• Title/Summary/Keyword: Coronal approach

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RECONSTRUCTION OF ANTERIOR TEMPORAL DEPRESSION AFTER THE CORONAL APPROACH (Coronal approach 시행 후 발생한 측두부 함몰의 재건)

  • Kim, Il-Kyu;Ryu, Seong-Hyun;Kim, Jae-Woo;Kim, Dong-Soo;Choi, Jin-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.2
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    • pp.183-187
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    • 2005
  • The coronal approach has been used for over a century by neurosurgeons to access to the anterior cranium. Indications for the coronal approach expanded from use in the correction of congenital skeletal anomalies to applications in acute maxillofacial trauma and secondary deformity correction, oncologic surgery and reconstruction, and esthetic surgery. Complications were such as injury to frontal branch of the facial nerve, motor nerve paralysis, hematoma under flap, trismus, ptosis, epiphora, infection and anterior temporal depression. $Medpor^{(R)}$ is made up of dense polyethylene connected in porous structures. It is easily shapable without collapsing the pores due to it's hardness and tissue growth takes place at the porosities. Based on these advantages, $Medpor^{(R)}$ has been used in augmentation and restoration in craniofacial defect. A temporal depression after the coronal approach for treatment of Le Fort III fracture was successfully reconstruction with $Medpor^{(R)}$ and we report this case with review of literature.

THE CORONAL APPROACH;ANATOMY, TECHNICAL CONSIDERATIONS AND MORBIDITIES (관상피판술;해부학, 수술시 고려사항, 병적인 상태)

  • Lee, Gi-Hyug;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Park, No-Seung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.615-620
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    • 1996
  • The coronal approach is a versatile surgical technique. This method becomes particulary useful for exposure and internal fixation of midfacial fractures and the harvest of calvarial bone graft to manage the complex facial bone fractures. The rectrospective clinical study on the use of this technique in 10 patients was performed. The result shows that this technique provides the excellent exposure of fractures site, the ability to reduce the fragment accurately and good cosmetic results in incision area. We discussed with literatures review that anatomy, technique, indications, and potential complications of the coronal approach.

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THE STUDY FOR HEMODYNAMIC CHANGE ON CORONAL APPROACH TO ZYGOMATICO-MAXILLARY COMPLEX FRACTURE (관골골절에 있어 관상피판 접근법시 혈액학적 변화에 대한 연구)

  • Kim, Hoon;Kim, Chul-Hwan;Yeo, Hwan-Ho;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.78-82
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    • 2001
  • Background : The coronal incision is versatile surgical approach to upper and middle region of the facial skeletal including the zygomatic arch. The advantages of coronal approach are minimal injury of facial tissue including facial nerve and satisfactory cosmetic result by hidden scar at hair. But wide exposure of scalp, its disadvantages are operation time and massive blood loss. Methods : Thirty patients undergoing elective surgery were divided 3 groups. Group I used only coronal approach, group II used coronal with subciliary approach and group III used coronal with subciliary and intraoral approach. And then retrospected of the preoperative, postoperative red blood cell count, hemoglobin(Hb), hematocrit, transfused red blood cell units and platelet cell units, and the amount of infused crystalloids and colloids, and postoperative hemovac count was estimated. Results: 1. Red blood cell count were decreased in all groups at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II but increased group III of postoperative third day. 2. Hemoglobin and hematocrit were decreased in all group at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II., but increased group III postoperative third day. 3. Platelet was decreased in all group at immediated postoperation, and decreased in group II, III but increased in group I of postoperative first day and decreased in group I but increased group II, III of postoperative third day. 4. Mean postoperative hemovac mean drainage group I of first day is $48.63{\pm}21.12ml$ and second day is $23.92{\pm}19.53ml$ and third day is $7.82{\pm}5.32ml$ and group II of first day $60.45{\pm}22.65ml$ and second day is $22.14{\pm}13.21ml$ and third day is $7.32{\pm}6.25ml$. III group of first day $58.16{\pm}10.13ml$ and second day is $21.27{\pm}11.72ml$ and third day is $7.13{\pm}4.90ml$. 5. Infusion of group I is mean PRC $1.08{\pm}0.91$ pint, FFP $1.03{\pm}0.75$ pint, crystalloid $2562.23{\pm}1345.53ml$ and group II is mean PRC $1.05{\pm}0.89$ pint, FFP $1.71{\pm}0.78$, crystalloid $2650.47{\pm}1096.36ml$ and group III is mean PRC $1.79{\pm}1.45$ pint, crystalloid $3295.43{\pm}1472.432ml$.

