• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.212-216
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• 2001

The cervical flap, comprising skin, fascia, and platysma muscle, has significant application in the head and neck region after radical ablative surgery for cancer of the oral cavity. The flap may be used for reconstruction of the cheek, floor of the mouth, and lateral side of the tongue. This flap minimizes donor morbidity by use of cervical operation wound and flap size available is adequate for most oral defects and the procedure is relatively simple and time-saving. However the flap is not applicable in patients where there are large tissue defects and metastasis is suspected. We have used the cervical flap for its rapid, simple, and effective closure of oral defects after cancer ablation and found it is very useful for the reconstruction of relatively small oral defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.555-562
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• 1996

A competent velopharyngeal sphincter is essential for intelligible speech. If the velopharyngeal incompetence exist, the seal will not be complete during speech, with a resultant hypernasal speech quality. The patient with velopharyngeal incompetence(VPI) may develope other compensatory speech problems. There are many approaches available to correct velopharyngeal incompetence, which include speech therapy, push back palatorrhaphy, pharyngeal wall implants and pharyngoplasty. This is cases report of velopharyngeal incompetence, which were successfully treated by superiorly based pharyngeal flap, covered with splitted hinge flap of nasal lining mucosa of the soft palate, named modified Hogan method. The advantages of this method are precision in the approximation of the flap due to pentagonal shaped flap design, good blood supply due to omission of the midsagittal incision on nasal lining mucosa, and simplicity than Hogan method.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.343-348
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• 2012

Treatment of hemifacial atrophy is a challenge for oral & maxillofacial surgeons. The surgical approach basically focused on skeletal correction so that the overlying soft tissues can be improved by the osseous change of the skeleton. However, the treatment ends up with insufficient soft tissue mophology in most cases even after skeletal correction. Therefore comprehensive hard and soft tissue reconstruction is needed for treating the hemifacial atrophy. In this case report, we experienced a successful result after combined orthognathic and microvascular adipofascial flap reconstruction for hemifacial atrophy patient.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.525-528
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• 2011

A deep circumflex iliac artery (DCIA) flap is usually used for reconstruction in oral and maxillo-facial surgery department since introduced by O'Brien in 1975. Various flap designs are possible for osteomusculocutaneous, musculocutaneous, musculosseous and vascularized bone types. Iliac crest shape is similar to contour of mandible. Moreover, though a fibular flap has only 15~20 mm of cutting plane width, a DCIA flap contains much more bone amount, making this a similar reconstruction compare with normal mandible. A 68 year-old male with squamous cell carcinoma on the anterior floor of the mouth had an impression with T2N0Mx and the treatment procedure was DCIA reconstruction after wide resection and marginal mandibulectomy, with both supraomohyoid neck dissection. We present an experience of DCIA flap for reconstruction with a literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.6
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• pp.526-530
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• 2009

Recently, the anterolateral thigh(ALT) flap, based on the septocutaneous vessels or musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery has gained popularity in head and neck soft-tissue reconstruction. It has some advantages in free-flap surgery with respect to the radial forearm free flap, such as low donor site morbidity, availability of different tissues with large amounts of skin, adaptability as a sensate or flow-through flap (with the possibility of harvesting a long pedicle with a suitable vessel diameter). Moreover, the thickness of the flap is adjustable until the subdermal fat level, allowing it to be used as a thin or ultrathin flap. This clinical cases are ALT free flap reconstructions without functional impairment of the donor limbs (transitory and permanent) based on anastomosis with superficial temporal arteries and veins in patient of huge resection defect on face, lip and tongue.

• The Journal of the Korean dental association
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• v.34 no.10 s.329
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• pp.742-751
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• 1996

본 연구의 목적은 관통된 뼈의 결손부위를 각기 다른 membrane(Gore-tex, Vicryl, Guidor)을 사용하여 보다 나은 골 재생을 얻을 수 있는 가를 평가하는 데 있다. 여섯 마리 흰 족제비의 12개 하악 소구치를 근관치료한 후, 치근단 절제술을 실시하여 $3mm\times5mm$ 크기의 관통된 뼈의 결손을 소구치의 근첨부에 형성하였다. 전부 12개의 결손부위가 형성되었고, 이를 3개의 군으로 나누었다. 대조군으로 결손부위를 membrane barrier없이 점막골막피판으로 덮었다. 다른 각 군은 결손부위를 각 Gore-Tex, Vicryl, Guidor membrane을 사용하여 설측과 협측 모두 덮었다. 각 군을 치유기간 6주와 12주로 두 아군으로 분리하였다. 방사선학적 소견으로 6주군에서 대조군은 $65\%$, Gore-Tex군은 $90\%$, Vicryl군은 $95\%$, Guidor군은 $65\%$의 결손부위의 치유를 보였다. 12주 군에서 대조군은 $80\%$, Gore-Tex군은 $95\%$, Vicryl군은 $95\%$, Guidor군은 $90\%$의 치유를 보였다. 조직학적 소견으로 대조군에서는 완전한 골 재생이 일어나지 않았으며, 결손부위로 결합조직이 자라들어온 것이 관찰되었다. Gore-Tex 6 주군에서는 대부분 fibrillar bone이 관찰되었고, 12 주군에서는 부분적으로 lamellar bone이 형성되었다. Vicryl군에서는 거의 완전한 골의 재생이 관찰되었다. 6주군에서는 재생된 뼈는 fibrillar bone이고 부분적으로 lamellar bone을 관찰되었고, 12주 군에서는 주로 lamellar bone으로 구성되었다. Guidor군에서는 제한적인 골 재생과 함께 심한 염증이 관찰되었다. 본 연구의 결과에서 조직재생유도술은 일반적으로 골 재생을 증진시킴을 볼 수 있었고, Vicryl membrane이 가장 뛰어난 골 재생유도 가능성을 보였다.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.281-286
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• 2005

