• 제목/요약/키워드: Craniofacial

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저온 열처리 자가 종양골이식을 이용한 이마뼈의 단골성 섬유성이형성증의 재건 (Pasteurized Tumoral Autograft for the Reconstruction of Monostotic Fibrous Dysplasia in Frontal Bone)

  • 이의태
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.91-94
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    • 2010
  • 저온 열처리법은 두개안면골 종양의 절제 후 재건에 있어 간단하고, 믿을만하며, 모양이 우수하고, 경제적이면서 또한 오랫동안 유지가 가능한 방법이다. 이 방법은 종양 재발의 걱정없이 생물학적으로 융합이 가능함과 동시에 기계적인 강도가 높은 장점을 가지고 있다. 따라서 두개안면골의 양성종양뿐만 아니라 절제가 가능한 악성종양의 경우에도 재건 시 우선적으로 고려해볼 만한 방법으로 사료된다.

두개안면골 결손부 재건에 있어서 티타늄 그물판의 임상적 유용성 (Clinical Usefulness of Titanium Mesh in Reconstruction of the Craniofacial Bone Defects)

  • 서영민;정승문
    • Archives of Plastic Surgery
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    • 제33권6호
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    • pp.688-694
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    • 2006
  • Purpose: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load-bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. Methods: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from $1.0{\times}1.5cm$ to $12{\times}10cm$. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. Results: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. Conclusion: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.

Transactivators for the Odontoblast-specific Gene Targeting

  • Chung, Kyung-Chul;Kim, Tak-Heun;Yang, Yeon-Mee;Baek, Jin-A;Ko, Seung-O;Cho, Eui-Sic
    • International Journal of Oral Biology
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    • 제34권2호
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    • pp.105-113
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    • 2009
  • Dentin, a major component of teeth, is formed by odontoblasts which produce the dentin matrix beneath the dental epithelium and induce the mineralization of dentin. To date, the biochemical properties of dentin matrix proteins have been well characterized, but upstream regulators of these proteins are not yet well known. Recently in this regard, several transcription factors have been identified as potential regulators of matrix proteins. Most transcription factors are generally involved in diverse biological processes and it is essential to identify those that are odontoblast-specific transactivators to further understand the process of dentin formation. We thus analyzed the expression pattern of dentin matrix proteins and the activities of established transactivators containing a Cre-locus. Expression analyses using in situ hybridization showed that dentin matrix proteins are sequentially expressed in differentiating odontoblasts, including type-I collagen, Dmp-1 and Dspp. The activities of the transactivators were evaluated using ${\beta}$-galactosidase following the generation of double transgenic mice with each transactivator and the ROSA26R reporter line. The ${\beta}$-galactosidase activity of each transactivator paralled the expression of the matrix proteins. These results thus showed that these transactivators could be utilized for odontoblastspecific conditional gene targeting. In addition, time- and tissue-specific conditional gene targeting might also be achieved using a combination of these transactivators. Odontoblast-specific conditional gene targeting with these transactivators will likely also provide new insights into the molecular mechanisms underlying dentin formation.

Dyke-Davidoff-Masson 증후군 환자의 두개골 변형: 증례보고 (Craniofacial Deformity in a Patient with Dyke-Davidoff-Masson Syndrome: A Case Report)

  • 이승현;이혜경;정희선
    • 대한두개안면성형외과학회지
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    • 제13권1호
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    • pp.50-53
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    • 2012
  • Purpose: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. Methods: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. Results: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. Conclusion: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.

구순구개열 환자의 악교정 수술 후의 골조직 안정도와 연조직 변화율 (Bony Stability and Soft Tissue Changes after Orthognathic Surgery on Patients with Cleft)

  • 신혜경;;;;조명수
    • 대한두개안면성형외과학회지
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    • 제13권1호
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    • pp.4-10
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    • 2012
  • Purpose: The objective of this retrospective study was to assess the skeletal stability after orthognathic surgery for patients with cleft lip and palate. The soft tissue changes in relation to the skeletal movement were also evaluated. Methods: Thirty one patients with cleft received orthognathic surgery by one surgeon at the Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Osseous and soft tissue landmarks were localized on lateral cephalograms taken at preoperative (T0), postoperative (T1), and after completion of orthodontic treatment (T2) stages. Surgical movement (T0.T1) and relapse (T1.T2) were measured and compared. Results: Mean anteroposterior horizontal advancement of maxilla at point A was 5.5 mm, and the mean horizontal relapse was 0.5 mm (9.1%). The degree of horizontal relapse was found to be correlated to the extent of maxillary advancement. Mean vertical lengthening of maxilla at point A was 3.2 mm, and the mean vertical relapse was 0.6 mm (18.8%). All cases had maxillary clockwise rotation with a mean of 4.4 degrees. The ratio for horizontal advancement of nasal tip/anterior nasal spine was 0.54/1, and the ratio of A' point/A point was 0.68/1 and 0.69/1 for the upper vermilion/upper incisor tip. Conclusion: Satisfactory skeletal stability with an acceptable relapse rate was obtained from this study. High soft tissue to skeletal tissue ratios were obtained. Two-jaw surgery, clockwise rotation, rigid fixation, and alar cinch suture appeared to be the contributing factors for favorable results.

Somatosensory evoked potentials are abnormal with plagiocephaly

  • Harma, Maiju;Lauronen, Leena;Leikola, Junnu;Hukki, Jyri;Saarikko, Anne
    • 대한두개안면성형외과학회지
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    • 제23권2호
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    • pp.59-63
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    • 2022
  • Background: Deformational plagiocephaly is usually managed conservatively, as it tends to improve over time and with the use of conservative measures. However, before the year 2017 we operated on patients with severe plagiocephaly and neurological symptoms at the Helsinki Cleft Palate and Craniofacial Center. Methods: Of the 20 infants with severe deformational plagiocephaly and neurological symptoms referred to us between 2014 and 2016, 10 underwent cranioplasty open reshaping of the posterior cranial vault. The parents of the last 10 patients were given information on the natural history of the condition and the patients were followed up with an outpatient protocol. The aim of this study was to gain information on the brain electrophysiology and recovery of patients after total cranial vault reconstruction by measuring the electroencephalogram (EEG) somatosensory evoked potentials (SEP; median nerve). Results: Of the 10 participants in the operation arm, six had abnormal SEP at least on the affected cerebral hemisphere and all SEPs were recorded as normal when controlled postoperatively. In the follow-up arm, eight out of 10 participants had abnormal SEP at the age of approximately 24 months, and all had normalized SEPs at control visits. Conclusion: Our data suggest that cranioplasty open reshaping of the posterior cranial vault did not affect abnormal SEP-EEG recordings. We have abandoned the operations in deformational plagiocephaly patients due to findings suggesting that expanding cranioplasty is not beneficial for brain function in this patient group.