• Title/Summary/Keyword: Palate, Soft

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The measurement of nose dimensions through the three-dimensional reformation images after nasal bone fracture

  • Jang, Seung Bin;Han, Dong Gil
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.31-36
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    • 2019
  • Background: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. Methods: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017. Using the ruler tool in Adobe Photoshop CS3, we measured preoperative and postoperative nasal base heights, long nostril axis lengths, both nasal alar angles, and amount of nasal deviation through the 3D reformation of soft tissue via CT scans. We then compared the dimension of nose. Results: The amount of postoperative correction for nasal base height was 1.192 mm. The differences in nostril length between each side were found to be 0.333 mm preoperatively and 0.323 mm postoperatively. The differences in the nasal alar angle between each side was $1.382^{\circ}$ preoperatively and $1.043^{\circ}$ postoperatively. The amount of nasal deviation was found to be 5.248 mm preoperatively and 1.024 mm in postoperatively. Conclusion: After the reduction of nasal bone fractures, changes in nasal dimensions were noticeable in terms of nasal deviation but less significant in nasal tips, except for changes in nasal alar angles, which were notable.

Mucosa-associated lymphoid tissue lymphoma on right lower eyelid previously diagnosed as lymphoid hyperplasia

  • Kim, Yang Seok;Na, Young Cheon;Huh, Woo Hoe;Kim, Ji Min
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.66-70
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    • 2019
  • Mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon form of non-Hodgkin lymphoma involving the mucosa-associated lymphoid tissue. Most commonly affected organ is the stomach. But, it could affect almost every organ in the whole body. If they have suspicious lesion, excision biopsy could be made. For staging, blood test including blood smear, abdomen and chest tomography or scan will be checked. Also, bone marrow test can be done if it is needed. The patient had visited the clinic for palpable mass on right lower eyelid. With excisional biopsy, it was diagnosed as lymphoid hyperplasia on pathologic test. But 2 years later, the patient came with recurrent symptom for our department with worry. At that time, we recommended excisional soft tissue biopsy under general anesthesia. Unfortunately, it was revealed MALT lymphoma on pathologic finding. It turned out to be stage 3 in Ann Arbor staging system without B symptoms. Hematologic consultation was made and she was treated with adjuvant chemotherapy for eight cycles to complete remission. We report a case of MALT lymphoma on subcutaneous tissue at right lower eyelid previously diagnosed as lymphoid hyperplasia.

Primary orbital tuberculosis on the lower eyelid with cold abscess

  • Yoon, Hyun Sik;Na, Young Cheon;Lee, Hye Mi
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.274-278
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    • 2019
  • Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule ($1.5{\times}1.2cm$) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.

Morphological variation of the velum in children and adults using magnetic resonance imaging

  • Kotlarek, Katelyn J.;Haenssler, Abigail E.;Hildebrand, Kori E.;Perry, Jamie L.
    • Imaging Science in Dentistry
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    • v.49 no.2
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    • pp.153-158
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    • 2019
  • Purpose: The purpose of this study was to investigate variations in velar shape according to age, sex, and race using magnetic resonance imaging (MRI). Materials and Methods: The study sample consisted of 170 participants (85 children, 85 adults) between 4 and 34 years of age. Velar morphology was visually classified using midsagittal MRI scans for each participant by 2 independent raters. Inter- and intra-rater reliability was assessed. Statistical analyses were performed to identify correlations of velar shape with sex, age, and race. Results: The most frequent velar shape was "butt" for both adults(41%) and children (58%) in this study. The least common shapes for adults were "leaf" and "S." The children did not exhibit any "leaf" or "straight" velar shapes. A statistically significant difference was noted for age with respect to velar shape (P=0.014). Sex and race were found to have no significant impact on velar shape in this study. Conclusion: When using MRI to evaluate velar morphology, the "butt" shape was most common in both children and adults. Velar shape varied significantly with age, while race and sex did not have a significant impact.

Atypical proliferative nodule in congenital melanocytic nevus with dural invasion: a case report

  • Jung, Jae Hoon;Jang, Kee-Taek;Kim, Ara;Lim, So Young
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.139-143
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    • 2019
  • Here we report a case of a focal atypical proliferative nodule (PN) arising from a congenital melanocytic nevus (CMN). Diagnosis was challenging because it had both benign and malignant clinical features. Unusual histopathology, immunohistochemistry, and intraoperative findings of this atypical PN are discussed. A 5-year-old girl was admitted for a congenital $5{\times}5cm$ sized scalp mass. This hemangioma-like soft mass showed biphasic characteristics such as a slow, gradual, and benign increase in size but worrisome dural invasion with cranial bone defect. We removed the scalp mass with clear resection margins. Interoperatively, we found that the cranial bone defect had already filled. Histopathologic examination showed CMN with focal atypical PN. The nodule showed sharp demarcation and cellular pleomorphism. However, in immunohistochemical study, Ki-67 proliferation index and expression levels of protein S-100 and Melan-A were very low. These were unusual findings of atypical PNs. Despite her worrisome preoperative radiologic features, she showed an indolent clinical course compatible with previously reported biologic behavior. The patient underwent follow-up inspection with magnetic resonance imaging every 6 months for up to 3 years. The nodule appeared to be stationary at the last visit.

