• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.1-5
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• 2011

Purpose: The management of frontal sinus fractures and frontal sinus outflow tract (=FSOT) injuries is controversial. Traditional treatments include frontal sinus obliteration with a variety of material grafts, which all employ complicated algorithms for treatment planning. A simplified algorithm aiming for frontal sinus ventilation, however, can be achieved through the advanced technology of image guided endoscopic surgery and instruments. The authors explain this simplified treatment algorithm of frontal sinus fractures. Methods: The authors reviewed articles on the management of frontal sinus fractures. Results: Complicated treatment planning algorithms of frontal sinus fractures aiming for obliteration were replaced with a simplified algorithm aiming for ventilation of the frontal sinus. Conclusion: The authors suggest that a simplified algorithm can replace the complicated algorithms in selective cases.

• Anatomy and Cell Biology
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• 제56권2호
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• pp.179-184
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• 2023

The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive "precision surgery" to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero's classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.558-562
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• 2010

Sinusitis has been reported as a complication of sinus lift surgery. Obstruction of the sinus outflow tract by mucosal edema and particulate graft material may result in sinusitis. Two main surgical procedures have been proposed for the treatment of associated infectious complications; inferior meatal antrostomy and functional endoscopic sinus surgery through transnasal approach. We performed superior lateral wall antrostomy through introral approach in patient suffering from the sinusitis after sinus floor augmentation and implant installation. This procedure permitted easier access to the maxillary sinus for treat sinusitis caused by sinus lifting.

• Journal of Yeungnam Medical Science
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• 제19권1호
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• pp.28-38
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• 2002

1999년 6월에서 2000년 6월까지 영남대학교 의과대학 부속병원 이비인후과에 내원하여 내시경 검사와 부비동 전산화단층촬영으로 만성 부비동염 혹은 만성 부비동염과 비용으로 진단받고 한 사람의 수술자에 의해 내시경적 부비동 수술을 시행받은 성인 157명의 환자 중 전향적으로 6개월 이상 추적관찰이 가능하였고 비강음향통기도 검사를 시행한 84명을 대상으로 하였다. 수술 결과는 증상접수, 비내시경점수, 방사선점수, 수술접수, 음향비강통기도 검사치를 각각 구하여 이들의 연관성을 조사하였다. 수술 전과 수술 후 3개월, 수술 전과 수술 후 6개월째의 각각 증상 점수는 통계학적으로 의의 있게 감소하였다. 음향비강통기도 검사상 전비공에서 7cm 후방을 기준으로 측정한 수술 전과 수술 후 3개월 째 비강체적은 $17.10cm^3$에서 $27.37cm^3$로 통계학적으로 의의 있게 증가하였다. 수술 전과 수술 후 3개월 째는 내시경 점수가 낮은 군과 높은 군에서 각각의 증상 점수와 호전도는 차이가 없었다. 수술 전과 수술 후 3개월 째의 증상 접수의 호전도는 모든 증상이 호전되었지만 특히 두통, 후각장애, 안면부 통증 및 중압감, 전반적 불편감이 통계학적으로 의의 있게 CT점수가 높은 군에서 낮은 군보다 높았다. 수술점수가 높은 군과 낮은 군에서 수술 전과 수술 후의 증상 점수의 호전도와 음향비강통기도 검사결과는 차이가 없었다. 이상의 결과로 보아 만성 부비동염 환자에서 내시경적 부비동 수술 후 수술 전-후의 호전도를 분석하기 위해서는 주관적인 증상의 호전여부와 객관적인 음향비강통기도 검사를 통한 비강체적의 측정이 수술 후 결과의 판정에 도움이 될 것으로 사료되고, 수술 전 내시경 점수, 수술 전 CT점수 및 수술점수에 따른 증상의 호전여부에 대한 분석 중 수술 전 CT점수가 수술 결과의 판정에 가장 도움이 될 것으로 사료된다.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.691-694
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• 2011

