• Journal of Korean Neurosurgical Society
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• 제67권1호
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• pp.60-72
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• 2024

Objective : Recently, robotic-assisted spine surgery (RASS) has been considered a minimally invasive and relatively accurate method. In total, 495 robotic-assisted pedicle screw fixation (RAPSF) procedures were attempted on 100 patients during a 14-month period. The current study aimed to analyze the accuracy, potential risk factors, and learning curve of RAPSF. Methods : This retrospective study evaluated the position of RAPSF using the Gertzbein and Robbins scale (GRS). The accuracy was analyzed using the ratio of the clinically acceptable group (GRS grades A and B), the dissatisfying group (GRS grades C, D, and E), and the Surgical Evaluation Assistant program. The RAPSF was divided into the no-breached group (GRS grade A) and breached group (GRS grades B, C, D, and E), and the potential risk factors of RAPSF were evaluated. The learning curve was analyzed by changes in robot-used time per screw and the occurrence tendency of breached and failed screws according to case accumulation. Results : The clinically acceptable group in RAPSF was 98.12%. In the analysis using the Surgical Evaluation Assistant program, the tip offset was 2.37±1.89 mm, the tail offset was 3.09±1.90 mm, and the angular offset was 3.72°±2.72°. In the analysis of potential risk factors, the difference in screw fixation level (p=0.009) and segmental distance between the tracker and the instrumented level (p=0.001) between the no-breached and breached group were statistically significant, but not for the other factors. The mean difference between the no-breach and breach groups was statistically significant in terms of pedicle width (p<0.001) and tail offset (p=0.042). In the learning curve analysis, the occurrence of breached and failed screws and the robot-used time per screw screws showed a significant decreasing trend. Conclusion : In the current study, RAPSF was highly accurate and the specific potential risk factors were not identified. However, pedicle width was presumed to be related to breached screw. Meanwhile, the robot-used time per screw and the incidence of breached and failed screws decreased with the learning curve.

• 대한핵의학회지
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• 제36권1호
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• pp.1-7
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• 2002

Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

• Advances in pediatric surgery
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• 제1권2호
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• pp.149-161
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• 1995

국내에서 처음으로 기관식도기형에 관하여 대한소아외과 학회 회원을 대상으로 조사하였다. 본 연구는 두 부분으로 구성되어 있었는데 하나는 최근 3년간 출생한 기관식도기형의 등록된 자료를 분석하여 국내의 기관식도기형의 현황 즉 발병율 처치 및 치료 결과등에 관한 총체적인 경향을 외국과 비교 분석하여 우리 자료와 구미 보고와의 차별성 및 유사성을 분석하고저 했으며, 다른 하나는 질문서(questionnaires) 분석을 토대로 11차 대한소아외과학회 학술대회에서 토의된 내용을 기초로 회원들의 식도기형의 진단 치료, 술후 관리, 합병증 등에 대한 경험과 의견을 종합하여 고안을 작성하였다.

• 여성건강간호학회지
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• 제6권2호
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2014년도 제46회 동계 정기학술대회 초록집
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• pp.298-298
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• 2014

Quantum dot infrared photodetectors (QDIPs) based on Stranski-Krastanov (SK) quantum dots (QDs) have been widely explored for improved device performance using various designs of heterostructures. However, one of the biggest limitations of this approach is the "pancake" shape of the dot, with a base of 20-30 nm and a height of 4-6 nm. This limits the 3D confinement in the quantum dot and reduces the ratio of normal incidence absorption to the off-axis absorption. One of the alternative growth modes to the formation of SK QDs is a sub-monolayer (SML) deposition technique, which can achieve a much higher density, smaller size, better uniformity, and has no wetting layer as compared to the SK growth mode. Due to the advantages of SML-QDs, the SML-QDIP design has attractive features such as increased normal incidence absorption, strong in-plane quantum confinement, and narrow spectral wavelength detection as compared with SK-DWELL. In this study, we report on the improved device performance of InAs/InGaAs SML-QDIP with different composition of $Al_xGa1-_xAs$ barrier. Two SML-QDIPs (x=0.07 for sample A and x=0.20 for sample B) are grown with the 4 stacks 0.3 ML InAs. It is investigated that sample A with a confinement-enhanced (CE) $Al_{0.22}Ga_{0.78}As$ barrier had a single peak at $7.8{\mu}m$ at 77 K. However, sample B with an $Al_{0.20}Ga_{0.80}As$ barrier had three peaks at (${\sim}3.5{\mu}m$, ${\sim}5{\mu}m$, ${\sim}7{\mu}m$) due to various quantum confined transitions. The measured peak responsivities (see Fig) are ~0.45 A/W (sample A, at $7.8{\mu}m$, $V_b=-0.4V$ bias) and ~1.3 A/W (sample B, at $7{\mu}m$, $V_b=-1.5V$ bias). At 77 K, sample A and B had a detectivity of $1.2{\times}10^{11}cm.Hz^{1/2}/W$ ($V_b=-0.4V$ bias) and $5.4{\times}10^{11}cm.Hz^{1/2}/W$ ($V_b=-1.5V$ bias), respectively. It is obvious that the higher $D^*$ of sample B (than sample A) is mainly due to the low dark current and high responsivity.

