• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.77-80
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• 2009

Mucosa-associated lymphoid tissue(MALT) lymphoma is thought to originate from marginal zone B-cells. In the WHO classification, Extranodal marginal zone lymphoma of MALT is classified B-cell Non-Hodgkin lymphoma. Common sites of MALT lymphoma include stomach, lung and the ocular-adnexa. Although less common in other sites, it is the most common low-grade lymphoma of the breast, thyroid, bowel skin and soft tissue. No strong age or gender predominance exists in MALT lymphoma. Dissemination to other sites can occur. In the oral cavity, MALT lymphoma is rare. Herein, we present a case of intra-oral MALT lymphoma. 66 year-old woman without any background of immunodeficiency or autoimmune disease admitted department of oral & maxillofacial surgery in Ulsan university hospital for evaluation of long-standing mild upper lip swelling. The lesion was completely resected and biopsied. Histological and immunohistochemical stains(CD3, CD5, CD20, CD21, CK) findings were used to confirm the lesion. Bone marrow biopsy was done and no bone marrow involvement was found. She did not receive chemotherapy and radiotherapy after surgery. No recurrence has been noted in the 22 months to date.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.175-180
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• 2018

Background: The facial bone has a complex structure compared to other bones, and various types of fractures can occur due to its characteristics. Among them, in comminuted fractures of anterior maxillary wall, multiple depressed and impacted bony segments cannot be reduced easily when performing internal fixation using plates and screws or wires, and inadequate restoration leads to a range of complications. This paper introduces an alternative technique using a resorbable mesh with fibrin glue to restore comminuted fractures of anterior maxillary wall. Methods: Thirteen patients were diagnosed with comminuted fractures of anterior maxillary wall between March 2017 and February 2018 in the authors' hospital. All patients with comminuted fractures of anterior maxillary wall underwent restoration using resorbable mesh with fibrin glue. The patients' demographics, causes of facial trauma, mean operation time, length of hospital stay, follow-up period, and complications were recorded. Results: No major complications and only one hypoesthesia of the skin area was noted. Three months after surgery, the hypoesthesia recovered completely. After surgery (mean, 3.9 months; range, 2-12 months), computed tomography showed that the bone fragments in all patients were fixed successfully in their anatomical places. Conclusion: In comminuted fractures of anterior maxillary wall, the use of a resorbable mesh with fibrin glue can be an advantageous and effective method for a successful restoration without complications.

• Korean Journal of Head & Neck Oncology
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• v.1 no.1
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• pp.35-61
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• 1985

The surgical treatment of advanced carcinomas and some benign tumors having clinically malignant behaviors of the head and neck region often require extensive resection, necessitating large flaps for reconstruction. Since the original upper arm flap was described by Tagliacozzi in 1597, a variety of technique such as random pattern local flap, axial flap, distant flap, scalping flap, myocutaneous flap, free flap etc. have been proposed for reconstruction of head, face and neck defects. Reconstruction of the facial defects usually require the use of distant tissue. Traditionally, nasal reconstruction has been carried out with a variety of forehead flaps. In recent years, there has been more acceptance of immediate repairs following the removal of these tumors. As a result, patients are more willing to undergo these extensive resections to improve their chances of cure, with the reasonable expectation that an immediate reconstruction will provide an adequate cosmetic result. Authors experienced 13 cases of head and neck tumor during last three and half years that required wide excision and immediate reconstruction with various flaps, not with primary closure or simple skin graft. We present our experience with varied flaps for reconstruction after wide resection of head and neck tumors 3 cases of defect of dorsum of nose or medial canthus with island forehead flaps, lower eyelid defect with cheek flap, cheek defect with Limberg flap, orbital floor defect with Temporalis muscle flap, lateral neck defects with Pectoralis major myocutaneous flap or Latissimus dorsi myocutaneous free flap, subtotal nose defect with scalping flap, wide forehead defect with Dorsalis pedis free flap and 3 cases of mandibular defect or mandibular defect combined with lower lip defect were reconstructed with free vascularized iliac bone graft or free vascularized iliac bone graft concomitantly combined with free groin flap pedicled on deep circumflex iliac vessels We obtained satisfactory results coincided wi th goal of treatment of head and neck tumors, MAXIMAL CURE RATE with MINIMAL MORBIDITY, OPTIMAL FUNCTION, and an APPEARANCE as close to normal as possible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.485-489
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• 2008

Basal cell nevus syndrome is a hereditary disease of an autosomal dominant trait with variable conditions such as basal cell carcinomas of the skin, deformity of rib, fusion of vertebrae, mental retardation, hypertelorism, and multiple odontogenic keratocysts. A 32 years old man with pus discharge from fistula on the vestibule of left upper 1st molar visited to Chosun University Dental Hospital. Radiographic evaluation revealed multiple maxillary and mandibular cysts that had multilocular radiolucency on left mandibular body area, thining of inferior border of left border of ramus and well defined unilocular radiolucency above right upper 1st and 2nd molar and from left upper 1st premolar to 2nd molar. In chest PA view, he had a forked rib in the left 4th rib and in skull PA view the calcification of falx cerebri was observed. There was not any skin lesion. After the preliminary evaluation, the patient was diagnosed with basal cell nevus syndrome and he underwent marsupialization for decreasing the size of cystic lesion and came to hospital for dressing 3days a week. As time goes by, the size of lesion decreased. So, one and half year after marsupialization, he underwent cyst enucleation and iliac bone graft for the mandibular lesion and buccal fat pad grafts for the maxillary lesions. After the surgery, the patient experienced normal healing without any complications and he is on long-term follow-up.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.70-75
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• 2022

