• 제목/요약/키워드: Free head

검색결과 654건 처리시간 0.028초

고령 환자군에 있어서 유리피판술을 이용한 두경부재건의 안전성 (The Safety of Microsurgical Head and Neck Reconstruction in the Elderly Patients)

  • 최봉균;김영석;이원재;유대현;탁관철
    • Archives of Plastic Surgery
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    • 제33권3호
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    • pp.289-293
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    • 2006
  • By means of microsurgical free-tissue transfer providing a large amount of required tissue, the surgeon can resect tumoral tissue more safely, which allows tumor-free margins and enhances the reliability of the ablative surgery that otherwise could not be performed radically. The morbidity of elective free-tissue transfer seems to be quite low, carrying acceptable risks for most patients. But the elderly patients are at risk for cardiac and respiratory problems, deep vein thrombosis, pulmonary emboli and infection merely as a function of age. This study was undertaken to define further risks of the elderly population with regards to free-tissue transfer. We retrospectively reviewed our experience with 110 microsurgical free-tissue transfers for head and neck reconstruction in patients greater than 60 years of age. Microsurgical procedures in all cases were preformed by the plastic and reconstructive department at Yonsei medical center. The investigated parameters were patient demographics, past medical history, American Society of Anesthesiologists(ASA) status, site and cause of defect, the free tissue transferred and postoperative complication including free-flap success or failure. There were 46 patients in the age group from 60 to 64 years, 34 patients from 65 to 70 years, and 30 patients 70 years or older. There happened 3 flap losses, resulting in a flap viability rate of 97%. Patients with a higher ASA designation experienced more medical complication(p=0.05, 0.01, 0.03 in each age group I, II, III) but not surgical complication p=0.17, 0.11, 0.54 in each age group I, II, III). And the relationship between postoperative complication and age groups was not significant. These observations suggest that major determinant for postoperative medical complication be the patient's American Society of Anesthesiologists score, and chronologic age alone should not be an exclusion criterion when selecting patients for free-tissue transfer

종골 외측 1/2 이상의 결손을 동반한 개방성 골절의 동종 대퇴골두 이식과 유리 피판술을 이용한 치료 (1예 보고) (Treatment of Open Calcaneal Fracture with Massive Bone Loss using Femoral Head Allograft and Myocutaneous Free Flap (A Case Report))

  • 성기선;은상수;문구현
    • 대한족부족관절학회지
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    • 제11권1호
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    • pp.111-114
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    • 2007
  • Open calcaneal fracture with more than lateral half of bone loss and soft tissue defect occurred in 17 year-old male patient due to motor vehicle accident. Soft tissue defect included heel pad, peroneal tendon. Bone loss involved mainly most part of inferior tuberosity but not subtalar joint. Open dressing and debridement were done daily in operating room and antibiotics administration was started. After granulation tissue formed, femoral head allograft was performed and fixed with 6.0 mm screws to replace bone defect. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap. No sign of infection nor major osteolysis was observed in 15 months follow up period. Soft tissue defect was covered with latissimus dorsi musculocutaneous free flap.

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광배근 근피판을 통한 두피 재건 및 두개골성형 (Scalp Reconstruction and Cranioplasty using the Latissimus Dorsi Musculocutaneous Flap in a Patient with Recurrent Wound Dehiscence Accompanied by MRSA Infection)

  • 윤태근;김상화
    • 대한두경부종양학회지
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    • 제38권1호
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    • pp.59-63
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    • 2022
  • The latissimus dorsi flap has high vascularity and is helpful for the reconstruction of infected areas. Herein, we present a patient with recurrent infections and soft-tissue defects who underwent cranial reconstruction using a free latissimus dorsi flap. The patient had undergone craniectomy and reconstruction using alloplastic bone 18 years previously. A scalp defect accompanied by infection occurred five years ago, and patient underwent reconstruction using a free flap at another hospital; however, the problem persisted. After debridement and bone flap removal, the right latissimus dorsi musculocutaneous flap was elevated, and the thoracodorsal artery and vein were anastomosed end-to-end to the right superficial temporal artery and vein. Methicillin-resistant Staphylococcus aureus was eradicated, and the flap survived. Cranioplasty was performed eight months later, and one year follow-up proceeded without complications. Effective reconstruction and cranioplasty are possible using the free latissimus dorsi musculocutaneous flap, even on scalp with persistent infections and soft-tissue defects.

