• Archives of Craniofacial Surgery
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• v.23 no.5
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• pp.237-240
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• 2022

A 67-year-old man visited our plastic surgery clinic complaining of a palpable protruding mass (2.0×2.5 cm) in the right occipital region. To establish an appropriate treatment plan for the cystic mass, brain magnetic resonance imaging was performed. A 2.2 cm nodular lesion with peripheral enhancement in the right occipital region of the scalp was confirmed. In addition, two rim-enhancing nodular lesions up to 9 mm with marked perilesional edema in the right frontal lobe were confirmed. The findings suggested metastasis from cancer. After further evaluations, a mass in the right lower lung field was identified as adenocarcinoma of the lung. Histological examination characterized the excised lesion as a cutaneous metastasis from lung adenocarcinoma. This case report shows that a cystic mass, which commonly occurs in the scalp, may indicate lung cancer. In particular, if a cystic mass of the scalp is identified in a person at high risk for lung cancer, appropriate evaluation and urgent treatment should be performed.

• Archives of Craniofacial Surgery
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• v.24 no.3
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• pp.124-128
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• 2023

Morbihan disease (MD) is a very rare condition characterized by rosaceous or erythematous lymphedema on the upper two-thirds of the face. A definitive management strategy for MD is lacking, and treatment is challenging. Herein, we present a case of persistent bilateral eyelid edema treated by lymphaticovenular anastomosis (LVA) and lymph node-vein bypass surgery. The patient experienced persistent bilateral eyelid edema. Indocyanine green lymphography was performed, and the diagnosis of bilateral facial lymphedema was confirmed. On the right side, a preauricular lymphatic vessel was anastomosed to a vein. On the left side, lymphostomy on the preauricular lymph node was done, with anastomosis to the transected proximal end of the concomitant vein of the transverse facial artery. Furthermore, a preauricular lymphatic vessel was anastomosed to a vein. Eyelid edema decreased and progressively improved on both sides. The outcome of this case suggests that LVA and lymph node-vein bypass surgery are appropriate for treating persistent eyelid edema related to MD.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.1
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• pp.1-11
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• 2001

Disposable blade is widely used for palatal and oral mucosal incision in oral and maxillofadal surgery nowadays, But its design and durability need for improvement, Especially, there are so many hard tissues intraoral area, such as bone and tooth, therefor the sharpness of the surgical blade was easily destroyed, The purpose of this study was to make basic data for developing new design of surgical blade using in oral and maxillofacial area including for the patients who have cleft lip and palate deformities, Some questionnaires about the usefulness of currently used surgical blades were sent to 150 dentists, the 54 of them made a reply, Secondly, The used-once blade and fresh new blade were examined under the scanning electron microscope with the 4000-times magnification, Lastly, the tissue reaction following the surgical incision with a fresh-new and a used blade on rat buccal cheek mucosa and hard palate was evaluated with light microscope with hematoxilin-eosin staining, The time interval from the surgical trauma to taking a sample were 1 day, 3 days, 7 days, and 14 days, At each time schedule, 2 Sprague-Dawley rats were sacrificed, Many dentists were agreed to need for changing the design of the surgical blades and also demand to improve the durability of the blades, They were also eager to adopt the new design of blade if it was available, The blade used in surgical extraction procedure was heavily damaged in its sharpe edge of number 15 blade, The histological differences were not prominent, but the delayed healing was detected in buccal mucosal defects especially in the surgical group with used blade, There are slight different changes in hard palatal defects between a used and a new blade group, In this study, we could find that there are imperative demanding on improvement of surgical blade design and durability for oral and maxillofadal area, The blade currently using in surgical extraction was easily damaged, The animal model of this study was not perfect for the purpose of this study.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.91-94
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• 2010

Purpose: For the best possible aesthetic reconstruction after craniofacial bone tumor resection, pasteurization has been adopted to devitalize neoplastic cells while maintaining osteoinductive properties and mechanical strength. This case report aims to demonstrate a long-term follow-up result of a monostotic fibrous dysplasia in frontal bone which was reconstructed by pasteurized tumoral autograft in situ. Methods: A 14-year-old girl presented with a hard, nontender, slowly growing mass of 6-year duration on her left supraorbital area. CT showed $5{\times}4{\times}3cm$ sized well defined bony mass confined to frontal bone with heterogeneous density. Tumor was excised completely through bicoronal approach and reimplanted to its original site after pasteurization at $60^{\circ}C$ for 30 minutes. The pathologic examination confirmed fibrous dysplasia. Results: She revisited our clinic 5 years later after suffering some assault on her face. On CT examination, pasteurized tumoral autograft was incorporated to host bone except the fractured upper orbital rim without any evidence of recurrence. She has been satisfied with the result. Conclusion: Pasteurization offers a simple, reliable, cosmetic, economic, and durable reconstruction method for craniofacial skeletal tumor. It has advantages of both biologic incorporation ability and mechanical strength without risk of recurrence. So, it should be considered as one of the primary options in benign as well as resectable malignant tumors of craniofacial skeleton.

