• Korean Journal of Audiology
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• v.23 no.1
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• pp.53-58
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• 2019

Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.663-666
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• 2007

Purpose: Autologous fat injection into the facial area is a frequently used technique in aesthetic plastic surgery for augmentation of the soft tissue. Fat injection is a very safe procedure because of the advantage of being autologous tissue. Minimal foreign body reaction or infections are noted after fat injection. However, there may be some complications including those as severe as blindness. There have been some case reports on visual disturbances after autologous fat injection reported in the literature. Methods: A 21-year-old female patient underwent autologous fat injection into left eyebrow area to correct depression of soft tissue. Immediately after injection of autologous fat, she complained sudden visual loss on the left eye. She had come to our emergency room and ophthalmologic evaluation showed that the patient could only recognize hand motion. There was no abnormality of the optic nerve on magnetic resonance imaging. Suspecting an ischemic optic neuritis from fat embolism of the central retinal artery, the patient was treated conservatively with occular massage, antiglaucomatic agent, anti-inflammatory drugs and antibiotics. Visual field examination showed visual defect of half the lower hemisphere. Results: While maintaining antiglaucomatic agents and non steroidal anti inflammatory drugs, fundoscopic examination showed no abnormalities on the second day of admission. Visual field examination showed an improvement on the fourth day along with decreased eyeball pain. Significant improvement of vision was noted and the patient was discharged on the fifth day of admission. The patient was followed-up 2 days afterwards with improved vision and visual field defect. Conclusion: We describe an unusual case of sudden unilateral visual disturbance following autologous fat injection into periorbital area.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.36-40
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• 1995

Sebaceous carcinomas of the eyelids are uncommon but lethal tumors. Lesions are usually seen in the elderly, predominantly women. The meibomian glands of the tarsus are the most frequent site of origin. Less commonly, the tumor arises in other sebaceous glands, e.g., the gland of Zeis, eyebrow or caruncle. Regardless of the location, sebaceous malignancies must be considered aggressive neoplasms with a potential for regional and distant metastasis. Diagnosis may be difficult, given the low incidence and inconsistencies in histopathologic classification. Treatment requires wide surgical excision with removal of involved regional lymph nodes and exenteration is reserved for those patients with orbital involvement or diffuse intraepithelial neoplasia. Opinions are divided regarding the use of postoperative irradiation or chemotherapy. Recently we experienced 46-year-old male patient with a 12-month history of painless, firm nodule and conjunctivitis due to sebaceous carcinoma of the left upper eyelid. After surgery, serial sections of the entire conjunctiva and eyelids showed a positive cut margin in medial and lateral border. We report herein this patient that supports irradiation as the postoperative treatment of these tumors in selected patients with a review of literatures.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.233-238
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• 2010

Purpose: As the use of soft tissue fillers becomes more popular, complications such as foreign body granuloma (FBG) are increasing. We report 120 cases of facial FBG and review the available literatures. Methods: 120 patients of facial FBG in our clinic from Mar. 2003 to Feb. 2008 were complied and analyzed. A retrospective chart review was done and patient satisfaction was evaluated with a questionnaire using 5 score scale. Patients with severe inflammation sign or bizarre deformity underwent surgical excision and those with minimal symptoms or a history of hyaluronic acid injection received injection therapy using hyaluronidase. Results: 100 females and 20 males were observed. The average age was 43.7 years (from 16 to 74). 84 patients received surgical therapy and 36, injection therapy. Deformity of facial contour, foreign body sensation and inflammation sign were the three main chief complaints. 84 patients did not know what the injection materials were. The known materials are as follows: collagen, hyaluronic acid, silicone oil, paraffin. 92 cases were performed by unlicensed practitioners, 29 by physicians. Anatomical site most frequently affected by the foreign body granuloma was the cheek (25.8%), followed by forehead (19.2%), lips (15.8%), nose (9.2%), mentum (8.3%), eyelid and eyebrow (4.3%) and temple (0.8%). In 21 patients (17.5%), FBGs were found on multiple sites. Patients with inflammation sign got the highest satisfaction ($3.19{\pm}0.73$) (p=0.001) among 3 chief complaints. And patient satisfaction was statistically higher in surgical therapy group ($3.43{\pm}0.72$) than in injection therapy group ($2.97{\pm}0.88$) (p=0.003). Conclusion: We suggest that it may be beneficial to tailor the type of treatment for FBG relying on wound state and patient's chief complaints. In surgical therapy, resolute approach is necessary to correct facial deformity definitely and to minimize inflammation. Injection therapy could be another option for those with minimal symptoms or a history of hyaluronic acid injection. To prevent foreign body granuloma, not only plastic surgeons but also other physicians should inject soft tissue fillers with great caution and we should warn the public of disastrous consequences associated with illegal medical practice.

• Journal of Yeungnam Medical Science
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• v.13 no.1
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• pp.22-31
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• 1996

It is difficult to get a satisfactory result for the correction of malunited fracture of zygoma. Triple osteotomy and reposition of malunited zygoma is accepted as the better surgical method than camouflage surgery by means of onlays, if the orbital floor is to be reconstructed. The surgical approach can be divided into bicoronal, periorbital, intraoral and old scar. In 7 patients with malunited fracture of zygoma, the authors used a limited approach through extension of periorbital incision and intraoral incision instead of wide exposure including bicoronal incision. And we performed triple osteotomy and advancement of zygoma complex. The patients were followed for 4.5 months with acceptable result, and this approach was an effective method for the relatively simple tripod type-malunited fracture of zygoma. The authors obtained following conclusions: 1. Preoperative evaluation through thorough measurement of X-rays, investigation of photographs and detail communication with the patients was an important process. 2. Through lateral extension of subciliary incision, lateral eyebrow and intraoral incision, we could obtain adequate exposure for triple osteotomy and advancement of zygoma. 3. The zygoma should be reduced and fixed in an overcorrected superior and medial direction. 4. Return of zygoma to its anatomical position was possible only when it is completely freed from the surrounding soft tissue including masseter. 5. We could not find any different results between autogenous calvareal bone graft and $Medpor^{(R)}$ insertion on the floor of orbit.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.249-254
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• 2000

Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.