• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.76-80
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• 2009

Purpose: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. Methods: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. Results: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. Conclusion: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.195-198
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• 2010

Purpose: The zygoma is a key element which composes the facial contour. Zygomatic fracture induces facial asymmetry. We use radiologic evaluation or inspections mainly for identification of symmetry after reduction depressed zygomatic fracture. But the disadvantages of such methods are time-consuming and complicated process. So we tried to develop a new testing method with a ruler and a level. Methods: In unilateral depressed zygomatic fracture patient, parallel to the patient's head to make sure lay horizontaly. Put the leg of a ruler on the malar eminence so that it is at the same distance from the facial midline. Then take the level of malar eminence as put the level above the ruler. This process was performed before and after the reduction. Results: We were able to fix with plate and screw after checking the results of reduction fast and easily. Good results were obtained at post-operative radiologic evaluation. Conclusion: We can easily get the ruler and level around life. This method is not only simple but also shorttime process compared with other method-radiologic evaluation or inspection. And the operator can explain the results to the patients easily and objectively. Authors obtained the good results with this new method, and would introduce it for another method of identifying the result of reduction in depressed zygomatic fractures.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.294-300
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• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.530-534
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• 2007

Nasal fractures are the most common type of facial fractures. Nowdays computed tomography is found to be very helpful in diagnosing nasal fracture, especially in findings the nasal septal fractures. From August 2004 to July 2005, 36 cases of nasal fracture were admited and reviewed to oral and maxillofacial surgery of Ulsan University Hospital, not including other facial bone fracture. Out of 223 cases of facial bone fractures, we treated 47 cases of nasal fractures. We reviewed and examined the 36 patients of nasal fractures 2months postoperative. The results were 28cases of male and 8cases of female. The highest age frequency was in the fourth decades group. The most frequent causes of injury were falling down and fist trauma. The 25(69%) patients were found to have septal fractures, after computed tomography findings. The treatment methods of nasal fracture were closed reduction(13cases), open reduction(20cases), ORIF(1case), non operation(2cases). Complications of nasal deformity were found in 2patients. Septoplasty was performed on 21 patients. Septal fractures in combination with nasal fracture are usually unrecognized and untreated at the time of injury, usually ended in nasal deformities. It is important to find out the exact type of nasal fractures. We will report the results of treatment of nasal fractures with a literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.91-95
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• 2014

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.281-283
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• 2012

The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

• 대한치과보철학회지
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• 제60권4호
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• pp.395-403
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• 2022

다발성 안면 골절의 경우 골절 부위를 원위치로 정복하기 위한 지표가 부족하기에 골절편의 정복 후 교합과 구강 구조의 형태 및 위치가 비정상적으로 변화된 결과를 보이는 경우가 많이 나타난다. 그리고 다발성 안면 골절환자에서 나타난 개구제한과 구역반사는 치과치료의 난이도를 높이고, 외상으로 인한 악골의 위치차이가 심미적, 기능적 회복을 어렵게 한다. 이러한 경우 환자의 불편감과 치과치료의 난이도를 줄이기 위해 최소한의 구내작업을 위한 디지털 워크플로우를 선택할 수 있다. 본 증례는 15년전 발생한 다발성 안면골절로 인한 후천적인 골격성 III급 및 개구제한, 구역반사를 가진 환자에서 상악 전치부 무치악 상태를 임플란트 계획부터 최종 보철물의 제작까지 디지털 워크플로우를 이용하여 수복한 증례이다. 이러한 치과치료의 어려움이 있는 환자에서 디지털 워크플로우의 사용이 환자의 불편감을 최소로 하고 심미적, 기능적으로 적절한 결과를 얻었기에 이를 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제17권1호
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• pp.1-4
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• 2016

Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.45-48
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• 2010

Purpose: After surgical interventions of mandible fractures, facial asymmetry can be occurred, and it leads to serious problems for patients. This can be solved by mandible angle ostectomy. Methods: A 19-year-old male underwent percutaneous surgical intervention for left mandibular angle and right parasymphyseal fractures 3.5 years ago. The left angle was protruded compared to the other side. Using a percutaneous approach, $4.5{\times}1cm$ sized piece of mandible angle was sawed off. For the right angle, intraoral approach was performed for angle ostectomy, and the angle was sawed off by a size of $4{\times}1cm$, using a pattern based on the piece from the left side. Results: After surgery, no complications such as subcondylar fractures, refractures, insufficient corrections, secondary angle formations, hematomas, and transient nerve palsies were seen, and symmetric correction of mandible angles were done. Conclusion: In facial asymmetries due to mandibular fractures, mandible ostectomy could be a solution. Using the bone section from the contralateral side, measurement of the amount of bone sawed off was possible, and via percutaneous approach on the previously operated site with simultaneous scar revision, and intraoral approach for the contralateral side, cosmetically satisfactory result was obtained.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.131-134
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• 2009

저자들은 보편적으로 보존치료가 불가능 하여 관혈적 정복술이 필요한 하악의 관절돌기골절 증례에서 당뇨, 고혈압의 병력, 고령으로 인한 절개 및 박리, 전신마취 시간증가로 발생할 수 있는 합병증을 줄이기 위해 우선적으로 시행한 형광투시하의 비관혈적 도수정복만으로 정확한 정복에 성공할 수 있었고 이후 골 유합까지 유지하여 만족스런 결과를 얻었기에 보고하는 바이다.