• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권2호
• /
• pp.208-214
• /
• 1994

Successful treatment of patients with multiple complex facial bone fractures is dependent on the precise clinical and diagnostic image, well-established systematic principles of fracture repair. The oral and maxillofacial surgeon should appreciate the postoperative complications and minimize or manage adequately. Most of complications can be treated secondarily, but we should appreciate the fatal complications which are impossible to treat.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권1호
• /
• pp.69-77
• /
• 1996

저자등은 중안면 발육부전으로 인한 심미적 및 기능적 장애를 주소로 경희대학교 치과대학 구강악안면외과에 내원한 23세 남자에 대해 관상절개술만을 통하여 두개하 Le Fort III 골절단술을 시행하여 중안면부의 심미성을 증진시키고 안구돌출증의 해소 및 반대교합의 개선등 양호한 결과를 얻었기에 이에 대한 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권2호
• /
• pp.137-144
• /
• 1994

Inselecting scars for treatment, attention be paid not only to the features of the defect as seen objectively but also to the element of the defect most disturbing to the patient. We revised the scar tissues with simple elliptical excision, Z-plasty, modified Z-plasty, W-plasty and hand dermabrasion in varialbe pattern of scars and got the favorable results. The success rate of scar revision usually depends on the patient's subjective judgement. We must inform our patient the limitation of scar revision and importance of postoperative care. The oral and maxillofacial surgeons must resolve the variable scars which re involved in variable operations and traumas.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제21권3호
• /
• pp.312-316
• /
• 1999

When the external force was applied to the orbit the most thin area might be displaced. These were usually orbital floor and/or medial wall of orbit. Among these cases some who showed the entrapment of the muscle between the fractured fragments needed the surgical treatment. We had operated 4 cases of the "blow-out" fracture via subciliary approach. The entrapped muscles were freed from fragments and the bony defect was restored with micro-titanium mesh. Mean follow-up periods was 15 months and there were no complication observed.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제13권2호
• /
• pp.191-198
• /
• 1991

안모비대칭은 심미적 정서적으로 영향을 줄 뿐만 아니라 기능적인 장애를 초래하는 경우도 있다. 안모비대칭은 안면골 중에서 특히 하악골과 관련된 경우가 많은데 이는 하악골이 안면하부의 연조직을 지지하므로 작은 위치, 형태 변화에도 두드러지게 나타나기 때문이다. 비대칭안모를 초래하는 하악과두의 거대증은 Hyperplasia, Hypertrophy, 골증, 외골증, 골연골증, 연골육종 등을 들 수 있다. 비대칭안모 분류는 여러 학자에 의해 다양하게 분류되지만 Bruce와 Hayward는 Deviation prognathism, Unilateral macroganthia, Unilateral condylar hyperpiasia로 분류한 바 있다. 과증식된 하악과두의 절제술은 1856년 Humphry에 의해 최초로 시행된 후 여러 학자들에 의해 성공적으로 시행되고 있다. 본 증례에서는 Unilateral condylar hyperlpasia와 골연골종으로 인한 안모비대칭 환자로써 Condylectomy, Le Fort I osteotomy, Vertical ramus osteotomy, Mandibular inferior border ostectomy, Genioplasty 등을 시행하여 심미적 기능적으로 양호한 결과를 얻었기에 이를 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권4호
• /
• pp.377-382
• /
• 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.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권1호
• /
• pp.29-32
• /
• 1994

IN 1956, Peer presented a very comprehensive account of free fatty tissue transplantation. The use of buccal fat pad had been usually used to reconstruct the perioral defects. The buccal fat pad is a special fatty tissue which is markedly different from subcutaneous fat. And it is a easily accessible fat tissue in oral and maxillofacial region. The buccal fat pad can be used as a free graft or pedicled flap. Recently, buccal fat pad is interested in cosmetic surgery because its' removal for cosmetic purpose has been favorable result. We used the buccal fat as an unlined, pedicled graft for closure of large oroantral fistula. We present a case of report and review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• pp.249-254
• /
• 1989

Transverse mandibular deficiency is rare maxillomandibular malrelationship. Most of this malrelationship is considered to be caused by loss of bone substances. This can be corrected by subapical osteotomy, midsagittal vertical osteotomy, midline horizontal L sliding osteotomy, etc., case by case. In these cases, malrelationship after malunion of mandibular fracture, combination of vertical osteotomy and sliding autogenous cortical bone graft was used and favorable results were obtained. Advantages over previous traditional surgical methods were as follows : 1. This method provided easy access and good visibility. 2. It provided broad bone contact area, thus no other operation to obtain bone graft was needed. 3. There were little circumstances to extract teeth. 4. There were no difficulty in tongue movement after operation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• pp.261-266
• /
• 1989

This study was undertaken to compare those 4 most commonly used incisions for exposure of fractures of the infraorbital rim and the orbital floor. The patient's age ranged from 19 to 67 years, the majority being in the 2nd decade. There were 17males and 1 female. Three orbital rim, 5 lower eyelid, 7 subciliary and 3 combined conjunctival-lateral canthotomy incisions were reviewed. Following points were the summury of author's experience. 1. The average scar following any of four incisions is barely noticeable. 2. Adequate fracture exposure was achieved with lower eyelid, orbital rim, subciliary and combined conjunctival-lateral canthotomy incisions. 3. One transient ectropion following subciliary incision occurred in 29-years old man with prolonged postoperative eyelid edema.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권4호
• /
• pp.343-350
• /
• 1997

Diagnosis of maxillofacial lesions is very difficult. Recent developments in computed tomography enable the production of three dimnesional images of complex anatomical structures from a series of conventional computed tomographic sections. Methods of three-dimensional analysis of computed tomographic images have recently been described. Mostly, reports have concentrated on applications relative to congenital deformities. In this report, one method of three dimensional reformatting is reviwes. Images formed by this method have solid surface appearance and can be color enhanced and manipulated to isolate anatomic structures of interest. The program allows tissue densitis, volumes, and distances. This report emphasizes maxillofacial applications other than those previously reported in the surgical and radiological literature.