• 제목/요약/키워드: Cleft surgery

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내측 반월상 연골판 후각 기시부 파열 봉합 후 추시 자기공명영상 검사의 유용성 (Magnetic resonance imaging Usefulness after Medial Meniscus Posterior Root Tear Repair)

  • 전재균;김준범;이봉주
    • 대한관절경학회지
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    • 제17권1호
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    • pp.6-10
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    • 2013
  • 목적: 슬관절 내측 연골판 후각 기시부 파열에 대하여 관절경적 봉합 수술을 시행한 후 유합 유무를 평가하기 위한 magnetic resonance imaging (MRI)의 유용성에 대하여 보고 하고자 한다. 대상 및 방법: 2007년 11월부터 2011년 6월까지 내측 반월상 연골판 후각 기시부 파열을 봉합한 환자 중 술후 MRI와 관절경검사를 모두 시행하였던 17명을 대상으로 하였다. 관절경검사와 MRI 검사를 시행하여 비교하였다. 결과: 술전 Lysholm knee score는 평균 56.4에서 평균 79.0으로 visual analogue scale (VAS) score는 8점에서 3점으로 호전되었다. 2차적 관절경 검사상 17예 모두 섬유화 재생 후 안정화된 소견이 확인되었다. 그러나 MRI 검사에서 내측 반월상 연골판 후각 기시부 파열을 시사하는 수직 직선 결함(cleft sign)은 술전후 모두 관찰되었고, 음영 손실(ghost sign)은 술전 10예에서 술후 9예, 방사선 직선 결함(radial linear defect) 소견은 술전 17예에서 술후는 15예에서 확인되었다. 결론: 내측 반월상 연골판 후각 기시부 파열의 관절경적 봉합술을 시행한 환자를 대상으로 비해부학적 위치에 봉합한 경우 술후 추시 MRI 검사는 유합 여부 판단에 유용하지 않았다. 유합 여부를 정확하게 평가하기 위해서는 관절경적 검사가 필요한 것으로 판단된다.

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안면이식에 대한 최근 동향: 한국에서의 안면이식은 어떤 단계에 있는가? (Current Status of Face Transplantation: Where Do We Stand in Korea?)

  • 홍종원;김영석;윤인식;이동원;이원재;노태석;유대현;김용욱;나동균;탁관철;박병윤
    • 대한두개안면성형외과학회지
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    • 제13권2호
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    • pp.85-94
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    • 2012
  • The world's first face transplantation was performed in France, in 2005. Since then, 21 cases of face transplantation have been performed. Face transplantation is one of the most prominent part of composite tissue allotransplantation (CTA) along with hand transplantation. Since these fields are not deal with life-saving organs, there are many arguments about immunosuppression therapy. Recent paradigm of face transplantation shows that surgical ranges are expanded from partial face transplantation to full face transplantation. Most immunosuppression protocols are triple therapy, which consists of tacrolimus (FK-506), mycophenolate mofetil and prednisolone. Anatomical researches, immunosuppression, and immunotolerance take great parts in the researches of CTA. The medical fields directly related to face transplantation are microsurgery, immunology, and transplantation. Nowadays, each field is performed widely. Therefore people, even medical teams think face transplantation could be easily realized, sooner or later. But there are lots of things that should be prepared for not only practice and immunosuppression therapy but also for the cooperation with relevant fields. That's the reason why only 21 cases of face transplantation have been done, while more than 70 cases of hand transplantation have been done in the past years. Especially in Korea, brain death patients are not enough even for organ transplantation and furthermore there are some troubles in taking part in the society of transplantation. Face transplantation has lots of problems concerning variable medical fields, administration, society, ethics, and laws. Therefore, for the realization of face transplantation in Korea, not only medical skills but also political powers are needed.

경동맥체 부신경절종 (Management of Carotid Body Paraganglioma: Review of the literature with report of three cases)

  • 박정수;김준식;홍원표;최은창;김동익
    • 대한두경부종양학회지
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    • 제5권1호
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    • pp.5-13
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    • 1989
  • Carotid body paraganglioma is uncommon, with appoximately 900 reports of it in the world literature, and with only 7 documented cases in the Korean literature. The classic carotid body paraganglioma develops in the bifurcation of common carotid artery and involves both the internal and external carotid arteries at it expands. The diagnosis may almost always be established preoperatively by selective angiography which shows a widening of the carotid bifurcation with a well defined vascular mass. Differential consideration of a single, lateral cervical mass in this location include branchial cleft cyst, neurogenic tumor, metastatic thyroid cancer, carotid body aneurysm and salivary gland tumor. Surgical therapy is the preferred method of treatment as these tumors are regarded as radioresistant. Because of their high vascularity and anatomical location, surgical removal of these tumors reguires a considerable degree of caution and a high degree of surgical expertise. With improved diagnostic and surgical technique, the morbidity and mortality has been reduced lately. This report details the management of 3 patients with carotid body paraganglioma who underwent safe resection by subadventitial dissection or using an internal vascular shunt.

