• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권4호
• /
• pp.214-217
• /
• 2023

Objectives: This case series aims to introduce the nasal floor approach for extracting inverted mesiodens. Materials and Methods: Through a retrospective chart review between January 2022 and February 2023, we included the mesiodens patients using nasal floor approach, and analysis the location of mesiodens from the anterior nasal spine (ANS), total operation time, and complications. Results: Each mesiodens was located 10 to 12 mm from the ANS and was covered with a cortical layer of the nasal floor. All mesiodens were successfully extracted without exposing the adjacent incisors or nasopalatine nerve within 30 minutes from draping to postoperative dressing. Conclusion: The nasal floor approach is an efficient extraction method that reduces bone removal and prevents anatomical damage while removing the mesiodens just below the nasal floor bone.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제37권
• /
• pp.35.1-35.7
• /
• 2015

After cleft lip repair, many patients suffer from nasolabial fistulas, asymmetrical nasal floor, or an indistinct nostril sill, as well as intraoral wound dehiscence and subsequent scar contracture of surgical wounds leading to vestibular stenosis. For successful primary nasolabial repair of complete cleft deformity of the primary palate, cleft surgeons need special care in reconstructing the sound nasal floor. Especially when the cleft gap is wide or when any type of nasoalveolar molding therapy was not performed, three-dimensional reconstruction of the nasal floor is critical for a balanced nasal shape. In this study, the author describes an effective method for reconstructing a double-layered nasal floor using two mucosal flaps from both sides of the fissured upper lip. This is a report of six patients with unilateral or bilateral complete cleft of the primary palate with a detailed description of the surgical technique and a literature review.

• 치과방사선
• /
• 제19권1호
• /
• pp.25-29
• /
• 1989

The author has evaluated the panoramic image clarity of the midfacial anatomic structures in dry skull according to the skull position. The radiopaque markers were attached to the anatomic structures: infraorbial rim, upper and lower borders of zygomatic arch, pterygomaxillary fissure, lateral pterygoid plate, pyriform aperture of nasal cavity, lateral wall of maxilla, orbital floor, infraorbital foramen, and nasal floor. Position of the skull were divided into four groups. standard, 25mm forward, chin-down, chin-up position. The results were as follows: 1. The pyriform aperture of nasal cavity, lateral wall of the maxilla, orbital floor, infraorbital foramen and nasal floor did net cast any discernible image. 2. Nearly all images of midfacial structures were blurred in the chin-up position. 3. The forward position provided good visualization of the maxillary sinus. 4. The chin-down position provided good visualization of the zygomatic arch, pterygomaxillary fissue, and lateral pterygoid plate.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제34권5호
• /
• pp.326-331
• /
• 2012

Purpose: Length measurement from maxillary anterior teeth root tip to nasal floor is incorrect in panoramic radiography. Comparison of cone beam computed tomography (CBCT) and panoramic radiography should be helpful in determining the vertical length. Methods: Sixty nine patients were taken CBCT and panoramic radiography of the maxillary anterior. First measurement is length of parallel lines from the central incisor and lateral incisor root tip to nasal floor on CBCT. Second measurement is length of perpendicular lines from the central incisor and lateral incisor root tip to nasal floor on CBCT. Third measurement is length from the central incisor and lateral incisor root tip to nasal floor on panoramic radiographys. Results: In the first measurement of the maxillary central incisors, an average of $11.36{\pm}2.49$ mm in males and $10.49{\pm}2.17$ mm in females. In the second measurement of the maxillary central incisors, $10.41{\pm}2.42$ mm in males and $9.18{\pm}2.08$ mm in females. In the third measurement of the maxillary central incisors, $10.71{\pm}2.20$ mm in males and $9.27{\pm}2.10$ mm in females. In the first measurement of the maxillary lateral incisors, an average of $13.40{\pm}2.04$ mm in males and $11.96{\pm}2.20$ mm in females. In the second measurement of the maxillary lateral incisors, $11.25{\pm}1.82$ mm in males and $10.06{\pm}1.68$ mm in females. In the third measurement of the maxillary lateral incisors, $11.47{\pm}2.01$ mm in males and $10.13{\pm}1.70$ mm in females. Conclusion: The vertical length from root tip to nasal floor was longer in male than female (P>0.05). First measurement was longer than third measurement (P<0.05). This is the actual placement of the implant site measured on the vertical length than the length of the panorama means that there are a few more free. The first measurement was longer than 114% over the third measurement.