Radiation prosthetic stents applied to oral cancer patients during the radiation therapy: case reports (효율적 방사선요법을 위한 구강 방사선스텐트의 적용: 증례보고)

  • Nam, Ki Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.282-288
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    • 2020
  • Radiation prosthetic stent is defined as the customized oral devices which serve for an efficient administration of radiation dose to the affected areas or a minimizing the unnecessary irradiation to surrounding normal tissues during maxillofacial cancer radiotherapy. Since the use of stents is individualized, a close collaboration among radiotherapist, surgeon and prosthodontist is essential thereby which helps in limiting the post-therapy morbidity as well as the stable oral rehabilitation. In this report, two customized stents (bolus carrier and tongue depressing) were fabricated and applied to patient undergone irradiation for soft palate and tongue carcinoma selectively. Multidisciplinary approach can be a proper strategy and recommended for control the sequel of post-irradiation.

Surgical Excision and Reconstruction in Oral Cavity Cancer (구강암의 수술적 접근과 재건)

  • Soon-Hyun Ahn
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.11-14
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    • 2023
  • The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.

Solitary fibrofolliculoma on the nasal septum: a case report

  • Young Hoon Chi;Joo Young Woo;Tae Kyung Koh;Soo Kweon Koo;Hyuni Son
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.139-142
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    • 2023
  • Fibrofolliculoma is a benign, perifollicular, connective tissue tumor that usually arises in the form of multiple lesions; it is rarely seen as a solitary lesion. The lesions are clinically asymptomatic, 2 to 4 mm skin-colored, soft dome-shaped papules. Here, we report a patient who visited our hospital with a palpable lesion on the nasal septum. The lesion did not cause pain upon palpation, and nasal endoscopy confirmed an irregular wart-like lesion measuring 6×6 mm in the left anterior nasal septum near the columella. Other otolaryngology findings were normal, and there were no similar lesions in other parts of the body. None of the patient's family members were known to have had such lesions. An excisional biopsy was performed on the mass for removal of the lesion, and histological examination confirmed the lesion as fibrofolliculoma. We report the first case of solitary fibrofolliculoma in the nasal septum in a healthy 62-year-old woman along with a review of the relevant literature.

HISTOLOGICAL AND CLINICAL STUDY OF ARTIFICIAL DERMIS IMPLANTATION FOR RESTORATION OF SOFT TISSUE DEFECTS (연조직 결손부 회복을 위한 인공진피 이식의 조직학적 및 임상적 연구)

  • Ryu, Sun-Youl;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.410-417
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    • 2006
  • The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

Results of Conventional Radiotherapy in Oropharyngeal Cancer (구인두암의 방사선 치료 성적)

  • Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.1-8
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    • 1996
  • Purpose: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancer in terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. Materials and Methods: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to APr. 1993. Of these, twenty six patients were treated by conventional radio-therapy alone, and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The Patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of Primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The range of follow-up periods was 3-102 months and median was 20 months. The range of a9e was 33-79 years old and median was 58 years old. Results : Overall 3-year actuarial survival rate (3YSR) of all patients was $39\%$. The 3YSRS of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55, 33 and $32\%$, respectively The 3YSRS of Tl+2, T3+4 and No, N+ were 55, $18\%$ (p=0.005) and 43, $36\%$ (p>0.1), respectively. There was no difference in 3YSRS between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs $43\%$, p>0.1). According to the original site of primary tumor, the 3YSRS of tonsil (n=32), base of tongue (n=8), soft palate or uvula (n=6) and pharyngeal wall (n=1) were 36 38, 67 and $0\%$, respectively The Patients of soft palate or uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 Patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not Primary extension, but the difference was marginally significant statistically (24 vs $60\%$, p=0.08). On Cox multivariate analysis in entire patients with variables of age, T stage, N stage, total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy, only T stage was a significant Prognostic factor affecting 3YSR. Conclusion : The difference of 3YASRS of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal cancer, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multi-modal approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.

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