• Radiation Oncology Journal
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• v.24 no.2
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• pp.144-148
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• 2006

Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects.

• Clinical and Experimental Pediatrics
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• v.52 no.12
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• pp.1388-1391
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• 2009

Poland syndrome is characterized by unilateral absence or hypoplasia of the pectoralis muscle and variable degree of ipsilateral hand anomalies. Mobius syndrome is a congenital neurological disorder characterized by complete or partial facial paralysis. Although the pathogeneses of these diseases are not well-characterized, diminished blood flow to the affected side is thought to play a role. A male infant weighing 2.670 g was born at 38+3 weeks of gestation with left facial paralysis, left chest wall defect with dextrocardia, and symbrachydactyly between the second and third fingers. The combination of Poland-Mobius syndrome is rare, and only 2 cases associated with dextrocardia have been reported worldwide. Here, we report the first case of Poland-Mobius syndrome associated with dextrocardia in Korea.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.549-558
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• 2011

The latissimus dorsi myocutaneous flap (LDMF) was initially described at the turn of the century by Tansini et al, and latissimus dorsi myocutaneous free flap (LDMFF) was also first described for the coverage of a chronically infected scalp by Maxwell et al. As a pedicled flap, LDMF has been often used for breast reconstruction and for soft tissue replacement near the shoulder and the lower reaches of the head and neck. LDMFF is a flat and broad soft tissue flap with large-caliber thoracodorsal vessels for microvascular anastomosis. A skin paddle of the LDMFF can be more than $20{\times}40$ cm, so very large defects in the oral cavity and outer facial region can be covered by this LDMFF. Other advantages include consistent vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with tumor resection. For a better understanding of LDMFF as a routine reconstructive procedure in large defects of the oral cavity and facial legion, anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of LDMFF with Korean language.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.367-375
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• 2012

Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.

• Journal of Acupuncture Research
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• v.31 no.1
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• pp.149-158
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• 2014

Objectives : The aim of this study is to investigate the influence of anxiety and depression on motor recovery of acute Bell's palsy to estimate how much psychological factors affect the clinical prognosis. Methods : A total of 20 inpatients with acute unilateral Bell's palsy within 1 week of onset participated in this study. The severity of participants' facial palsy was measured by Yanagihara(Y-system) score, FDI and House-Brackmann scale at the time of 1 week and 3 weeks from the onset. The motor recovery of acute Bell's palsy is defined as ${\Delta}Y$-system during 2 weeks. Beck anxiety scale(BAI) and the center for epidermiologic studies depression scale(CES-D) were adopted to assess anxiety and depression, respectively. Correlation analysis and linear regression analysis were conducted between ${\Delta}Y$-system and prognostic factors including anxiety and depression. Results : Significant associations were found between ${\Delta}Y$-system and depression(CES-D) but no significant associations were found between ${\Delta}Y$-system and other prognostic factors, hypertension, diabetes, postauricular pain, disgeusia, age, degree of initial palsy and anxiety(BAI). And a regression equation with 0.295 for coefficient of determination was obtained. Through this analysis, the ${\Delta}Y$-system can be predicted using regression equation which cover 29.5 % of depression index(CES-D). Conclusion : Depression is a significant clinical prognostic factor on motor recovery of acute Bell's palsy. So, Bell's palsy treatment should be combined with psychological care and support.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.2
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• pp.323-332
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• 1993

저자는 1988년 6월 1일부터 1993년 6월 30일까지 서울대학교병원 치과진료부에 내원하여, 병리조직학적으로 확인된 구강악안면부 악성종양환자 35명의 방사선사진 소견과 자기공명영상 소견을 비교하여 다음과 같은 결론을 얻었다. 1. 일반적인 방사선사진소견으로는 미만성의 골파괴가 15례 (42.9%), 연조직종괴의 음영이 7례 (20,0%), 부유치를 보인 경우가 3례 (8.6%), 골경화가 2례 (51.7%)로 나타났다. 2. 자기공명영상 소견은 연조직종괴가 23례 (65.7%), 골수침범이 12례(34.5%), 피질골 파괴가 14례(40.0%), 정상피질골에 골수침범이 1례 (2.9%), 지방층소실이 19례(54.3%), 림파절전이가 8례 (22.9%), 조영증강이 15례 (42.9%), 골증식이 1례 (2.9%)였다. 3. 구강악안면부의 악성종양환자에 있어서, 방사선사진에서 관찰하기 힘들었던, 종양의 구강저, 저작근, 부인두강, 사골동, 측두하와, 악하선, 비강 등 인접조직으로의 침범여부 및 골파괴 정도와 림파절전이를 평가하는 데 자기공명영상은 도움을 주었다. 4. 정진율은, 방사선사진에서 35례중 16례로 45.7%였고, 자기공명영상에서는 35례중 27례로 77.1%로 자기공명영상의 정진율이 더 높았으나, 일반적인 방사선사진이 자기공명영상보다 더 우세한 경우도 2례 있었다.

• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.107-110
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• 2011

Purpose: There have been few case reports regarding treatment plans for long-term, neglected scalp defects and calvarial defects with subdural abscess. The purpose of this case report is to present our experience with a free latissimus dorsi musculocutaneous flap for scalp and calvarial defects and to discuss flap options in comparison with a literature review. Methods: A 60-year-old man who fell down from a four-story-height that resulted in a craniotomy in 1979; he visited our outpatient clinic for a chronic, purulent scalp and calvarial defects with unidentified artificial bone. The artificial bone was removed by a neurosurgeon and reconstructed with a free latissimus dorsi musculocutaneous flap. The deep temporal artery was used as a recipient artery. The postoperative flap status was excellent until the 6th day post-operation when the patient experienced a seizure, and an arterial insufficiency occurred at the flap probably due to an arterial spasm. Emergency exploration with arterial re-anastomosis was performed and the flap status was stabilized. Results: Complete wound healing was achieved after 3 weeks without infectious and systemic postoperative complications. During the 6 month follow-up period, there were no complications. Conclusion: We suggest the latissimus dorsi myocutaneous free flap as a good treatment option for a chronic, purulent, complicated scalp with calvarial defect, as a well as treatment for an acute traumatic defect.

• Journal of Oral Medicine and Pain
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• v.37 no.3
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• pp.183-188
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• 2012

Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.133-141
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• 2009

We reviewed retrospectively the medical records of 600 elderly patients, over 65 years old who visited oral medicine. The ratio of the age group was composed of 65${\sim}$74 years old group was 63.7%, 75${\sim}$84 years old group was 32.2%, over 85years old group was 4.2%, and the patients were mostly females. The main chief complaint was composed of oral soft tissue problem(44.1%) and oromaxillofacial pain(39.0%). The majority of systemic diseases was composed of diseases of the circulatory system(30.1%), diseases of the musculoskeletal system and connective tissue(16.8%), endocrine, nutritional and metabolic diseases, and diseases of the digestive system(10.1%). The numerous pateints were diagnosed as soft tissue disease(32.0%), arthrogenous disease(24.1%), and myogenous disease(18.1%) of temporomandibular disease.Principally medication(43.9%), physical therapy(24.2%) were performed. 14.2% of all patients visited oral medicine with a letter of request written by other medical departments or local dental clinics, or referred from other departments in Chosun university dental hospital. These findings indicate epidemiologic characteristics on the elderly patients visited oral medicine. We hope that this study will play a basis in the future research about the elderly patients.

• The korean journal of orthodontics
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• v.41 no.2
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• pp.87-97
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• 2011

Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.