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A spindle cell squamous cell carcinoma on the cheek presenting with in-transit metastases and a satellite lesion

  • Lee, Eui-Tae
    • 대한두개안면성형외과학회지
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    • 제21권1호
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    • pp.58-63
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    • 2020
  • Spindle cell squamous cell carcinoma (SpSCC) is a biphasic tumor composed of squamous cell epithelial and spindle cell mesenchymal components, both of which are malignant. Cutaneous SpSCC can cause diagnostic and therapeutic difficulties because of its rarity, heterogeneity, morphological similarity to other cutaneous spindle cell neoplasms, and uncertain pathogenesis and prognosis, particularly when the squamous cell carcinoma component is minimal or missing. Intransit metastasis and satellite lesion (satellitosis) constitute a spectrum of non-nodal regional metastases. Here the author reports the first known case of cutaneous SpSCC presenting with intransit metastases and a satellite lesion, which were exceptionally aggressive. A 77-year-old female patient presented with a 3×3×0.5 cm mass on her right cheek. Despite wide excision and postoperative radiation, the patient resulted in local recurrence and multiple distant metastases within 3 months. If many high-risk factors-particularly satellitosis and in-transit metastases are observed in a tumor with epithelial to mesenchymal transition, then further wide excision and adjuvant chemoradiation should be considered early in the treatment process. A multidisciplinary approach could be the key to cure the most aggressive malignancies of the skin, as in other organs.

설유착증 환자의 언어병리학적 평가 (Speech pathologic evaluation of children with ankyloglossia)

  • 이주경
    • 대한음성학회:학술대회논문집
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    • 대한음성학회 2007년도 한국음성과학회 공동학술대회 발표논문집
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    • pp.155-157
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    • 2007
  • Objective : There are close relationship between intraoral abnormal structure and speech-functional problem. Patients with cleft palate & ankyloglossia are typical examples. Patients with abnormal structure can be repaired toward normal structure by operation. Ankyloglossia may cause functional limitation - for example, speech disorder - even if adequate surgical treatment were done. And, each individuals have each speech disorders. The objective of this study is to evaluate the speechs of childrens with ankyloglossia, and to determine whether ankyloglossia is associated with articulation problem. We wanted to present criteria for indication of frenectomy. Study design The experimental group is composed of 10 childrens who visited our department of oral and maxillofacial surgery, dental hospital, Chonbuk university, due to ankyloglossia and articulation problem,. The average age is 5 Y 7M, M : F ratio is 4 : 1 at the time of speech test. The VPI consonant discrimination degree, PPVT, PCAT, Nasometer II, Visi-Pitch test result were obtained from each group. Result : There was significant difference for 'language development' through PPVT. Except 3 members of experimental group, all remainder showed retardation for 'language development'. For 'errored consonant rate', data showed more higher scores in alveolar consonant. There 'consonant error' in experimental group, mostly showed 'alveolar consonant', also a major modality of 'consonant error' was mostly distortion. Conclusion : We can judge the severity of ankyloglossia patient by examinig language development degree & speech test of 'alveolar consonant' . And we can make a decision for frenulotomy using these results.

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Morphology of the Aging Forehead: A Three-Dimensional Computed Tomographic Study

  • Yi, Hyung Suk
    • 대한두개안면성형외과학회지
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    • 제16권2호
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    • pp.58-62
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    • 2015
  • Background: Age-related changes have been studied for lower and middle facial bones. Although the forehead comprises one-third of the facial area, no studies have investigated age-related changes in the upper part of the face or forehead. The purpose of this study was to use three-dimensional computed tomography (3D CT) to investigate age-related changes in the frontal bone. Methods: A retrospective review was performed for patients who underwent 3D CT scan of facial bones. Patients were divided by gender and age (20 to 40 years, 41 to 60 years, and above 60 years). The frontal bone curvature was evaluated by the length of frontal bone and by two frontal bone angles in relation to the Frankfurt horizon. Results: In both genders, aging was associated with increasing lower slope length. In elderly men (>60 years), the upper slope angle was significantly higher when compared to younger male subjects. Women demonstrated similar age-related changes, but the differences were only statistically significant for the middle and older age groups. Conclusion: This study demonstrates quantifiable age-related changes in the frontal bone. These findings contribute to the understanding of age-related changes of the facial soft tissues. The mean measurements in each age group can be used as a reference when planning forehead reconstruction.

