Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.32
no.5
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pp.410-417
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2006
The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.
Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki;Nah Byung Sik
Radiation Oncology Journal
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v.14
no.1
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pp.1-8
/
1996
Purpose: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancer in terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. Materials and Methods: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to APr. 1993. Of these, twenty six patients were treated by conventional radio-therapy alone, and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The Patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of Primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The range of follow-up periods was 3-102 months and median was 20 months. The range of a9e was 33-79 years old and median was 58 years old. Results : Overall 3-year actuarial survival rate (3YSR) of all patients was $39\%$. The 3YSRS of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55, 33 and $32\%$, respectively The 3YSRS of Tl+2, T3+4 and No, N+ were 55, $18\%$ (p=0.005) and 43, $36\%$ (p>0.1), respectively. There was no difference in 3YSRS between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs $43\%$, p>0.1). According to the original site of primary tumor, the 3YSRS of tonsil (n=32), base of tongue (n=8), soft palate or uvula (n=6) and pharyngeal wall (n=1) were 36 38, 67 and $0\%$, respectively The Patients of soft palate or uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 Patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not Primary extension, but the difference was marginally significant statistically (24 vs $60\%$, p=0.08). On Cox multivariate analysis in entire patients with variables of age, T stage, N stage, total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy, only T stage was a significant Prognostic factor affecting 3YSR. Conclusion : The difference of 3YASRS of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal cancer, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multi-modal approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.
The aim of present investigation was to clinically measure the thickness of palatal masticatory mucosa in the hard palate as potential donor site for mucogingival surgery, to determine the relation to shape of palatal vault, form of tooth, gender, and to serve the clinical criteria t o choose the proper surgical technique. 84(mean age:25yrs) systemically and periodontally healthy volunteers participated in this study and 18 standard measurement points were defined in the hard palate, located on 3 lies which ran at different distances parallel to the gingival margin. 6 positions were designated on each of these 3 lines between the level of canine and 2nd molar and a bone sounding technique using a periodontal probe with minimal local anesthesia was utilized to assess the thickness of palatal masticatory mucosa. Student t-test was used to determine the difference in mucosal thickness between 2 groups gender, shape of palatal vault (high palatal vault vs. low palatal vault), tooth form (short-wide vs. long narrow) The result of this study were as follows: 1. Soft tissue thickness progressively increased in sites further away from the gingival margin (p<0.01). 2. Depending on position, in line a and line c the masticatory mucosal thickness increased from Ca to M2(p<0.01), but in line b the thickness increased from Ca to P2, and decreased to M1 and increased again to M2. 3. Gender did not influence the thickness of masticatory mucosa. 4. Palatal vault shape was associated with the thickness of masticatory mucosa. Thickness of low palatal vault group was thicker than high palatal group between P2 and M2 position. 5. Form of tooth did not influence the thickness of masticatory mucosa. In conclusion, palatal vault shape was associated with the thickness of masticatory mucosa. So, mucogingival surgery can be considered as a treatment modality in high palatal vault group. But, Gender and tooth form did not influence the thickness of masticatory mucosa.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.5
no.1
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pp.44-58
/
1994
