• Journal of The Korean Dental Society of Anesthesiology
• /
• v.14 no.4
• /
• pp.227-232
• /
• 2014

The indication for submandibular intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasotracheal intubation. Thus, We reported 2 cased of endotracheal intubations via submandibular approach that is applicable in patients with skull base fractures for a reliable general anesthesia. Endotracheal intubation via submandibular approach was applied during general anesthetic procedures for open reduction in three patients with Le Fort II, III or nasoorbitoethmoid (NOE) fractures. No complications due to submandibular intubation, such as infection, postoperative scarring, nerve injury, hematoma, bleeding, or orocutaneous fistula, were observed following submandibular intubation. Endotracheal intubation via submandibular approach is effective in patients with skull base fractures. In our method, the tube connector is removed in orotracheal intubation in order to avoiding the tube removal or displacement. The advantages of this method are very simple, safe, and to provide the good operation field.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.50 no.3
• /
• pp.166-169
• /
• 2024

Ankylosis of the temporomandibular joint (TMJ) is a condition in which the mandibular condyle fuses with the mandibular fossa through fibrous or bone tissue. It is a debilitating pathology that interferes with chewing, speaking, and oral hygiene. Currently, alloplastic reconstruction is considered the gold standard for treating severely compromised TMJs, such as in ankylosis. The article describes a patient with a history of facial trauma, with bilateral ankylosis of the TMJs, inability to open his mouth, and poor dental condition. Due to a long period of immobilization of approximately 40 years, the initial treatment plan was to remove the ankylosis bilaterally and install customized PMMA (polymethylmethacrylate) spacers. The patient gained mouth opening and improved chewing quality with one year of customized spacer use prior to definitive alloplastic replacement with stock-type TMJ prostheses. Customized joint spacers are a provisional treatment option when definitive alloplastic reconstruction is not indicated. Spacers provide the patient with progressive jaw function and mobility gains.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.2
• /
• pp.116-120
• /
• 2012

The buccal fat pad is specialized fat tissue located anterior to the masseter muscle and deep to the buccinator muscle. Possessing a central body and four processes it provides separation allowing gliding motion between muscles, protects the neurovascular bundles from injuries, and maintains facial convexity. Because of its many advantageous functions, the use of the buccal fat pad during oral and maxillofacial procedures is promoted for the reconstruction of defects secondary to tumor resection, and those defects resulting from oroantral fistula caused by dento-alveolar surgery or trauma. We used the pedicled buccal fat pad in the reconstruction of intraoral defects such as oroantral fistula, maxillary posterior bone loss, or defects resulting from tumor resection. Epithelization of the fat tissue began 1 week after the surgery and demonstrated stable healing without complications over a long-term period. Thus, we highly recommend the use of this procedure.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.2
• /
• pp.148-154
• /
• 2012

Peripheral nerve injuries in the oral and maxillofacial regions require nerve repairs for the recovery of sensory and/or motor functions. Primary indications for the peripheral nerve grafts are injuries or continuity defects due to trauma, pathologic conditions, ablation surgery, or other diseases, that cannot regain normal functions without surgical interventions, including microneurosurgery. For the autogenous nerve graft, sural nerve and greater auricular nerve are the most common donor nerves in the oral and maxillofacial regions. The sural nerve has been widely used for this purpose, due to the ease of harvest, available nerve graft up to 30 to 40 cm in length, high fascicular density, a width of 1.5 to 3.0 mm, which is similar to that of the trigeminal nerve, and minimal branching and donor sity morbidity. Many different surgical techniques have been designed for the sural nerve harvesting, such as a single longitudinal incision, multiple stair-step incisions, use of nerve extractor or tendon stripper, and endoscopic approach. For a better understanding of the sural nerve graft and in avoiding of uneventful complications during these procedures as an oral and maxillofacial surgeon, the related surgical anatomies with their harvesting tips are summarized in this review article.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.4
• /
• pp.345-348
• /
• 2004

