• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.1.1-1.6
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• 2015

The restoration of extensive zygomatic complex defects is a surgical challenge owing to the difficulty of accurately restoring the normal anatomy, symmetry, proper facial projection and facial width. In the present study, an extensive post-traumatic zygomatic bone defect was reconstructed using a custom-made implant that was made with a selective laser melting (SLM) technique. The computer-designed implant had the proper geometry and fit perfectly into the defect without requiring any intraoperative adjustments. A one-year follow-up revealed a stable outcome with no complications.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.243-246
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• 2011

A 43-year-old woman was diagnosed with an intravenous leiomyomatosis at a previous hospital and transferred to our hospital to undergo surgical treatment. Emergency one-stage operation for coincidental removal of intra-abdominal, right atrial, and intravenous masses were planned. Upon arriving at the operating room, she suffered a sudden onset of severe dyspnea and showed hemodynamic instability. Intraoperative TEE showed pulmonary embolization of a right atrial mass. Removal of the pulmonary artery mass and the intra-abdominal mass, and the cardiopulmonary bypass were performed without any complications.

• Journal of Chest Surgery
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• v.25 no.2
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• pp.158-166
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• 1992

From 1985 to 1990, a total of 160 new valves were implanted for 125 adult patients to whom prosthetic valve replacement had been performed [One patient had consecutive 2 reoperations]. Following data are the results from the follow-up study from January 1985 to February 1991. Mean age of the patients was 37.9$\pm$12.1 years. Mean follow-up period was 25.8$\pm$18.8 months. In bioprosthesis, mean interval between the previous operation and reoperation was 85.6$\pm$36.4 months in aortic valve, and 87.3$\pm$30.0 months in mitral valve. The causes of reoperation were prosthetic valve failure[103 patients, 81.7%], prosthetic valve endocarditis[17 patients, 13.5%], periprosthetic leakage[5 patients, 4.0%], and aneurysm of ascending aorta[1 patient, 0.8%]. Fourteen patients[11.1%] died in hospital; 5 in 22 replacement of aortic valve[22.7%], 6 in 73 rereplacement of mitral valve[8.2%], and 3 in 31 replacement of multiple valves [9.7%] Except for 3 intraoperative deaths, postoperative, major and minor complications occurred in 39 patients[31.0%]. And the actuarial 5-year survival rate of operative survivors was 95.5$\pm$8.6%.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.725-731
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• 1991

Four patients with traumatic rupture of aorta underwent operative repair at Seoul national university hospital. All cases were confirmed by preoperative aortography. Rupture site was aortic isthmus or just distal to it. Operations were somewhat delayed due to the low degree of suspicion and difficulties in diagnosis: ranging from 5 hours to 8 days. Operation was performed as same manners in all cases: resection of the ruptured portion and tubular woven dacron graft interposition in conjunction with shunt or bypass procedures, TDMAC-Heparin shunt between ascending and descending aorta was used in 3 cases, and LA-femoral centrifugal pump was used in one case. There were no intraoperative or postoperative mortality. Hoarseness was developed in all patients but paraplegia or other significant complications were not found in any of patients. We concluded that 1] high degree of suspicion is essential in the early diagnosis and treatment of traumatic aortic rupture and 2] any kind of shunt or bypass procedure is necessary in operative repair of traumatic aortic rupture and use of centrifugal pump without systemic heparinization is easier and safer procedure than others for the maintenance of adequate distal flow.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.154-157
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• 2021

Tracheobronchial injury (TBI) is an uncommon but potentially fatal event. Iatrogenic lesions during bronchoscopy, endotracheal intubation, or thoracic surgery are considered the most common causes of TBI. When TBI is detected during surgery, concomitant surgical treatment is recommended. Herein we present a case of successful robotic primary repair of iatrogenic tracheal and left bronchial branch tears during a robot-assisted hybrid 3-stage esophagectomy after neoadjuvant chemoradiotherapy. A robotic approach can facilitate the repair of this injury while reducing both the potential risk of conversion to open surgery and the associated increased risk of postoperative respiratory complications.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.253-257
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• 2022

The free fibula flap (FFF) is based on the peroneal artery (PA) system, and it is well known that several anatomical variations of the lower limb vascular system exist, including peronea arteria magna (PAM). PAM is a rare congenital variation in which both anterior tibial artery and posterior tibial artery are either aplastic or hypoplastic, and as a result, PA will be the dominant blood supply to the foot. This variation was described as type III-C in Kim-Lippert's Classification of the Infra-Popliteal Arterial Branching Variations. The awareness of its existence is crucial as it often precludes FFF from being harvested due to the risk of significant limb ischemia and limb loss. Despite some literature reporting donor site complications and impending limb loss following FFF harvest in PAM, preoperative vascular mapping before FFF transfer remains controversial among the microsurgeons. We present a case with an incidental intraoperative finding of PAM that had a successful FFF harvest by luck, without preoperative vascular mapping.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.111-116
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• 2022

