• Title/Summary/Keyword: Pediatric plastic surgery

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Epidemiology of violence in pediatric and adolescent nasal fracture compared with adult nasal fracture: An 8-year study

  • Yu, Hahyun;Jeon, Minseok;Kim, Youngjun;Choi, Youngwoong
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.228-232
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    • 2019
  • Background: The epidemiology of nasal fractures varies according to factors such as the era and area of the study, as well as the age of the patient. We compared the characteristics and causes of pediatric nasal fractures. Methods: A total of 2,321 patients with nasal fractures from 2010 to 2017 were examined. The patients were divided into age groups using the Korean school system of age classification. The causes of injury were divided into five groups: violence, fall or slip down, sports, road traffic accidents, and others. Fractures were classified using the Stranc and Robertson standard: vector of force and plane of fracture. Results: Violence was the most common cause of nasal fracture in patients older than 12 years. Violence was a significantly less frequent cause among patients younger than 12 years old than among adolescent and adult patients. Nasal fractures due to violence were not observed in patients younger than 10 years. Plane 2 and lateral force fractures were the most common; however, in patients younger than 12 years, frontal force fractures were significantly more frequent than were lateral force fractures. Conclusion: As children may simply be injured due to a fall or slip down, it is important for the parents and guardians to ensure their safety. As they become older, children should abstain from violence and be monitored. It is therefore very important to ensure that the environment is free of violence in order to prevent such injuries.

Clinical Experience of Cleft Lip and/or Palate Repair in Complex Congenital Heart Disease (선천성 복잡심장병 환아의 구순 구개열의 치험례)

  • Koh, Kyung Suk;Lee, Sang Hyuk;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.385-388
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    • 2005
  • In cleft lip and/or palate patients with the complex congenital heart diseases, surgical repair of the cleft lip and/or palate has been postponed after the open heart surgery because the heart problem of the patient might cause more complications associated with anesthesia and surgery. There has been little report about experiences in the surgical management of these patients and optimal time of surgical intervention. Authors are introducing the experiences of performing corrective surgery of cleft lip and/or palate in the patients with congenital heart diseases before and after the open heart surgery. We managed five patients from May 1992 to March 2004. Two patients were male and the rest were female. One of them had cleft lip alone and others had cleft lip and palate. Two of them underwent delayed cleft lip and/or palate surgery after open heart surgery, and the rest had immediate intervention for cleft lip and/or palate. There was no complication during the operation and postoperative period. There would be no need to delay the corrective surgery of the cleft lip and/or palate after the open heart surgery, if solid medical team approach was available with the pediatric cardiologist and the anesthesiologist.

Ketamine-induced generalized convulsive seizure during procedural sedation

  • Kim, Ji Hoon;Lee, Chong Kun;Yu, Sung Hoon;Min, Byung Duk;Chung, Chang Eun;Kim, Dong Chul
    • Archives of Craniofacial Surgery
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    • v.22 no.2
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    • pp.119-121
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    • 2021
  • Ketamine is used widely in emergency departments for a variety of purposes, including procedural sedation for facial laceration in pediatric patients. The major benefits are its rapid onset of effects, relatively short half-life, and lack of respiratory depression. The known side effects of ketamine are hallucinations, dizziness, nausea, and vomiting. Seizure is not a known side effect of ketamine in patients without a seizure history. Here, we present the case of a patient in whom ketamine likely induced a generalized tonic-clonic seizure when used as a single agent in procedural sedation for facial laceration repair. The aim of this article is to report a rare and unexpected side effect of ketamine used at the regular dose for procedural sedation. This novel case should be of interest to not only emergency physicians but also plastic surgeons.

Pediatric Hand Trauma: An Analysis of 3,432 Pediatric Hand Trauma Cases Over 15 Years

  • Sung, Ki Pyo;Lee, Soo Hyang
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.257-262
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    • 2021
  • Purpose: Pediatric hand trauma is common and sometimes causes deformity or disability. The incidence and etiologies of hand trauma in children are different from those in adults. This study analyzed the characteristics of pediatric hand trauma cases and patients over a 15-year period. Methods: We conducted a retrospective medical record review of 3,432 children (2,265 boys, 1,167 girls, under 18 years of age) with hand injuries from January 2005 to December 2019. We evaluated the sex distribution and injury etiologies. Injuries were classified by type as burns, amputations, crushing injuries, lacerations, extensor and flexor tendon injuries, open and closed fractures, and nerve injuries. Results: Among the pediatric hand injury patients, males were predominant (1.94:1). Simple lacerations (58.4%) were the most common injury type, followed by fractures (22.8%). Lacerations and burns tended to be common in younger age groups, while tendon injuries, nerve injuries, and crushing injuries were more frequently encountered in older age groups. Conclusions: Hand trauma prevention strategies should be established considering the frequent trauma etiologies in specific age groups. An awareness of age-specific characteristics of pediatric hand trauma patients will be helpful to prevent hand trauma.

Unusual Gastrointestinal Complications due to Foreign Body Ingestion (이물섭취에 의한 드문 소화관 합병증)

  • Lim, Jai-Soo;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.42-45
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    • 1996
  • Children tend to ingest foreign bodies. The majority present in children between the ages of 6 months and 3 years. We experienced 2 cases of unusual gastrointestinal complications caused by ingested foreign bodies. First case was a 10-month-old male with intestinal perforation due to two pieces of ingested magnetic heads. Second case was a 7-month-old girl with esophageal stricture due to an ingested particle of plastic toy.

