiation therapy, alone or in combination. Multimodal treatment has been introduced with improvement of chemotherapy and immunotherapy. Multimodal treatment for the maxillary cancer is composed of surgery, radiation therapy, and regional intra-arterial chemotherapy. The present study was performed to evaluate the effectiveness of the multimodal treatment with Morita's method, with a slight modification, for the maxillary cancer. Twenty-four cases of the maxillary cancer were analyzed. The multimodal treatment increased the 5-year-survival rate up to 66% and reduced the need for maxillectomy. This method made the morphological and funtional preservation possible. This method may be recommended for the treatment of maxillary cancer.

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A CLINICAL STUDY ABOUT ADENOID CYSTIC CARCINOMA IN ORAL AND MAXILLOFACIAL AREA (구강악안면영역의 선양낭성암종환자의 생존율 등에 관한 임상적 연구)

  • Kim, Young-Kack;Park, Hyung-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.1
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    • pp.79-86
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    • 1997
  • Adenoid cystic carcinoma is characterized by sloe growth, multiple recurrence, a long clinical course and late metastasis. It is less than 1% of all head and neck malignancy, but most prevalent malignancy in salivary gland origin. During 14 years(from 1982 to 1995), 24 patients were diagnosed as adenoid cystic carcinoma in oral and maxillfacial area, in department of Oral and Maxillofacial Surgery, Korea Cancer Center Hospital. We studied clinically about their age and sex distribution, primary site distribution, TNM staging, treatment modalities, overall survival rates, survival rates according to stages. The age range were from 15 years to 79 years, average age weas 51 years. 15 were men and 9 Were women. Maxilla and palate were the most prevalent primary site. The most cases were in stage III(37%) and stage IV(46%). The 3 year and 5 year overall survival rate were 65.0% and 58.5%. The 5 year survival rate of the stage III cases was 66.7%, and that of the stage IV cases was 38.4%.

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A CLINICAL STUDY ABOUT COMPARISON OF INHALATION ANESTHESIA AND INTRAVENOUS ANESTHESIA WITH ORAL AND MAXILLOFACIAL PATIENTS (악안면구강외과 환자의 전신 마취에 있어서 흡입 마취와 정맥 마취의 차이에 대한 임상적 고찰)

  • Kim, Jin;Ro, Hong-sup;Kim, Il-woong;Lee, Sung-Ho;Yun, Han-ouk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.291-295
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    • 1998
  • Intravenous anesthesia was compared with inhalation anesthesia in 20 patients of oral and maxillofacial surgery. The patients were randomly assigned to study in two treatment groups. 20 patients were injected ketamine and propofol. 20 patients were administered Enflurane. The respond of patients consciousness and general recovery condition of the two groups were compared. Intravenous anesthesia group were awake significantly faster without complications such as nause, vomiting, and agitation after operation than inhalation anesthesia group. Full recovery time of intravenous anesthesia group was significantly 3 times less than inhalation anesthesia group. The authors conclude that intravenous anesthesia is a practical technique for oral and maxillofacial surgery patients undergoing and may be preferable to intravenous anesthesia because of the significantly short of recovery time without complications.

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BISPHOSPHONATE, IS IT AN EMERGING RISK FACTOR IN ORAL SURGERY? (Bisphosphonate, 구강악안면외과 영역의 새로운 위험 요소인가?)

  • Kwon, Yong-Dae;Yoon, Byung-Wook;Walter, Christian
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.5
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    • pp.456-462
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    • 2007
  • Since the first description of bisphosphonate related osteonecrosis of the jaw (BRONJ) in 2002, the number of report on the disease has rapidly been increasing. Now, BRONJ is considered as a new entity, which is emerging problem in oral and maxillofacial surgery. Bisphosphonates (BPs) can be categorized into 2 groups: nitrogen-containing and non-nitrogen containing, and nitrogen-containing BPs are considered to have more efficacy and toxicity possibly. It is unusual for osteonecrosis to occur in the maxilla but BRONJ is found in both the mandible and the maxilla, which is one of the special features of BRONJ compared with common infectious osteomyelitis of the jaws. Intravenous BPs are usually more likely to cause BRONJ than oral BPs which are frequently prescribed for osteoporosis and osteopenia. Nonetheless, the use of intravenous BPs cannot be prevented because of systemic condition of the patients. Although it is rare that oral BPs cause BRONJ in osteoporosis/osteopenia patients, we should be aware of BRONJ since the population of the patients is exceedingly increasing with the prolonging of life expectancy. So, we'd like to enlighten upon the problems and solutions of BRONJ.