• 대한구순구개열학회지
• /
• 제3권2호
• /
• pp.41-50
• /
• 2000

The alar base on the cleft side in unilateral complete cleft lip, alveolus and palate is markedly displaced laterally, caudally and dorsally, By incising the pyriform margin from the cleft margin of the alveolar process, including mucosa of the anterior part of the inferior turbinate, to the upper end of the postnasal vestibular fold, the alar base is released from the maxilla, A physiological correction of nasal deformity can be accomplished by careful reconstruction of nasolabial muscle integrity, functional repair of the orbicular muscle, raising and rotating the displaced alar cartilage, and finally by lining the lateral nasal vestibule, The inferior maxillary head of the nasal muscle complex is identified as the deeper muscle just below the web of the nostril, The muscle is repositioned inframedially, so that it is sutured to the periosteum that overlies the facial aspect of the premaxilla in the region of the developing lateral incisor tooth, And then, the deep superior part of the orbicular muscle is sutured to the periosteum and the fibrous tissue at the base of the septum, just in front of the anterior nasal spine, The nasal floor is surgically created by insertions of the nasal muscle complex in deep plane and of the orbicular muscle in superficial one, The upper part of the lateral nasal vestibular defect is sutured by shifting the alar flap cephalically, The middle and lower parts of this defect are closed by use of cleft margin flaps of the philtral and lateral segments, respectively, Authors stress the importance of nasal floor reconstruction at primary surgery and report the technique and postoperative results.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제38권
• /
• pp.21.1-21.6
• /
• 2016

Background: The Le Fort I osteotomy is one of the most widely used and useful procedure to correct the dentofacial deformities of the midface. The changes of the maxilla position affect to overlying soft tissue including the nasal structure. Postoperative nasal septum deviation is a rare and unpredicted outcome after the surgery. There are only a few reports reporting the management of this complication. Case Presentation: In our department, three cases of the postoperative nasal septum deviation after the Le Fort I osteotomy had been experienced. Via limited intraoral circumvestibular incision, anterior maxilla, the nasal floor, and the anterior aspect of the septum were exposed. The cartilaginous part of the nasal septum was resected and repositioned to the midline and the anterior nasal spine was recontoured. Alar cinch suture performed again to prevent the sides of nostrils from flaring outwards. After the procedure, nasal septum deviation was corrected and the esthetic outcomes were favorable. Conclusion: Careful extubation, intraoperative management of nasal septum, and meticulous examination of preexisting nasal septum deviation is important to avoid postoperative nasal septum deviation. If it existed after the maxillary osteotomy, septum repositioning technique of the current report can successfully correct the postoperative septal deviation.

• 치과방사선
• /
• 제14권1호
• /
• pp.17-26
• /
• 1984

The purpose of this study was radiographic analysis of the morphology of maxillary sinus in adolescents and adults. In order to analize the morphology of maxillary sinus in view point of anteroposterior width of medial wall, vertical distance between antral floor and nasal floor level, anterior extension, distance between antral floor and maxillary 1st molar apex, and types of lower border of maxillary sinus, specialized maxillary projection and periapical view with paralleling technique was taken. The author examined orthopantomograms and intraoral standard views taken from 400 adolescents and adults ranged 15-65 year-old. The obtained results were as follows: 1. The antero-posterior width of medial wall of maxillary sinus was 32.80mm in 15-19 year-old group, 33.86㎜ in 20-24 year-old group, 34.09㎜ in 25-29 year-old group, and 33.67㎜ in 30-65 year-old group, and the left maxillary sinus was somewhat smaller than the right. 2. The vertical distance between antral floor and nasal floor level was 8.49㎜ in 15-19 year-old group, 9.05㎜ in 20-24 year-old group, 8.95㎜ in 25-29 year-old group, and 8.32㎜ in 30-65 year-old group. 3. The order of anterior extension of maxillary sinus were distal half of canine, mesial half of canine, mesial half of 1st premolar, and distal half of 1st premolar. 4. The distance between antral floor and maxillary 1st molar were 4.36㎜ in 15-19 year-old group, 4.77㎜ in 20-24 year-old group, 3.58㎜ in 25-29 year-old group, and 2.33㎜ in 30-65 year-old group. 5. The order of the types of lower border of maxillary sinus were entire downward type, close type, partially downward type, waving type, separating type, and indistinct. In the types of antral floor, there was a tendency to increase the seperating type with age.

