• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권6호
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• pp.496-500
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• 2005

A 22-year-old male patient had developed a submasseteric abscess secondary to a mandibular osteomyelitis at the age of 7 years old. The initial presentation at that time seems to be acute suppurative parotitis. The computed tomographic scans taken before surgery demonstrated diffuse deformity, sclerotic change and osteolytic lesion in the mandible. There was no marrow space on both sides of mandibular ramus and thin-walled cortical bone was seen. So, from the results of the computed tomography, the surgery was performed intraoral vertical ramus osteotomy (IVRO) instead of performing the more commonly used bilateral sagittal split ramus osteotomy (BSSRO). In this report, we present a case of surgical correction of mandibular prognathism with fibrous-osseous lesion of mandible with using IVRO.

• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.219-222
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• 2019

The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone.

• 대한두개안면성형외과학회지
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• 제19권1호
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• pp.41-47
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• 2018

Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.788-794
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• 2010

Purpose: The fingertip is the most commonly injured part of the hand and its injury frequently results in avulsion or crushing of a segment of the nail bed and fracture of the distal phalangeal bone. Restoration of a flat and smooth nail bed is essential for regrowth of a normal nail, which is important not only for cosmetic reasons but also for tactile capability of the fingertip. It is also anatomical reduction of the distal phalanx to promote patient's cosmetics and prevent nail bed deformity. Absence or no replacement of the nail plate results in obliterated proximal skin fold. When the avulsed nail plate cannot be returned to its anatomic position or when it is absent, we use a synthetic material for splinting the nail bed and alternative reductional method for distal phalangeal bone fracture, especially, instead of hardwares. Methods: From January of 2006 to June of 2009, a total of ten patients and fourteen fingers with crushing or avulsion injuries of the fingertip underwent using the artificial nails for finger splint. We shaped artificial nails into the appropriate sizes for use as fingernail plates. We placed them under the proximal skin fold and sutured to the fold proximally and to the lateral and medial edges of the nail bed or to the distal fingertip. Our splints were as hard as K-wire and other fixation methods and more similar to anatomic nail plates. Artificial nails were kept in place for at least 3 weeks. Results: No artificial nail related complication was noted in any of the ten cases. No other nail fold or nail bed complications were observed, except for minor distal nail deformity because of trauma. Conclusion: In conclusion, in order to secure the nail bed after injury and reduce the distal phalangeal bone fracture, preparing a nail bed splint from a artificial commercial nail is a cheap and effective method, especially, for crushed or avulsion injuries of the fingertip.

• Asian Spine Journal
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• 제12권6호
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• pp.1028-1036
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• 2018

Study Design: Single-center, observational, case-control study. Purpose: Comparison and analysis of the metabolic and coagulative profiles in patients with idiopathic scoliosis, patients with congenital scoliosis, and healthy controls. Overview of Literature: Serum melatonin deficiency has been a controversial topic in the etiopathogenesis of scoliosis. Low bone mineral density, low vitamin D3 levels, and high parathyroid hormone levels are common metabolic abnormalities associated with scoliosis that may be responsible for its pathogenesis. In addition to metabolic defects, several studies have shown coagulation defects that either persist from the preoperative period or occur during surgery and usually lead to more than the expected amount of blood loss in patients undergoing deformity correction for scoliosis. Methods: The study population (n=73) was classified into those having congenital scoliosis (n=31), those with idiopathic scoliosis (n=30), and healthy controls (n=12). After detailed clinicoradiological evaluation of all the subjects, 10-mL blood samples were collected, measured, and analyzed for various metabolic and coagulation parameters. Results: The mean serum melatonin levels in patients with idiopathic scoliosis were significantly lower than those in the healthy controls. Although the mean serum melatonin level in the congenital group was also low, the difference was not statistically significant. Serum alkaline phosphatase and parathyroid hormone levels were higher in the scoliosis groups, whereas the vitamin D level was lower. No differences were observed in the coagulation profiles of the different groups. Conclusions: Low serum melatonin levels associated with scoliosis can be a cause or an effect of scoliosis. Moreover, low bone mineral density, high bone turn over, and negative calcium balance appear to play an important role in the progression, if not the onset, of the deformity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.232-236
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• 1998