Trends in Ankyloglossia and Surgical Treatment among Pediatric Patients in South Korea (국내 소아청소년 환자에서의 혀유착증 진단과 설소대 수술 시행의 최근 경향)

  • Taehyun Kim;Daewoo Lee;Jae-Gon Kim;Yeonmi Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.229-238
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    • 2023
  • The objective of this study was to investigate trends in ankyloglossia and its surgical treatment among pediatric patients in South Korea from 2011 to 2020. Data from Health Insurance Review and Assessment Service (HIRA)'s Healthcare Bigdata Hub were used for analysis of the ankyloglossia diagnosis rate and frenum surgery rate. Considering annual population change, crude rates per 100,000 were calculated and analyzed. To investigate other factors of frenum surgery incidence besides gender and age, pediatric patient sample data from HIRA were used. The diagnosis rate of ankyloglossia increased from 204.4 in 2011 to 356.6 per 100,000 people in 2020, while the frenum surgery rate increased from 26.8 to 34.3 per 100,000 people. Males were more likely to receive frenum surgery than females. Surgeries were more likely to be done at a hospital instead of a clinic or a general hospital. In the age group of 0 - 4 years, the largest number of frenum surgeries were performed in pediatrics, and in the age group of 5 - 9 years, the largest number of surgeries were conducted in pediatric dentistry. In the older age groups, the largest proportion of frenum surgeries were performed in the departments of conservative dentistry and oral and maxillofacial surgery. The diagnosis of ankyloglossia and the operation of frenum surgery among South Korean children increased during the last decade. Since the function of the tongue can affect maxillofacial development in many aspects, pediatric dentists should pay more attention to the functional management of intraoral soft tissue in growing children.

FIXATION OF FRACTURED ORBITAL BONE USING AUTOGENOUS CALVARIAL BONE PLATE (자가 두개골 플레이트(autogenous calvarial bone plate)를 이용한 골절된 안와골의 고정)

  • Yang, Yun-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.377-382
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    • 1997
  • Miniplate의 사용은 Champy등의 보고 이후 구강외과 영역에 있어서 외상 혹은 악교정수술등 많은 분야에 이용되기 시작했다. 전통적인 악간고정 방법에 비해 miniplate는 사용하기 쉽고, 정확한 해부학적 정복 및 고정을 가능케 하며 결과적으로 빠른 치유를 가능케 한다는 장점들을 갖고 있다. 그러나 감염, wound dehiscence, 부식, 나사의 헐거워짐, 주위조직의 변색 그리고 stress shielding effect등의 후유증들이 보고되어 왔으며 가장 무해한 금속이라고 알려진 titanium 또한 주위조직 및 lung, spleen, liver 그리고 kidney 등과 같은 조직으로 metal을 전이시키는 것으로 보고되고 있다. 특히 안와골 주변과 같은 상부 연조직이 얇은 곳에 miniplate를 사용할 경우 miniplate가 만져지거나 보일수도 있다는 점이 보고되었으며 따라서 술후 사용되었던 miniplate를 제거 해야만 할 것인가가 또한 주된 관심사로 보고되고 있다. 이에 저자는 이러한 금속성 miniplate의 단점을 개선하고자 자가 두개골을 이용한 플레이트를 고안하였다. '자가 두개골 플레이트'의 적응증은, enophthalmos 개선의 목적으로 두개골을 채취해 임플란트로 사용하는, enophthalmos를 동반한 관골 및 안와골의 복합골절환자에 있어 두개골의 추가채취가 가능한 경우가 될 수 있겠다. 자가 두개골을 이용해 플레이트를 고안하려고 본 증례에서의 시도는 구강외과 영역에 있어서 자가 두개골이 골편이 고정재료로도 쓰일 수 있다는 가능성을 보여주었다는 점에서 의미가 있다고 저자는 생각한다.

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Use of a Variety of Facial Bone Grafts in Oral and Maxillofacial Surgery (구강악안면 영역에서 다양한 안면골 이식의 이용)

  • Kim, Yeong-Gyun;Kim, Hyeon-Tae;Yeo, Hwan-Ho
    • The Journal of the Korean dental association
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    • v.37 no.3 s.358
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    • pp.221-227
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    • 1999
  • The aim of this study was to describe the clinical availability of a variety of facial bone grafts in oral and maxillofacial surgery. Thirty patients with oral and maxillofacial bone defects were treated with mandible, maxilla, and zygoma bone grafts. The ages of the patients ranged from 8 to 64 years, with a mean age of 28.6 years. The follow-up period ranged from 2 to 30 months, with a mean follow-up of 11.7 months. Although postoperative follow-up was of short duration, the recilient sites were favorable to healing and bone consolidation. Healing progressed normally without severe morbidity. The donor site did not present a management problem in any of the patients.Some minor complications developed in 8 patients, of which three were infections and another three were wound dehiscence. There complications were easily managed with incision and drainage, antibiotics and local wound care. We consider that a variety of facial bone grafts can be used for reconsider that a variety of facial bone grafts can be used for reconstruction of small or moderate large bony defects.

