• Title/Summary/Keyword: Orbital rim

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Pasteurized Tumoral Autograft for the Reconstruction of Monostotic Fibrous Dysplasia in Frontal Bone (저온 열처리 자가 종양골이식을 이용한 이마뼈의 단골성 섬유성이형성증의 재건)

  • Lee, Eui-Tai
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.91-94
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    • 2010
  • Purpose: For the best possible aesthetic reconstruction after craniofacial bone tumor resection, pasteurization has been adopted to devitalize neoplastic cells while maintaining osteoinductive properties and mechanical strength. This case report aims to demonstrate a long-term follow-up result of a monostotic fibrous dysplasia in frontal bone which was reconstructed by pasteurized tumoral autograft in situ. Methods: A 14-year-old girl presented with a hard, nontender, slowly growing mass of 6-year duration on her left supraorbital area. CT showed $5{\times}4{\times}3cm$ sized well defined bony mass confined to frontal bone with heterogeneous density. Tumor was excised completely through bicoronal approach and reimplanted to its original site after pasteurization at $60^{\circ}C$ for 30 minutes. The pathologic examination confirmed fibrous dysplasia. Results: She revisited our clinic 5 years later after suffering some assault on her face. On CT examination, pasteurized tumoral autograft was incorporated to host bone except the fractured upper orbital rim without any evidence of recurrence. She has been satisfied with the result. Conclusion: Pasteurization offers a simple, reliable, cosmetic, economic, and durable reconstruction method for craniofacial skeletal tumor. It has advantages of both biologic incorporation ability and mechanical strength without risk of recurrence. So, it should be considered as one of the primary options in benign as well as resectable malignant tumors of craniofacial skeleton.

MALT Lymphoma of Ocular Adnexa: A Case Report (안구 부속기의 점막연관 림프조직형 림프종의 증례보고)

  • Cho, Jeong Nam;Kim, Yoong Soo;Chung, Chan Min;Suh, In Suck;Cho, Ji Woong;Park, Hye Rim;Choi, Jae Gu
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.321-324
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    • 2008
  • Purpose: Lymphoma originated from mucosa associated lymphoid tissue(MALT) is most common in gastrointestinal system, and rarely found in salivary gland, thyroid, bronchus or orbit. We experienced a case of MALT lymphoma which was originated from conjunctiva and involving lower eyelid without metastasis. Methods: A 40-year-old man suffered palpable mass on right lower eyelid without pain. Orbital computed tomographic and ultrasonographic findings showed a conical mass($1.9{\times}1.2{\times}0.9cm$ size) inside lower eyelid. The mass was completely excised under local anesthesia and histopathological examination was followed. Results: Microscopic finding showed a multiple follicular colonization. In the follicle, small lymphocytes and plasma cells differentiated to centrocyte-like cell, monocyte B cell, plasma cell were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. After excision, SPECT, abdominal CT was carried out and there were no evidence of extraorbital disease. Conclusion: Biopsy and pathological examination should be performed in patients who complain palpable mass on lower eyelid because of possibility of MALT lymphoma. Although MALT lymphoma is rarely metastasized, it is necessary to evaluate the extraorbital involvement using SPECT or other radiologic exams. For detecting extraorbital involvement, periodic follow-up examination is need.

Transconjuctival Incision with Lateral Paracanthal Extension for Corrective Osteotomy of Malunioned Zygoma

  • Chung, Jae-Ho;You, Hi-Jin;Hwang, Na-Hyun;Kim, Deok-Woo;Yoon, Eul-Sik
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.119-127
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    • 2016
  • Background: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. Methods: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). Results: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication-oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. Conclusion: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.

