• Archives of Plastic Surgery
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• 제37권4호
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• pp.465-468
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• 2010

Purpose: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. Methods: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. Results: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. Conclusions: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.90-94
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• 2024

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy of the sweat glands that most commonly affects the periorbital area. It is characterized by slow growth over a prolonged period, and its morphology can be easily confused with a benign tumor, such as an epidermal cyst. Consequently, many patients experience recurrence after undergoing multiple resections. However, there are few reports concerning the surgical management of PCMC. We present two cases of PCMC originating in the periorbital area. The first case involved a 76-year-old man with a mass measuring 3.0×1.5 cm that had been increasing in size. The second case was a 61-year-old man with two masses, each measuring 1.0×1.0 cm, that were also growing. Both patients underwent wide excision with a 5-mm safety margin, which was determined based on the widest view of the cross-section of the mass on the magnetic resonance imaging. Subsequently, based on the intraoperative frozen biopsy results, both patients underwent additional excision with a 5-mm safety margin in only one direction. This report shows that, when determining the surgical margin of PCMC in periorbital area, employing imaging modalities and intraoperative frozen biopsies can be helpful for narrowing the surgical margin.

• Journal of International Society for Simulation Surgery
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• 제1권1호
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• pp.7-12
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• 2014

Purpose Surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these surgeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable reationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. Method Author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Results The method was allowed to evaluate inter-dacryon distance, inter-centroid distance, movement of the medial orbital wall, movement of the lateral orbital wall, alteration of thickness of the lateral periorbital fat as indicator of movement of the orbital wall and orbit in the patient with congenital periorbital anomaly and postoperative periorbital surgery. The goal of surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these sugeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable relationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. In this report, author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Conclusion The method suggested is objective and accurate method in measurement of the orbital contents. It takes time and is not easy to do, however, this kind of measurement for fine structures will be more easily available in near future.

• 한방안이비인후피부과학회지
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• 제25권3호
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• pp.88-96
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• 2012

Objectives : We investigated the skin properties on the periorbital region and cheek of Korean female according to age pattern by 7year based on Sang Go Cheun Jin Ron (上古天眞論) in So Moon (素問,) Methods : 49 Korean females, aged 21-56 years ($39.54{\pm}10.04$ years) were participated in this study. We measured the skin properties of periorbital region and cheek with SkinTouch (Amorepacific, Korea). Skin moisture, sebum, elasticity, lightness, roughness, area of wrinkle, depth of wrinkle were assessed. Results : Differences were noticed depending on the site and age. The level of moisture was higher on the eyelid than crow's feet. The level of lightness and elasticity were lower on the periorbital region than cheek. Skin lightness was highest on group1(under 28y) and lowest on group5(over 49y). Skin roughness was highest on group1(under 28y) and lowest on group4(over 42y under 49y). The level of wrinkle are was lowest on group1(under 28y) and highest on group 5(over49y). The level of wrinkle depth was lowest on group1(under 28y) and highest on group 4(over 42y under 49y). Conclusion : Unique aging pattern by 7 years of female is reflected to diverse skin properties of eyes. It can be possible to apply the theory on Sang Go Cheun Jin Ron (上古天眞論) to practical use in dermatology and cosmetic.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.36-44
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• 2008

목 적 : 안와주위 봉와직염은 더 위험한 질병인 안와 봉와직염과 감별이 힘들다는 점에서 중요한 의미를 가지고 있다. 저자들은 최근 7년 동안 서울 지역의 두 군데 병원에서 안와와 안와주위 봉와직염으로 진단된 환아의 임상적 특징, 선행요인, 치료 경험 등을 보고하고 자 한다. 또한 감별 진단을 위한 유용한 소견 및 방사선검사의 유용성을 조사하였다. 방 법 : 본 연구는 2000년 1월부터 2006년 12월까지 한일병원과 경희대학교 부속병원에 안와와 안와주위 종창을 주소로 입원하여 안와와 안와주위 봉와직염으로 진단된 18세 이하의 환아 41명을 대상으로 의무기록지를 통한 후향적 연구를 시행하였다. 결 과 : 대상 환아 41명 중 안와 봉와직염으로 진단된 환아는 7명(17.1%)이었고 안와주위 봉와직염으로 진단된 환아는 34명(82.9%)이었다. 발병연령은 0세부터 12세까지 분포하였으며, 대상 환아 중 2세 이하의 환아가 25명(61%)으로 많았고, 41명의 평균연령은 $3.2{\pm}3.4$세였다. 입원 일수는 안와군에서 $8.0{\pm}5.2$일이었고 안와주위군에서는 $5.7{\pm}3.4$일로 안와군에서 의미있게 길었다.(P= 0.04) 동반질환으로는 안와군에서 부비동염 6명, 안구 농포 1명, 누선염 1명, 안구내염 1명, 결막염 1명, 암 3명이었으며 암은 3명 모두 혈액종양인 급성 임파구성 백혈병이였다. 안와주위군에 서는 부비동염 10명, 중이염 3명, 안구농포 12명, 맥립종 5명, 산립종 1명, 곤충 물림 8명, 누낭염 7명, 결막염 5명, 치주염 1명, 균혈증 1명이었다. 백혈구 수의 평균은 안와군에서 $15,280{\pm}9,717/mm^3$와 안와주위군에서의 $10,040{\pm}5,004/mm^3$으로 안와군에서 통계학적으로 유의하게 높았으며 (P=0.03), C-반응 단백 수치의 평균은 각각 $4.57{\pm}3.68mg/dL$, $2.64{\pm}3.43mg/dL$로 안와군에서 통계학적으로 유의하게 높았다(P=0.04). 전체 환아중 혈액 배양검사는 23명이 시행되었고 이중 안와주위군의 1명에서 S. aureus가 자랐으며 MSSA였다. 혈액 배양검사 양성율은 4.3%로 낮았다. 농양부위의 배양검사는 안와주위군의 3명에서 시행되었고 이중 2명에서 각각 S. pyogenes, S. viridans가 동정되었다. 결 론 : 안와와 안와주위 봉와직염은 별개의 질환으로 병인이 서로 다르다. 안와 주위종창으로 내원한 환아들 중 부비동염이 선행되었거나, 안와증상인 안근마비, 결막부종, 안구돌출 등이 보이는 경우, 안검의 종창으로 이학적 검사가 힘들고 안와 봉와직염이 의심스러운 경우 CT scan은 필수적이며 치료를 위해 소아감염, 이비인후과, 안과 등 다양한 과로 구성된 팀(multi-speciality team)의 협진이 필요할 것으로 생각된다.

