• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.146-156
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• 1998

저자들은 1997년 1월부터 1998년 7월까지 두경부 악성종양 및 반안면왜소증과 같은 선천성 안면기형을 주소로 본원에 내원하였던 환자 9명을 대상으로 하여 9례의 외측대퇴 유리피판술을 시행하여 다음과 같은 결과를 얻을 수 있었다. 첫째, 두경부 재건에 있어서 외측대퇴 유리피판은 다른 유리피판술에 비해 여러 장점을 가지고 있었다. 특히, 공여부 추형이 노출되지 않는 부위이며 동시에 두팀이 수술에 참여할 수 있어서 수술시간이 단축될 수 있었다. 둘째, 술후 방사선치료를 시행하면 피판의 모발은 사라지지만 모공의 과각화증 및 색조 침착이 증가하므로, 외측대퇴부에 모발이 많은 환자는 술후 방사선치료의 여부와 관계없이 미용적인 금기사항에 해당한다. 셋째, 악성종양 절제후에 발생하는 결손의 재건시 피판의 두께가 문제시 되지 않았으며, 피판의 두께는 피판을 도안할 때의 위치, 성(sex), 피하지방층의 제거정도, 근육의 포함 정도, 술 후 피판의 위축정도에 따라 조절 가능하였다. 넷째, 모든 증례에서 정맥이식없이 혈관문합이 가능하였으므로 두경부 재건시 혈관경의 길이는 충분한 것으로 사료된다. 다섯째, 가능한 피판을 장축으로 길게 도안하여 두 번째 또는 네 번째 관통동맥을 포함시켜 수술 후 발생할지도 모르는 혈류부전에 대비하는 것도 피판의 생존률을 높이는 좋은 방법으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.15.1-15.5
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• 2019

Background: Actinic cheilitis (AC) is a variant of actinic keratosis which is known to be a premalignant condition that could develop into squamous cell carcinoma (SCC). Epimyoepithelial carcinoma (EC) is a very rare salivary gland (SG) neoplasm that has classical biphasic histologic findings of small tubules and glandular lumina surrounded by clear myoepithelial cells. Case presentation: We report a very rare case of AC occurring on the lower lip of a 70-year-old woman, which is developing to the EC later. Conclusions: Diverse appearances of AC include edematous reddish in the acute stage and grey-whitish or dried hyperkeratotic wrinkled lesions in the chronic stage for several months or even years. Accurate treatment of AC in its initial stage could be recommended to avoid further malignant transformation; proper management of clinically suspicious AC is suggested.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.13.1-13.11
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• 2019

Background: Maxillary sinusitis of odontogenic origin, also known as maxillary sinusitis of dental origin or odontogenic maxillary sinusitis (OMS), is a common disease in dental, otorhinolaryngologic, allergic, general, and maxillofacial contexts. Despite being a well-known disease entity, many cases are referred to otorhinolaryngologists by both doctors and dentists. Thus, early detection and initial diagnosis often fail to detect its odontogenic origin. Main body: We searched recent databases including MEDLINE (PubMed), Embase, and the Cochrane Library using keyword combinations of "odontogenic," "odontogenic infection," "dental origin," "tooth origin," "sinusitis," "maxillary sinus," "maxillary sinusitis," "odontogenic maxillary sinusitis," "Caldwell Luc Procedure (CLP)," "rhinosinusitis," "functional endoscopic sinus surgery (FESS)," "modified endoscopy-assisted maxillary sinus surgery (MESS)," and "paranasal sinus." Aside from the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) trial, there have been very few randomized controlled trials examining OMS. We summarized the resulting data based on our diverse clinical experiences. Conclusion: To promote the most efficient and accurate management of OMS, this article summarizes the clinical features of rhinosinusitis compared with OMS and the pathogenesis, microbiology, diagnosis, and results of prompt consolidated management of OMS that prevent anticipated complications. The true origin of odontogenic infections is also reviewed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권6호
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• pp.327-336
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• 2016

Cervical cancer is the second most prevalent cancer among women, and it arises from cells that originate in the cervix uteri. Among several causes of cervical malignancies, infection with some types of human papilloma virus (HPV) is well known to be the greatest cervical cancer risk factor. Over 150 subtypes of HPV have been identified; more than 40 types of HPVs are typically transmitted through sexual contact and infect the anogenital region and oral cavity. The recently introduced vaccine for HPV infection is effective against certain subtypes of HPV that are associated with cervical cancer, genital warts, and some less common cancers, including oropharyngeal cancer. Two HPV vaccines, quadrivalent and bivalent types that use virus-like particles (VLPs), are currently used in the medical commercial market. While the value of HPV vaccination for oral cancer prevention is still controversial, some evidence supports the possibility that HPV vaccination may be effective in reducing the incidence of oral cancer. This paper reviews HPV-related pathogenesis in cancer, covering HPV structure and classification, trends in worldwide applications of HPV vaccines, effectiveness and complications of HPV vaccination, and the relationship of HPV with oral cancer prevalence.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.18-23
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• 2005