• Tuberculosis and Respiratory Diseases
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• 제48권3호
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• pp.331-338
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• 2000

연구배경 : 우리 나라의 경우 청소년들과 여성들의 흡연이 크게 증가하고, 담배를 피우기 시작하는 나이 역시 계속 낮아지고 있어 30-40년 후에도 우리 나라의 폐암발생률은 계속 증가할 것으로 추측하고 있다. 저자들은 우리 나라 폐암환자의 흡연습관을 분석하여 폐암발생과 관계 있는 흡연요소를 알아보고, 이를 폐암발생과 예방에 대한 기본자료로 이용하고자 본 연구를 시행하였다. 방 법 : 본 연구는 환자-대조군 연구로 1995년 11월부터 1996년 7월까지 영남대학교 부속병원 내과를 방문하여 폐기능 검사를 받은 환자들을 대상으로 흡연력 및 흡연량, 흡연습관 등에 관한 정보가 기록된 설문지를 이용하여 직접면담을 통하여 설문조사를 시행하였다. 폐암발생에 대한 각 흡연습관의 상대위험도는 Mantel Haenszel의 방법을 이용하여 구하였다. 결 과 : 습관적으로 담배를 피우기 시작한 나이는 22.5세, 일일 흡연량은 1.2갑, 흡연기간은 40년, 그리고 담배연령은 47 갑 년이었다. 습관적으로 흡연을 시작한 나이가 어릴수록, 흡연기간 및 담배연령, 그리고 일일흡연량이 많을수록 폐암발생의 교차비는 높았다. 금연여부에 따른 교차비의 차이도 의미 있었다. 연기를 깊게 흡입하는 경우 폐암발생의 교차비가 약간 증가하는 경향이 있었으나, 한번 피울 때 피운 담배의 길이와는 뚜렷한 관계가 없었다. 16년 이상 필터 없는 담배를 피운 경우 교차비가 증가하였다. 결 론 : 폐암발생에 영향을 미치는 중요한 흡연과 관계된 요인은 흡연기간 및 담배연령, 일일 흡연량, 습관적으로 담배를 피우기 시작한 나이, 필터 없는 담배를 피운 기간, 그리고 금연여부 등이었다. 그러나 이에 대한 정확한 결론은 더 많은 흡연정보를 포함하는 전향적인 연구가 도움이 될 것으로 생각한다.

• 대한원격탐사학회지
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• 제25권4호
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• pp.383-389
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• 2009

TerraSAR-X자료를 이용하여 고해상 X-밴드 SAR시스템을 이용한 조간대 갯벌 관측에의 적용 가능성을 시험하였다. 연구대상지 역은 강화도 남단과 영종도를 잇는 조간대이며, 단일편파자료와 이중편파자료를 이용하였다. 연구내용은 다음과 같은 세 가지로 분류된다. 첫째, X-밴드 영상에서의 연안의 레이더 반사도 특성 연구 및 waterline 추출 정밀도를 평가하였다. 연안지역의 waterline은 HH 편광자료의 레이더 반사도 특성을 통하여 추출하였을 때 가장 신뢰도가 높았으며, TerraSAR-X 시스템의 짧은 파장과 높은 궤도정밀도로 인하여 정밀한 지리좌표로의 변환이 가능하였다. 연구지역의 조간대 지형 경사도는 평균적으로 수평방향으로 60 m당 20 cm의 고도변화를 가지므로, TerraSAR-X HH 편광자료를 이용한 waterline 추출은 정밀한 조간대 DEM 추출로 응용될 수 있다. 둘째, 이중편파자료의 편파특성을 이용한 조간대 영생식물의 산란특성을 관측하였다. 조간대 수륙경계부에서 잘 관측되는 칠면초와 같은 염생식물은 해수면변화에 따른 조간대의 육지화 모니터링에 좋은 표적이 된다. TerraSAR-X 이중편파자료의 산란특성을 이용한 염생식물 관측결과는 2007년에 현장에서 취득된 실측자료와 비교하여 3 dB 이내의 정밀도로 일치하였다. 셋째, 단일편파자료의 레이더 간섭기법을 이용한 조간대 DEM작성을 시도하였다. 조간대 내에서 육지화가 진행된 지역은 표면에 염생식물이 발달하였음에도 불구하고 높은 간섭긴밀도를 나타내었다. 레이더 간섭기법을 통한 DEM의 제작은 일반적인 조간대에서는 적용이 제한적이며, TanDEM-X의 적용이 필요하다.

