• Archives of Plastic Surgery
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• 제48권4호
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• pp.427-432
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• 2021

The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2-0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.

• Journal of Korean Neurosurgical Society
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• 제60권3호
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• pp.371-374
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• 2017

Ganglioneuroma (GN) is a rare benign tumor of neural crest origin usually found in the abdomen, but may occasionally present at uncommon sites including the cervical, lumbar, or sacral spine. However, GNs of thoracic spine are extremely rare. In this report, we describe a 12-year-old girl with giant GN in the thoracic spine, who underwent successful resection (T1-4 level) of the tumor. Histopathological examination confirmed the diagnosis. GN should be considered in the differential diagnosis of any paraspinal mass. A high index of suspicion and correlation of clinico-radiological findings is necessary in differentiating a large benign tumor from a malignant growth. Complete surgical excision is the treatment of choice; however tumor size and location need to be considered for the surgical approach (one-step or multiple surgeries). Close follow-up after surgery is mandatory.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.61-70
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• 2019

Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.563-568
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• 2022

Rhinoplasty is one of the first surgical procedures described with evidence in the history of medicine. At first, these were performed for the reconstruction of traumatic defects caused by punishments, sequels of war, and then it had been reused after suffering from diseases such as syphilis. Many techniques have been developed from the need of aesthetics outcomes in this field. The objective of our work is to describe a modified approach of recycled dorsum preservation procedure that we have proposed as a safe and reliable technique. In this work, we have showed that this technique has a marked advantage of preserving the natural tissue with satisfactory postoperative result. We had no functional complications up to date. We recommend that every specialist in the field of rhinoplasty should be able to use it as a reproducible and feasible alternative.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.225-230
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• 1999

The labiomandibulotomy approch to the oral cavity and oropharygeal region was first described by Roux in 1836 and become popular for oral and oropharyngeal tumors in cases where there are no clinical and radiological signs of mandible invasion. Anterior labiomandibulotomy and swing procedure provides excellent access and facilitate a mandibular resection and subsequent repair. In last two years, 8 cases of oral and oropharyngeal tumors were treated by this approach at the Dept. of Oral & Maxillofacial Surgery, Holy Family Hospital, Catholic University of Korea. And we analyzed postoperative complications as well as functional evaluations, and the results were as follows; In 4 cases, marginal mandibulectomy were combined with labiomandibulotomy and in case of malignancies, neck dissection was performed simultaneously. In almost case, plate and miniscrew fixation was used for osteotomy sites. Histologic evaluation of the resection margins of the specimens revealed tumor free in all cases. The postoperative complications were occured in 3 cases, one case of nonunion, one case of orocutaneous fistula, and one case of wound dehisence. Occlusal stability, jaw movement and swallowing function were acceptable postoperatively in 3 months. From above results, we concluded that, this approach not only provides wide exposure, permitting radical removal of benign and malignant lesions but also preserves function with minimal complications.

• Journal of Chest Surgery
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• 제49권6호
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• pp.489-492
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• 2016

The original valve-sparing procedures for aortic root aneurysms were remodeling and reimplantation of the aortic root. The remodeling technique provides more physiologic movement of the cusps within 3 reconstructed neo-sinuses, thus preserving root expansibility through the interleaflet triangles. However, the durability of remodeling has been a matter of concern due to the high rate of aortic insufficiency when annular dilation is not addressed. Therefore, a modified approach was developed, combining a physiologic remodeling of the root with a subvalvular annuloplasty. This case report highlights the first case of successful aortic root remodeling with external subvalvular ring annuloplasty in Korea.

• 대한두개안면성형외과학회지
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• 제20권3호
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• pp.195-198
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• 2019

A-50-year-old male patient presented with complaint of tenderness on the left malar area after traffic accident. Our first impression on him was zygomatic fracture, we did radiologic work-up and physical examination on him. But, on the computed tomography scan, there was no fracture or discontinuity on his facial bone. The computed tomography scan was revealed a 4-cm long foreign body in left maxillary sinus with a large amount of fluid collection. After thorough history taking from him, we reveal the patient had a history of trauma 30 years back on the left zygomatic area with a chopstick. The foreign body was removed via transoral approach with the endoscopic assist. There was no complication after operation.

• Archives of Plastic Surgery
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• 제49권4호
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• pp.538-542
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• 2022

Performing the first peer review of a plastic surgical research article can be an overwhelming task. However, it is an essential scholarly skill and peer review is used in a multitude of settings: evaluation of journal articles, conference abstracts, and research proposals. Furthermore, peer reviewing provides more than just the opportunity to read and help improve other's work: peer reviewing can improve your own scientific writing. A structured approach is possible and recommended. In these ten tips, we provide guidance on how to successfully conduct the first peer reviews. The ten tips on peer reviewing concern: 1) Appropriateness: are you qualified and prepared to perform the peer review? 2) Familiarization with the journal and its reviewing guidelines; 3) Gathering first impressions of the paper followed by specific tips for reviewing; 4) the abstract and introduction; 5) Materials, methods, and results (including statistical considerations); and 6) discussion, conclusion, and references. Tip 7 concerns writing and structuring the review; Tips 7 and 8 describe how to provide constructive criticism and understanding the limits of your expertise. Finally, Tip 10 details why-and how-you become a peer reviewer. Peer review can be done by any plastic surgeon, not just those interested in an academic career. These ten tips provide useful insights for both the aspiring and the experienced peer reviewer. In conclusion, a systematic approach to peer reviewing is possible and recommended, and can help you getting started to provide quality peer reviews that contribute to moving the field of plastic surgery forward.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권12호
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• pp.697-701
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• 2018

Background and Objectives The aim of this study was to evaluate surgical completeness in endoscopic total thyroidectomy with central neck dissection via unilateral axillo-breast approach (UABA) compared with bilateral axillo-breast (BABA) and open approach (OA) by means of the radioactive iodine uptake (RAIU) ratio and thyroglobulin (Tg) of remnant thyroid. Subjects and Method From July 2010 to March 2013, 82 patients who had underwent total thyroidectomy with central neck dissection and postoperative radioactive iodine (RAI) ablation for papillary thyroid carcinoma were enrolled. Of these patients, 27 patients underwent UABA, 24 patients BABA, and 31 patients OA. Clinicopathologic data, surgical outcome, stimulated Tg and RAIU ratio on the first postoperative RAI ablation scan were compared among 3 groups. Results Patients in the endoscopic surgery groups (UABA, BABA) were younger than those in the OA groups. Invasiveness such as operation time, postoperative pain, and drain amount in UABA was less than that in BABA and severer than that in OA. Other variables regarding clinicopathologic and surgical data were not significantly different. Stimulated Tg and RAIU ratio did not show significant differences among 3 groups (p=0.659 and p=0.664). Conclusion The completeness of UABA was comparable with that of BABA and OA. The UABA may be a safe option for patients who need endoscopic thyroidectomy for papillary thyroid carcinoma.

• Journal of Chest Surgery
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• 제5권1호
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.