Purpose: To report the results and the efficacy of the sensory bearing scapular free flap which is known as non-sensible flap. Materials and Methods: Authors underwent 24 cases of sensory bearing scapular free flap to the hands and feet from March 1995 to November 2002. average follow-up period was six year three months. The used flaps were a ordinary scapular flap in fifteen cases, and a parascapular flap in nine. Sensibility of the flaps were checked every one month. Actual sensory evaluation was mostly depends on objective feeling of the patients. Two point discrimination test was performed in all cases. Results: 23 flaps had good skin circulation after microvascular anastomosis among 24. Objective deep touch sensation were observed about three months later after the operation in three cases, between three and six months in nine. In three case whose results were excellent than others, two point discrimination was 2.7 cm at last follow-up. Most of the sensory recovery is confined in deep touch, temperature and light touch sensation was recovered limitedly in 3 cases during our follow-up period. Conclusion: Authors can propose that sensory bearing free scapular flap was considered as one of useful methods for the reconstruction to hand with soft tissue defect and mutilating hand.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.80-87
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• 2000

Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.129-134
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• 1998

The ability for tissue transfer based on microvascular anastomosis has created a revolution in microsurgical free tissue transplantation. The advantages of cutaneous flaps are that they are soft, durable and provide a good cosmetic reconstruction and muscle flaps have a more vigorous blood supply and a longer, larger vascular pedicle than cutaneous flaps. From June 1992 through May 1997, 68 patients had received reconstructive microsurgery in the lower extremity at Department of Orthopedic Surgery, Chonbuk National University Hospital. The results were as follows. 1. The age distribution was from 15 years of age to 67 and male were 59 cases and female 9 cases. 2. The most common cause was traffic accident(54 cases, 79.4%) and followed chronic osteomyelitis(9 cases, 13.2%), industrial accident(3 cases, 4.4%), burn(1 case, 1.5%) and farm injury(1 case, 1.5%). 3. Latissimus dorsi myocutaneous flap were 25 cases(36.8%), rectus abdominis muscle flap 21 cases(30.9%), gracilis muscle flap 10 cases(14.7%), dorsalis pedis flap 9 cases(13.2%), groin 2(2.9%) and vascularized iliac osteocutaneous flap 1(1.5%). 4. 61 cases(89.7%) of 68 cases were survived and the exposed vital tissues and bones were covered and revealed good cosmetic results.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.263-267
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• 2006

In both cosmetic and functional aspects, loss of digital pulp is a common problem. Compound or composite defects of the hand and fingers with exposed denuded tendon, bone, joint, or neurovascular structures may require flap coverage. Most often these lesions can be repaired by using simple local flap, neurovascular flap, thenar flap, and cross-finger flap. But microvascular reconstruction is sometimes needed for large defects. But Authors do not recommend these procedures in case of severe crushing injuries involving multiple finger pulp losses because they have possibility of damage of the vascular network and infection. So we applied distant flaps such as chest flaps, groin flaps, abdominal flaps and etc. And then we applied surgical rubber gloves for remodeling the flap after cutaneous healing. We have acquired satisfactory results, after the simple molding method for distant flap finger by using surgical rubber gloves treatment.

• Journal of Chest Surgery
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• 제29권12호
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• pp.1392-1397
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• 1996

지난 2년동안 식도암 환자 6례, 식도협착 환자 1례에서 식도절제술후 유리공장 이식수술을 시행하였다. 환자들은 부분 식도절제술과 함께 기능적 경부청소술 또는 종격동 임파절 절개을 시행하였다. 유리공장이식술은 대개 경부식도 질환에서 경부혈관을 이용하여 시행되어 왔으나, 저자들은 늑간동정맥을 이용하여 3례 에서 공장이식을 하였다. 수술후유증은 이식괴사 1례, 문합부 누출 1례 였다. 유리공장이식술은7명의 환자중6명의 환자에서 성공하였가. 늑간동정 맥을 이용하면 흉부 식도 질환에서도 유리공장이식술을 할수 있으며, 5명의 환자는 현재 추적관찰 중이다.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.41-46
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• 1998

Microvascular free tissue transfer technique is widely accepted for reconstruction of extensive soft tissue defects on the extremities. The system of flap based on the subscapular artery and vein provides the widest ways of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flaps, the serratus anterior and latissimus dorsi muscular flaps, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available to mutiple tissue defects or complex defects because it can incorporated with skin, muscle and bone flaps. A strikig advantage is the independent vascular pedicles of each components, which allow freedom in orientation of each components. So, it can be freely applied to any forms of three demensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in seven patients to reconstruct massive deefcts on the extremities. There was no flap failure and little complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed.