• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.99-103
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• 2012

Purpose: Many surgical methods for reconstruction of orbital floor fracture have been reported, which include subciliary approach, transconjunctival approach, transantral and transnasal endoscopic approach, etc. The purpose of this study is to demonstrate a surgical technique and analyze the results of transnasal endoscopic approach with Foley catheter ballooning without implantation of artificial surgical material through subciliary approach. Methods: Between February 2007 and November 2010, 29 orbital floor fracture patients, who had no herniated muscles through bone fragments, were treated through transnasal endoscopic approach with Foley catheter ballooning. Under the endoscopic view, the operator identified the opening of maxillary sinus. After widening of the opening using forceps, the operator reduced the fragmented bone with curved suction tip. Thereafter, 18-Fr Foley catheter was inserted. Four weeks after the operation, the catheter was removed. Results: Preoperatively, 6 patients had diplopias, 4 patients had limitations of extraocular motions and 3 patients had enophthalmos. After removal of the Foley catheter 4 weeks after the operation, 2 patients had diplopias, 1 patient had a limitation of extraocular motion, 1 patient has an enophthalmos and 1 patient had numbness on the cheek. These symptoms were resolved about 6 months after the surgery. Conclusion: The operative technique of Foley catheter ballooning through transnasal endoscopic approach without implantation of the artificial surgical material through subciliary approach can be considered one of the appropriate techniques for orbital floor fracture.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.2
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• pp.277-285
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• 1993

This study was performed to evaluate the role of Waters' view and panoramic view for the interpretation of mucosal cyst of the maxillary sinus and to determine the radiographic features of that according to the sites and sizes. For this study, clinically 25 cases of mucosal cyst of the maxillary sinus were used, and experimentally with two dry skulls, rubber ball of 15mm in diameter for marked radiopacity, and two jelly balls of 8 and 20㎜ in diameter for the similar radiopacity to cyst were used. The 25 cases with 25 panoramic views and 15 Waters' views were first analyzed, and secondly, the radiographic features of artificial lesions attached to the each wall of the antrum on Waters' view and panoramic view were analyzed. The obtained results were as follows: At clinical analysis, 1. 4 cases of 13-14㎜, 4 cases of 15-19mm, 14 cases of 20-25㎜, 3 cases of over 30㎜ in dia- meter were found on panoramic views. And 24 cases of 25 cases showed no relationship with teeth, and only 1 case was associated with advanced periodontal disease 2. The majority of mucosal cysts appeared to arise the posterior portion of the floor of the sinus and were superimposed with the inominate line of zygoma and the horizontally linear image of hard palate on panoramic view. 3. Only 2 cases of 15 cases were identified on both films. At experimental analysis, 4. On Waters' view, the images of the artificial lesion of the anterior portion and midportion of the floor of the sinus were lessend in diameter compared with the real size. On panoramic views, the images of the lesion were more radiolucent with lessened diameter than images on Water' view. 5. The images of the lesion of the posterior wall and the posterior portion of the floor of sinus on panoramic view were well detected by the preeducated group but not or poorly detected by the non-preeducated observer group. 6. On Waters' view, both observer groups recognized that the cystic images of the posterior portion of the floor of the maxillary sinus were superimposed with the petrous portion of the skull.

• 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.

• Archives of Craniofacial Surgery
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• v.25 no.3
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• pp.116-122
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• 2024

Background: Due to the importance of evidence-based research in plastic surgery, the authors of this study aimed to assess the accuracy of ChatGPT in generating novel systematic review ideas within the field of craniofacial surgery. Methods: ChatGPT was prompted to generate 20 novel systematic review ideas for 10 different subcategories within the field of craniofacial surgery. For each topic, the chatbot was told to give 10 "general" and 10 "specific" ideas that were related to the concept. In order to determine the accuracy of ChatGPT, a literature review was conducted using PubMed, CINAHL, Embase, and Cochrane. Results: In total, 200 total systematic review research ideas were generated by ChatGPT. We found that the algorithm had an overall 57.5% accuracy at identifying novel systematic review ideas. ChatGPT was found to be 39% accurate for general topics and 76% accurate for specific topics. Conclusion: Craniofacial surgeons should use ChatGPT as a tool. We found that ChatGPT provided more precise answers with specific research questions than with general questions and helped narrow down the search scope, leading to a more relevant and accurate response. Beyond research purposes, ChatGPT can augment patient consultations, improve healthcare equity, and assist in clinical decision-making. With rapid advancements in artificial intelligence (AI), it is important for plastic surgeons to consider using AI in their clinical practice to improve patient-centered outcomes.