The formants of the 9 Korean standard vowels(which used by the average people of Seoul, central-area of the Korean peninsula) were measured by analysis with the linear predictive coding(LPC) and fast Fourier transform(FFT). The author already had reported the constriction area for the Korean standard vowels, and with the existing data, the distance from glottis to the constriction area in the vocal tract of each vowel was newly measured with videovelopharyngograms and lateral Rontgenograms of the vocal tract. We correlated the formant frequencies with the distance from glottis to the constriction area of the vocal tract. Also we tried to correlate the formant frequencies with the position of tongue in the vocal tract which is divided into 2 categories : The position of tongue in oral cavity by the distance from imaginary palatal line to the highest point of tongue and the position in pharyngeal cavity by the distance from back of tongue to posterior pharyngeal wall. This study was performed with 10 adults(male : 5, female : 5) who spoke primary 9 Korean standard vowels. We had already reported that the Korean vowel [i], [e], $[{\varepsilon}]$ were articulated at hard palate level, [$\dot{+}$], [u] were at soft palate level, [$\wedge$] was at upper pharynx level and the [$\wedge$], [$\partial$], [a] in a previous article. Also we had noted that the significance of pharyngeal cavity in vowel articulation. From this study we have concluded that ; 1) The F$_1$ is related with the oral cavity articulated vowel [i, e, $\varepsilon$, $\dot{+}$, u]. 2) Within the oral cavity articulated vowel [i, e, $\varepsilon$, $\dot{+}$, u] and the upper pharynx articulated vowel [o], the F$_2$ is elevated when the diatance from glottis to the constriction area is longer. But within the lower pharynx articulated vowel [$\partial$, $\wedge$, a], the F$_2$ is elevated when the distance from glottis to the constriction area is shorter. 3) With the stronger tendency of back-vowel, the higher the elevation of the F$_1$ and F$_2$ frequencies. 4) The F$_3$ and F$_4$ showed no correaltion with the constriction area nor the position of tongue in the vocal tract 5) The parameter F$_2$- F$_1$, which is the difference between F$_2$ frequency and F$_1$ frequency showed an excellent indicator of differenciating the oral cavity articulated vowels from pharyngeal cavity articulated vowels. If the F$_2$-F$_1$ is less than about 600Hz which indicates the vowel is articulated in the pharyngeal cavity, and more than about 600Hz, which indicates that the vowel is articulated in the oral cavity.
Journal of the korean academy of Pediatric Dentistry
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v.29
no.1
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pp.44-50
/
2002
Apert syndrome is a kind of congenital-acrocephalosyndactyly syndrome which was first reported by Apert in 1906 and characterized by its acrocephaly and syndactyly. Clinical characteristic features are cone-shaped skull morphology due to early fusion of coronal suture, fusion of fingers of hands and toes of feet. It is an autosomal dominant-heritable syndrome. Due to hypo-development of midface region, Apert syndrome patients have a tendency to have ocular proptosis, hypertelorism, maxillary deficiency. High palate and soft palate cleft are common findings in these patients. In general, mandibular growth pattern is normal, but relative maxillary deficiency exaggerates mandibular forward position, so relative mandibular prognathism is inevitable. Narrow maxillary and mandibular dental arch worsen teeth alignment and crowding. Skeletal malocclusion and open bite are also common. This is a case report of a Korean 3 year 1 month male Apert syndrome child referred by department of plastic surgeon for the possibility of orthodontic treatment. General features of Apert syndrome, patient's medical history, radiographic evaluation, clinical examination, orthodontic and surgical treatment planning are discussed in this report.
Kim, Minji;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Jang, Ki-Taeg
The Journal of Korea Assosiation for Disability and Oral Health
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v.15
no.1
/
pp.79-83
/
2019
Treacher Collins syndrome(TCS) is an autosomal craniofacial development disorder which results from mutations in the gene TCOF1. Major features include midface hypoplasia, micrognathia, microtia, conductive hearing loss. Oral manifestations are characterized by cleft palate, shortened soft palate, malocclusion, anterior open bite and enamel hypoplasia. The purpose of this presentation is to describe the interesting aspects of dental treatment of a patient with TCS. A 6-year-old boy with TCS visited Seoul National University Dental Hospital for dental caries. Multiple caries was observed from clinical and radiographic examination. Because of multiple caries and behavior management ploblem, dental treatment under general anesthesia was planned. Treatment of posterior teeth was performed and some primary teeth were extracted. General anesthesia was induced and maintained with sevoflurane, nitrous oxide and oxygen. Under general anesthesia, successful dental procedure was done. Considering behavior management problem and medical condition of patient with TCS, general anesthesia can be useful.
