• Title/Summary/Keyword: facial deformity

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Conservative therapy of extensive unicystic ameloblastoma: a case report (낭종성 법랑아 세포종의 치험례: 증례 보고)

  • Hyun, Chang Lim;Song, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.246-250
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    • 2018
  • Ameloblastoma is a benign neoplasm originating from odontogenic epithelium. It is the most common neoplasm in the jaws and is characterized by aggressive behavior and local invasion. Unicystic ameloblastoma (UA) has a unilocular feature in radiologic examination and a cystic feature histologically. Decompression and marsupialization are conservative method of treatment of large UA. The purpose of decompression and marsupialization are size reduction of the mass, which makes it easy to handle at total enucleation with protection of nerve damage and facial deformity. Here we report successful conservative treatment of extensive UA using decompression and marsupialization with a review of literatures.

Clinical analysis of early reoperation cases after orthognathic surgery (악교정수술 후 조기 재수술 증례의 분석)

  • Lee, Ju-Hwan;Lee, In-Woo;Seo, Byoung-Moo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.28-38
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    • 2010
  • The factors influencing the relapse and recurrence of skeletal deformity after the orthognathic surgery include various factors such as condylar deviation, the amount of mandibular set-back, stretching force by the soft tissues and muscles around the facial skeleton. The purpose of this report is to recognize and analyze the possible factors of reoperation after orthognathic surgery, due to early relapses. Six patients underwent reoperation after the orthognathic surgeries out of 110 patients from 2006 to 2009 were included in this study. In most cases, clincal signs of the insufficient occlusal stability, anterior open bite, and unilateral shifting of the mandible were founded within 2 weeks postoperatively. Although elastic traction was initiated in every case, inadequate correction made reoperation for these cases inevitable. The chief complaints of five cases were the protruded mandible combined with some degree of asymmetric face and in the other one case, it was asymmetric face only. Various factors were considered as a major cause of post-operative instability such as condylar sagging, counter-clockwise rotation of the mandibular segment, soft tissue tension related with asymmetrical mandibular set-back, preoperatively existing temporomandibular disorder (TMD), poor fabrication of the final wafer, and dual bite tendency of the patients.

Treatment of nevoid basal cell carcinoma syndrome: a case report

  • Seo, Dong-Uk;Kim, Su-Gwan;Oh, Ji-Su;You, Jae-Seek
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.284-287
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    • 2016
  • Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is characterized by various embryological deformities and carcinoma formation. It is caused by PTCHI gene mutations and is autosomal dominantly inherited. Some of the main symptoms of NBCCS are multiple basal cell carcinomas, multiple keratocystic odontogenic tumors (KCOTs) of the mandible, hyperkeratosis of the palmar and plantar, skeletal deformity, calcification of the falx cerebri, and facial defomity. Recurrent KCOT is the main symptom of NBCCS and is present in approximately 90% of patients. In NBCCS, KCOTs typically occur in multiples. KCOTs can be detected in patients under the age of 10, and new and recurring cysts develop until approximately the age of 30. The postoperation recurrence rate is approximately 60%. This case report presents a 14-year-old female patient with a chief complaint of a cyst found in the maxilla and mandible. The patient was diagnosed with NBCCS, and following treatment of marsupialization and enucleation, the clinical results were satisfactory.

Early-diagnosed silent sinus syndrome and cone-beam computed tomography in a pediatric patient: a case report

  • Leidens, Natali;Franco, Ademir;Santos, Marco C.J.;Makeeva, Irina M.;Fernandes, Angela
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.155-159
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    • 2020
  • Chronic maxillary atelectasis (CMA) is a progressive alteration in the volume of the maxillary sinuses that may result in facial asymmetry. CMA in asymptomatic patients is known as silent sinus syndrome (SSS) and is a rare entity, especially in pediatric patients. This study reports a case of SSS in a pediatric patient who received an early diagnosis through cone-beam computed tomography (CBCT). An asymptomatic 12-year-old female patient in orthodontic treatment presented with opacification of the left maxillary sinus on a panoramic radiograph. Clinically, the patient had discrete hypoglobus and enophthalmos. CBCT and nasal video-endoscopy revealed ostiomeatal obstruction with bone deformity, leading to diagnosis of SSS. Endonasal endoscopic maxillary sinusotomy was performed. Two years later, the patient remained asymptomatic, and a second CBCT exam confirmed a stable condition. This case highlights the role of optimal radiographic interpretation for early diagnosis of maxillofacial alterations in pediatric patients.

