• Title/Summary/Keyword: Mandible preservation

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A Case of Mandibulectomy with Partial Preservation of Mandible in Mucoepidermoid Carcinoma Invading Mandible (하악골을 침범한 점액표피양 암종에서 하악 일부를 보전한 변형적 하악 절제술 치험 1예)

  • Hwang Joon-Sik;Lim Young-Chang;Kim Jin-Hwan;Park Il-Suk;Rho Young-Su
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.223-226
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    • 2002
  • The segmental mandibulectomy should be performed, if mandiblie invasion is suspected clinically and radiologically. And if tumor is located to mandible very closely or when microinvasion to mandible is suspected, marginal mandibulectomy is recommended. But in segmental mandibulectomy, reconstruction is difficult and cosmetic problem remains. In this case, we performed modified segmental resection of mandible, preserving the inferior margin of mandible, and maintains the continuity of the bone, in mucoepidermoid carcinoma of parapharynx, invading mandible. We reviewed the diagnosis, pathology, and treatment, and report the case with reviews of literature.

Partial Mandibulectomy for Oral Cavity and Oropharyngeal Carcinoma (구강 및 구인두암의 수술에 있어서 하악골 부분절제술에 대한 고찰)

  • Choi Eun-Chang;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.163-170
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    • 1994
  • Segmental mandibulectomy causes severe functional disability and cosmetic problem. Many methods of reconstruction have been used but none of these procedures provides the ideal solution. There has been increased interest in the possibility of preserving a portion of the mandible and still carrying out a adequate tumor resection. We experienced four cases of marginal with sagittal mandibulectomy in patients with floor of mouth. buccal. and soft palate carcinoma, and sagittal mandibulectomy in 8 patients with tonsillar carcinoma and a case of marginal mandibulectomy in tonsillar cancer patient. In all cases mandible facing the tumor were successfully resected and repair of the mandible. postoperative facial contour were satisfactory. We think. that these sagittal procedures are oncologically sound in its removal of tumor. biomechanically secure and maximize postoperative rehabilitation while maintaining the normal contour of the face.

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Clinical Evaluation between Mandibulotomy and Mandible Sparing Approaches in Oropharyngeal Cancer Operation and Reconstruction (구인두암의 절제 및 재건수술에서 하악골 절개 접근법과 하악골 보존 접근법의 임상적 비교)

  • Kim, Jeong Tae;Lee, Jung Woo;Jo, Dong In;Lee, Hae Min
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.152-158
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    • 2008
  • Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.

OSTEOBLASTOMA OF THE MANDIBLE : A CASE REPORT (하악골에 발생한 골아세포종의 치험례)

  • Jeong, Se-Heon;Yoon, Hyun-Joong;Lee, Sang-Hwa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.6
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    • pp.649-652
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    • 2008
  • Osteoblastoma is a relatively rare benign bone tumor representing less than 1% of all bone tumors. The tumor usually involves the spine and sacrum of young individuals, less than 10% being localized to the skull, and nearly half of these affect the mandible, especially the posterior segments. In clinical finding, osteoblastoma present mainly with pain, swelling, and expansion of bone cortex. Radiographic appearances are variable, but frequently a well-delineated radiolucent lesion containing varying amounts of mineral deposits is seen. Histologically, ostoeblastoma is consists of irregular trabeculeae of osteoid and immature bone present within highly vascular connective tissue matrix. Osteoblastoma must be differentiated from a number of bone-producing lesions, including osteoid osteoma, fibrous dysplasia, ossifying fibroma, fibrous dysplasia, and osteosarcoma. If diagnosis may be mistaken for osteosarcoma, there are risks of more aggressive and irreversible treatment. Differential diagnosis of osteoblastoma is important. The preferred treatment of osteoblastoma is conservative approach and surgical excision. Recurrence following surgical intervention is rare. We treated osteoblastoma located in premolar area of mandible by excision with preservation of vital structure, such as nerves and teeth. So we report our clinical treatment with literature review

Bone remodeling of the fibula segment as a form of neocondyle after free vascularized bone transfer: a report of two cases

  • Han Ick Park;Hoon Je Chang;Jee-Ho Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.354-359
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    • 2023
  • The temporomandibular joint is a unique structure composed of the joint capsule, articular disc, mandibular condyles, glenoid fossa of the temporal bone, surrounding ligaments, and associated muscles. The condyle is one of the major components of a functional temporomandibular joint. Reconstruction of large mandibular defects involving the condyle is a surgical challenge for oral and maxillofacial surgeons. To restore large mandibular defects, there are different options for free flap method such as fibula, scapula, and iliac crest. Currently, the vascularized fibula free flap is the gold standard for reconstruction of complex mandibular defects involving the condyle. In the present report, neocondyle regeneration after mandible reconstruction including the condyle head with fibula free flap was evaluated. In this report, two patients were evaluated periodically, and remodeling of the distal end of the free fibula was observed in both cases after condylectomy or mandibulectomy. With preservation of the articular disc, trapezoidal shaping of the neocondyle, and elastic guidance of occlusion, neocondyle bone regeneration occured without ankylosis. Preservation of the articular disc and maintenance of proper occlusion are critical factors in regeneration of the neocondyle after mandible reconstruction.