Forehead reconstruction with a custom-made three-dimensional titanium implant in a Parry-Romberg syndrome patient

  • Kim, Jae Yoon;Jung, Bok Ki;Kim, Young Suk;Roh, Tai Suk;Yun, In Sik
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.135-138
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    • 2018
  • Parry-Romberg syndrome is a rare neurocutaneous syndrome characterized by progressive shrinkage and degeneration of the tissues usually on only one side of the face. It is usually difficult to restore the facial contour due to skin tightness. In this case report, we report a forehead reconstruction with custom-made three-dimensional (3D) titanium implant of a Parry-Romberg syndrome patient who was treated with multiple fat grafts but had limited effect. A 36-year-old man presented with hemifacial atrophy. The disease progressed from 5 to 16 years old. The patient had alopecia on frontal scalp and received a surgery using tissue expander. The alopecia lesion was covered by expanded scalp flap done 22 years ago. Also, he was treated with fat grafts on depressed forehead 17 years ago. However, it did not work sufficiently, and there was noted depressed forehead. We planned to make 3D titanium implant to cover the depressed area (from the superior orbital rim to the vertex). During the operation, we confirmed that the custom-made 3D implant accurately fit for the depressed area without any dead spaces. Previously depressed forehead and glabella were elevated, and the forehead contour was improved cosmetically. A custom-made 3D titanium implant is widely used for skull reconstruction and bring good results. In our case, the depressed forehead of a Parry-Romberg syndrome patient was improved by a 3D titanium implant.

Physical Properties of Transiting Planetary System TrES-3

  • Lee, Jae-Woo;Youn, Jae-Hyuck;Kim, Seung-Lee;Lee, Chung-Uk;Koo, Jae-Rim;Park, Byeong-Gon
    • The Bulletin of The Korean Astronomical Society
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    • v.35 no.2
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    • pp.65.2-65.2
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    • 2010
  • We present four new transits of the planetary system TrES-3 observed between 2009 May and 2010 June. Among those, the third transit by itself indicates possible evidence for brightness disturbance, which could originate from a starspot or an overlapping double transit. A total of 107 transit times, including our measurements, were used to determine the improved ephemeris with a transit epoch of $2454185.910950\pm0.000073$ HJED (Heliocentric Julian Ephemeris Date) and an orbital period of $1.30618698\pm0.00000016$ d. We analyzed the transit light curves using the JKTEBOP code and adopting the quadratic limb-darkening law. In order to derive the physical properties of the TrES-3 system, the transit parameters are combined with the empirical relations from eclipsing binary stars and stellar evolutionary models, respectively. The stellar mass and radius obtained from a calibration using $T_{eff}$, log $\rho$ and [Fe/H] are in good agreement with those from the isochrone analysis within the uncertainties. We found that the exoplanet TrES-3b has a mass of $1.93\pm0.07\;M_{Jup}$, a radius of $1.30\pm0.04\;R_{Jup}$, a surface gravity of $28.2\pm1.1\;m\;s^{-1}$, a density of $0.82\pm0.06\;\rho_{Jup}$, and an equilibrium temperature of $1641\pm23K$.

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Lower Eyelid Full-Thickness Reconstruction Using a Radial Forearm Free Flap with Palmaris Longus Tendon Sling: A Case Report (장장근건을 포함한 요골 전완 유리피판술을 이용한 하안검 전층 재건 치험례)

  • Kim, Tae Hoon;Eun, Seok Chan;Baek, Rong Min
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.48-52
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    • 2011
  • Purpose: Many advances have been made in lower eyelid reconstruction surgical procedures after tumor ablative therapy. These include skin grafts, local flaps, free flaps, and skin expansion. When a full-thickness defect of the lower eyelid is reconstructed with many free flaps, ectropion and deformity of the medial and lateral canthal areas are common late complications caused by gravitational descent. The radial forearm free flap is widely used because of its lack of bulk, ease of dissection, malleability, and hairlessness. This report introduces a novel method for preventing ectropion using a composite radial forearm free flap reconstruction and palmaris longus suspension technique. Methods: A 70-year-old man had a malignant melanoma on his left lower eyelid. The patient was referred to our department after a biopsy confirmed the initial diagnosis. A full-thickness wide resection with a 25 mm free margin was performed, and a $5{\times}8cm$ radial forearm flap was elevated with a vascularised palmaris longus tendon. The palmaris longus tendon was fixed to the medial and lateral orbital rim perisoteum and the deep temporal fascia. The buccal mucosa was grafted to reconstruct the inner conjunctival layer. The pedicle vessels were anastomosed to the left superficial temporal artery and vein. Results: The postoperative clinical course was uneventful. The flap showed good texture and color match. No ectropion was noted 14 months after surgery and the tumor did not recur. The patient was quite satisfied with the final outcomes. Conclusion: Use of a radial forearm free flap and the palmaris longus tendon is an effective method for a full-thickness lower eyelid reconstruction.