A Case of Primary Reconstruction using Fibular Osteocutaneous Free Flap after Total Maxillectomy Due to Rhabdomyosarcoma (횡문근육종으로 인한 상악골 전절제술 후 유리비골골피판을 이용한 치험례)

  • Kim, Tae Hyung;Oh, Deuk Young;Lee, Paik Kwon;Kim, Min Sik;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.381-384
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    • 2005
  • Rhabdomyosarcoma is a rare malignancy of head and neck region. When rhabdomyosarcoma occurs in maxillary area, total maxillectomy is necessary. Total maxillectomy causes defects of orbital floor, palate, gingiva, and alveolar bone, causing severe facial deformity and functional impairment. Immediate maxillary reconstruction has to cover both bone and soft tissue to minimize cosmetic and functional problems. The fibular osteocutaneous free flap can provide paranasal, gingiva, oral mucosal lining and foundation for dental prosthesis, thus ensuring good cosmetic results and mastication, phonation function. We have experienced a reconstruction case of a 19-year-old man with rhabdomyosarcoma of the left maxillary sinus. The patient underwent total maxillectomy and neck dissection. We designed a fibular free flap that had a vascularized bone segment and a double skin paddle. Surgical outcomes were excellent in cosmetic and functional aspects.

CASE REPORT : THE CONSERVATIVE TREATMENT OF UNILOCULAR PLEXIFORM AMELOBLASTOMA (보존적 치료를 통한 단방성 총상형 법랑모세포종의 치험례 : 증례보고)

  • Choi, Su-Jin;Chee, Young-Deok;Koh, Se-Wook;Kim, Hyong-Woo;Choi, Ji-Yeun;Lee, Jae-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.498-502
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    • 2008
  • Ameloblastoma is the most common aggressive benign odontogenic tumor of the jaws. Because of slow growth and tendency to local invasion of bone and soft tissue, high rates of recurrence are common. The treatment for ameloblastoma is still controversial and poses some special problems in children. Because of growth of the jaw and the different incidence, prognosis of the tumor make the surgical consideration different from adults. Radical resection cause facial deformity, jaw abnormal movement and masticatory disturbance especially to child and adolescents. So conservative treatment as enucleation, curettage is acceptable initial treatment of ameloblastoma in children who can be followed up in a precise, detailed manner. This report describes a case of unilocular plexiform ameloblastoma treated by enucleation and curettage followed by marsupialization.

Multidetector computed tomography in preoperative planning for temporomandibular joint ankylosis: A pictorial review and proposed structured reporting format

  • Singh, Rashmi;Bhalla, Ashu Seith;Manchanda, Smita;Roychoudhury, Ajoy
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.313-321
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    • 2021
  • Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

Noonan syndrome and RASopathies: Clinical features, diagnosis and management

  • Lee, Beom Hee;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.16 no.1
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    • pp.1-9
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    • 2019
  • Noonan syndrome (NS) and NS-related disorders (cardio-facio-cutaneous syndrome, Costello syndrome, NS with multiple lentigines, or LEOPARD [lentigines, ECG conduction abnormalities, ocular hypertelorism, pulmonic stenosis, abnormal genitalia, retardation of growth and sensory neural deafness] syndrome) are collectively named as RASopathies. Clinical presentations are similar, featured with typical facial features, short stature, intellectual disability, ectodermal abnormalities, congenital heart diseases, chest & skeletal deformity and delayed puberty. During past decades, molecular etiologies of RASopathies have been growingly discovered. The functional perturbations of the RAS-mitogen-activated protein kinase pathway are resulted from the mutation of more than 20 genes (PTPN11, SOS1, RAF1, SHOC2, BRAF, KRAS, NRAS, HRAS, MEK1, MEK2, CBL, SOS2, RIT, RRAS, RASA2, SPRY1, LZTR1, MAP3K8, MYST4, A2ML1, RRAS2). The PTPN11 (40-50%), SOS1 (10-20%), RAF1 (3-17%), and RIT1 (5-9%) mutations are common in NS patients. In this review, the constellation of overlapping clinical features of RASopathies will be described based on genotype as well as their differential diagnostic points and management.