• 대한두개안면성형외과학회지
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• 제15권1호
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• pp.43-46
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• 2014

Nodular fasciitis is a reactive, non-neoplastic lesion that is most commonly found in the subcutaneous or superficial fascia of the extremities and trunk. Head and neck lesions are relatively uncommon and reports vary from 7% to 15% depending on the authors. Nodular fasciitis grows quickly, and shows a pleomorphic spindle cell pattern with increased mitotic activity. Such factors lead to cases where the lesion is mistaken for a malignancy such as fibrosarcoma and the case may end up with unnecessarily aggressive treatments. The intent of this paper is to report a relatively rare case of nodular fasciitis occurring in the periorbital area and also to highlight the importance of accurate diagnosis and non-aggressive management of this benign lesion.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.35-40
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• 2020

Background: Extensive eyelid defects are extremely challenging to reconstruct. Although numerous procedures for reconstructing periorbital defects have been proposed, no method is universally used. However, the Tenzel flap is the most commonly used technique to reconstruct eyelid defects affecting one-third to two-thirds of the eyelid. Methods: Recognizing the usefulness of the Tenzel method, we adapted it to reconstruct larger defects around the eyes. Seven patients underwent reconstruction with a modified Tenzel flap with an extended concept after wide excision of a malignant skin lesion. The main difference from the conventional method is that the modified Tenzel flap includes the medial portion of the lower lid defect. The design of a modified Tenzel flap begins as a semicircle at the lateral canthal area, in the same way as a classical Tenzel flap, and extends medially along the subciliary line to cover the defect on the medial lower eyelid. The follow-up time ranged from 3 to 28 months. Results: All flaps survived and healed well, with minimal scarring and natural palpebral outlines. Conclusion: Compared to traditional procedures, the modified Tenzel flap has several advantages, including a one-stage operation, a less noticeable scar, and effective prevention of complications such as lower eyelid ectropion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.110-116
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• 2000

A 61-years old man with diabetes mellitus(DM) was admitted to our hospital, complaining of progressive right periorbital swelling, headache and toothache on the right lower second molar. On the first visit, moderate swelling was noticed from the right periorbital region with exophthalmos and subconjunctival effusion. Intraorally, right lower second molar had a severe periodontal disease and fistular formation on its distal area. From 3 days after hospitalization, the visual acuity of his right eye was gradually worsen and we performed CT scan. CT scan demonstrated an inflammatory change at the right orbit with subperiosteal abscess at the inferior orbital wall, which was extended from the right infratemporal, parapharyngeal and internal pterygoid space. Patient was treated by mean of intraoral(right upper vestibular and retromolar) and extraoral(infraorbital) incision and drainage, massive anti-therapy and DM control. The patient improved gradually and finally was discharged from the hospital, but his visual loss of right side was not recovered.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.427-431
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• 2013

Angioedema is defined as self-limited, localized swelling. The swelling is asymmetric, non-pitting, and non-tender. Common locations of swelling include periorbital area, lips, tongue, extremities, and bowel wall. A 54-year-old woman visited our hospital with the clinical complaint of left maxillary swelling. Swelling of the left maxillary area was diffuse and temperature of the involved area was normal. No infectious source was found on panoramic radiography and cone-beam computed tomography. After considering the patient's medical history and assessing clinical examination, we suspected angioedema and administered corticosteroid only. In the oral and maxillofacial area, proper diagnosis and prompt treatment of angioedema is important because angioedema of the tongue or larynx may lead to airway obstruction or a life-threatening condition.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.60-63
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• 2001

The reconstruction of the suborbital area followed by resection of skin cancer has been used many methods including skin graft, local flaps, free flaps, and skin expansion. The radial forearm free flap has become a workhorse flap in this area because of its lack of bulk, ease of dissection, malleability, and hairlessness. When the suborbital defect especially including full-thickness defect of lower lid was reconstructed with many free flaps, the ectropion and the deformity of medial and lateral canthal area were common problems encountered as late complication due to gravitational descent. To improve the final aesthetic result in patients with suborbital defect, the radial forearm free flap was elevated as a composite radial forearm - palmaris longus free flap, in which the vascularized palmaris longus london was included and anchored to the periorbital bone with $mitek^{(R)}$ as sling, to suspend the flap against gravity and inferior descent, and thereby creating a more natural cheek contour. Two clinical cases were presented as an example of this procedure. Postoperative results emphasize the importance of suspension sling with palmaris longus tendon using $mitek^{(R)}$ in reconstruction of the suborbital defect with radial forearm free flap.