Unusual anomaly of the radial artery encountered during the elevation of a radial forearm free flap: a case report

  • Jin Myung Yoon;Tae Jun Park;Sae Hwi Ki;Min Ki Hong
    • 대한두개안면성형외과학회지
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    • 제24권1호
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    • pp.28-31
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    • 2023
  • The radial forearm free flap (RFFF) has become popular for head and neck reconstructions. Owing to a constant anatomy the RFFF is relatively easy to dissect. Nevertheless, anatomical variations of the radial artery have been reported. Some variations could affect the survival of the flap. This paper reports an unusual anomaly of the radial artery where the radial artery was not located between the brachioradialis (BR) and flexor carpi radialis. The radial artery was observed above the BR and on the radial side of the BR. The survival of the elevated flap was deemed questionable because it had only few perforators. So we decided to discard the flap and to elevate another free flap for the head and neck defect. The donor area on the forearm was covered using the original skin of the first flap as a full-thickness skin graft. This case highlights a means to deal with anomalies of the radial artery encountered during the elevation of RFFF and the checking process for variations of the radial artery before RFFF.

다축 적층 시스템과 실험 계획법을 이용한 3차원 PCL/PLGA/ICP 바이오 인 공지지체 제작 (Fabrication of 3D PCL/PLGA/TCP Bio-scaffold using Multi-head Deposition System and Design of Experiment)

  • 김종영;윤준진;박의균;김신윤;조동우
    • 한국정밀공학회지
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    • 제26권1호
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    • pp.146-154
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    • 2009
  • In recent tissue engineering field, it is being reported that the fabrication of 3D scaffolds having high porous and controlled internal/external architectures can give potential contributions in cell adhesion, proliferation and differentiation. To fabricate these scaffolds, various solid free-form fabrication technologies are being applied. The solid free-form fabrication technology has made it possible to fabricate solid free-form 3D microstructures in layer-by-layer manner. In this research, we developed a multi-head deposition system (MHDS) and used design of experiment (DOE) to fabricate 3D scaffold having an optimized internal/external shape, Through the organization of experimental approach using DOE, the fabrication process of scaffold, which is composed of blended poly-caprolactone (PCL), poly-lactic-co-glycolic acid (PLGA) and tricalcium phosphate (TCP), is established to get uniform line width, line height and porosity efficiently Moreover, the feasibility of application to the tissue engineering of MHDS is demonstrated by human bone marrow stromal cells (hBMSCs) proliferation test.

유리피판을 이용한 설재건 후의 기능평가 (Functional Assessment after Tongue Reconstruction using Free Flap)

  • 박성호;정철훈;이종욱;장용준;노영수
    • 대한두경부종양학회지
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    • 제25권2호
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    • pp.119-122
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    • 2009
  • Objectives : Ablation of carcinoma of the tongue leads to deficits in speech and swallowing, but none to date has provided all of the qualities of mobility and sensation to simulate the complex function of the tongue. The authors evaluated postoperative swallowing and pronouncing function in patients who underwent tongue reconstruction using free flap. Material and Methods : This is a retrospective review documenting the outcome of 42 patients between January of 1991 and August of 2008. We classified patients according to the size of resection of the tongue like as 7 partial glossectomy, 25 hemiglossectomy, 2 subtotal glossectomy, and 8 total glossectomy. Swallowing function was graded into 4 point scale and pronouncing function was analyzed using picture consonant articulation test. Aspiration was evaluated with videofluoroscopic swallowing study. Results : The average points for swallowing function were 3.43 in partial glossectomy, 3.52 in hemiglossectomy, 3 in subtotal glossectomy, and 2.63 in total glossectomy. The percentage of consonants correct showed 76.5% in partial glossectomy, 72.29% in hemiglossectomy, 47.69% in subtotal glossectomy, and 29.94% in total glossectomy. Aspiration was noted in 3 patients(1 hemiglossectomy and 2 total glossectomy) and 2 total glossectomy patients were taken permanent feeding gastrostomy. Conclusion : Free flap gave us proper volume in tongue reconstruction and showed good result in preserving swallowing function. Swallowing function difference according to the size of defect showed no statistical significance, whereas articulation function was shown to decrease in accuracy as the size of defect was larger.