보툴리늄 독소 A를 이용한 이하선누공의 치험례 (Treatment of Parotid Fistula with Type A Botulinum Toxin: A Case Report)

  • 이상열;김삼수
    • 대한두개안면성형외과학회지
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    • 제12권2호
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    • pp.129-131
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    • 2011
  • Purpose: The purpose of this report is to present a case of persistent parotid fistula treated successfully with preoperative botulinum toxin type A injection into the parotid parenchyma, followed by fistulectomy. Methods: A 72-year-old female patient presented to the hospital with a 5-month history of clear, watery discharge from a tiny opening on the left cheek, which increased during food intake. A chemistry test of the fluid revealed an high amylase level. An ultrasonography of left parotid gland showed a $1.13{\times}0.6cm$ sized fistula. After demarcating the left parotid gland with assistance of ultrasonography, a total 40 units of botulinum toxin type A (Botox, Allergan, Irvine, CA) was injected into 4 subdivisions of the left parotid gland. The clear serous discharge ceased completely on the 5th day after botulinum toxin injection. On the 7th day, a fistulectomy was performed under the local anesthesia. Results: The parotid fistula healed completely without complications. During the 6-month follow up period, there was no discharge from the cheek. Conclusion: On the basis of our experience with type A botulinum toxin as a local anticholinergic agent in treating parotid fistula, preoperative botulinum toxin A injection seems to be very useful to prevent recurrence after fistulectomy.

Analysis of Facial Asymmetry

  • Choi, Kang Young
    • 대한두개안면성형외과학회지
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    • 제16권1호
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    • pp.1-10
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    • 2015
  • Facial symmetry is an important component of attractiveness. However, functional symmetry is favorable to aesthetic symmetry. In addition, fluctuating asymmetry is more natural and common, even if patients find such asymmetry to be noticeable. However, fluctuating asymmetry remains difficult to define. Several studies have shown that a certain level of asymmetry could generate an unfavorable image. A natural profile is favorable to perfect mirror-image profile, and images with canting and differences less than $3^{\circ}-4^{\circ}$ and 3-4 mm, respectively, are generally not recognized as asymmetry. In this study, a questionnaire survey among 434 medical students was used to evaluate photos of Asian women. The students preferred original images over mirror images. Facial asymmetry was noticed when the canting and difference were more than $3^{\circ}$ and 3 mm, respectively. When a certain level of asymmetry is recognizable, correcting it can help to improve social life and human relationships. Prior to any operation, the anatomical component for noticeable asymmetry should be understood, which can be divided into hard tissues and soft tissue. For diagnosis, two-and three-dimensional (3D) photogrammetry and radiometry are used, including photography, laser scanner, cephalometry, and 3D computed tomography.

Optic foramen location on computed tomography

  • Vuong Duc Nguyen;Minh Tran Quang Le;Chuong Dinh Nguyen;Tho Thi Kieu Nguyen
    • 대한두개안면성형외과학회지
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    • 제24권4호
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    • pp.174-178
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    • 2023
  • Background: This study aimed to identify the location of the optic foramen in relation to the anterior sphenoid sinus wall, which is essential information for surgeons in planning and performing endoscopic transnasal surgery. Methods: Computed tomography scans of 200 orbits from 100 adult patients with no abnormalities were examined. The results included the location of the optic foramen in relation to the anterior sphenoid sinus wall and the distance between them, as well as the distance from the optic foramen and the anterior sphenoid sinus wall to the carotid prominence in the posterior sphenoid sinus. Results: The optic foramen was anterior to the anterior sphenoid sinus wall in 48.5% of orbits, and posterior in the remaining 51.5%. The mean distance from the optic foramen to the anterior sphenoid sinus wall was 3.82±1.25 mm. The mean distances from the optic foramen and the anterior sphenoid sinus wall to the carotid prominence were 7.67±1.73 and 7.95±2.53 mm, respectively. Conclusion: The optic foramen was anterior to the anterior wall of the sphenoid sinus in approximately half of the orbits examined in this study, and posterior in the remaining half. The mean distance from the optic foramen to the anterior sphenoid sinus wall of the sphenoid sinus was 3.82±1.25 mm.

Genetic determinants of periosteum-mediated craniofacial bone regeneration: a systematic review

  • Eyituoyo Okoturo
    • 대한두개안면성형외과학회지
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    • 제24권6호
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    • pp.251-259
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    • 2023
  • Background: Periosteum-mediated bone regeneration (PMBR) is a recognized method for mandibular reconstruction. Despite its unpredictable nature and the limited degree to which it is understood, it does not share the concerns of developmental changes to donor and recipient tissues that other treatment options do. The definitive role of the periosteum in bone regeneration in any mammal remains largely unexplored. The purpose of this study was to identify the genetic determinants of PMBR in mammals through a systematic review. Methods: Our search methodology was designed in accordance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. We conducted a quality assessment of each publication, and evaluated the differences in gene expression between days 7 and 15. Results: A total of four studies satisfied the inclusion criteria. The subjects and tissues examined in these studies were Wistar rat calvaria in two studies, mini-pigs in one study, and calves and mice in one study. Three out of the four studies achieved the necessary quality score of ≥ 3. Gene expression analysis showed increased activity of genes responsible for angiogenesis, cytokine activities, and immune-inflammatory responses on day 7. Additionally, genes related to skeletal development and signaling pathways were upregulated on day 15. Conclusions: The results suggest that skeletal morphogenesis is regulated by genes associated with skeletal development, and the gene expression patterns of PMBR may be characterized by specific pathways.