• Korean Journal of Cleft Lip And Palate
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• v.5 no.2
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• pp.109-112
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• 2002

구순 구개열 환자의 악교정 성형수술로 구강내 Le Fort II 골절단술이나 비중격 성형술이 많이 이용되는데, 이때 비골의 외측골절단술을 요하며, 이에 대한 술 후 합병증으로 비루관의 폐쇄나 비골의 분쇄골절 등이 발생할 수 있어, 악안면기형 환자를 다루는 구강악안면외과의사에게 비루관의 웅용해부학적 연구는 중요하다. 본 연구의 목적은 교합면을 기준으로 촬영된 컴퓨터 단충 촬영에서 비루관의 위치와 크기를 조사하는데 있다. 2000년 7월부터 2003년 2월까지 서울대학교병원 구강악안면방사선과에서 컴퓨터 단층촬영을 시행한 환자 62명을 대상으로 비상악봉합선에서 비루관까지의 최단거리와 비루관의 최대반경과 최소반경을 측정하였다. 우측비상악 봉합선에서 비루관까지의 거리는 5.68mm이고, 좌측은 5.67mm였다. 좌우 및 성별간의 차이는 없었다. 이의 해부학적 지견은 악기형 수술시의 비루관 폐쇄라는 합병증의 예방책으로 기여하리라 생각된다.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.28-34
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• 2006

Purpose: In maxillofacial surgery, proper preoperative diagnosis is very important in achieving good postoperative results. Although conventional CT scans are useful for visual representations of fractures, they cannot provide direct guidance for reconstructing facial bone fractures. However, the recent technology of multislice scanning has brought many clinical benefits to CT images. Direct correlations can be made between preoperative imaging data and operative planning. The aim of the current study is to evaluate the differences between conventional CT and multidetective three-dimensional CT(3D MDCT) measurements in craniofacial deformities. Methods: From January 2005 to November 2005, MDCT scans of 41 patients were evaluated by comparing them with conventional CT scans. The 3D MDCT images were assessed and reviewed by using a simple scoring system. Results: The 3D MDCT scans offered easy interpretation, facilitated surgical planning, and clarified postoperative results in malar complex fractures, mandibular fractures, and extensive maxillofacial fractures and cranioplasty. However, 3D MDCT images were not superior to conventional CT scans in the diagnosis of blowout fractures. Conclusion: In spite of its limitations, the 3D MDCT provided additional and more comprehensive information than the conventional CT for preoperative assessment of craniofacial deformities. Therefore, the 3D MDCT can be a useful tool for diagnosis and systematic treatment planning in craniofacial skeletal deformities.

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.94-97
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• 2014

Unilateral nostril hypoplasia is an extremely rare congenital malformation of unknown etiology, and only a few cases have been reported in literature. Owing to variability and complexity of the deformity, surgical correction of unilateral nostril hypoplasia represents one of the most significant reconstructive challenges to reconstructive plastic surgeons. We report a 7-year-old Vietnamese child with nasal and periocular deformity resembling a craniofacial cleft. Grossly, the right nostril was patent but with alar rim deformity, and the left nostril was not readily identifiable. A dystopic medial canthus was present on the left side as well. Closer inspection and palpation of the left side of nose revealed a patency through the soft tissue and underlying bony structure, Thus, a new alar rim were reconstructed with an irregularly shaped Z-plasty to create patency on the involved side. Simulatneously, a second Z-plasty was performed to address the medial canthal deformity. Postoperative appearance and function was sastisfactory at one-year follow up visit. In the treatment of patients with nostril hypoplasia, a careful preoperative physical examination is a prerequisite, and Z-plasty can be a valuable option for surgical correction.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.5-8
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• 2016

Background: Lobular keloid appears to be a consequence of hypertrophic inflammation secondary to ear piercings performed under unsterile conditions. We wish to understand the pathogenesis of lobular keloids and report operative outcomes with a literature review. Methods: A retrospective review identified 40 cases of lobular keloids between January, 2005 and December, 2010. Patient records were reviewed for preclinical factors such as presence of inflammation after ear piercing prior to keloid development, surgical management, and histopathologic correlation to recurrence. Results: The operation had been performed by surgical core extirpation or simple excision, postoperative lobular compression, and scar ointments. Perivascular infiltration was noted in intra- and extra-keloid tissue in 70% of patients. The postoperative recurrence rate was 10%, and most of the patients satisfied with treatment outcomes. Conclusion: Histological perivascular inflammation is a prominent feature of lobular keloids. Proper surgical treatment, adjuvant treatments, and persistent follow-up observation were sufficient in maintaining a relatively low rates of recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.540-548
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• 2011

Proteus syndrome is a congenital hamartomatous malformation that is characterized by a wide range of deformities, including craniofacial deformities. Proteus syndrome features partial gigantism and asymmetry of the limbs, plantar hyperplasia, hemangiomas, lipomas, lymphangiomas, varicosities, verrucous epidermal nevi, macrocephaly, cranial hyperostosis, and long bone overgrowth. We diagnosed Proteus syndrome in a male patient who visited our hospital with a chief complaint of limited mouth opening and report the case because we obtained a good healing outcome after treating the condition with a corrective osteotomy.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.145-148
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• 2017

Cutaneous leiomyosarcoma is an uncommon superficial soft tissue sarcoma and mainly found in the middle aged to elderly males. It can occur in any part of the body, mostly affecting the extremities and rarely affecting the face. It grows relatively slowly, can be diagnosed by biopsy and is treated by surgical excision. It needs to be distinguished from other spindle cell neoplasms, and immunohistochemical markers are usually required to attain an accurate diagnosis. We report a case of cutaneous leiomyosarcoma appeared on the left cheek within 6 month of a 73-year-old female patient suspected with malignant melanoma before surgery