첨단 헤드업 디스플레이 장치용 비구면 자유형상 금형의 초정밀 가공에 관한 연구 (A study on the ultra precision machining of free-form molds for advanced head-up display device)

  • 박영덕;장태석
    • 한국산학기술학회논문지
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    • 제20권1호
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    • pp.290-296
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    • 2019
  • 차량용 HUD는 자동차 전면 유리창에 안전 운전과 편의 운전 관련 다양한 정보를 표시해 주는 장치로 중요한 역할을 수행한다. 본 논문에서는 증강현실 기술에 적용이 가능한 대면적 비구면 자유형상 미러를 가공하기 위해 초정밀 가공기를 이용하여 가공을 실시하였고 그 결과를 측정하였다. 초정밀 다이아몬드 절삭은 정밀도가 높을 뿐만 아니라 표면 거칠기와 잔류 응력을 낮게 할 수 있어서 우수한 표면 무결성을 갖는 고급 부품의 생산에 유리하다. 또한 비구면 자유 형상의 몰드를 사용함으로써 광학 전달 함수의 개선, 왜곡 경로의 감소 및 특수 이미지 필드 곡률의 실현과 같은 장점을 얻을 수 있다. 이와 같은 비구면 자유형상 금형을 가공하기 위한 방법으로는 초정밀가공기를 이용한 다이아몬드 절삭 방법을 사용하였으며, 제작된 비구면 자유형상 미러 금형의 평가는 비구면 형상 측정기를 이용하여 실시하였다. 이러한 방법에 의해 $1{\mu}m$ 이하의 형상 정밀도(PV)와 $0.02{\mu}m$ 이하의 표면 거칠기(Ra)를 갖는 비구면 자유형상 금형을 제작할 수 있었다.

이개에 발생한 모낭암종 1예 (A Case of Trichilemmal Carcinoma in Auricle)

  • 정재윤;박으뜸;이기일
    • 대한두경부종양학회지
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    • 제22권2호
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    • pp.159-162
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    • 2006
  • Trichilemmal carcinoma is a rare malignant neoplasm of the hair follicle from the outer root of the hair follicle sheath. This tumor can be misleading, and a false diagnosis of a squamous cell carcinoma. We report a case of trichilemmal carcinoma with a review of literature. The patient presented with an exophytic well circumscribed nodular mass on the left auricle, which was detected 6 months ago. Histopathologically, the tumor consisted of atypical clear cells which contained abundant glycogen. The tumor cells shows lobular growth pattern with necrosis, foci of trichilemmal keratinization and peripheral pallisading. Total excision and repair with full-thickness skin graft was done with minimal surgical morbidity. The patient has been free of recurrence or metastasis for 8 months.

조기후두암의 치료 성적 (Treatment Results of Early Laryngeal Carcinoma)

  • 김광현;성명훈;윤자복
    • 대한두경부종양학회지
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    • 제12권2호
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    • pp.206-211
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    • 1996
  • On 147 patients with early laryngeal cancer undertaken surgery or radiation therapy at Seoul National University Hospital from January 1987 through December 1994, retrospective analysis with reviewing the medical record was performed. The number of recurred cases was twenty six. The recurrence rate was higher in the cases with radiation therapy than in those with surgical therapy. And the recurrence rate was remarkable in the cases with T2 in supraglottic cancer and in those with T1 in glottic cancer. Of the patients undertaken surgery, recurrence rate was higher in the patients with laser operation than in those with other procedures. It was, however, lower in the patients with laryngofissure with cordectomy than in those with other surgical techniques. The overall three year disease free survival rate was 72 % in early laryngeal carcinoma.

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