• Archives of Plastic Surgery
• /
• 제34권1호
• /
• pp.18-23
• /
• 2007

Purpose: Anthropometry can be divided into two methods, direct anthropometry and indirect anthropometry. The most ideal and accurate method is a direct anthropometry. However, it is difficult to measure in the case of children because of poor cooperation, and it lacks re-productivity. Cast model has advantages of three dimensional featuring, inexpensive and easy fabrication. This study is conducted to find out an accuracy of indirect anthropometry on cast model by comparing it with direct anthropometry. Methods: Total 48 cleft lip nasal deformity patients (unilateral, 40; bilateral, 8) were included in this study. Cast models were made before surgery under general anesthesia with alginate impression material and model plaster. Eleven linear measurements among 7 landmarks were taken as direct anthropometry before surgery with Castroviejo spreading caliper. At the same time, indirect anthropometry on cast model was done at the same linear distances as well. Results: Of the total 11 linear measurements, both ala lengths, both columella lengths, nose width, projective distance between facial insertion points of the ala, projective distance between the alar base points, right nostril floor width, and columella width were statistically correlated between indirect anthropometry on cast model and direct anthropometry. However, the nasal tip protrusion and the left nostril floor width were not statistically correlated. Conclusion: Accuracy of indirect anthropometry on cast model can be influenced by cast model fabrication techniques and correct identification of landmarks. Nasal tip protrusion could be reduced by compression of the nasal tip in the process of cast model fabrication and nostril floor width can be varied by muscle relaxation of anesthetics and incorrect identification of subalare in cleft lip nasal deformity. If sufficient care is taken to make cast model and to define landmarks exactly, indirect anthropometry on cast model can be a reliable method as direct anthropometry.

• Imaging Science in Dentistry
• /
• 제34권1호
• /
• pp.49-54
• /
• 2004

Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. A 56-year-old patient who complained of delayed healing after extraction of upper left central incisor visited our department. The conventional radiographs showed a bony destructive lesion with ill-defined margin and moth-eaten appearance. On the computed tomographic images, the lesion perforated the labial cortex of alveloar bone, elevated the left nasal floor superiorly, and perforated partially both nasal floor. The magnetic resonance images showed low signal intensity at T2 and Tl weighted images at the area and adjacent soft tissue. Histologically, there were irregular epithelial islands with cell atypia, nuclear hyperchromatism, pleomorphism, atypical mitosis. The final diagnosis was PIOC.

• 대한두개안면성형외과학회지
• /
• 제22권2호
• /
• pp.85-92
• /
• 2021

Background: Patients with secondary deformities associated with unilateral cleft lip and nose might also suffer from nostril stenosis due to a lack of tissue volume in the nostril on the cleft side. Here, we used full-thickness skin grafts (FTSGs) to reduce nostril stenosis and various methods for skin volume augmentation. We compared the changes in the symmetry of both nostrils before and after surgery. Methods: From February 2016 to January 2020, 34 patients underwent secondary cheiloplasty and open rhinoplasty for secondary deformities of the unilateral cleft lip and nose with nostril stenosis. FTSG was used on the nostril floor, nasal columella, and alar inner lining. The measured nasal profile included the nostril surface, nostril circumference, width of the nostril floor, and distance from the alar-facial groove to the nasal tip. The "overlap area," which was defined as the largest overlapping area when the image of the cleft nostril was flipped to the left and right and overlaid on the image of the normal side nostril, was also calculated. The degree of symmetry was evaluated by dividing the value of the cleft side by that of the normal side of each measured profile and expressed as "ratios." Results: The results of all profile ratios, except for the nostril floor width, became significantly close to 1, which represents full symmetry. The overlap area ratio improved from 62.7% to 77.3%, meaning that the length and width of the nostril as well as the overall shape became similar (p< 0.05). Conclusion: When performing cleft rhinoplasty with nostril stenosis, FTSG is useful to achieve symmetry in the nostril size and shape. Skin grafting is simpler to perform than the other types of local flap, and the results are generally satisfactory.