A novel histologic description of the fibrous networks in the lid-cheek junction and infraorbital region

  • Sang-Hee Lee;Kyu-Ho Yi;Jung-Hee Bae;You-Jin Choi;Young-Chun Gil;Kyung-Seok Hu;Eqram Rahman;Hee-Jin Kim
    • Anatomy and Cell Biology
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    • v.57 no.1
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    • pp.25-30
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    • 2024
  • The aim of this study was to identify the anatomical feature of retaining ligament and fat compartment on the lower eyelid and infraorbital region using a histological method, and to investigate clear definitions for them which could be used generally in the clinical area. Eighteen specimens from eight fresh Korean cadavers were stained with Masson trichrome or hematoxylin and eosin. The ligamentous and fascial fibrous tissue were clearly identified. The ligamentous fibrous tissue which traversed in the superficial and deep fat layer was skin ligament and orbicularis retaining ligament (ORL). The fascial fibrous tissue enclosed the orbicularis oculi muscle (OOc) and circumferencial adipose tissue. Based on the ligamentous and fascial structure, three fat compartments, septal, suborbicularis oculi and infraorbital fat compartment, could be identified. The OOc attached to orbital rim and dermis by ORL and skin ligament, and the muscle fascicle and fat fascicle provided the connection point to the ORL and skin ligament as enclosing all muscle and fat tissue. The combination of the force made by the skin ligament in the lower eyelid and ORL may decide the level and form of the infraorbital grooves.

Cephalometric Evaluation of the Midfacial Soft Tissue Changes on Smiling (두부규격 방사선 사진을 이용한 미소 시의 중안면부 연조직의 변화량 측정)

  • Cheon, Kang-Yong;Shin, Dong-Whan;Chun, Won-Bae;Kim, Soo-Ho;Kim, Eu-Gene;Park, Hyong-Wook;Cho, Jin-Yong;Yun, Jun-Yong;Seo, Mi-Hyun;Lee, Won-Deok;Suh, Je-Duck;Lee, Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.421-425
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    • 2012
  • Purpose: The aim of this study is to compare the soft tissue changes of the midfacial area at the repose position and the natural smiling position for the improvement of evaluation and planning in the orthognathic surgery. Methods: The total of 30 subjects, 15 male and 15 female, were included in this study. The metal point landmarks were placed at the cheek, orbital rim, subpupil, and nasal base. The movements of the landmarks were evaluated at the repose position and smiling position in the lateral and posteroanterior cephalograms. Paired t test and correlation analysis were used for the evaluation of the soft tissue changes statistically. Results: In the lateral cephalograms, the cheek point (4.49 mm in female, 4.87 mm in male) showed the most distant movement. All points presented significant movements, except the orbital rim and nasal base point in male. Cheek point presented significant positive correlation between the horizontal and vertical change in male. Subpupil point presented significant positive correlation between horizontal and vertical change in both male and female. In the posteroanterior cephalograms, the nasal base point (5.41 mm in female, 6.30 mm in male) showed the most distant movement. Subpupil point and nasal base point presented significant movements in both female and male. Nasal base point presented significant negative correlation between the horizontal and vertical change in both male and female. In the lateral and posteroanterior cephalograms, the positional changes of all points presented significant positive correlation with each other in both female and male. Conclusion: The cheek point in the sagittal view and the nasal base point in the frontal view showed the most distant movement on smile. In the sagittal view, the subpupil point and cheek point moved anteriorsuperiorly on smile. In the frontal view, the nasal base points moved laterosuperiorly on smile. In both the sagittal and frontal view, the positional changes of all point were highly correlated to each other. These results may be used in the soft tissue references for the treatment planning of the dentofacial deformity patients.