Retropharyngeal schwannoma is rare. To the best of our knowledge, only 18 cases have been published in the English literature. Complete surgical excision is the treatment of choice for schwannomas. Transoral approaches have been applied for smaller lesions, and external cervical approaches are preferred for larger and more complex lesions. In this report, we present a case of large retropharyngeal schwannoma that was excised using an endoscopic-assisted transoral approach with palatal splitting. Postoperative functional and oncologic outcomes were satisfactory with no reported intraoperative/postoperative complications.

• Journal of Korean Foot and Ankle Society
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• v.27 no.1
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• pp.1-6
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• 2023

Displaced intra-articular calcaneal fractures are difficult to treat because of complex anatomy and high soft tissue complications. Various surgical approaches have been introduced to solve these problems, but the treatment remains complex. Recently, clinically and radiographically superior results were reported using a subtalar arthroscopy in reducing the posterior facet in both percutaneous and open approaches. In the percutaneous approach, the arthroscopically assistant percutaneous approach must be selected carefully for mild-to-moderately displaced fractures because of the limited view. In the open approach, there is little evidence of the utility of subtalar arthroscopy. Therefore, intraoperative arthroscopy should always be used in conjunction with fluoroscopy to achieve reduction and assess the internal fixation placement.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.407-412
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• 2017

Background Among the various signs and symptoms of orbital fractures, certain clinical findings warrant immediate surgical exploration, including gaze restriction, computed tomographic (CT) evidence of entrapment, and prolonged oculocardiac reflex. Despite proper surgical reconstruction, prolonged complications such as diplopia and gaze restriction can occur. This article evaluated the prognostic factors associated with prolonged complications of orbital fractures with muscle incarceration. Methods The medical records of 37 patients (37 orbits) with an orbital fracture with muscle incarceration from January 2001 to January 2015 were reviewed. The presence of Incarcerated muscle was confirmed via CT, as well as by intraoperative findings. Various factors potentially contributing to complications lasting for over 1 year after the injury were categorized and analyzed, including age, cause of injury, injury-to-operation time, operative time, fracture type, nausea, vomiting and other concomitant symptoms and injuries. Results All patients who presented with extraocular muscle limitations, positive CT findings, and/or a positive forced duction test underwent surgery. Of the 37 patients, 9 (24%) exhibited lasting complications, such as diplopia and gaze restriction. The mean follow-up period was 18.4 months (range, 1-108 months), while that of patients who experienced prolonged complications was 30.1 months (range, 13-36 months). Two factors were significantly associated with prolonged complications: injury-to-operation time and nausea/vomiting. Loss of vision, worsening of motility, and implant complication did not occur. Conclusions Patients who present with gaze limitations, with or without other signs of a blow-out fracture, require a thorough evaluation and emergent surgery. A better prognosis is expected with a shorter injury-to-operation time and lack of nausea and vomiting at the initial presentation.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.753-758
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• 2007

Purpose: Penoscrotal extramammary Paget's disease is a rare cutaneous malignancy that primarily affects the elderly. To prevent local recurrence, adequate surgical excision with its intraoperative frozen section, proper reconstruction, and careful follow-ups are required. The present study describes the treatment of patients with penoscrotal extramammary Paget's disease, focusing on the reconstruction after the ablation of lesion. Methods: Nine patients were selected who had undergone a local pedicle flap procedure due to the large defects after ablation of extramammary Paget's disease of the penoscrotal area, during the period of 1999 to 2005. Wide excision combined with intraoperative frozen sectioning was performed, and the penoscrotal wound was reconstructed with a local skin flap. Three flaps were chosen depending on the size of the defect. If the defect size was small and the scrotal tissue was adequate, scrotal flap(n=5) was enough for its reconstruction. However, as there were large defects with insufficient remnant scrotal tissue, a groin flap(n=2) or an anterolateral thigh flap(n=2) were performed. Results: There were no complications with the postoperative wound. Furthermore, no local recurrence was noted during two to six years of follow-up period (mean average 3.7 years). Conclusion: For the resurfacing the penoscrotum at large defects after ablation of extramammary Paget's disease, we performed reconstruction with a local flap. In the aspect of both function and cosmetic concerns, the results were satisfactory.