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Estimation of Halo CME's radial speeds using coronal shock waves based on EUV observations

  • Jeong, Hyunjin;Moon, Yong-Jae
    • The Bulletin of The Korean Astronomical Society
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    • v.43 no.1
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    • pp.54.4-55
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    • 2018
  • Propagating speeds of coronal mass ejections (CMEs) have been calculated by several geometrical models based on multi-view observations (STEREO/SECCHI and SOHO/LASCO). But in 2015, we were unable to obtain radial velocity of a CME because the STEREO satellites were located near the backside of the sun. As an alternative to resolve this problem, we propose a method to combine a coronal shock front, which appears on the outermost of the CME, and an EUV-wave that occurs on the solar disk. According to recent studies, EUV-wave occurs as a footprint of the coronal shockwave on the lower solar atmosphere. In this study, the shock, observed as a bubble shape, is assumed as a perfect sphere. This assumption makes it possible to determine the height of a coronal shock, by matching the position of an EUV-wave on the solar disk and a coronal shock front in coronagraph. The radial velocity of Halo-CME is calculated from the rate of coronal shock position shift. For an event happened on 2011 February 15, the calculated speed in this method is a little slower than the real velocity but faster than the apparent one. And these results and the efficiency of this approach are discussed.

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A 2-plane micro-computed tomographic alveolar bone measurement approach in mice

  • Catunda, Raisa Queiroz;Ho, Karen Ka-Yan;Patel, Srushti;Febbraio, Maria
    • Imaging Science in Dentistry
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    • v.51 no.4
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    • pp.389-398
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    • 2021
  • Purpose: This study introduces a standardized 2-plane approach using 8 landmarks to assess alveolar bone levels in mice using micro-computed tomography. Materials and Methods: Bone level differences were described as distance from the cemento-enamel junction (CEJ) to alveolar bone crest (ABC) and as percentages of vertical bone height and vertical bone loss, comparing mice infected with Porphyromonas gingivalis (Pg) to controls. Eight measurements were obtained per tooth: 2 in the sagittal plane (mesial and distal) and 6 in the coronal plane (mesiobuccal, middle-buccal, distobuccal, mesiolingual, middle-lingual, and distolingual). Results: Significant differences in the CEJ-to-ABC distance between Pg-infected mice and controls were found in the coronal plane (middle-lingual, mesiobuccal, and distolingual for the first molar; and mesiobuccal, middle-buccal, and distolingual for the second molar). In the sagittal plane, the distal measurement of the second molar was different. The middle-buccal, mesiobuccal, and distolingual sites of the first and second molars showed vertical bone loss relative to controls; the second molar middle-lingual site was also different. In the sagittal plane, the mesial sites of the first and second molars and the distal site of the second molar showed loss. Significantly different vertical bone height percentages were found for the mesial and distal sites of the second molar (sagittal plane) and the middle-lingual and distolingual sites of the first molar(coronal plane). Conclusion: A reliable, standardized technique for linear periodontal assessments in mice is described. Alveolar bone loss occurred mostly on the lingual surface of the coronal plane, which is often omitted in studies.

REDUCTION MALARPLASTY THROUGH INTRAORAL APPROACH (구개 접근법에 의한 협골 축소 성형술)

  • Woo, Soon-Seop;Kim, Myung-Jin;Min, Byong-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.171-177
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    • 1993
  • The prominent malar region has been recognized a sign of youth and beauty in caucasian who generally have a dolichocephalic and long face. But in the orients, especially Koreans who generally have a mesocephalic or brachycephalic face, it is considered an agressive, unesthetic facial appearance. So many patients require the shaving of prominent malar eminence and arch, and many methods of its reduction have been devised. For the exposure of malar complex, infraorbital skin incision, intraoral approach, preauricular approach, supraauricular scalp incision, and coronal approach have been used. And for the reduction of bony structure, direct shaving, contouring and repositioning of the malar complex after extirpation, and medially fracture of zygomatic arch have been used with its own merits. We performed the reduction malarplasty through intraoral approach. After two parallel oeteotomy at medial part of the zygomatic bone, the midsegment is removed. The posterior arch of zygoma was bended or green stick fractured. When more correction was required, the posterior arch was fractured medially through the step incision at skin. This method has a some advantages. Compared with the method for extirpation of malar complex, the infection rate is diminished, the resorption is small because of no free bone graft. And cheek drooping is prevented. Compared with the method of coronal approach, the surgical trauma is minimal. Now we report some cases of reduction malarplasty performed through intraoral approach and disscus the surgical technique and results.

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Reduction of Closed Frontal Sinus Fractures through Suprabrow Approach

  • Hahn, Hyung Min;Lee, Yoo Jung;Park, Myong Chul;Lee, Il Jae;Kim, Sue Min;Park, Dong Ha
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.230-237
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    • 2017
  • Background: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. Methods: From March 2007 to October 2016, the authors identified patients with anterior wall frontal sinus fractures treated by open reduction through a suprabrow incision. Only cases with photographic/radiographic documentation and a minimum follow-up of 6 months were included. The incision line was designed to be at the upper margin of the eyebrow. Medical records and radiographic data were retrospectively reviewed. Surgical outcomes, cosmetic results, and complication were assessed. The patient scale of the patient and observer scar assessment scale was used to assess patient satisfaction for incisional scar at the 6-month follow-up. Results: Thirty-one patients underwent fracture reduction through a suprabrow approach during the study period, with a mean follow-up of 41 months. No patients showed any recurrent displacement, eyebrow asymmetry, or infection during follow-up. Thirteen patients reported their forehead paresthesia postoperatively, and 12 of them had preoperative symptom. One patient complained of incisional scar and underwent scar revision. All patients were satisfied with their eyebrow and forehead contour. Conclusion: The suprabrow approach allowed for an accurate reduction of the fractures in the anterior wall frontal sinus by providing direct visualization of the fracture. This transcutaneous approach can effectively restore forehead contour with acceptable postoperative complications and patient satisfaction.

