• Archives of Plastic Surgery
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• v.38 no.3
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• pp.257-262
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• 2011

Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.

• Anatomy and Cell Biology
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• v.57 no.1
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• pp.25-30
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• 2024

The aim of this study was to identify the anatomical feature of retaining ligament and fat compartment on the lower eyelid and infraorbital region using a histological method, and to investigate clear definitions for them which could be used generally in the clinical area. Eighteen specimens from eight fresh Korean cadavers were stained with Masson trichrome or hematoxylin and eosin. The ligamentous and fascial fibrous tissue were clearly identified. The ligamentous fibrous tissue which traversed in the superficial and deep fat layer was skin ligament and orbicularis retaining ligament (ORL). The fascial fibrous tissue enclosed the orbicularis oculi muscle (OOc) and circumferencial adipose tissue. Based on the ligamentous and fascial structure, three fat compartments, septal, suborbicularis oculi and infraorbital fat compartment, could be identified. The OOc attached to orbital rim and dermis by ORL and skin ligament, and the muscle fascicle and fat fascicle provided the connection point to the ORL and skin ligament as enclosing all muscle and fat tissue. The combination of the force made by the skin ligament in the lower eyelid and ORL may decide the level and form of the infraorbital grooves.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.266-275
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• 2017

Since the time of its inception within facial anatomy, wide variability in the terminology as well as the location and extent of retaining ligaments has resulted in confusion over nomenclature. Confusion over nomenclature also arises with regard to the subcutaneous ligamentous attachments, and in the anatomic location and extent described, particularly for zygomatic and masseteric ligaments. Certain historical terms-McGregor's patch, the platysma auricular ligament, parotid cutaneous ligament, platysma auricular fascia, temporoparotid fasica (Lore's fascia), anterior platysma-cutaneous ligament, and platysma cutaneous ligament-delineate retaining ligaments of related anatomic structures that have been conceptualized in various ways. Confusion around the masseteric cutaneous ligaments arises from inconsistencies in their reported locations in the literature because the size and location of the parotid gland varies so much, and this affects the relationship between the parotid gland and the fascia of the masseter muscle. For the zygomatic ligaments, there is disagreement over how far they extend, with descriptions varying over whether they extend medially beyond the zygomaticus minor muscle. Even the 'main' zygomatic ligament's denotation may vary depending on which subcutaneous plane is used as a reference for naming it. Recent popularity in procedures using threads or injectables has required not only an accurate understanding of the nomenclature of retaining ligaments, but also of their location and extent. The authors have here summarized each retaining ligament with a survey of the different nomenclature that has been introduced by different authors within the most commonly cited published papers.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.5
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• pp.246-249
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• 2014

Eagle syndrome is a rare condition caused by elongation of the styloid process or calcification of the stylohyoid ligament. Patients with Eagle syndrome typically present with dysphagia, dysphonia, cough, voice changes, otalgia, sore throat, facial pain, foreign body sensation, headache, vertigo, and neck pain. Here we report a case in which the patient initially presented with sore throat, left-sided facial pain, and cough. This case report provides a brief review of the diagnosis and nonsurgical management of this rare syndrome.

• The Journal of Korean Medicine
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• v.30 no.3
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• pp.15-27
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• 2009