• Journal of Veterinary Clinics
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• v.30 no.5
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• pp.384-386
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• 2013

A two-year-old, female English bulldog was referred for breeding by artificial insemination with frozen semen of male English bulldog, a litter of female bulldog's grandfather. Intrauterine artificial insemination was done two days after the ovulation day. Sperm was evaluated after thawing by computer assisted sperm analyzer, and its motility was 89.8% with normal shape. Pregnancy bearing eight fetuses was diagnosed by ultrasonography and radiography. Cesarean section was performed sixty days after the artificial insemination. Eight pups were delivered with safe, but the entire pup had abnormalities including severe bow-legged malformations, cleft lip, cleft palate, and enlarged cranial part.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.4 no.1
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• pp.24-32
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• 1991

Cleft palate or velopharyngeal incompetence shows many disorders and disabilities affecting speech transmission. including distortion. substitution. and the nasalization of the vowels. The nasalized vowels are produced primarily by lowering of the velum. resulting in opening a side passage for the air flow through the nasal cavity. These abnormal movements give rise to complex modification of the physical property of the sound or in the sound spectrum. The authors employed Sonagraph$^{\circledR}$ as a sound analyzer in order to ascertain the features which characterize the nasalization of vowels. Twenty healthy Korean male adult voluteers were analyzed in artificial conditions of anterior and posterior nasal obstruction. and velo-pharyngeal incompetence. The results were as follows : 1) Fundamental frequency was not changed by nasal obstruction or velopharyngeal incompetence. 2) There was no significant difference of the formant intensity between normal and nasal vowels. 3) In VPI, a decrease of the frequency of $F_2$ was observed in /e/ and /i/ vowels(p<0.001). 4) In VPI, the $F_2$ was frequently missed in /o/ and /u/ vowels. 5) In the consonant spectra of VPI, the 'release burst' was usually not observed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.410-417
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• 2006

The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.198-204
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• 2017

Maxillofacial defect comes from congenital defect, trauma and surgical resection. Patients with intraoral defect are commonly related to maxillary defect and they need prosthetic rehabilitation. Functional reconstruction of partially edentulous mandible has many limitations. However, if both condyles are intact, maxillofacial prosthesis using partial denture give competent results. In this case, a patient of 58 year-old male has a defect on palate and left mandibular posterior teeth from gunshot. The maxillary defect of this patient is Class IV according to Aramany classification and the mandibular one is Type V according to Cantor and Curtis classification. For retention of the obturator, remaining teeth are fully utilized and artificial teeth are arranged harmoniously to provide stable occlusion. Mandibular RPD covered limited range of deformed soft tissue derived from mandibular resection surgery. With these treatments, the patient in this case showed improvements in mastication, swallowing and speech.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.173-179
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• 1990

We report 2 cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap. In these cases, the main points to cover the defects were as follows ; 1. For the contour of zygoma and maxilla, it was well preserved without bone graft which was not used for second stage reconstruction. In first case, for application of artificial eye and in second case, for, operation after full development. 2. For the drainage of paranasal sinuses, we made the nostril with skin graft, and it was well preserved without any complications during follow up. 3. It was sufficient to cover the defect with latissimus dorsi muscle well designed before surgery and thick enough to fill the defect. 4. In second case, the remained defect of palate and maxilla was not covered for the appropriate reconstructions after full development. In conclusions, we experienced two cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap without any complication and with good results.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.177-182
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• 2021

Background: Although prompt surgery after an orbital fracture is preferable, the actual timing of surgery in real-world settings varies. Therefore, this study investigated the outcomes of implant surgery for inferior orbital wall fractures by comparing three groups according to the time interval between the injury and surgery. Methods: A retrospective review was conducted of patients' medical charts and initial computed tomography images from 2009 to 2020. The time to treatment was chosen by patients or their guardians based on the patients' comorbidities and the physician's explanation. The patients were divided into three groups according to the time of surgery (group 1: 3-7 days, group 2: 8-14 days, group 3: 15 or more days). Data were collected on age, the time interval until surgery, the dimensions of the defect, the operation time, the follow-up period, and the postoperative paresthesia score (ranging from 0 to 10). The outcomes were evaluated using a 4-point scale: 4=good (no complications), 3=fair (no subjective symptoms), 2=poor (remaining paresthesia), and 1=very poor (strabismus and/or enophthalmos). Results: The study included 85 patients with unilateral fractures who underwent surgery from 3 to 93 days after injury. The overall score distribution of the surgical outcomes was as follows: good=63, fair=7, poor=6, and very poor=9. The three groups showed no significant differences in the transverse dimension of the injury (p=0.110) or the anteroposterior dimension (p=0.144). In groups 1, 2, and 3, the postoperative outcome scores were 3.84±0.37, 3.63±0.87, and 2.93±1.33 (p=0.083), and the percentage of patients with good outcomes was 84%, 81.25%, and 57.14%, respectively. Conclusion: Performing surgery using an artificial implant within 2 weeks of the injury showed better outcomes and fewer postoperative complications than when treatment was delayed.