Kyeong-Hee Lee;Yoon-Young Choi;Eun-Seo Jung;Hyun-Young Moon;Mi-Sook Yoon;Kyeong-Jin Lee
Journal of Korean society of Dental Hygiene
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v.24
no.3
/
pp.209-218
/
2024
Objectives: This study aimed to develop educational content for a smartphone app on oral muscle training and examine its effects on the elderly population. Methods: A total of twelve training sessions were delivered through the smartphone app over a six-week period, from late August to early October 2023. Each session lasted approximately 60 minutes. Participants were followed up after the program. Results: The experimental group showed significant improvements in oral health before and after using the smartphone app. These improvements included decreased dental plaque (p<0.05) by 0.69 units, decreased gingivitis (p<0.001) by 0.99 units, decreased tongue plaque (p<0.01) by 1.11 units, increased salivary secretion rate (p<0.001) by 0.73 units, increased hard palate strength (p<0.001) by 5.25 units, and increased soft palate strength (p<0.01) by 6.82 units. Compared to the control group, the experimental group showed significant improvements in dental plaque (p<0.001), gingivitis (p<0.001), and tongue coating (p<0.01). Conclusions: This study found that oral muscle strengthening training using the smartphone app effectively improved oral health in the elderly. The developed app content has the potential to be a valuable tool for promoting oral health in this population within their daily routines. However, further efforts are needed to ensure clear communication and effective utilization of the training program through user training or educational materials.
Purpose: We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. Materials and Methods: From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. Results: The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Conclusion: Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.
Ahn, Hee Chang;Youn, Dong Hyun;Choi, Matthew Seung Suk;Chang, Jung-Woo;Lee, Jang Hyun
Archives of Craniofacial Surgery
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v.16
no.3
/
pp.131-135
/
2015
Background: Variable methods have been introduced for reduction of the zygomatic fractures. The Dingman elevator is used widely to reduce these fractures but is inappropriate in certain types of fractures which require atypical traction vectors. We introduce and examine an alternate method of reducing zygomatic fractures using wire and hook traction. Methods: A retrospective study was performed for all zygomatic fracture patients admitted between 2008 and 2014. Medially rotated fractures were reduced by using a wire looped through an intermaxillary screw secured on the medial side of the zygoma. Laterally rotated fractures were reduced using a hook introduced through an infrazygomatic skin incision. Results: No accidental bleeding or incomplete reduction was observed in any of the cases. Postoperative imaging demonstrated proper reduction immediately after the operation. Follow-up computed tomography study at 1 month after operation also demonstrated proper reduction and healthy union across the previous site of fracture. Conclusion: The hook and wire method allowed precise application of traction forces across zygomatic fractures. The fractured bone fragment could be pulled in the direction precisely opposite to the vector of impact at the time of trauma. Soft tissue damage due to dissection was minimized. In particular, this method was effective in reducing rotated bone fragments and can be an alternative option to using the zygoma elevator.
Background: The reduction of orbital blowout fracture primarily aims to normalize the extra-ocular movement by returning the herniated orbital soft tissue into the original position, and to prevent enophthalmos by normalizing the orbital cavity volume. We introduce a balloon catheter-assisted orbital floor reduction technique. Methods: A retrospective review was performed for all patients with orbital floor fracture who underwent the technique described in the main body of this text. Medical records were reviewed for demographic data, clinical presentation and course, degree of enophthalmos, intraorbital volume on computed tomography scan, and postoperative outcomes. The enophthalmos and intraorbital volume of the injured site were compared to the uninjured eye and orbit. Results: The review identified 14 patients (11 male, 3 female). The mean preoperative difference in en-exopthalmos was 2.13 mm, while the mean orbital volume was 116%. The mean postoperative difference in en-exophthalmos had improved to 0.61 mm with a mean orbital volume of 101.85%. At the time of catheter removal at 10 days, three patients experienced diplopia (n=1), extra-ocular movement disorder (1), or enophthalmos (1). All of these had resolved by the 6-month follow-up visit. Conclusion: Balloon catheter-assisted reduction of the orbital floor fractures was associated with improvements in intraorbital volume and enopthalmos in the 14 patients. Notable complications included diplopia, enophthalmos, and limited extra-ocular movement, all of which were transient in the early postoperative period and had resolved by 6-month follow up.
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