Stereotactic Radiation Therapy for Nasal Carcinoma with Cribriform Plate Destruction in Three Dogs: A Serial CT Study

  • Soyon An;Gunha Hwang;Moonyeong Choi;Chan Huh;Young-Min Yoon;Hee Chun Lee;Tae Sung Hwang
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.139-146
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    • 2023
  • Three dogs were referred with epistaxis and facial deformity. Computed tomography (CT) scan identified masses in the bilateral nasal cavity with soft tissue attenuation and contrast enhancement. These masses had caused adjacent bones lysis, especially lysis of cribriform plate that extended to the intracranial region. Base on histopathology and CT imaging results, tumors were diagnosed as nasal carcinomas at stage 4. Three dogs were treated with stereotactic radiation therapy (SRT). These dogs received 30-35 Gy from 3-5 daily treatments (7-10 Gy per treatment). The sizes of tumors decreased the most on follow-up CT images at one month after treatment. Recurrence was confirmed between 3 and 5 months after completing SRT. The survival time of dogs treated with SRT were 110, 190, and 210 days, respectively. This study confirmed that SRT could treat canine nasal carcinomas with cribriform plate lysis without causing serious radiation toxicities. Follow-up CT examination is considered at 1 month and 3 to 6 months after SRT to accurately evaluate the prognosis and the timing of recurrence.

A study of facial soft tissue of Korean adults with normal occlusion using a three-dimensional laser scanner (3차원 레이저 스캐너를 이용한 한국 성인 정상교합자의 안면 연조직에 대한 연구)

  • Baik, Hyoung-Seon;Jeon, Jai-Min;Lee, Hwa-Jin
    • The korean journal of orthodontics
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    • v.36 no.1 s.114
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    • pp.14-29
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    • 2006
  • Developments in computer technology have made possible the 3-dimensional (3-D) evaluation of hard and soft tissues in orthodontic diagnosis, treatment planning and post-treatment results. In this study, Korean adults with normal occlusion (male 30, female 30) were scanned by a 3-D laser scanner, then 3-D facial images formed by the Rapidform 2004 program (Inus Technology Inc., Seoul, Korea.). Reference planes in the facial soft tissue 3-D images were established and a 3-D coordinate system (X axis-left/right, Y axis-superior/inferior, Z axis-anterior/posterior) was established by using the soft tissue nasion as the zero point. Twenty-nine measurement points were established on the 3-D image and 43 linear measurements, 8 angular measurements, 29 linear distance ratios were obtained. The results are as follows; there were significant differences between males and females in the nasofrontal angle $(male:\;142^{\circ},\;female:\;147^{\circ})$ and transverse nasal prominence $(male:\;112^{\circ},\;female:\;116^{\circ})$ (p<0.05). The transverse upper lip prominence was $107^{\circ}$ in males, $106^{\circ}$ in females and the transverse mandibular prominence was $76^{\circ}$ in both males and females. Li-Me' was 0.4 times the length of Go-Me'(mandibular body length) and the mouth height was also 0.4 times the width of the mouth width. The linear distance ratio from the coronal reference plane of FT, Zy, Pn, ULPm, Li, Me' was -1/-1/1/0.5/0.5/-0.6 respectively. The 3-D facial model of Korean adults with normal occlusion were be constructed using coordinate values and linear measurement values. These data may be used as a reference in 3-D diagnosis and treatment planning for malocclusion and dentofacial deformity patients and applied for 3-D analysis of facial soft tissue changes before and after orthodontic treatment and orthognathic surgery.