• 대한화상학회지
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• 제24권2호
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• pp.21-29
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• 2021

Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin^®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

• 산학경영연구
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• 제23권1호
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• pp.45-68
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• 2010

현재 대학졸업자는 과잉공급 되고 있으나 산업계에서 필요로 하는 인력은 절대적으로 부족하며, 대학 졸업자에 대한 기업의 불만족과 재교육 비용의 부담증가는 전반적인 대학교육과 산업체 현장과의 괴리현상을 야기하고 있다. 특히 전문대학은 직무중심의 직업교육을 목적으로 사회각 분야에 관한 전문적인 이론과 지식을 교수, 연구하고 재능을 연마하며, 국가사회 발전에 필요한 전문 작업 인력을 양성할 목적으로 설립하였다. 그러나 오늘날의 전문대학은 이러한 설립목적에 크게 벗어나 있으며, 산업체의 니즈를 반영한 교육과정의 개발를 통하여 전문대학의 본래의 설립취지 및 설립목적에 맞는 교육기관으로의 변화를 사회가 요구되기에 이르렀다. 산업체 현장의 니즈를 반영한 교육과정개발이란 "산업체의 각 직무단위에서 직무분석을 통하여 요구하는 직무역량을 갖추기 위해 대학에서 교육 되어야 할 교과목 목록과 각 교과목들의 중요도 와 발생빈도 등을 분석하여 교육과정 개발에 반영하고, 이를 통하여 산업체에서 요구하는 직무 와 대학의 교육과정에서 오는 괴리현상을 제거하기 위한 연구"이다. 연구방법으로는 직무분석 중심의 교육과정 개발에 일반적으로 사용되는 DACUM 기법을 활용하였으며, 이를 통하여 교과목 스킬 대비표, 조사대상기업의 선정 직무모형의 설정, 직무명세서 및 작업명세서 등을 작성하여 직무를 분석하였으며, 이를 전문가 집단을 활용한 면접평가 방법과 WEB을 통한 설문지 조사방법으로 교육과정의 결과를 평가하여 산업체 현장의 니즈가 반영된 교육과정을 개발하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.141-148
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• 2010

The bilateral sagittal split ramus osteotomy (BSSRO) is preferred method of surgical correction for mandibular prognathism, retrognathism and asymmetry. This technique performed from primarily an intraoral incision to avoid a scar. After forward movement of the distal segment of the mandible, healing of bone by primary or secondary intention is easily accomplished through large areas of cancellous bony overlap. When rigid fixation is used for the BSSRO, it is possible to open the mouth during the immediate post-operative period because it promotes the healing process. Although this surgical procedure has been well-documented, the incidence of postoperative trigeminal neurosensory disorder in the region of the inferior alveolar nerve and the mental nerve remains one of the major complication. However, evaluation of objective methods for sensory recovery patterns is insufficient although most patients find their sensory return. Neurometer electrodiagnostic device performs automated neuroselective sensory nerve conduction threshold evaluation by determining current perception threshold (CPT) measures. The purpose of this study was to evaluate the sensory recovery patterns of inferior alveolar and mental nerve over time. Nerve examination with a neurometer was performed in 30 patients undergoing the BSSRO at pre-operative, post-operative 1-, 2-, 4- week, and 2-, 3-, 4-, 5-, 6- month follow-up visits after the osteotomy to compare the differences of nerve injury and recovery patterns after the BSSRO with or without genioplasty and sensory recovery patterns associated with the kind of nerve fiber.