The goal in facial paralysis treatment is to achieve the normal appearance of the face as well as to reconstruct the natural symmetrical smile. In cases of facial paralysis, a widely accepted procedure is the two stage method, which combines neurovascular free muscle transfer with cross face nerve grafting. Although the results are promising, the two operations of this method, which are about 1 year apart, impose an economic burden on the patients and require a lengthy period before results are obtained. In order to overcome these drawbacks, one stage method, using latissimus dorsi neurovascuular free muscle flap was introduced. Between January 2000 and January 2004, fifteen patients with long standing facial paralysis were treated in the Korea University Anam Hospital. The segmental latissimus dorsi with long nerve and pedicle was transferred to the paralyzed side of the face. The first postoperative movement of the transferred muscle was reported at 8.9 months, faster than that of the two stage method. During the next 24 months, a constant increase in the power of muscle contraction was observed. The fifteen cases were evaluated within an average of 31.7 months following the surgery and satisfactory results including muscle contraction were obtained in eleven of the cases but muscle contraction was not found in three cases.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.271-280
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• 2005

There are various types of flap in head and neck reconstruction. We chose the appropriate flap considering the indication and patient's condition. In case of conventional flaps, its type is decided according to the reconstruction site. In other words, the types of considerable flaps are limited in a way. But, perforator flaps can reduce donor limitation and harvest flaps depending on the condition of the recipient. Therefore, the flap is very useful for the head and neck reconstruction needed for 2-dimensional or 3-dimensional reconstruction. We report the 29 cases of perforator-based flap including 8 cases of latissimus dorsi perforator free flap, 5 thoracodorsal perforator free flap, 4 anterolateral thigh perforator free flap, 3 peroneal osteocutaneous perforator free flap and 9 submental perforator island flap for the head and neck reconstruction. Free flaps include 2 cases of chimeric pattern, 7 controlled resurfacing pattern, 4 3-D pattern, 3 dermoadiposal pattern, 1 folded pattern and 3 osteocutaneous pattern. The flaps were successfully used for the head and neck reconstruction. But one patient died during a follow up period because of the recurrence of tumor. Various perforator flaps(island/free pattern) can be highly competitive to the conventional flaps in the head and neck reconstruction, considering a thin character for resurfacing, more flexible and versatile option, variable composition, long pedicle with donor structures saved, and less prominent donor morbidity.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.18-23
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• 2005

Purpose: To report the results and the efficacy of the sensory bearing scapular free flap which is known as non-sensible flap. Materials and Methods: Authors underwent 24 cases of sensory bearing scapular free flap to the hands and feet from March 1995 to November 2002. average follow-up period was six year three months. The used flaps were a ordinary scapular flap in fifteen cases, and a parascapular flap in nine. Sensibility of the flaps were checked every one month. Actual sensory evaluation was mostly depends on objective feeling of the patients. Two point discrimination test was performed in all cases. Results: 23 flaps had good skin circulation after microvascular anastomosis among 24. Objective deep touch sensation were observed about three months later after the operation in three cases, between three and six months in nine. In three case whose results were excellent than others, two point discrimination was 2.7 cm at last follow-up. Most of the sensory recovery is confined in deep touch, temperature and light touch sensation was recovered limitedly in 3 cases during our follow-up period. Conclusion: Authors can propose that sensory bearing free scapular flap was considered as one of useful methods for the reconstruction to hand with soft tissue defect and mutilating hand.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.24-30
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• 2005

Thigh perforator flaps are used popularly, because they have a small thickness, a long vascular pedicle and a low rate of donor site morbidity. Among thigh perforator flaps, anterolateral thigh perforator flaps are generally used, but it is not easy to dissect the vastus lateralis muscle to find the vasuclar pedicle. The authors have planed 11 anteromedial thigh perforator flaps that have septocutaneous perforators. We were able to find anteromedial thigh perforators in 8 cases(72.7%). The perforators originated from the medial descending branch of the lateral circumflex femoral artery in 2 cases and a branch to the rectus femoris muscle in 6 cases. Of this type of surgery, 7 flaps survived. However, 1 flap failed because of arterial insufficiency. We believe the anteromedial thigh perforator flap is a good option when the thigh region is decided as a donor site, but surgeons should keep in mind that the perforator of anteromedial thigh flap may be absent.