Purpose: With an increase in the population of immunocompromised patients, the incidence of maxillary sinus aspergillus infection has also escalated. Maxillary sinus aspergillosis is generally extended to the sinus antrum, base or thin orbital wall and ethmoid air cell region. We experienced a case of maxillary sinus aspergillosis which was extended directly to the soft tissue of the cheek. Methods: A 46-year-old man with acute myelogenous leukemia was consulted for the defect of the anterior wall of the maxillary sinus, and cheek. Radiologic and histologic findings were consistent with invasive maxillary sinus aspergillosis. The otolaryngology department performed debridement via endoscopic sinus surgery first. Coverage of the resulting defect in the anterior wall of the maxillary sinus and its inner layer was undergone by the plastic and reconstructive surgery department, using a pedicled superficial temporal fascia flap and a split thickness skin graft. The remaining skin defect of the cheek was covered with a local skin flap. Results: The patient went through an uneventful recovery. There was no recurrence during 6 months of follow-up. Conclusion: Maxillary sinus aspergillosis usually involves the orbit or the gingiva but in some cases it may directly invade soft tissues of the cheek. Such an atypical infection extending into the cheek may lead to a large soft tissue defect requiring coverage. Thus, any undiagnosed soft tissue defect involving the cheek or maxillofacial area, especially in immunocompromised patients, should be evaluated for aspergillosis. We present this rare case, with a review of the related literature.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.552-556
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• 2006

Purpose: As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach. Methods: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with $Medpor^{(R)}$ insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture. Results: The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases. Conclusion: The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.

• 대한두개안면성형외과학회지
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• 제18권3호
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• pp.197-201
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• 2017

Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately $2.5{\times}3.3cm$. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권2호
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• pp.127-132
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• 2012

Maxillary sinus hypoplasia (MSH) is an uncommon clinical disease that represents a persistent decrease in sinus volume, which results from centripetal reaction of the maxillary sinus walls. We present a unilateral MSH case of a 46-year-old male patient with a history of nasal obstruction and headache for 3 years. He had a history of Caldwell Luc operation (CLOP) 10 years ago, and no enophthalmos, hypoglobus or facial asymmetry. After confirming the right diagnosis of MSH, filled with bone in the computed tomography scan, hyperplastic bone was removed by the CLOP approach. The uncinate process and infundibular passage were found to be degenerated and ostium was also examined to be obstructed under endoscopic confirmation. MSH can be mistaken for chronic maxillary sinusitis because of the plain x-ray appearance, so the aggravated state of MSH can be the result of surgeon's misjudgment. With additional literature reviews, this rare experience is first introduced in our Korean oral and maxillofacial surgery field.

• Journal of Korean Neurosurgical Society
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• 제53권4호
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• pp.218-222
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• 2013

Objective : To clarify the anatomical correlations of the sphenoid sinus with surrounding structures in the normal Korean population, and to identify surgical landmarks for safe sellar floor dissection in the anterior skull base by endoscopy and microscopy. Methods : We reviewed the 196 brain magnetic resonance imaging findings showing a normal appearance, and measured the distances between anatomical landmarks. Results : The mean distances from the base of the columella to the anterior wall of the sphenoid sinus and the sellar floor were $69.71{\pm}4.25$ mm and $86.26{\pm}4.57$ mm, respectively in the over 15 age group, and showed the smallest degree of variation among the measurements. The mean angles between the floor of the nasal cavity and the straight line connecting the base of the columella and the sellar floor were $29.45{\pm}3.25^{\circ}$ and $24.75{\pm}4.00^{\circ}$ in the over 15 and under 15 age groups, respectively. The mean values of both distances and angles increased with age until 15 years after which no further increases were evident. There were no significant differences in the measurements between males and females or among subjects with different degrees of pneumatization in the over 15 age group. Conclusion : The distances from the base of the columella to the sellar floor and the anterior wall of the sphenoid sinus, which were consistent among individuals, could be used as a surgical indicator to investigate the sellar floor in endoscopic or microscopic transsphenoidal approaches.

• 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.