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Rhabdomyomatous Mesenchymal Hamartoma Presenting as a Midline Mass on a Chin

  • Kim, Hyeonwoo;Chung, Jee Hyeok;Sung, Ha Min;Kim, Sukwha
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.292-295
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    • 2017
  • A 17-month-old boy was evaluated for a midline mass on his chin. The mass was anchored to the mentalis muscle with a stalk-like structure. The pathological diagnosis of the mass was rhabdomyomatous mesenchymal hamartoma. This is the first report of rhabdomyomatous mesenchymal hamartoma presenting as a midline chin mass in Korean pediatric patients.

Gorlin-Goltz Syndrome: A Case Report and Literature Review with PTCH1 Gene Sequencing

  • Hyo Seong Kim;Seung Heo;Kyung Sik Kim;Joon Choi;Jeong Yeol Yang
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.384-388
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    • 2023
  • Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant disease characterized by multisystemic developmental defects caused by pathogenic variants such as patched-1 (PTCH1) gene variants and/or SUFU gene variants. The presence of either two main criteria or one major and two minor criteria are required for the diagnosis of Gorlin-Goltz syndrome. Recently, a major criterion for molecular confirmation has also been proposed. In this article, we report the case of an 80-year-old male who was admitted at our department for multiple brown-to-black papules and plaques on the entire body. He was diagnosed with Gorlin-Goltz syndrome with clinical, radiologic, and pathologic findings. While the diagnosis was made based on the clinical findings in general, confirmation of the genetic variants makes an ideal diagnosis and suggests a new treatment method for target therapy. We requested a genetic test of PTCH1 to ideally identify the molecular confirmation in the hedgehog signaling pathway. However, no pathogenic variants were found in the coding region of PTCH1, and no molecular confirmation was achieved.

Solitary mastocytoma presenting at birth

  • Ha, Non Hyeon;Lee, Yoo Jung;Park, Myong Chul;Lee, Il Jae;Kim, Sue Min;Park, Dong Ha
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.127-130
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    • 2018
  • Mastocytosis is a rare disease which occurs in both children and adults, and it can manifest as a solitary or multiple skin lesions. Both can cause cutaneous or systemic symptoms. Because of the heterogeneity of clinical presentation of mastocytosis and its rare prevalence, it can be hard to suspect the mastocytosis at the first time. Most solitary mastocytomas are about 1-5 cm in diameter and have features of brownish-yellow, minimally elevated plaques with a smooth shiny surface. This article presents a case of solitary mastocytoma which occurred in neonate and that we treated through surgical excision. In histopathological examination, it consisted of c-kit-positive mast cells. Although pediatric cutaneous mastocytosis might regress spontaneously, clinicians should keep in mind that it could be associated with systemic mastocytosis which involves hematopoietic system.

Aggravated Concealed Penis Resulting from Circumcision (포경수술에 의해 악화된 매복음경)

  • Nam, Seung Min;Choi, Hwan Jun;Kim, Mi Sun;Kim, Young Bae
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.514-517
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    • 2006
  • Purpose: To report a rare case of concealed penis that was aggravated by circumcision and simple way of treatment using skin flap. The concealed penis is a primarily pediatric disease and is usually treated by urologists. The plastic surgeons tend to see these patients when it become secondary deformation or in conjoinment with other specialties. In such situation, the plastic surgeons do not have many experiences. Methods: A 3-year-old boy was admitted with aggravated concealed penis after circumcision in congenital webbed penis. Patient had been operated with scar revision and skin flap and peri operative antibiotics. Results: The patient recovered well without any complication such as infection, hematoma and necrosis of flap. Patient was discharged POD#7 with remaining sutures. Patient was followed up for 7 months and he has no sign of erectile dysfunction, voiding dysfunction and evidence of inflammation of the urinary system. Conclusion: We experienced a case of concealed penis that was aggravated from aggressive circumcision in congenital webbed penis.

Image-guided surgery and craniofacial applications: mastering the unseen

  • Wang, James C.;Nagy, Laszlo;Demke, Joshua C.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.43.1-43.5
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    • 2015
  • Image-guided surgery potentially enhances intraoperative safety and outcomes in a variety of craniomaxillofacial procedures. We explore the efficiency of one intraoperative navigation system in a single complex craniofacial case, review the initial and recurring costs, and estimate the added cost (e.g., additional setup time, registration). We discuss the potential challenges and benefits of utilizing image-guided surgery in our specific case and its benefits in terms of educational and teaching purposes and compare this with traditional osteotomies that rely on a surgeon's thorough understanding of anatomy coupled with tactile feedback to blindly guide the osteotome during surgery. A 13-year-old presented with untreated syndromic multi-suture synostosis, brachycephaly, severe exorbitism, and midface hypoplasia. For now, initial costs are high, recurring costs are relatively low, and there are perceived benefits of imaged-guided surgery as an excellent teaching tool for visualizing difficult and often unseen anatomy through computerized software and multi-planar real-time images.