• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.95-101
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• 1990

This is a case report of polyostotic fibrous dysplasia developed in the craniofacial region of 21 year old male patient, who had complained the buccolingual expansion of left mandibular body area, malocclusion and facial asymmetry. We could achieve satisfactory results by radical resection of the relatively well defined small lesion of mandible and by cosmetic bone shaving procedure on the widely dispersed and poorly defined lesions of cranium. But the persistent growth and recurrence of the lesions may produce loss of hearing, visual difficulties, facial paralysis and anosmia, and as it is a polyostotic type occured in the craniofacial region of male patient, the possibility of malignant degeneration should not be excluded completely and periodic recall and check up will be necessary.

• 대한두개안면성형외과학회지
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• 제20권5호
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• pp.310-313
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• 2019

Post-traumatic hematoma formation is a common complication of contusion. If the hematoma is large enough to aspirate or drain, it can be treated quickly and appropriately. However, if the hematoma is small or concealed by local swelling, it may be overlooked and left untreated. In most cases, a hematoma will resolve following conservative treatment; however, associated infection or muscle fibrosis can occur. Herein, we present the case of a patient with a chin deformity caused by a post-traumatic hematoma. The deformity was treated using botulinum toxin and triamcinolone acetonide injections as minimally invasive treatments. The course of treatment was good.

• The Journal of Korean Physical Therapy
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• 제4권1호
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• pp.19-25
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• 1992

The purposes of this study is to survey the clinical findings of congenital muscular torticollis. The subjects were 44 congenital muscular torticollis patients who were treated at physical therapy department of rehabilitation medicine, presbyterian medical center during the period Jan. Dec. 1991 The results were as follows : 1. Patients were evenly divided by gender(22 bodys, 22 girls). Left-sided involvement was found in 27 cases$(61.4\%)$, and right side in 17 cases$(38.6\%)$. 2. Abnormal delivery was 29 cases$(65.9\%)$. Those included resarean section, breech presentation with vaginal delivery and difficulty delivery. 3. Most of torticollis were primipara infant 33 cases$(75\%)$ 4. Associated congenital anomalies were noted in 12 cases, the most common cases were central co-ordination disturbance. 5. Patients was most commonly referred form the department of pediatrics. 6. Sternocleidomastoid fibrotic nodules were noted in 32 cases$(72.7\%)$. 7. Four cases had excision of the sternocleidomastoid fibrotic nodules in infancy and average at which operation was twelve months of life(range from nine months to fourteen months). 8. Facial asymmetry was noted in 13 cases at the begining of treatment, and the asymmetry was corrected after treatment in 10 cases. 9. The average duration of treatment was 3 months when the treatment was started in 3 weeks old. 10. The result was good in 22 cases$(50\%)$, fair in 12 Cases$(27.3\%)$.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.291-300
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• 2012

The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

• 대한두개안면성형외과학회지
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• 제20권1호
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• pp.3-9
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• 2019

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

• 대한두개안면성형외과학회지
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• 제14권2호
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• pp.119-123
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• 2013

Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.92-98
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• 2020

Background: Posttraumatic acquired facial deformities require surgical treatment, with options including scar revision, fat grafts, implant insertion, and flap coverage. However, each technique has specific advantages and disadvantages. Methods: From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressed scar) were treated using dermofat grafts from the groin. The harvested dermofat was then inserted into the undermined dead space after the contracture was released, and a bolster suture was done for fixation considering the patient's contour and asymmetry. A modified version of the Vancouver Scar Scale and satisfaction survey were used to compare deformity improvements before and after surgery. Results: In most cases, effective volume correction and an aesthetically satisfactory contour were maintained well after dermofat grafting, without any major complications. In some cases, however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated. A significant difference was found in the modified Vancouver Scar Scale before and after surgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20 points. Conclusion: A dermofat graft with the groin as the donor site can be considered as an effective surgical option that is the simplest and most cost-effective method for the treatment of acquired facial deformities with scar contracture.

• Journal of Acupuncture Research
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• 제31권2호
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• pp.51-63
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• 2014

Background or Objectives : The purpose of this study is to measure surface Electromyography(sEMG) of facial muscles in normal person and to find method for standardizing of sEMG's value. Methods : We measured 3points on face, frontalis muscle($GB_{14}$), zygomaticus muscle($SI_{18}$), orbicularis oris muscle($LI_{19}$) of 40 normal person by sEMG. 40 normal person consist with two groups, each 20 male, 20 female. Average age of subject was $26.50{\pm}4.79$. SEMG instrument QEMG-4 XL was used. After training exercise of facial muscles, sEMG's root mean square value was measured once. Results : 1. In whole experimental group, frontalis muscle's both side average was $78.36{\pm}40.87$, zygomaticus muscle's both side average was $84.70{\pm}49.81$, orbicularis oris's both side average was $104.83{\pm}38.81$. 2. Left side of Frontalis muscle, both side of zygomaticus muscle are high marked in male than female in statistically. 3. In whole experimental group, average of ratio comparing smaller value with bigger value in difference between left side and right side was $19.60{\pm}12.88$ %. 4. Average of asymmetry index(AI) was $11.46{\pm}8.36$ %. orbicularis oris muscle's average of AI had least difference was $8.95{\pm}7.50$ %. zygomaticus muscle's average of AI had most difference was $13.95{\pm}8.90$ %. Conclusions : The result of this study could provide useful information of field of sEMG is used in oriental medicine treatment of facial muscles. To assess efficacy of treatment in facial muscles, we need to standardize facial muscle's sEMG values by using AI, ratio comparing values and etc.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.373-381
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• 2021

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.221-224
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• 2009

Purpose: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications - mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. Materials: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular - maxillary fixations were removed after 3 weeks, and patients went into training for mouth opening. Results: The technique didn't result in complications - joint dysfunction, facial nerve injury, sore, infection and nonunion during follow - up period. Radiologic follow - up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. Conclusions: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.