• 제목/요약/키워드: Partial maxillectomy

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A hollow definitive obturator fabrication technique for management of partial maxillectomy

  • Patil, Pravinkumar Gajanan;Patil, Smita Pravinkumar
    • The Journal of Advanced Prosthodontics
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    • 제4권4호
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    • pp.248-253
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    • 2012
  • Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.

상악골 절제 환자에서 임플란트를 이용한 구개폐쇄장치 증례 (Implant assisted obturator in patient after maxillectomy: a case report)

  • 서윤희;이준석;송영균
    • 구강회복응용과학지
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    • 제32권4호
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    • pp.322-329
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    • 2016
  • 상악골 절제술을 받은 환자의 구개폐쇄장치 보철 수복은 구강과 비강 및 상악동의 개통으로 인한 저작기능, 연하, 발음 및 심미성의 상실을 회복하는 것을 목적으로 하는 치료이다. 상악골 절제술 환자에서 구개폐쇄장치 설계 시 측방력으로 인해 야기되는 응력은 적절한 교합 양식의 선택, 조기 교합접촉의 제거, 광범위한 지지영역의 활용으로 최소화될 수 있다. 또한 기능 시 응력이 지대치로 전달되는 것을 줄여주는 유지장치의 고안이 필요하다. 본 증례보고는 임플란트 실패를 경험한 상악골 절제술 환자에게 잔존 임플란트를 이용한 가철성 국소의치(implant assisted removable partial denture, IARPD) 형태의 구개폐쇄장치를 제작하여 기능과 심미성 회복을 이룬 보철수복을 보고하고자 한다.

측두근-오훼돌기 피판을 이용한 안와저의 재건 예 (A CASE REPORT OF ORBITAL FLOOR RECONSTRUCTION WITH TEMPORAL MUSCLE-CORONOID PROCESS FLAP)

  • 이상철;김여갑;류동목;최재용
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제15권1호
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    • pp.1-6
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    • 1993
  • The maxillary squamous cell carcinoma is major part of maxillary malignant tumor. The treatment of maxillary malignancy tumor is the maxillectomy in combination with radiation therapy and chemorherapy. When tumor invasion is occured to the orbit, orbital exenteration is required. But if the periosteum of the orbital floor is intact, the orbit can be preserved. There are many orbital floor reconstruction materials for the prevention of ptosis of the orbital content. The patients on this paper were diagnosised as squamous cell carcinoma on maxilla, we performed the partial maxillectomy including the orbital floor, and we used temporalis muscle-coronoid process flap for the reconstruction of the orbital floor after partial maxillectomy and obtained good esthetic and functional results, as followed. 1. We obtained sufficient flap width for defect of orbital floor. 2. It permits good blood supply and no necessary other donor site. 3. It gives a solid base for the support the globe and the orbital floor. 4. It gives minimal postoperative morphorogical defect and functional disturbance.

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상악골에 생긴 섬유성이형성증의 치료 경험: 안면윤곽술, 부분적 상악골 절제술과 상악동 형성 (Clinical Experience of Maxillary Fibrous Dysplasia: Shaving, Partial Maxillectomy & Maxillary Sinus Formation)

  • 이윤호;주춘승
    • Archives of Plastic Surgery
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    • 제33권2호
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    • pp.259-262
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    • 2006
  • Fibrous dysplasia(FD) of the bone is a slowly progressive, benign disease of unknown cause where normal architectures are replaced with fibrous and osteoid tissue. FD of the maxilla usually manifests as a bony enlargement with painless swelling and bone deformity, contouring to facial asymmetry. The lesion may involve the nasal fossae, orbits, or alveolus bone, causing diverse functional disturbance. Treatment options range from shaving to total maxillectomy and reconstruction depending on the presenting symptoms. Shaving, partial maxillectomy and maxillary sinus formation was performed in 5 patients with fibrous dysplasia in the past 2 years. Follow up period ranged from 1 month to 11 months. Aesthetic appearance, CT findings, and relief from symptoms were compared. In all patients, facial asymmetry was restored to symmetry and nasal obstructive symptoms were improved. With this procedure, expansion of the lesion will be controlled until puberty, preventing the development of new functional disturbances. After puberty, no further treatment can be anticipated due to the growth arrest inherent to the disease.

상악골 부분절제술 시행한 부분 무치악 환자에서 폐쇄 장치를 이용한 보철 수복 증례 (Prosthetic rehabilitation of partially edentulous patient after maxillectomy: A case report)

  • 허경회;임영준;김명주;권호범
    • 대한치과보철학회지
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    • 제54권2호
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    • pp.167-171
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    • 2016
  • 상악골 부분 절제술을 시행한 환자들은 저작, 발음, 연하 기능에 문제가 발생하고 안모의 변화로 인해 사회적, 심리적인 어려움을 겪게 된다. 따라서 악안면 보철적 치료를 통한 기능적, 심미적 회복이 매우 중요하다. 적절한 폐쇄 장치는 구개의 외형을 회복시키고 구강과 비강, 상악동, 비인두를 분리시킴으로써 연하와 발음 기능을 회복시키는데 목적이 있다. 본 증례는 편평상피암으로 인해 우측 상악 구치부에서 비인두에 이르기까지 상악골 부분 절제술을 시행한 환자에서 폐쇄장치를 제작하였다. 이를 통해 발음 및 연하 기능을 회복하고 저작 기능의 향상을 도모하였으며 심미적인 부분에서 개선이 이루어졌다. 1년간의 임상적 관찰기간 동안 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