Background Fingertip injuries are very common; however, the reconstruction of volar pulp defects with nail bed defects is challenging in the absence of the amputated segment. We reconstructed fingertip amputations with nail bed defects using a new surgical approach: a subcutaneous flap and composite graft. Methods We treated 10 fingertip amputation patients without an amputated segment, with exposed distal phalangeal bone and full-thickness nail bed defects between February 2018 and December 2020. All patients underwent two-stage surgery: in the first stage, a subcutaneous flap was performed to cover the exposed distal phalanx, and in the second stage, a composite graft, consisting of nail bed, hyponychium, and volar pulp skin, was applied over the subcutaneous flap. Results All flaps survived and all composite grafts were successful. The wounds healed without any significant complications, including the donor site. The average follow-up duration was 11.2 months (range, 3-27 months). The new nail and the shape of the volar pulp were evaluated during follow-up. All patients were satisfied with their natural fingertip shapes and the new nails did not have any serious deformities. Conclusions A subcutaneous flap in combination with a composite graft fitting the shape of the defect could be another option for fingertip injuries without amputated segments.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.87-93
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• 2012

Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.407-413
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• 1997

The soft tissue injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade(20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3%) 2. The sexual ration was 4 : 1(M : F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.748-753
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• 2013

Background Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction. Methods Seven patients underwent surgical reconstruction of full-thickness nasal defects with a bi-pedicled forehead flap shaped appropriately to the defect. Patients were aged between 58 and 86 years, with a mean age of 63.4 years. All of the tumors were excised using traditional surgery, and in 4 of the patients, reconstruction was performed simultaneously following negativity of fresh frozen sections of the margins under general anesthesia. Results Nasal reconstruction was well accepted by all of the patients suffering non-melanoma skin tumors with acceptable cosmetic outcomes. The heart-shaped forehead flap was harvested in cases of subtotal involvement of the nasal pyramid, while smaller defects were reconstructed with a wing-shaped flap. No cartilaginous or osseous support was necessary. Conclusions This bi-pedicled forehead flap was a valid, versatile, and easy-to-implement alternative to microsurgery or multi-step reconstruction. The flap is the best indication for full-thickness nasal defects but can also be indicated for other complex facial defects in the orbital (exenteratio orbitae), zygomatic, and cheek area, for which the availability of a flap equipped with two thick and hairless lobes can be a valuable resource.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.194-198
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• 2011

Purpose: Heterotopic calcification is the abnormal deposition of calcium salts in tissues other than bone and enamel, and it occurs in the form of dystrophic calcification or metastatic calcification. This deposition can occur under many conditions, but in some rare cases, it may develop in burns and nonhealed scars. It is difficult to treat the combination of heterotopic calcification and ulceration in scar tissues by using conservative therapy and to determine the margin of excision in such cases. Our study proposes the use of intraoperative C-arm-guided mapping of lesions with heterotopic calcification, and adequate excision of ulcers in chronic scars where heterotopic calcification is also observed. Methods: This study included 2 patients and was conducted from January 2010 to July 2010. The first patient was a 63-year-old woman who presented with atypical calcium deposits and chronic ulceration in the lower one-third region of the right leg. The second patient was a 38-year-old man who presented with a nonhealing ulcer that had developed on the right leg 3 months earlier he had a history of 40% scalding burns on the entire body. Surgery is the most reliable method for treating heterotopic calcification therefore, both patients were treated using intraoperative C-arm-guided marginal mapping of heterotopic calcification, followed by release of contracture, and eventually split-thickness skin grafting. Results: Plain radiographs of the leg showed spotty radiopaque areas in the hard part of the scar well superficial to the underlying bones. Histopathological analysis revealed multiple foci of calcified deposits, increased fibrosis, and inflammation in the scar tissue. Surgery-related complications were not observed. Conclusion: C-arm guided excision of calcified scars and the release of contracture can cure nonhealing ulcers and may therefore prevent recalcification.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.462-470
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• 2022

Background Reactive oxygen species cause serious damage to the physiological function of tissues. Determination of total antioxidant capacity of skin tissue is one of the determinants of damaged tissue function. Mast cells (MCs) are one of the groups of cells that are invited to the site of injury. The healing process begins with the rapid release of various types of MCs' intermediate factors at the site of injury. Bone marrow mesenchymal stem cell (BMMSC) production and secretion have been shown to regenerate the skin. The aim of this research was to evaluate the wound-healing and antioxidant effects of BMMSCs per MCs. Methods Fifty-four albino Wistar male rats were divided into three groups: (1) nonsurgery, (2) surgery, and (3) surgery + BMMSCs. Groups 2 and 3 were operated with a 3 × 8 cm flap and in group 3, cell injections (7 × 10⁹ cell injection at the time of surgery) were performed. After days 4, 7, and 15, percentage of the surviving tissue, histological characteristics, superoxide dismutase (SOD) activity, and amount of malondialdehyde (MDA) were measured in the groups. For results, Graph Pad Prism 8 software was used, and data were analyzed and compared by analysis of variance and Tukey test. Results BMMSCs' application decreased the amount of MDA, increased SOD activity and survival rate of the flaps, and improved the histological characteristics. Conclusion This study revealed the protective effects BMMSCs alongside MCs against oxidative stress on the survival of the flaps. However, for clinical use, more research is needed to determine its benefits.