Cryptogenic Temporal Hollowing

  • Park, Ie Hyon;Kwon, Heeyeon;Kim, Sang Wha
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.218-221
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    • 2016
  • Temporal hollowing is a common complication that occurs after coronal approach surgeries. However, temporal hollowing without previous nerve damage or trauma history is rare. Herein, we present a patient with cryptogenic temporal hollowing. A 22-year-old man without any history of craniofacial interventions or trauma presented with temporal hallowing. Magnetic resonance imaging revealed fatty degeneration of the left temporalis muscle. Electromyography and nerve conduction study showed no signs of neurologic abnormalities. The patient received autologous fat injection of 30 mL harvested from the left thigh using the modified Coleman technique. Temporal hollowing is commonly caused by atrophy of the superficial temporal fat pad. Its incidence is reported to be as high as 6% after coronal approach operation. Augmentation using porous hydroxyapatite or titanium mesh is a treatment option. Autologous fat graft can also be an option for mild to moderate temporal hollowing. In this case, a patient with no history of trauma, surgery, or myogenic disease developed temporal hollowing. Further study of the little-known cryptogenic form of temporal hollowing is warranted.

Comparison of Transforaminal Lumbar Interbody Fusion with Direct Lumbar Interbody Fusion : Clinical and Radiological Results

  • Lee, Young Seok;Kim, Young Baeg;Park, Seung Won;Chung, Chan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.469-474
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    • 2014
  • Objective : The use of direct lumbar interbody fusion (DLIF) has gradually increased; however, no studies have directly compared DLIF and transforaminal lumbar interbody fusion (TLIF). We compared DLIF and TLIF on the basis of clinical and radiological outcomes. Methods : A retrospective review was performed on the medical records and radiographs of 98 and 81 patients who underwent TLIF and DLIF between January 2011 and December 2012. Clinical outcomes were compared with a visual analog scale (VAS) and the Oswestry disability index (ODI). The preoperative and postoperative disc heights, segmental sagittal/coronal angles, and lumbar lordosis were measured on radiographs. Fusion rates, operative time, estimated blood loss (EBL), length of hospital stay, and complications were assessed. Results : DLIF was superior to TLIF regarding its ability to restore disc height, foraminal height, and coronal balance (p<0.001). As the extent of surgical level increased, DLIF displayed significant advantages over TLIF considering the operative time and EBL. However, fusion rates at 12 months post-operation were lower for DLIF (87.8%) than for TLIF (98.1%) (p=0.007). The changes of VAS and ODI between the TLIF and DLIF were not significantly different (p>0.05). Conclusion : Both DLIF and TLIF are less invasive and thus good surgical options for treating degenerative lumber diseases. DLIF has higher potential in increasing neural foramina and correcting coronal balance, and involves a shorter operative time and reduced EBL, in comparison with TLIF. However, DLIF displayed a lower fusion rate than TLIF, and caused complications related to the transpsoas approach.

A Case of Surgical Correction of Undercorrected Unicoronal Synostosis (부족교정된 일측성 관상봉합 조기유합증 환자의 수술 교정예)

  • Shim, Hyung Sup;Paik, Hye Won;Byeon, Jun Hee
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.85-89
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    • 2008
  • Purpose: Unicoronal synostosis is the craniofacial anomaly caused by premature fusion of unilateral coronal suture. Ipsilateral flattening of the frontal and parietal bones, temporal retrusion with elevation and recession of the supraorbital rim are main clinical features. Compensatory contralateral frontal bossing and deviation of the nasal root and/or chin can also occur. There is a controversy about techniques for surgical correction, however, bilateral approach technique is more effective for correction of deformity. Methods: A 4-year-old patient with unicoronal synostosis had undergone unilateral suturectomy at 28-month-old but fronto-facial deformity had remained and aggravated as she grew older. She had both fronto-facial and endocranial asymmetry. We performed coronal cranial approach and fully exposed affected cranium including supraorbital rim. Anterior 2/3 calvarial reconstruction with bilateral frontal bone osteotomy and fronto-orbital bandeau advancement was performed. Results: Fronto-facial symmetry including fronto-orbital contour, nasal devation was improved. Endocranial twisting was also improved from $158^{\circ}$ to $162^{\circ}$ in CSO(crista gallisella turcica-opisthion) degree. There was no postoperative complications and no need for revision, and facial asymmetry improved at the period of 2 years of follow-up. Conclusion: Bilateral approach with fronto-orbital bandeau remodeling in surgery of unicoronal synostosis looked superior to unilateral approach in achieving better symmetry and preventing recurrence of asymmetry. Remodeling surgery should be tried in patients even at an older age to correct fronto-facial asymmetry.