Objective : This study was carried to identify the anatomical component of BMM (Foot Taeyang Meridian Muscle in the human truncus), and further to help the accurate application to real acupunctuation. Methods: The human truncus was stripped off in order to demonstrate muscles, nerves and other components, and to display the internal structure of the BMM, dividing into outer, middle, and inner parts. Results: The BMM in the human truncus is composed of muscles, nerves, ligaments etc. The internal composition of the BMM in the human truncus is as follows: 1. Muscle A. Outer layer: medial palpebral ligament, orbicularis oculi, frontalis, galea aponeurotica, occipitalis, trapezius, latissimus dorsi, thoracolumbar fascia, gluteus maximus. B. Middle layer: frontalis, semispinalis capitis, rhomboideus minor, serratus posterior superior, splenius cervicis, rhomboideus major, latissimus dorsi, serratus posterior inferior, levator ani. C. Inner layer: medial rectus, superior oblique, rectus capitis, spinalis, rotatores thoracis, longissimus, longissimus muscle tendon, longissimus muscle tendon, multifidus, rotatores lumbaris, lateral intertransversi, iliolumbaris, posterior sacroiliac ligament, iliocostalis, sacrotuberous ligament, sacrospinous ligament. 2. Nerve A. Outer layer: infratrochlear nerve, supraorbital n., supratrochlear n., temporal branch of facial n., auriculotemporal n., branch of greater occipital n., 3rd occipital n., dorsal ramus of 1st, 2nd, 3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th, 11th, 12th thoracic n., dorsal ramus of 1st, 2nd, 3rd, 4th, 5th lumbar n., dorsal ramus of 1st, 2nd, 3rd, 4th, 5th sacral n. B. Middle layer: accessory nerve, anicoccygeal n. C. Inner layer: branch of ophthalmic nerve, trochlear n., greater occipital n., coccygeal n., Conclusions : This study shows that BMM is composed of the muscle and the related nerves and there are some differences from already established studies from the viewpoint of constituent elements of BMM at the truncus, and also in aspect of substantial assay method. In human anatomy, there are some conceptional differences between terms (that is, nerves which control muscles of BMM and those which pass near by BMM).

• The korean journal of orthodontics
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• v.48 no.5
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• pp.283-291
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• 2018

Objective: This study was conducted to perform histomorphometric evaluations of the bone surrounding orthodontic miniscrews according to their proximity to the adjacent tooth roots in the posterior mandible of beagle dogs. Methods: Four male beagle dogs were used for this study. Six orthodontic miniscrews were placed in the interradicular spaces in the posterior mandible of each dog (n = 24). The implanted miniscrews were classified into no loading, immediate loading, and delayed loading groups according to the loading time. At 6 weeks after screw placement, the animals were sacrificed, and tissue blocks including the miniscrews were harvested for histological examinations. After analysis of the histological sections, the miniscrews were categorized into three additional groups according to the root proximity: high root proximity, low root proximity, and safe distance groups. Differences in the bone-implant contact (BIC, %) among the root proximity groups and loading time groups were determined using statistical analyses. Results: No BIC was observed within the bundle bone invaded by the miniscrew threads. Narrowing of the periodontal ligament space was observed in cases where the miniscrew threads touched the bundle bone. BIC (%) was significantly lower in the high root proximity group than in the low root proximity and safe distance groups. However, BIC (%) showed no significant differences among the loading time groups. Conclusions: Regardless of the loading time, the stability of an orthodontic miniscrew is decreased if it is in contact with the bundle bone as well as the adjacent tooth root.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.285-289
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• 1996

The styloid process is normally a small, slender, pointed, downward and forward projection of the temporal bone. It is developed from the ossification of the Reichert's cartilage of the second branchial arch. In the adult, It is about 2.5cm in length and lies between the internal and external carotid arteries and lateral to the tonsillar fossa. Elongation of the styloid process , ossification of the stylohyoid or slylomandibular ligament causes recurrent nonspecific throat discomfort, foreign-body sensation, dysphagia, referred otalgia or facial pain. Symptoms are provoked by swallowing, turning head, carotid compression, and posttonsillectomy. Recently, the authors have experienced two cases of Eagle's syndrome. So we report them with review of literature.