Cephalic tetanus is a rare subtype of tetanus in which trismus is a charateristic symptom. The paralysis of one or more cranial nerves can occur. The 7th cranial nerve is most frequently involved. It account for 1 to 3% of the tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of tetanus cases progress to generalized tetanus. Generally, the symptoms of cephalic tetanus can include : facial pain, trismus, dysphagia, muscle twitching spasms of the face and jaw (risus sardonicus), neck stiffness and malaise. We present a case of cephalic tetanus who 54-year male patient had trismus and dysphagia. There was no history of trauma. As there was a delay in diagnosis of cephalic tetanus, respiratory disorder and intermittent general spasm occurred. The patient was treated by injection of antibiotics, muscle relaxant, and human anti-tetanus immunoglobulin. His symptoms were disappeared, and he was discharged ambulatory.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.40 no.3
• /
• pp.135-139
• /
• 2014

This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.3
• /
• pp.265-269
• /
• 2010

Radiation therapy for malignancy of head and neck leads to secondary effects, such as mucositis, xerostomia, dental caries and osteoradionecrosis. Osteoradionecrosis is a delayed complication which causes chronic pain, infection and constant deformity after necrosis. It occurs spontaneously or after primary oncologic surgery, dental extraction or by trauma of prosthesis. To reduce the incidence of osteoradionecrosis, appropriate antibiotic usage, atraumic procedure, tension-free primary suture and hyperbaric oxygen therapy are essential. This case is about a 74 years old woman who was treated for osteoradionecrosis after extraction of right lower molar at year 2006. She had received radiation therapy for angiosarcoma on tongue at year 2004. At year 2008 the patient came to our hospital for extraction of the opposite premolar but despite careful treatment, osteoradionecrosis occurred again. She was successfully treated by surgical procedure so we report this case.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.2
• /
• pp.197-203
• /
• 2000

Maxillary defect may be induced by trauma, inflammation, cyst, tumor and surgical procedure. In case of limited wall defect, free bone graft has been preferred. But it has some problems such as postoperative bone resorption and soft tissue inclusion to recipient site. And we can not use free bone in the case who has inflammation in the donor site. So we used the micro-titanium mesh as reconstructive material for the maxillary wall defect. We had operated 8 patients who were diagnosed as maxillary partial defects from June 1997 to September 1998 in the Chin-Hae military hospital. They were 1 case of antral wall defect, 1 case of palatal wall defect, 5 cases of infra-orbital wall defects and 1 case of oroantral fistula case. As a result, the micro-titanium mesh has shown the morphological stability and biocompatibility and it could be used in case who has infection. And mesh structure could prevent soft tissue ingrowth to bony defect area. Thus it can be used to the case of maxillary partial defect successfully.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.5
• /
• pp.543-547
• /
• 2007

The plunging ranula is a kind of ranula that goes over the mouth floor to the neck and other adjacent tissue. Sublingual gland is gently accepted as origin of plunging ranula. Plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. It is not true cyst so that there is no epithelium. And it consisted with thin connective tissue, inflammation cell infiltration and salivary secretion. Left without treatment, it can grow into the 10 cm more huge lesion. This report is a case of 73 years old female who was diagnosed as plunging ranula with review of literature. She presented 5 cm submandibular swelling at first. When surgery was delayed because of patient's condition, the lesion grew into the l2cm huge size. We performed excision of sublingual gland, submandibular gland and plunging ranula and had a good result without recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.14 no.4
• /
• pp.305-313
• /
• 1992

Facial asymmetry can be most distressing for the young child and parents. It can cause functional problems as a result of malocclusion. Classification of facial asymmetry has not been yet well-organized because of its varieties on etiologic factors, involved sites and clinical expressions. Even though, we don't know its causes definitely. It is generally believed that problems with aberrant pattern of condylar growth are related to facial asymmetry. This is a case report on surgical correction of the patients who had severe facial asymmetry. One patient was diagnosed as condylar hyperplasia and the other was diagnosed as a condylar hypoplasia related to trauma. We performed a simultaneous two-jaw surgery, condylar shaving, inferior border ostectomy of affected mandible in the former case, and a simultaneous two-jaw surgery, reverse-L osteotomy and alloplastic implantation with $Biocoral^{TM}$ in the latter case. The postoperative results of the two cases were excellent functionally and esthetically.