APPLICATION OF RECONSTRUCTION PLATE USING SIMPLE CONDYLAR REPOSITIONING MINIPLATE AFTER SEGMENTAL RESECTION OF MANDIBLE (하악골 절제술후 간단한 과두재위치 소형금속판을 이용한 재건 금속판의 적용: 증례보고)

  • Kim, Young-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.3
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    • pp.231-233
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    • 2002
  • Temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can be used for the preservation of normal facial contour and oral function and for periodic follow up of recurrence. Reconstruction plates are adapted to the bone before the resection and provisionally fixated with some screws. Accurate contouring and adaptation are very important for the prevention of displacement of bony stumps and decubituous skin ulcer. However, if there is large expanding buccal tumor mass in mandible, it is very difficult or even impossible to contour the plate before resection. I, therefore, introduce the reconstruction plate application technique using a simple condylar repositioning miniplate after segmental mandibular resection.

A Case of an EXIT procedure for Airway management of fetus with Agnathia (하악결손증 태아에서 기도확보를 위해 시행한 EXIT 시술 1례)

  • Bong Jeong Pyo;Kim Yoo Jung;Yang Jong Won;Kim Jin Hyung;Kim Tae Hwan;Choi Seong Jin
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.32-36
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    • 2005
  • This study aimed to report a case of infant who presented with a prenatal ultrasound diagnosis of agnathia, polyhydramnios followed by a review of previous studies. As widely acknowledge, agnathia is a complex lethal malformation characterized by absent mandible, microstomia, microglossia and ear anomaly which are secondary results to a defect of the first branchial auh. Newborn infants with agnathia often suffer from airway obstruction, causing fatal respiratory failure. The most difficult part of treating those newborns is to keep the airway patent. Therefore, as early airway management planning as possible is the most important part. Airway management was achieved with tracheotomy through an ex utero intrapartum treatment procedure(EXIT). The case of this infant, reporting here, was underwent tracheotomy with preservation of uteroplacental blood flow and gas exchange.

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CRANIUM-ORIENTED MAXILA AND CONDYLE POSITIONING DEVICE (두개골에 기준을 둔 상악 및 과두 고정용 장치)

  • Lee, Won-Hak;Hong, Kwang-Jin;Lee, Jeong-Gu;Sohn, Hong-Bum;Cho, Yun-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.1
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    • pp.29-34
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    • 1999
  • Special attention should be directed toward the preservation of preoperative condylar position during orthognathic surgery because their positional change may leads to postoperative skeletal relapse as well as TM joint problem. Various condylar positioning devices, therefore, have been introduced and utilized in orthognathic surgery. Even though most of them provided us with improvement of surgical results, we also found some problems including limited indication, etc. For more accurately repositioning the maxilla and the mandible and its wide versatility, a newly designed maxilla and condylar positioning device based on the fixed part of cranium is introduced.

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Buccal nerve schwannoma mimicking a salivary gland tumor: a rare case report

  • Jeong-Kui Ku;Dawool Han;Jong-Ki Huh;Jae-Young Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.148-151
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    • 2023
  • Schwannomas are benign tumors originating from myelinating cells constituting nerve sheaths but rarely contain cellular elements of the nerve. The authors encountered a 47-year-old female patient with a schwannoma on the anterior mandibular ramus arising from the buccal nerve, measuring 3 cm×4 cm. Surgical resection was performed with preservation of the buccal nerve via microsurgical dissection. After one month, the sensory function of the buccal nerve was recovered without complications.

THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF MANDIBULAR STRESSES UNDER COMPLETE DENTURES WITH VARIANT ARTIFICIAL TEETH FORMS AND OCCLUSAL PATTERNS (총의치 교합면 형태가 하악골 응력 분포에 미치는 영향에 관한 삼차원 유한요소분석적 연구)

  • Lee Cheol-Gyu;Kim Chang-Whe;Kim Yung-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.3
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    • pp.351-384
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    • 1993
  • Complete denture occlusion must be developed to function efficiently and with the least amount of trauma to the supporting tissues. For the preservation of supporting tissues, it is imperative to reduce to a minimum the functional stress induced by dentures. The magnitude of the horizontal component of functional stress contributed by various occlusal teeth forms has not been studied. This study was aimed to investigate the influence of different occlusal teeth forms on the mode of distribution of the stresses in the mandibular tissue, and the displacement of lower dentures during the variant functional movement of mandible for this study three dimensional finite element analysis was used. FEM models were created using commercial software Super Sap for IBM 32 bit computer. The model was composed of 3380 brick elements and 4346 nodes. The results were as follows. 1. The magnitude of stress was similar between two models in centric occlusion, in the case of anatomic model, the stress was concentrated on the buccal side of alveolar ridge beneath the bicuspids. 2. During the protrusive movement, the increasing of stress from the posterior to anterior part of mandible was seen in the case of anatomic model. 3. During the lateral movement, the stress of anatomic model was greater than that of nonanatomic model. 4. The stress of anatomic model was concentrated on the anterior region of residual ridge during the lateral movement. 5. In the case of anatomic model the anterior part of denture was displaced severely at the centric and lateral position, but the denture of nonanatomic model was displaced minutely at the protrusive and lateral position.

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