• Imaging Science in Dentistry
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• v.30 no.3
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• pp.217-222
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• 2000

A 31-year-old male with the complaint of severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no facial swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the condylar head at both sides. Laboratory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the laboratary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.235-243
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• 1998

Cementifying fibroma is an odontogenic tumor of periodontal ligament origin, consisting of a proliferation of fibrous tissue that forms cementum. Cemento-ossifying fibroma, cementifying fibroma and ossifying fibroma are difficult to distinguish on clinical and radiographic exmination, and on histopathology. However, when the calcified product is represented by ovoid or curvilinear deposits, the lesion is often referred to as cementifying fibroma. Cementifying fibromas of the jaws are well-circumscribed, generally slow-growing lesions. Although most lesions appear to be limited to the tooth-bearing areas, a few have extended into the angle-ramus area or encroached on the maxillary sinus. Radiographically, the cementifying fibroma could present as a radiolucent, radiopaque or mixed density lesion, depending on the degree of maturity. We have observed two cases of cementifying fibroma occurred in the left maxillary premolar-molar area of 38-year-old woman and 35-year old man. We obtained that two cases were shown the followed results; 1. Clinically, main clinical symptom was facial swelling and pain at palpation 2. Radiographically, well-circumscribed radiolucent lesion and radiolucent lesion with radiopaqu e foci were seen on the left maxillary premolar-molar areas. Loss of lamina dura and root resorption or divergency were also seen. 3. Histopathologically, many cementum-like calcifications were observed in the hypercellular connective tissue.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.799-821
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• 1996

The ultimate goal of periodontal treatment has been to facilitate regeneration of diseased periodontal tissues, destroyed by inflammatory periodontal disease. For regeneration of the periodontium to occur, all of component tissues must be restored to their original position and architecture. Growth factors which were known to promote the cellular processes, ie, proliferation, migration and matrix synthesis, have been in the spotlight of current periodontics. Platelet-derived growth factor(PDGF) stimulates collagen and non collagen protein synthesis, migration and proliferation of periodontal ligament cells. Insulin-like growth factor(IGF) has potentials to induce collagen and bone matrix synthesis so that it regulates normal bone remodeling. Application of the combination have been known to facilitate formation of bone and cementum, and to synergistically interact to promote coronal migration and proliferation of periodontal ligament cells. These two growth factors have been reported to exhibit positive effect in the periodontally diseased teeth or class m furcation defects. The aim of the present study was to test the hypothesis that PDGF-BB alone or the combination of PDGF-BB and IGF-I can predictably enhance regeneration of the periodontium in the dehiscence defect. Following the resection of premolars, roots were embedded. After 12 weeks of healing period, standardized experimental $4{\times}4mm$ dehiscence defects were created on the mid-facial of the premolar roots in each of 4 young adult dogs. In control group, only methylcellulose gel was inserted in the defects. In experimental group I and II, gel with $2{\mu}g$ of PDGF-BB or $2{\mu}g$ of PDGF-BB and $1{\mu}g$ of IGF-I was inserted in the defects, respectively. At 8 weeks postsurgery, the dogs were sacrificed. The results were observed histologically and analyzed histomorphometrically.The results of this study were as follws. 1. The new cementum formation was $1.26{\pm}0.69mm$ in the control group, $1.80{\pm}0.84mm$ in the experimental group I, $1.93{\pm}0.51mm$ in the experimental group II. The experimental group III, the experimental group I, the control group were in the order of cementum formation without statistically significant differences between control and all experimental groups. 2. The new bone formation was $1.00{\pm}0.53mm$ in the control group, $1.53{\pm}0.63mm$ in the experimental group I, $l.33{\pm}0.45mm$ in the experimental group II. The experimental group I, the experimental group II, the control group were in the order of bone formation without statistically significant differences between control and all experimental groups. 3. The root resorption was $1.12{\pm}0.64mm$ in the control group, $1.34{\pm}0.73mm$ in the experimental group I, $0.79{\pm}0.59mm$ in the experimental group II without statistically significant differences between control and all experimental groups. These results suggested that the use of PDGF-BB alone or PDGF-BB and IGF-I in the dehiscence defects might facilitate periodontal regeneration in some degree, but has not shown statistically significant results.