• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.3
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• pp.264-276
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• 1995

This is a clinical and retrospective study on the patients with oral and maxillofacial trauma. This study was based on a series of 917 patients were treated as in-patients, at Chon-buk National University Hospital, during the period of Jan., 1989 through Dec., 1993. The results obtained were as follows : 1. The ratio of men to women were 3.59 : 1 in oral and maxillofacial injuries, 3.92 : 1 in facial bone fractures, and 3.18 : 1 in soft tissue injuries. 2. The oral and maxillofacial injuries occurred most frequently in the third decade(32.2%), and fourth, second, fifth decade in orders. 3. The major etiologic factors were traffic accident(57.4%) and fall-down(17.1%), interpersonal accident(16.6%), and industrial accident were next in order of frequency. 4. The incidence of facial bone fracture was 72.1%, soft tissue injury 58.8%, and dental injury 40.5%. 5. The most common site of fracture were mandible(62.9%) and maxilla(19.9%), zygoma and zygomatic arch(18.7%), and nasal bone(4.7%) were next in order of frequency. 6. The most common type of soft tissue injury was laceration(51.0%). The lesion of soft tissue injuries were mostly 1 or 2 lesions and deep.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.143-150
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• 2011

Purpose: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl$^{(R)}$ (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. Method: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl$^{(R)}$) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar) Result: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant ($p$ <0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. Conclusion: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.99-104
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• 2021

Background: To fight the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented social distancing and lockdowns. We investigated the changes in the trauma patterns of emergency plastic surgeries in the midst of a pandemic. Methods: A retrospective review of the medical records of all patients treated for emergency plastic surgeries was performed at our hospital in Seoul. We conducted the analysis between March 1 and June 30, 2020, and compared the data obtained with that of the same period in 2019. We also investigated changes in trauma patterns according to the social distancing level from July 2020 to February 2021. Results: There was a total of 800 emergency plastic surgery patients from March to June 2020, which was less than the 981 in the corresponding period in 2019. The proportion of patients aged 7-17 years and ≥ 80 in 2020 showed a significant decrease. In 2020, patients presenting with facial trauma decreased and hand trauma, markedly laceration, increased significantly. In 2020, more injuries happened at home, whereas significantly fewer injuries happened on the streets. In 2020, slipping and sports injury decreased, whereas penetrating injury increased significantly. In the changes observed according to the social distancing level, there were significant differences in age classification, facial open wound, and the mechanism of injury. Conclusion: Social distancing has caused a change in emergency plastic surgeries. To ensure safe and appropriate treatment, strict epidemiologic workup and protective equipment are required.

• Medical Lasers
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• v.8 no.1
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• pp.1-6
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• 2019

Background and Objectives A facial laceration is a commonly occurring trauma of children. In addition, appropriate treatment and scar management are very important because the psychosocial impact of facial scars is much greater in children than in adults. Materials and Methods In the authors' hospital, primary closure was conducted targeting a total of 8,924 patients from January 2015 to December 2017. Of these, scar management was conducted on 808 people using a CO₂ fractional laser and Q-Switch Nd:YAG laser. To prove the effectiveness of the laser treatment on the linear scar, the patients were divided retrospectively into children and adults and sub-divided into those who received the treatment and those who did not. The subjective satisfaction of patients was evaluated using the Numeric Rating System (NRS). The objective scar scoring was evaluated using the image panel assessment based on the Vancouver Scar Scale (VSS), and the scoring was made by averaging the evaluations of three plastic surgeons. Results Evaluated NRS showed 8.50 ± 1.83 for adults without a laser, 8.51 ± 1.47 for adults with a laser, 7.93 ± 2.10 for children without a laser, and 8.9 ± 1.24 for children with a laser. The image panel assessment revealed 7.06 ± 1.31 for adults without a laser, 6.40 ± 2.37 for adults with a laser, 6.86 ± 1.45 for children without a laser, and 5.93 ± 1.21 for children with a laser. Conclusion When the linear scar is managed using a CO₂ Fractional laser, it can be managed in children better than adults, which is believed to be useful because it leads to better satisfaction and prognosis.

• Child Health Nursing Research
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• v.14 no.1
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• pp.5-13
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• 2008

Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.243-248
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• 2000

Carotid cavernous sinus fistula(CCSF) is an abnormal communication at the base of the skull between the internal carotid artery and the cavernous sinus. Fistula is almost associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of fractures through the base of the skull, which cause the laceration of the internal carotid artery near the cavernous sinus. The signs and symptoms of CCSF are pulsating exophthalmosis, orbital headache, pain, orbital or frontal bruit, loss of visual acuity, diplopia and ophthalmoplegia. Angiography reveals a definite CCSF and a detachable balloon embolization is known to be the treatment of choice. Even though carotid cavernous sinus fistula is an uncommon complication after orthognathic surgery, several cases of CCSF due to congenital anomalies, pre-existing aneurysms and abnormally thickened maxillary posterior wall have been reported in the literature. We have experienced a case of CCSF after Le Fort I osteotomy for maxillary advancement in skeletal class III patient and the cause, pathogenesis, diagnosis and treatment of this case.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.128-131
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• 2017

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.31.1-31.8
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• 2018

Background: Verrucous carcinoma (VC) accounts for 1-10% of cases of squamous cell carcinoma (SCC) in the oral cavity, and 75% of VC occur in the oral cavity. Only 3% of primary intraosseous squamous cell carcinomas (PIOSCC), which means SCC occurring primarily in the bone, are VC. Verrucous carcinoma arising from odontogenic cysts (OC) is very rare, with only seven cases reported to date. Case presentation: This study reported a case of a patient who underwent partial maxillectomy and neck dissection for VC that occurred in the right anterior maxilla. The patient was admitted to the emergency department at our institution 8 years ago and showed cystic lesions in the anterior maxilla on facial computed tomography (CT) images. Treatment through other departments including assessment of laceration in the mental region and only suture was performed. This report highlights a very rare case of VC in the right anterior maxilla arising from a previous cystic lesion. Conclusions: Since PIOSCC can arise from OC, appropriate treatment of intraosseous cysts and regular radiologic evaluation are necesssary. Surgical exicision of the primary lesion without neck dissection can lead to good prognosis for patients with primary intraosseous verrucous carcinoma.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.524-527
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• 2007

Purpose: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. Methods: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. Results: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. Conclusion: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.435-446
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• 1997

Overall study was carried out for the patients visiting Department of Oral & Maxillofacial Surgery through Emergency Room in Chonnam University Hospital, from Jan. 1, 1992 to Dec. 31, 1996. Result obtained were as follows ; Male predilection was shown, the male to female ratio being 2.5 to 1. The frequently developing age group were the first 3rd and 4th decade and under the age of 9 was followed. The number of patients for emergency was peak in September and October to 11%. About the causes for emergency, traffic accident was the most, and fall down injury and assault were followed. About the injury lists, facial laceration was preceded and the next facial bone fracture and the tooth injury followed. In the facial bone fracture, fracture in the mandible only was the most, and zygomaticomaxillary complex fracture, and mandible-maxilla complex fracture were followed. when the case of the mandible fracture, symphysis, condyle, angle were marked in succession. 57% was predomunatly ranged in the timea of 18 : 00 to 03 : 00 for the emergency. From injury onset to visiting emergency room, the range of 8 hours to 12 hours was predominant. Above results suggest that urgent patients of oral and maxillofacial area were relatively so high that division of oral and maxillofacial surgery should be established immediately.