• 대한두경부종양학회지
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• 제24권1호
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• pp.69-72
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• 2008

Lymphomas of the nasal sinuses are relatively uncommon and represent less than 1% of all head and neck malignancies. Most common symptoms are nasal obstruction, epistaxis, rhinorrhea. We report a case of primary extranodal diffuse large B-cell non-Hodgkin's lymphoma in nasal sinuses accompanying with exophthalmos. A 70-year-old male patient was referred to our hospital with exophthalmos and severe septal deviation. We conducted endoscopic biopsy with septoplasty and biopsy result was diffuse large B-cell lymphoma. He received chemotherapy(R-CHOP) and radiotherapy. At follow-up, he remained free of disease.

• Medical Lasers
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• 제10권2호
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• pp.90-95
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• 2021

Background and Objectives Surgery for harvesting costal cartilage is often required for revision septorhinoplasty due to a lack of septal cartilage in patients with a severely contracted nose, and postoperative scarring on the anterolateral rib cage commonly requires additional treatment. This study aimed to evaluate the therapeutic efficacy and safety of combined polydeoxyribonucleotide (PDRN) and microlens array (MLA)-type nanosecond-domain neodymium (Nd):yttrium-aluminum-garnet (YAG) laser treatment for postoperative scars after costal cartilage harvest surgery. Materials and Methods Nine Korean patients with scars after costal cartilage harvest surgery treated with PDRN injections and MLA-type Nd:YAG laser treatments were retrospectively reviewed. Results Most of the scar lesions exhibited clinical improvement at 2 weeks after PDRN and MLA-type nanosecond-domain laser treatments, and the lesions further improved after adding more treatment sessions. The median Vancouver Scar Scale (VSS) score decreased from 6 (interquartile range [IQR]: 6-7) before combined intralesional PDRN injection and MLA-type, nanosecond-domain Nd:YAG laser treatments to 3 (IQR: 2-4) thereafter. Patient satisfaction after the combination treatments was rated as satisfactory. None of our patients reported major adverse events. Conclusion This case series study demonstrated that combined PDRN and MLA-type, nanosecond-domain Nd:YAG laser treatments are effective and safe for treating scars from costal cartilage harvest surgery.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.3-9
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• 2021

Background For an attractive and natural tip contour in Asian rhinoplasty, insertion of a nasal implant and reinforcement of the cartilaginous framework are essential. However, scar contracture, which often results from augmentation with implant insertion and inadequate soft tissue coverage of the framework, is one of the most common causes of alar retraction. This study reports a novel method of redraping soft tissue along the alar rim to prevent alar retraction in Asians. Methods Twenty young Asian men who underwent primary rhinoplasty with septoplasty were retrospectively reviewed. After the usual rhinoplasty procedures, alar rim redraping was conducted for the soft tissue along the transcolumellar and bilateral infracartilaginous incisions. The longest axis of the nostril (a) and the height of the nostril from that axis (b) were measured in anterior-posterior and lateral views. The preoperative and postoperative ratios (b/a) were analyzed using the paired t-test. Results All 20 patients showed natural contours of the nasal tip, nostrils, and alae after a mean follow-up of 53.6 weeks (range, 52-60 weeks). The ratio of the nostril axes significantly decreased postoperatively in all patients except one, by an average of 11.08%±6.52% in the anterior-posterior view and 17.74%±8.49% in the lateral view (P<0.01). There were no complications, including asymmetry, contracture, subdermal plexus injury, flap congestion, or infection. Conclusions A quantitative analysis of alar retraction by evaluating the ratio of nostril axes showed that alar rim redraping is a simple and effective adjuvant technique for preventing alar retraction in rhinoplasty for young Asian men.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.569-579
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• 2022

Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.

• 의료법학
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• 제16권1호
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• pp.3-82
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• 2015

