• The Journal of the Korean dental association
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• v.55 no.10
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• pp.696-705
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• 2017

Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.83-86
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• 2015

Recently, computer-assisted surgery is popular for performing well-planned operations. Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, segmental mandibulectomy and reconstruction flap surgery have done by extra-oral approach such as, submandibular approach. This case report describes performing intra-oral segmental mandibulectomy and reconstruction with monocortical deep circumflex iliac artery (DCIA) flap and CT guided implant surgery by using computer-aided surgical guide and navigation for managing ameloblastoma in a 31 years old female patient.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.277-281
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• 2022

Craniocerebral gunshot injuries is gradually increasing in the civilian population with a worse prognosis than closed head trauma. We experienced a case of craniocerebral gunshot injury which a bullet penetrating from the submandibular area into the clivus of a patient. The patient did not show any symptom. However, serial laboratory findings showed an increase in blood lead level. We removed foreign bodies without any problems using an endoscopic transnasal transclival approach. Due to the extremely low frequency, guidelines for definitive management of gunshot injuries have not been presented in Korea yet. We introduce our surgical experience of a craniocerebral gunshot injury with an unusual approach for removing intracranial foreign bodies.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.33-36
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• 2009

Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.6
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• pp.631-635
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• 2007

Purpose: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. Material and methods: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 patients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. Result: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. Conclusion: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.186-190
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• 1995

타석증을 동반한 만성 악하선 타액선염의 경우 악하선 적출은 일반적인 치료 방법이다. 일반적으로 악하선 적출술은 수술의 용이성, 수술시야의 확보 등의 장점으로 구강외접근에 의해서 시행되어져 왔다. 그러나 시대적으로 심미적인 요구가 증대되고 있는 요즈음 구외 접근으로 인한 술후 반흔은 구외접근법의 가장 결정적인 단점이라 할 수 있다. 또한 설하선과 함께 적출하여야 할 경우 구내접근과 구외접근을 동시에 실시할 경우 술후 치유과정상의 후유증을 유발할 수도 있다. 반면에 구강내 접근에 의한 악하선의 적출은 수술상의 고도의 난이도로 수술자체의 어려움은 있으나 구강의 반흔을 남기지 않아 심미적으로 만족할 만한 결과를 얻을 수 있다. 이에 본 저자 등은 타석증을 동반한 악하선 타액선염의 환자에 있어 구내 접근으로 악하선 및 설하선 적출술을 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.395-400
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• 1999

Elongation of the styloid process (styloid syndrome, Eagle's Syndrome) is named after Eagle who insisted the styloid process as a cause of pain but distinguishable from the glossopharyngeal neuralgia. Eagle's syndrome is characterized by a dull nagging pharyngeal pain, a palpable hardness in the tonsillar fossa, radiopaque elongation and enlargement of the syloid process. This is to report two cases of Eagle's Syndrome. The clinical and radiological features, development and pathogenesis of the Eagle's Syndrome and pathologic findings of the calcified styloid ligaments were described with review of literatures. The external cervical approach to resect the enlarged calcified processes can be an option due to better visualization and accessbility, less infection at risk than intra-oral approach. The findings and results were as follows ; 1. The calcified styloid ligaments accompanied with throat pain were reseded in size of $5.5{\times}48mm(#1,\;Rt)$, $3.6{\times}5mm(#1,\;Lt)$, $5.2{\times}51mm(#2,\;Rt)$ and $3.1{\times}38mm(#2,\;Lt)$. 2. The submandibular approach to resect the calcified styloid process is of help to get better visibility and accessiblilty avoiding the injury to the deep cervial vital structures. 3. The resected styloid processes were examined histopathologically as the matured cortical bones with marrow structures or cartilagenous cells without any findings of neoplasmic changes. 4. The remained process did not show any noticeable regrowth in 3 years after surgical amputation.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.284-286
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• 2011

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.351-358
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• 2010

A 31-year-old woman with hemifacial microsomia presented to the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The patient was previously treated with distraction osteogenesis device to elongate right maxilla and mandibular ramus. But, the result was not satisfactory, to correct residual facial asymmetry due to hemifacial microsomia we planned costochondral graft for reconstruction of ramus and condyle, Le Fort I osteotomy and sagittal split ramus osteotomy for facial asymmetry. The right mandibular condyle and ramus was reconstructed with right eleventh costochondral graft via submandibular approach. Using costochondral graft and orthognathic surgery the facial asymmetry in hemifacial microsomia patient was corrected. 1-stage treatment consists of costochondral graft and orthognathic surgery can achieve function and esthetics at the same time, is timesaving to both patient and surgeon.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.442-446
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• 2001

Purpose : This study evaluated clinical and radiographic results after open reduction and lag-screw fixation of mandibular condyle fractures. Patients and Methods : 26 patients had been treated by lag-screw fixation for madibular condyle fracures via submandibular approach and follow up for over 6 months. The lag-screw used in this study was designed by Eckelt. Results : Radiographically, resorption of the condyle head found in 4 cases (15%) and minimal displacement of the condyle head was found in 3 cases (12%). Post-operative infection were not found in all cases. Clinically, All patiens had a stable occlusion and normal mouth opening (over 40mm). TMD problems with crepitus or some discomfort encountered in 4 patients but tolerable to the patients. Conclusion : Lag screw fixation can be a good option especially high level condylar fractures, however this procedure must be used in cautiously because of slipping of the fragments and possible to resorption of the fragments.