Fibrous dysplasia is a benign pathologic condition of bone which medullary bone is replaced and disturbed by poorly organized, structually unsound fibro-osseous tissue. When facial bones are involved, considerable esthetic deformity may result. The term monostotic fibrous dysplasia has been applied when one bone is involved : when more than one bone is affected, the term polyostotic used. The polyostotic form may be accomplished by pigmented skin lesion (Jaffe type), or by pigmented skin lesions with endocrine disturbance (Albright syndrome). No general agreement exists on the cause of fibrous dysplasia. A few authors have suggested that fibrous dysplasia as a result of trauma. It occurs predominantly in infant, adolescent females and runs a variable clinical coures. When several bones are involved, it tends to be unilateral. Involvements of alveolar bone may produce displacement of teeth with malocclusion, or loss of teeth, or both. Now, we will present a case of fibrous dysplasia on the left facial region treated by conservative contouring surgery.

• 대한두개안면성형외과학회지
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• 제9권2호
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• pp.81-84
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• 2008

Purpose: The goals of cranioplasty are to protect the brain from trauma and restore normal cranial contour with as few complication as possible. In patient who suffered from cranial defect, the most satisfactory form of cranioplasty may be archived with autogenous bone grafts. We report on the treatment of large frontal bone defect using pericranial flap and split-rib graft. Methods: A 29-year-old male was referred to our department. He was involved in an automobile accident resulting in large frontal bone and sinus defect and skull basal defect. The reconstruction was undertaken using galeal frontalis myofascial flap and split-rib cranioplasty using bicoronal incision. Results: The postoperative course was successful. For 9 months follow up period, there was no complication about hematoma, infection, CSF leakage and washboard deformity. He was pleased with the results even when absolute symmetry was not achieved. Conclusion: We experienced large frontal bone and sinus defect and skull basal defect patient and successfully treated with split-rib graft and galeal frontalis myofascial flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.53.1-53.6
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• 2019

Background: The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods: A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient's records, and radiographic images of nasal bone fractures were evaluated. Results: Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion: Closed reduction could be performed successfully within 2 weeks after injury.

• 대한치과교정학회지
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• 제50권6호
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• pp.391-400
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• 2020

Objective: Increased gingival elasticity has been implicated as the cause of relapse following orthodontic rotational tooth movement and approaches to reduce relapse are limited. This study aimed to investigate the effects of sulforaphane (SFN), an inhibitor of osteoclastogenesis, on gene expression in gingival fibroblasts and relapse after rotational tooth movement in beagle dogs. Methods: The lower lateral incisors of five beagle dogs were rotated. SFN or dimethylsulfoxide (DMSO) were injected into the supra-alveolar gingiva of the experimental and control group, respectively, and the effect of SFN on relapse tendency was evaluated. Changes in mRNA expression of extracellular matrix components associated with gingival elasticity in beagles were investigated by real-time polymerase chain reaction. Morphology and arrangement of collagen fibers were observed on Masson's trichrome staining of buccal gingival tissues of experimental and control teeth. Results: SFN reduced the amount and percentage of relapse of orthodontic rotation. It also decreased the gene expression of lysyl oxidase and increased the gene expression of matrix metalloproteinase (MMP) 1 and MMP 12, compared with DMSO control subjects. Histologically, collagen fiber bundles were arranged irregularly and were not well connected in the SFN-treated group, whereas the fibers extended in parallel and perpendicular directions toward the gingiva and alveolar bone in a more regular and well-ordered arrangement in the DMSO-treated group. Conclusions: Our findings demonstrated that SFN treatment may be a promising pharmacologic approach to prevent orthodontic rotational relapse caused by increased gingival elasticity of rotated teeth in beagle dogs.

• 대한족부족관절학회지
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• 제7권1호
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• pp.13-20
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• 2003

Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.