이 논문에서는 미용성형의료관계에서 설명의무의 위반과 시술상 오류로 인한 민사책임에 관한 판결(대법원 2013. 6. 13. 선고 2012다94865 판결, 서울중앙지방법원 2014. 12. 5. 선고 2013가소865646 판결)의 평석적 분석을 통해 설명의무만를 강화하여 책임귀속을 판단한 논지의 법리적 문제점을 지적하고, 다음과 같은 논점을 전개한다. 미용성형도 현행 의료법상 의료행위에 해당한다는 판례(대법원 1974. 11. 26. 선고 74도1114 전원합의체 판결)와 학계의 통용되는 견해는 공법적 관점에서만 타당하며, 적응증이 없는, 즉 질병 치료를 목적으로 하지 않는 순수한 미용성형시술은 의술적으로 신체, 건강 등에 위해를 가할 수 있는 의료법상 의료행위에 해당하지만, 민사책임법에서는 질병치료를 목적으로 하는 진료행위와 구별되어야 한다. 그리고 오늘날 의료생활에서 의료보험의 불가결성에 비추어, - 방법적으로 사회법상 개념 및 규준을 곧바로 민사책임법에 적용되는 것은 아니라는 점을 견지하면서 -, 성형시술에 대한 보험급여에 관한 독일 연방사회법원 판결(BSGE 63, 83, BSGE 72, 96, BSGE, 82, 158, BSGE 93, 252 etc.)을 소개하여 비교한다. 또한 진료계약의 법적 성질에 관한 교조적 논점과 관련하여 독일 연방법원의 판결(BGHZ 63, 306)도 비교적으로 검토한다. 소결적으로 성형의료를 (1) 신체의 물리적 기능의 침해의 교정, (2) 기형(騎形)의 교정, (3) 심인적 침해의 교정, (3) 정상적 체형(體型)의 미화(美化)로 유형적으로 분류하는 관점에서, 적응증 있는 진료계약(수단채무)에 적용하는 책임귀속법리와 달리, (4)의 유형에 해당하는 미용성형시술에는 예외적으로 도급계약의 법리 적용을 긍정적으로 재검토할 것을 제안한다.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.589-596
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• 2008

Purpose: The nasal bone fracture is most common fracture in facial bone injuries. Regardless of the severity or type of fracture, closed reduction has traditionally been the common method of treatment. However, through detailed pre-operative evaluation, we found out that many patients consider rhinoplasty prior to trauma due to aesthetic desire or nasal deformity with or without septal deviation. In treatment of nasal bone fracture, we focused not only on the fracture management but also on the patients' desire prior to trauma, and we made additional operation according to patients' desire with fracture reduction and gained rewarding outcomes. Methods: From March 2005 to June 2007, total 263 patients were treated for nasal bone fracture. Among these patients, 57 patients (21%) had the additional operation with nasal fracture reduction. The additional operations were categorized in three types: augmentation rhinoplasty with tip plasty (40%), septoplasty only (16%), corrective rhinoplasty (44%). The mean follow-up period was 5.6 months and results were evaluated by scoring. Results: Forty four of 57 patients (77%) were highly satisfied regardless of any additional operation kinds. The complications were one septal perforation, two displacement of implant and four remnant nasal deformities. For the septal perforation, no further management was performed because we lost the contact with the patient. Then 4 of the other complicated patients were revised. Conclusion: In general, many physicians tend to consider nasal fracture as a simple trauma. However through the strict history taking, physical examination and professional counseling, we could catch the patient's cosmetic desire and get the eyes on new concept: the nasal fracture is not only a trauma but a cosmetic and functional field. In the treatment of nasal bone fracture, if additional rhinoplasty is performed, patients will be more satisfied and we also can expect higher profits.

• 수면정신생리
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• 제12권1호
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• pp.64-67
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• 2005

폐쇄성 수면무호흡증은 이비인후과영역에서 흔하게 관찰되는 질환 중 하나로 수면 중에 상기도의 폐쇄로 인한 호흡정지가 주요한 병인이며 상기도를 구성하는 비강, 구강, 인두, 후두 중 어느 한 부분에서 폐쇄가 일어나도 질환의 원인이 될 수 있다. 비폐색의 가능한 원인들로는 주로 비중격 만곡, 비용, 기포성 갑개, 후비공 폐쇄, 종양, 이물, 술 후 또는 외상 후 발생한 유착, 여러 가지 비염, 기타 질환 등이 있다. 폐쇄성 수면무호흡증의 수술적 치료에는 비강수술, 구개인 두수술, 편도 및 아데노이드 절제술, 설부 축소수술, 기관절개술 등 여러 가지가 있는데 문헌들을 고찰한 결과 지금까지 성인에서 수면무호흡증 치료로 시행한 비강수술의 효과에 대해서는 아직 논란의 여지가 있는 상태이다. 최근 저자들은 비폐색과 동반된 코골이 및 수면무호흡증 환자에서 비폐색과 수면무호흡증의 원인으로 생각되는 비중격 만곡증 및 비후성비염을 교정하기 위해 비중격 교정술 및 하비갑개 절제술을 시행한 결과 수술 전, 후의 증상 및 수면 다원검사 비교에서 뚜렷한 호전을 경험하였기에 보고하는 바이다.