• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.64-70
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• 2022

Background: Anterolateral thigh (ALT) flaps are versatile soft tissue flaps that have become the standard soft-tissue flaps used for head and neck reconstruction. They provide a long vascular pedicle, constant vessel diameter, abundant soft tissue coverage, and minimal donor site morbidity. The ALT flap was initially designed on the basis of a septocutaneous (SC) perforator. However, more recent research has shown that a substantial number of ALT flaps are now based on musculocutaneous (MC) perforators, and the ratio between MC and SC perforators varies among studies. In this study, we analyzed the perforating pattern of ALT flaps along with their clinical outcomes during head and neck reconstruction in the Korean population. Methods: From October 2016 to July 2020, 68 patients who had undergone an ALT flap procedure for head and neck reconstruction were enrolled retrospectively. The perforating pattern of the cutaneous perforator vessel (MC perforator/SC perforator/oblique branch), pedicle length, and flap size were analyzed intraoperatively. Patient demographics and flap necrosis rates were also calculated. Results: The highest number of cutaneous perforator vessels supplying the ALT flap were the MC perforators (87%). The proportion of MC perforators was significantly higher than that of the SC perforators and oblique branches. Flap necrosis occurred in seven cases (11.86%); sex, hypertension, diabetes mellitus, coronary artery disease, perforator course, and history of radiotherapy did not significantly affect flap necrosis. Conclusion: The ALT free flap procedure remains popular for reconstruction of the head and neck. In this study, we observed that the majority of cutaneous vessels supplying the flaps were MC perforators (87%). When using the MC perforator during flap elevation, careful dissection of the perforator is required to achieve successful ALT flaps because intramuscular dissection is difficult. Perforator pattern and history of radiotherapy did not affect flap necrosis.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.102-111
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• 2021

Implant placement in the anterior region is performed in several stages, and harmonization of both hard and soft tissues is essential. In addition, adequate esthetic and functional evaluations are necessary in the process of transitioning from the provisional to the final prosthesis to attain patient satisfaction. Although gingiva can be molded in the anterior region, depression in the occlusal view can yield good results through the augmentation procedure. However, the harvesting of connective tissue from the palate is not suitable for various reasons, such as postoperative discomfort and intraoperative bleeding. Compared to the palatal area, the harvesting of connective tissue from the maxillary tuberosity can easily result in relatively thick tissue and quick healing of the donor site, thus proving to be a good modality for graft procedures. The purpose of this report is to examine the relevant evidence from previous studies and evaluate the process of soft tissue augmentation through a case presentation.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.327-341
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• 1998

Aims : The purpose of this study was to investigate whether there are any changes in taste sensitivity with advancing age and to see if smoking or oral hygiene can affect the taste sensitivity. Method : Nine hundred and thirty four subjects(458 male and 476 females) were included for the study and they were categorized into 4 age groups( under 20, 20 to 39, 40 to 59, and over 60 age group ). The electrical taste thresholds were measured using an electrogustometer for the 4 different sites in the oral cavity, I.e., tongue tip, tougue alteral, circumvallate papilla, and soft palate. Results : The elctrical taste thresholds were significantly incresed with advancing age in both gender, but the pattern of change is moere abrupt in female after 40. There were not significant differences in electrical taste threshold between smoking and non-smoking people. Taste thresholds were significantly lower in the groups with higher frequency of daily toothbrushing than the groups with lower frequency Conclusion : The electrical taste threshold is increased with aging. It is not influenced by smoking but by toothbrushing.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.212-216
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• 1999

Renal cell carcinoma is the third most common metastatic tumor to the bone and soft tissues of the head and neck. The common sites of metastatic renal cell carcinoma in head and neck region are nasal cavity, paranasal sinuses, oral mucosa, gingiva, tongue, palate, lip as the favored site. The present paper deals with one patient with metachronous oral tongue, nasal cavity and suspicious brain metastases after 2 years of renal cell carcinoma nephrectomy. Also, the patient had history of total thyroidectomy for thyroid follicular carcinoma. Total excision of nasal cavity and tongue mass were performed. Therapeutic aspects are briefly reviewed in literature.

• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.41-44
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• 2020

In general, patients with neurofibromatosis type I have a higher risk than those with other types of neurofibromatosis of developing soft-tissue sarcomas related to the nervous system. We here present a 42-year-old man with neurofibromatosis type I who developed a protruding mass over only 2 weeks. The histopathological diagnosis was epithelioid sarcoma. Epithelioid sarcomas are rare and, to the best of our knowledge, no epithelioid sarcomas have been reported in patients with neurofibromatosis type I. Radical excision of the primary lesion was performed and postoperative radiotherapy and chemotherapy administered, as is recommended for epithelioid sarcoma. Our case emphasizes that patients with neurofibromatosis type I may develop malignant tumors.

• Archives of Craniofacial Surgery
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• v.21 no.4
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• pp.211-218
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• 2020

Autologous fat grafts are widely used in soft-tissue augmentation and reconstruction. To reduce the unpredictability of fat grafts and to improve their long-term survival, cell-assisted lipotransfer (CAL) was introduced. In this alternative method, autologous fat is mixed and grafted with stromal vascular fraction cells or adipose-derived stem/stromal cells (ASCs). In regenerative medicine, ASCs exhibit excellent therapeutic potential and are also simple to harvest. Although the efficacy of CAL has been demonstrated in experimental and clinical research, studies on its safety in terms of oncologic risk have reported inconclusive results. In order to establish CAL as a viable stem cell therapeutic approach, it will be necessary to demonstrate its oncologic safety in basic and clinical studies. Doing so could transform the paradigm of clinical strategy and practice for the treatment of a wide variety of diseases.

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.131-134
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• 2018

Treacher Collins syndrome is a congenital disorder that is characterized with a wide range of cranio-facial deformities. Zygomatic hypoplasia or aplasia is one of the key features, and surgical reconstruction of the consequent depression on the zygomatic area is deemed necessary by many patients. Various surgical options are available-injectables, alloplastic materials, autologous grafting, and autogenous tissue transfer. It depends on each patient which technique to use. Here, we present a clinical case, in which bilateral free groin flaps were adopted in attempt to resolve the remnant aesthetic deformity associated with zygomatic depression, despite a series of previous surgical efforts, in a 25-year-old Treacher Collins syndrome male patient.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.397-400
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• 2019

Frontonasal dysplasia is an uncommon congenital anomaly with diverse clinical phenotypes and highly variable clinical characteristics, including hypertelorism, a broad nasal root, median facial cleft, a missing or underdeveloped nasal tip, and a widow's peak hairline. Frontonasal dysplasia is mostly inherited and caused by the ALX genes (ALX1, ALX3, and ALX4). We report a rare case of a frontonasal dysplasia patient with mild hypertelorism, a broad nasal root, an underdeveloped nasal tip, an accessory nasal tag, and a widow's peak. We used soft tissue re-draping to achieve aesthetic improvements.

• Archives of Craniofacial Surgery
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• v.21 no.5
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• pp.305-308
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• 2020

Madelung's disease (MD) otherwise known as Launois-Bensaude syndrome, multiple symmetrical lipomatosis, or benign symmetric lipomatosis, is a rare disease characterized by abnormal diffuse lipomatosis in proximal upper limbs and neck. Here, we report a rare case of MD. A 66-year-old man presented with massive growth of soft tissues in the cervico-occipital region of more than 2 years duration. Physical examination showed diffuse enlargement of the anterior neck (Madelung's collar) and three huge humps at the posterior neck. Under a diagnosis of MD, lipectomy via a single anterior transverse incision and liposuction were performed. This rare case report may be helpful for assessing patients with abnormal diffuse lipomatosis in the neck and proximal upper limbs.

• Speech Sciences
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• v.3
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• pp.18-25
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• 1998

Background: The results of treatment in functional velopharyngeal insufficiency (VPI) was not good compared to physician's common practice. Objectives: Authors conducted this study to evaluate the efficacy of fat injection on posterior pharyngeal wall in the functional velopharyngeal insufficiency as the supportive treatment. Materials and Methods: The preoperative assessment includes history of patients, the perceptual analysis of patient's voice, nasopharyngoscopic finding of velopharyngeal movements, nasometer, movement findings of soft palate during phonation and swalling. Fat which was taken from umbilical area was injected in 5 patients with conducted functional velopharyngeal insufficiency. Results: All 5 patients had good results in voice quality after fat injection. Conclusions: Fat injection is a good treatment method in functional velopharyngeal insufficiency as a supportive method.