상악골에 발생한 치성 점액종의 치험례 (ODONTOGENIC MYXOMA OF MAXILLA : A CASE ROPORT)

  • 장정우;최소영;김진욱;변기정;김진수
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권6호
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    • pp.486-489
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    • 2009
  • Odontogenic Myxoma of the jaws is a rare benign tumor derived from embryonic mesenchymal elements of dental anlage. It appears to originate from the dental papilla, follicle or periodontal ligament. Odontogenic Myxoma of the maxilla is less frequent but behaves more aggressively than that of the mandible, because it spreads through the maxillary sinus. Radiographically, the tumors present as unilocular or multilocular radiolucent lesions with well-defined borders with fine, bony trabeculae. On gross examination, the tumor appears as a smooth, glistening, gelatinous, lobulated mass. On microscopic examination, these neoplasms exhibit loose arrangement of stellate-shaped cells. The intercellular substance is a mucinous and homogeneous matrix. We report a case of odontogenic myxoma of the maxilla observed in our clinic with good prognosis after partial maxillectomy.

Nosocomial submandibular infections with dipterous fly larvae

  • Joo, Chong-Yoon;Kim, Jong-Bae
    • Parasites, Hosts and Diseases
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    • 제39권3호
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    • pp.255-260
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    • 2001
  • In September 1998, a case of nosocomial cutaneous myiasis caused by Lucilia serocata (Meigen, 1826) in a 77-year-old male was found. The patient had been receiving partial maxillectomy due to the presence of malignant tumor on premaxilla. This is the first verified case involving Lucilia sericata in Taegu, Korea. In the present paper, the salient morphological features of the third instar larvae involved have been studied.

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편측 절제된 상악골 환자에서 하이브리드 텔레스코픽 이중관 의치를 이용한 구강 폐색기 수복 증례 (Prosthetic rehabilitation for patient with hemi-maxillectomy: Obturator combined with a hybrid telescopic double crown using friction pin)

  • 서정교;조진현
    • 구강회복응용과학지
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    • 제34권4호
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    • pp.317-323
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    • 2018
  • 구강암이 상악에 발생하게 되면 원발 부위의 제거를 포함한 외과적 처치 후 비구강 개통(oro-nasal communication)이 발생하게 된다. 비구강 개통으로 인한 음식물의 저류를 막고 및 원할한 발음 및 심미적 회복을 위해서는 구강 폐색장치(Obturator)를 통한 수복이 필요하다.본 증례에서는 구강암으로 인해 우측 상악 편측절제술(hemi-maxillectomy) 시행하고 두경부 방사선 치료의 영향으로 인해 잔존 지대치의 우식과 불량한 치주지지를 보이는 환자에서 구강폐색장치(obturator)를 하이브리드형 이중관의치(hybrid telescopic double crown denture)로 수복하였다. 18개월 간 경과관찰에서 성공적인 예후를 보여 이를 보고하고자 한다.

상악골 부분 절제술을 받은 무치악 환자에서의 구강폐쇄장치 수복 (Prosthetic rehabilitation using an obturator in a fully edentulous patient who had partial maxillectomy)

  • 정유진;김종진;백진;차현석;이주희
    • 구강회복응용과학지
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    • 제34권4호
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    • pp.331-337
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    • 2018
  • 상악골 결손을 갖고 있는 무치악 환자를 폐쇄장치로 수복할 때 임상가들은 많은 어려움을 겪게 된다. 결손부를 통한 공기의 누출, 안정성과 지지의 부족, 감소된 의치 피개 면적은 의치의 흡착과 변연 폐쇄를 어렵게 한다. 본 증례는 편평상피암에 이환된 우측 상악동 부위에 상악골 절제술을 받은 무치악 환자로 술전 치과 검진, 수술용 폐쇄장치, 이행 폐쇄장치, 그리고 최종 폐쇄장치에 이르는 단계적 치료 과정을 통해 보철적 재건을 완료하였다. 본 증례의 환자는 전상악골 및 양측 상악 결절이 온전하며 한정된 크기의 결손부를 가져 적절한 유지와 지지를 갖는 폐쇄장치를 제작할 수 있었으며 심미 및 기능면에서 양호한 예후를 보였기에 이를 보고하는 바이다.

Mucormycosis Management in COVID-19 Era: Is Immediate Surgical Debridement and Reconstruction the Answer?

  • Gupta, Samarth;Goil, Pradeep;Mohammad, Arbab;Escandon, Joseph M.
    • Archives of Plastic Surgery
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    • 제49권3호
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    • pp.397-404
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    • 2022
  • Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.