• 대한두개안면성형외과학회지
• /
• 제23권5호
• /
• pp.232-236
• /
• 2022

Post-traumatic enophthalmos and hypoglobus are common sequelae of facial bone fractures, even after reduction surgery. They are associated with functional and esthetic issues, which may lower the quality of life. These deformities frequently present late, and adequate correction is difficult. We report three cases of late inferior orbital rim reconstructions with three-dimensional printed implants to help resolve these problems. The average duration between the traumatic event and surgery was 3 years and 4 months. One patient was treated with a completely absorbable implant and exhibited satisfactory results until the implant started to biodegrade at 1 year and 9 months after surgery. Two patients were treated with a permanent implant and demonstrated satisfactory results. However, longer follow-up periods were needed. There were no complications such as infection, diplopia, or restriction of ocular motion and the patients were satisfied with the esthetic results.

• 대한두개안면성형외과학회지
• /
• 제23권6호
• /
• pp.278-281
• /
• 2022

The face is one of the most important parts of the body. Untreated facial fractures can result in deformities that can be harmful to patients. Three-dimensional (3D) printing is a rapidly evolving technology that has recently been widely applied in the medical field as it can potentially improve patient treatment. Although 3D printing technology is mostly used for craniofacial surgery, some studies have proved that it can be used to treat nasoethmoid orbital fractures. In this study, a patient-customized plate was constructed using a 3D printer and applied in a simulated surgery for the treatment of nasoethmoid orbital fracture.

• 대한두개안면성형외과학회지
• /
• 제25권4호
• /
• pp.197-200
• /
• 2024

Ethmoid myoepithelial carcinoma is a rare tumor, with only 14 cases reported to date. This report discusses the largest tumor of this type ever recorded in the ethmoid region. The tumor caused extensive damage to facial structures, complicating treatment. The patient's age and comorbidities increased the risk of intraoperative bleeding, presenting challenges to the complete removal of the tumor and the reconstruction of the damaged structures. To reduce the risk of intraoperative hemorrhage, shorten the surgery time, and manage potential heart-related complications, arterial embolization was performed using gelatin sponges and coils. Definitive surgery was then carried out using a skin flap and mucosal flap to successfully reconstruct the defect. Postoperative radiotherapy was deemed unnecessary. The patient recovered well, with a satisfactory aesthetic outcome. No recurrence was observed during a 3-year follow-up period.

• 대한두개안면성형외과학회지
• /
• 제21권4호
• /
• pp.229-236
• /
• 2020

Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.

• 대한두개안면성형외과학회지
• /
• 제18권4호
• /
• pp.255-260
• /
• 2017

Background: Surgery for reconstruction of defects after surgery should be performed selectively and the many points must be considered. The authors conducted this study to compare the local flap and skin graft by facial location in the reconstruction after resection of facial skin cancer. Methods: The authors performed the study in patients that had received treatment in Department of Plastic Surgery, Gyeongsang National University. The cases were analyzed according to the reconstruction methods for the defects after surgery, sex, age, tumor site, and tumor size. Additionally, the authors compared differences of aesthetic satisfaction (out of 5 points) of patients in the local flap and skin graft by facial location after resection of facial skin cancer by dividing the face into eight areas. Results: A total of 153 cases were confirmed. The most common facial skin cancer was basal cell carcinoma (56.8%, 87 cases), followed by squamous cell carcinoma (37.2%, 57 cases) and bowen's disease (5.8%, 9 cases). The most common reconstruction method was local flap 119 cases (77.7%), followed by skin graft 34 cases (22.3%). 86 patients answered the questionnaire and mean satisfaction of the local flap and skin graft were 4.3 and 3.5 (p=0.04), respectively, indicating that satisfaction of local flap was significantly high. Conclusion: When comparing satisfaction of patients according to results, local flap shows excellent effects in functional and cosmetic aspects would be able to provide excellent results rather than using a skin graft with poor touch and tone compared to the surrounding normal skin.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제37권1호
• /
• pp.77-80
• /
• 2011

A calcifying epithelial odontogenic tumor (CEOT) was first described as a separate entity in 1955 by Pindborg, and has since been referred to as Pindborg tumor. CEOT is characterized by the presence of squamous-cell proliferation, calcification and amyloid deposits, and accounts for only 1% of all odontogenic tumors. CEOT is a benign, though occasional locally invasive, slow-growing neoplasm. It is located either intraosseously or extraosseously, and is usually associated with an unerupted permanent tooth. A 24 year-old female visited our clinic, presenting with a palatal swelling and intra-oral ulcer. After an incisional biopsy, the lesion was confirmed to be odontogenic tumor. A tumor resection and reconstruction surgery with tongue flap were performed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제48권2호
• /
• pp.85-93
• /
• 2022

Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

• 대한두경부종양학회지
• /
• 제11권1호
• /
• pp.41-46
• /
• 1995

저자들은 14례의 구인두암례에서 원발병소를 절제한 후 그 결손을 대흉근피판을 이용하여 동시에 재건하였다. 합병증으로는 근피판의 전괴사가 1례, 부분괴사가 3례, 창상감염이 1례, 혈종 2례, 하악골수염 및 불유합이 각 1례, 공여부위의 혈종이 1례 있었다. 인두피부누공 3례는 피판의 전괴사 및 부분괴사의 3례이었으며 변연절제(debridement)시 인두피부누공을 만든 예이었다. 8례에서는 합병증이 없었으나 6례에서 총 12건의 합병증이 발생하였다. 대부분의 합병증은 변연절제를 제외하고는 이차적인 재건술식 없이 치유되었다. 편도주위의 결손은 재건을 필요로하는 면적은 많으나 그 부피가 작아 재건이 어려웠으며 경부피부 혹은 구강 등 타 부위보다 합병증이 많음을 경험하였으나 대흉근피판은 안전하고 쉽게 사용할 수 있는 유용한 재건방법이었으며 특히 구강과 경부가 통하는 경우에도 경동맥을 안전하게 보호할 수 있는 방법이었다. 하지만 편도주위의 재건에는 피판이 필연적으로 접히게 되므로 대흉근피판의 부피가 큰 것이 단점으로 사료되었다. 따라서 편도주위의 재건에 있어서는 대흉근의 두께 및 피하조직의 두께, 근피판의 적응, 디자인, 술기, 수술후 처치 등 선택에 보다 신중을 기해야 할 것으로 사료되었다. 이를 위하여 저자들이 사용하는 bilobular모양이 피판의 부피를 줄일 수 있는 한 방법으로 사료되었다.

• 대한두개안면성형외과학회지
• /
• 제10권1호
• /
• pp.49-54
• /
• 2009

상악골 악성종양의 경우 적출 후 골편들을 이식해 상악동 전체를 재건하는 경우는 재발이 많아 잘 시행하지 않는다. 이러한 이유로 안와하연의 재건을 통해 안구 및 안면윤곽만을 재건하는데, 저자들이 시행한 혈행화된 부분 두께의 골이식(vascularized split thickeness calvarium)은 술기방법에 있어 골피판이 혈관경에서 쉽게 분리되는 성질이 있어 시행에 주의가 필요하고 혈관경을 포함한 temporalis muscle이 부피감을 주므로 미용상 불리한 점이 있는 반면에 골편의 높은 생존율이 보장된다는 장점과 공여부의 합병증이 적다는 장점을 가진다. 또한 술후 복시 현상이나 안구함몰이 관찰되지 않았다는 점이 합리적인 술기임을 지지해준다. 따라서 측두동맥 및 정맥을 혈관경으로 하는 혈행화된 두정골 부분층 이식술은 안와하벽을 재건하는데 있어 안전하게 시행가능 한 술기였음을 보고하는 바이다.

• 대한두개안면성형외과학회지
• /
• 제11권1호
• /
• pp.1-6
• /
• 2010

Purpose: Many surgical approaches for reconstruction of blow out fracture have been introduced, which include subciliary incision, transconjunctival incision and transcaruncular incision. Recently endoscopic approach has been attempted. This study was intended to show the effectiveness of the approach through transconjunctival incision combined with transnasal reduction in reconstructing blow out fracture to its original position. Methods: Medical recoreds of 43 patients from March 2008 to March 2009 who underwent surgery for orbital fracture were reviewed, retrospectively. All fractures were operated through transconjuctival incision approach combined with transnasal reduction. The average follow-up period was 10.1 months. To evaluate the surgical outcomes of orbital fracture, we performed CT of the facial bone before and after the surgery. In addition, preoperative and postoperative data of enophthalmos, diplopia and the limitation of extraocular motion was assessed with physical examination. Results: Post-operative CT scan of 43 patients assured that the bone fragments of the orbital fractures were restored to their original positions. Although a few patients developed postoperative transient diplopia or impairment of ocular movement, most of the patients recovered during the follow-up period without complication. Conclusion: From this study, we were able to demonstrate the effectiveness of the transnsasal reduction technique combined with the approach through transconjunctival incision. This technique can be considered as very useful means of repairing orbital fracture. It is not only easy to perform but also it can minimize the damage to the orbital bone. Furthermore, it can restore the fracture to its original position as much as possible.