• 대한소아치과학회지
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• 제25권3호
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• pp.545-548
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• 1998

Sialolithiasis is the formation of calcareous concretions within ductal system of a major or minor salivary gland. They are formed by deposition of calcium salts around a central nidus which may consist of desquamated epithelial cells, bacteria, foreign bodies, or products of bacterial decomposition. An 11-year-old boy complained of pain during meals and intermittent mild swelling in the right submandibular region. Although it was not detected in true occlusal radiograph, panoramic radiograph showed a round radiopaque mass 3mm in diameter. Computed tomography(CT) was taken for locating the stone and 3-dimensional reconstruction was performed. Under general anesthesia, sialoadenectomy was done through extraoral approach. Diagnosis of submandibular sialolithiasis using high-resolution CT with reconstructions was helpful for surgical decisions, namely radical removal of the submandibular gland and its duct.

• 대한치과의사협회지
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• 제40권8호통권399호
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• pp.615-619
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• 2002

• Archives of Plastic Surgery
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• 제37권1호
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• pp.75-78
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• 2010

Purpose: Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. The purpose of this study is to examine the clinical characteristics of rare bilateral plunging ranula arising from accessory submandibular gland in order to provide our experience for its correct diagnosis and treatment. Methods: A 13-year-old girl manifests as a slow growing painless, non-mobile swelling in the anterior neck. She underwent surgery via a cervical approach. A pseudocyst was extirpated and adjacent accessory gland tissue and related lymph node were removed. Results: The histologic appearance is characteristically of a cyst, devoiding of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophage stuffed with mucin. Pathologic findings represented a form of myxomatous degeneration and lined by condensed connective tissue and granulation tissue. The nature of the accessory gland tissue was same as subligual gland. Although total submandibular or sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods. Conclusion: Usually, unilateral plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. But our case developed because of bilateral congenital accessory submandibular gland. This is thought to be a result from a congenital failure of canalization of the terminal end of the duct. Finally, the correct diagnosis is essential for the most effective treatment, which is excision of the ranula and related accessory salivary gland. We performed excision of accessory submandibular gland and plunging ranula and had a good result without recurrence.

• 대한기관식도과학회지
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• 제14권1호
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• pp.23-28
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• 2008

Background and Objectives : Traditionally, the excision of submandibular gland (SMG) has been commonly used for treatment of calculi in the proximal duct or gland parenchyma. Over the last 10 years several new minimally invasive techniques including lithotripsy, sialendoscope were introduced in the treatment of sialolithiasis. But these have some limitation on large, infected calculi. The aim of this study is to assess the intraoral treatment of submadibular stones. Subjects and Method : The records of one hundred and seventy-three patients who underwent intraoral removal of submadibular sialolithiasis between June 1, 1989 and July 31, 2006 were retrospectively reviewed. Results : Stone location was distal to the edge of the mylohyoid muscle in 127 patients and proximal to gland in 48 patients (mean size of sialoliths, 7.1mm [range 3.0-25mm]). The complete removal of stones was observed in 170 (97.1%) patients regardless of size and location. Recurrence of lithiasis was found in 8 patients (then treated with intraoral removal in 5 patientsand resection of SMG (submandibular glands) in 3 patients). Acalculous sialadenitis in 9 patients (5.1%) and cyst formation in 2 patients (1.1%) was found. But no evidence of postoperative complications including hemorrhage, fistula, damage to lingual nerve were found. Conclusion : The intraoral removal of submandibular stone is useful in preservation of submandiblar function and effective in palpable stones regardless of location, size.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.267-276
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• 2022

Objectives: Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Materials and Methods: Six cases of condylar fractures treated with modified HSMA technique were reviewed. Results: Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Conclusion: Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.61-69
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• 1997

The submandibular gland is one of the major salivary glands, salivary diseases frequently occuring site due to its anatomical weakness. This retrospective study evaluated data pertaining to history, sex, operation method, age distribution, diagnosis through the chart, operation record, radiographs, histologic finding of 51 patients operated on for the submandibular gland excision from 1986 to 1995 in our hospital so that we improve on the understand of the salivary gland diseases. The results were as follows ; 1. The chief complaints was mass, swelling mainly. 2. The ratio of affected site was 47.1 : 51 in left : right respectly, both sites was 1 case especially. 3. The ratio of men to women was 56.9 : 43.1 4. The operation performed all through the extraoral approach. 5. The sialolith presented at 24 cases. 6. The most patients had a two weeks duration period. 7. The age distribution was the third decade(29.4%), the second decade(27.5%) in order. 8. The symptoms accompanied the chief complaints was pain(37.3%), mass(17.6%), swelling(13.7%), trismus(13.7%) in order. 9. The diagnosis was sialadenitis with stone(S.W.S.) (45.1%), sialadenitis without stone(S.W.O.S.) (17.6%), pleomorphic adenoma(P.A.) (15.7%), abscess(Abs) (5.9%), tuberculosis(Tbc) (5.9%) in drder.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권3호
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• pp.149-155
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• 2015

Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixate the fractured unit tangentially. Tangential fixation is critical to osteosynthesis. Disadvantages of the transmasseteric antero-parotid facelift approach include damage to the facial nerve and a longer operation time. However, after the initial learning curve, facial nerve damage can be avoided and operation time may decrease. We report three cases of subcondylar fractures that were treated with a transmasseteric antero-parotid facelift approach. Among these, two cases had trivial complications that were easily overcome. Instead of dissecting through the parotid gland parenchyma, the transmasseteric antero-parotid facelift approach uses transmasseteric dissection and reduces facial nerve damage more than the retromandibular transparotid approach. The esthetic result is superior to that of other approaches.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.141-144
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• 2010

Sialolithiasis is the common pathology of salivary gland. The size of sialoliths vary from 1 mm to a few cm, but most of that are less than 10 mm. Large sialoliths (larger than 15 mm) are extremely rare. It is called Giant sialolithiasis or megalith. Symptom of the giant sialolithiasis is similar to that of regular sialolithiasis. First choice of treatment is removal of the stone. Many literatures reported various methods to remove the sialoliths. For this case report, we accidentally found the giant sialolith on the computed tomography taken for dental implant, and successfully removed the stone by minimal invasive surgical approach. Base on this result, we report this case with literature reviews.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권1호
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• pp.72-82
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• 2008

Various surgical approaches in the mandibular condyle fracture have been reported and many advantages of intraoral reduction were also introduced. But there are still controversies about surgical method of condylar fractures up to date. To establish the surgical approach protocol of condylar fracture, from May 2001 to December 2004, total 65 patients with 74 fractures of the mandibular condyle were reviewed during 2 years, retrospectively. All cases were classified according to the treatment considering factors, such as the level of fracture, degree and direction of displacement of fractured segment, patient’s age and gender, surgical approach methods, and their complications. Especially, advantages and surgical limitations of extraoral surgical approach, such as direct reduction and fixation via submandibular approach, Nam’s method, and endaural approach, were compared with those of intraoral surgical approach, such as direct intraoral reduction with transbuccal fixation or right angle driver system, and intraoral reinsertional approach after extraoral fixation of fractured fragment. The guidelines of surgical approach of condylar fracture based on our clilnical retrospective experiences and literature reviews can be suggested.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권3호
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• pp.182-185
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• 2017

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.