CLINICAL STUDY OF AUGMENTATION MALARPLASTY WITH POROUS POLYETHYLENE (Porous polyethylene을 이용한 관골증대술의 임상연구)

  • Kook, Min-Suk;An, Jin-Suk;Kim, Young-Joon;Park, Hong-Ju;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.3
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    • pp.283-291
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    • 2008
  • The malar mound defines the contour of the lateral face between the inferior orbital rim and the mandible, and hypoplasia or asymmetry of this region is readily noticeable. A flat, hypoplastic malar eminence can make the face blunt and wearisome, which contributes to a premature aged appearance. Patients with congenital or traumatic flattening of the malar eminence can obtain esthetic improvement with implants. Indications for placement of malar implants to improve the appearance of subtle flattening or to enhance the esthetic harmony of a patient's face have been suggested in several studies. Many augmentation materials, such as silicone, proplast, polyamide, and porous polyethylene implants have been used. Many methods of localization have been described, the key to proper placement of the implants lies in a through understanding of the esthetics of the malar mound. From August 2001 to June 2007, 12 patients with malar depression who visited the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital were treated by augmentation malarplasty with Porous polyethylene. The location and amount of augmentation are determined by preoperative interview, physical examinations, facial models and radiographic findings. 12 patients were satisfied with the results of augmentation malarplasty and severe complications were not occurred.

1SWASP J093010.78+533859.5: A Possible Hierarchical Quintuple System

  • Koo, Jae-Rim;Lee, Jae Woo;Lee, Byeong-Cheol;Kim, Seung-Lee;Lee, Chung-Uk;Hong, Kyeongsoo;Lee, Dong-Joo;Rey, Soo-Chang
    • The Bulletin of The Korean Astronomical Society
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    • v.38 no.2
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    • pp.71.1-71.1
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    • 2013
  • Among quadruples or higher multiplicity stars, only a few binary systems have been discovered. They are important targets to understand the formation and evolution of multiple stellar systems because we can obtain accurate stellar parameters from photometric and spectroscopic studies. We present the observational results of this kind of rare object 1SWASP J093010.78+533859.5, for which the doubly eclipsing feature had been detected previously from the SuperWASP photometric archive. Individual PSF photometry for two objects with a separation of about 1.9 arcsec was performed for the first time in this study. Our time-series photometric data show that the brighter object A is an Algol-type detached eclipsing binary with an orbital period of 1.3 days and the fainter B is a W UMa-type contact eclipsing binary with a period of 0.23 days. Using the high-resolution optical spectra, we obtained well-defined radial velocity variations of the system A. Furthermore, stationary spectral lines were detected and should have originated from the other stellar component, which was confirmed by the third object contribution from the light curve analysis. No spectral feature of the system B was detected, probably due to its faintness. We obtained the binary parameters and the absolute dimensions from each light curve synthesis. The primary and secondary components of the system A have a spectral type of K1 and K5 main sequences, respectively. Two components of system B have nearly the same type of K3 main sequence. Light variations at out of eclipses were appeared in both systems, interpreting as the effect of stellar spots on these late spectral type stars. We estimated the distances to the systems A and B individually. They may have similar distances of about 70 pc and seem to be gravitationally bound with a separation of about 130 AU. In conclusion, we suggest that 1SWASP J093010.78+533859.5 is a quintuple stellar system with a hierarchical structure of a triple system A(ab)c and a binary system B(ab).

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