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A Study on Synovial Fluid Analysis of Chronic TMD and Effects of Pumping Technique (만성 악관절장애환자의 활액분석 및 악관절 도약술의 효과에 관한 연구)

  • 김용우;김영구;연태호
    • Journal of Oral Medicine and Pain
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    • v.22 no.2
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    • pp.241-252
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    • 1997
  • 본 연구는 임상검사 및 방사선 사진상 악관절장애로 진단된 환자중 물리치료,악관절 안정장치 등의 보존적 치료방법을 시행하였으나 증상의 개선이 별로 없는 퇴행성 관절질환이나 중등도의 개구제한을 가진 환자를 대상으로하여 aspirin을 이용한 활액성분 분석 및 악관절 도약술과 sodium hyaluronate의 주입을 시행한후 이에 따른 치료결과를 평가하기 위하여 시행되었다. 평균연령이 31.2세(21-42세)인 11명의 악관절 장애환자를 대상으로 하였다. 악관절 도약술과 sodium hyaluronate의 주입은 악관절의 동통과 개구제한의 해소를 위해 시행되었으며 그 결과를 시술전, 시술 즉시, 시술 1주후 및 4주후로 나누어 분석하였으며 활액 채취시 생리식염수의 희석에 의한 활액성분의 농도 변화에 따른 오차를 막고자 활액과 혈액내의 aspirin의 농도차를 이용하여 정확한 활액 성분농도를 측정하였다. 이상의 연구를 통하여 다음과 같은 결론을 얻었다. 1. 전체 환자의 생리식염수에 의한 악관절 활액의 희석계수는 1.4-12.9(5.5$\pm$4.2)로 상당히 넓은 범위를 나타내었다. 2. 만성 폐구성 과두걸림 환자군(n=7)의 생리식염수에 의한 활액의 희석계수 (6.2$\pm$3.5)는 퇴행성 관절질환을 갖는 환자군(4.4$\pm$5.7, n=4)과 유의한 차이가 없었다. 3. 만성폐구성 과두걸림군과 퇴행성 관절 질환군간의 활액성분의 농도는 유의한 차이가 없었으나 희석계수를 이용한 수정된 Hyaluronic acid와 총단백질의 농도는 만성 폐구성 과두걸림군의 경우에서 유의하게 더 높게 나타났다. 4. 악관절 도약술과 sodium hyaluronate의 주입 직후 만성 폐구성 과두걸림 환자군의 경우 평균 8.3mm의 추가적인 개구 증가로 유의한 차이가 관찰되었고 퇴행성 관절질환의 경우 평균 1.3mm의 추가적인 개구증가가 있었으나 유의한 차이가 관찰되지 못했다. 5. 시술전, 시술 1주후 및 4주후의 여러 검사항목을 비교한 결과 두 군에서 모두 시간의 경과에 따라 기능이상 및 동통 감소의 경향을 나타내었으나 유의하지는 않았으며 만성 폐구성 과두걸림의 경우 기능장애지수(dysfunction index) 와 최대개구시 동통의 정도는 시술전과 시술 4주후간에 유의한 차이가 관찰되었다.

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RECONSTRUCTION OF INTRAORAL DEFECT USING RADIAL FOREARM FREE FLAP: A CASE REPORT (유리전완피부피판을 이용한 구강내 결손의 재건례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Kwon, Yong-Dae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.246-249
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    • 1998
  • With the recent progress of microsurgical techniques, radial forearm free flap has an established place in oral reconstruction. Providing thin, soft and pliable skin with a large and constant vascular pedicle, this flap is optimal for intraoral reconstruction. One of the disadvantages of the flap is donor site morbidity, therefore various methods can be used to reduce it. A male complained of palatal and retromolar area mass with ulceration, which was diagnosed as squamous cell carcinoma. He also complained of discomfort and mouth opening limitation, attributed to the location and characteristics of the mass. Because of mouth opening limitation, mandibular swing approach was performed to allow for the surgical approach to the mass. After the surgical excison of the lesion, the intraoral defect was successfully reconstructed with radial forearm free flap.

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