• Title/Summary/Keyword: intraoral approach

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Intramuscular epidermal cyst in the masticator space: a case report

  • Sang Woo Han;Jiye Kim;Sug Won Kim;Minseob Eom;Chae Eun Yang
    • Archives of Craniofacial Surgery
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    • v.24 no.4
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    • pp.193-197
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    • 2023
  • An epidermal cyst, also known as an epidermoid cyst or epidermal inclusion cyst, is the most prevalent type of cutaneous cyst. This non-cancerous lesion can appear anywhere on the body, typically presenting as an asymptomatic dermal nodule with a visible central punctum. In the case presented herein, an epidermal cyst with uncommon features was misdiagnosed as a lymphatic malformation based on preoperative magnetic resonance imaging (MRI). A 61-year-old man came to us with a swollen left cheek that had been present for 11 months. The preoperative MRI revealed a 3×3.8×4.6 cm lobulated cystic lesion with thin rim enhancement in the left masticator space. The initial differential diagnosis pointed toward a lymphatic malformation. We proceeded with surgical excision of the lesion via an intraoral approach, and the specimen was sent to the pathology department. The pathological diagnosis revealed a ruptured epidermal cyst, indicating that the initial diagnosis of a lymphatic malformation based on preoperative MRI was incorrect. Epidermal cysts located under the muscle with no visible central punctum are uncommon, but should be considered if a patient presents with facial swelling.

A Submandibular Gland Mucocele Extending to the Skull Base (두개저까지 확장된 악하선 점액류)

  • Kim, Il-Kyu;Yang, Jung-Eun;Chang, Jae-Won;Ju, Sang-Hyun;Pyun, Young-Hun;Kim, Lucia
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.180-184
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    • 2011
  • The mucocele is a mucus extravasation cyst arising from the salivary gland. Although it is a common?lesion of the minor salivary gland, it is uncommon when it originated from the submandibular gland. The ranula is a form of mucocele which specifically occurs in the floor of the mouth and the sublingual gland is generally accepted as the origin of ranula. They can be classified into two types based on extent: simple ranula are confined to the sublingual space and plunging ranula extend into the adjacent space. It is difficult to differentiate the submandibular gland mucocele from the plunging ranula because both of them can occupy the submandibular space. A 37-year old male visited our clinic with the chief complaint of left facial swelling. The patient's history revealed that he had suffered from a cystic lesion on the left side of the floor of the mouth 10 months previously. He supposed the cystic lesion had come from trauma at other dental clinics. Using CT and MRI, we diagnosed a simple ranula on the sublingual space and a submandibular gland mucocele. We then excised the mucocele with the submandibular gland by an extraoral approach and the sublingual gland by an intraoral approach under general anesthesia. We report a rare case of an enormous submandibular gland mucocele which extended into the pterygoid plate and parapharyngeal space with good surgical results.

The Avalibility of C-Arm in Reduction of Zygomatic Arch Fracture Intraoperatively: Case Report (관골궁 골절의 정복시 수술 중 C-Arm 사용의 유용성: 증례보고)

  • Seo, Mi-Hyun;Cheon, Kang-Yong;Yun, Jun-Yong;Yoo, Chung-Kyu;Lee, Eun-Kyung;Lee, Won-Deok;Suh, Je-Duck
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.359-362
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    • 2010
  • The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography, CT to evaluate preoperative state. Gilles approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.

Eagle's syndrome: a case report

  • Moon, Chang-Sig;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Yun, Sun-Ung;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.43-47
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    • 2014
  • Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.

A CLINICAL STUDY ON FRACTURES OF THE MANDIBULAR CONDYLES: EFFECTIVE EXTRACORPOREAL FIXATION TECHNIQUE (하악 과두골절에 관한 임상적 연구: 효과적인 체외고정법)

  • Kwon, Kwang-Jun;Chung, Ji-Hun;Kim, Ji-Hyuck;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.359-369
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    • 2008
  • Purpose: Fractures of the mandibular condyle accounts for 15% to 30% of all the mandibular fractures and lots of complications are reported. Among these complications, condylar resorption is the most important one to be taken into account. The purpose of this study is evaluating condylar resorption pattern in relation to extracorporeal fixation technique. Patients & methods: Thirty four patients with 42 mandibular condylar fractures were retrospectively examined with an average follow-up of 18.5 months (6-66 months). Male/female ratio is 27 males (7 bilateral cases) and 7 females (1 bilateral case). Applicated surgical techniques were extracorporeal fixation via submandibular approach and extracorporeal fixation via intraoral approach. We compared radiographic views of post-operative periods with that of most long term follow up in 34 operated sites respectively. Result: There were 2 generalized condylar resorption sites and 3 partial resorption sites with clinical implications. Others (29 joints) showed good healing or satisfactory adaptive state of temporomandibular joints clinically. Radiologically, signs of partial condylar resorption and/or osteoarthrosis were diagnosed in 11 patients. But, 8 out of the 11 patients didn't show significant clinical symptoms, which means successful adaptive remodeling of the surgically located condylar head. Conclusion: From the above results, intentional ramal osteotomy, temporary detachment of the fractured condyle and extracorporeal fixation technique seems to be effective and useful in those cases of condylar fractures in which reduction of the dislocated condyle is very difficult or virtually impossible.

Retrospective studies of dental implant placement at each intraoral site and situation (임플란트 식립 유형에 따른 후향적 연구)

  • Hong, Ji-Youn;Chae, Gyung-Joon;Jung, Ui-Won;Kim, Chang-Sung;Cho, Kyoo-Sung;Chae, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.37 no.4
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    • pp.805-824
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    • 2007
  • Purpose: Developments in micro/macrostructures of implants and surgical techniques brought out stable outcomes of implant dentistry. The aim of this study was to evaluate the distributions of implant patients, the types of implanted sites, and the success or survival rates of various implant systems and to analyze the implant placement done at each specificintraoral site and situation. Materials and Methods: The data of dental implantations collected between 1992 and 2006 at the Department of Periodontology in 00000 University Hospital were analyzed. Results: 1. Largest part of the patients were at the age of 40s and 50s in bothgender who lost their teeth mostly by periodontaldiseases and caries at the posterior intraoral sites as major ones. Bone densities of type II(mandible) and III(maxilla) were likely to be seen with quantity of type B. Lengths of the implants between 10 and 15 mm and wide platform took the largest part. 2. Survival rates of $Implantium^{(R)}(98.8%)$, $Xive^{(R)}(100%)$ and ITI $TE^{(R)}(100%)$ were high when $Frialit-2^{(R)}$ showed 82%(poor bone density area) or 87.2%(combined with additional therapy). $IMZ^{(R)}$ had lowest cumulative survival(67.5%) and success rate(49.4%) amongst all. 3. Replacement with 2 wide or 3 regular platforms showed no significant differences in survival rate and marginal bone loss atmandibular posterior area. In single restoration of mandibular second molar, 5-year success rate of machined surface $Br{\aa}nemark^{(R)}(70.37%)$ was lower than that of rough surface $ITI^{(R)}$ SLA(100%). 4. Replacement of single tooth in anterior area showed high survival rate of 94.5%. 5. The success rates of $Br{\aa}nemark$ Ti-Unite and ITI SLA at posterior maxilla with poor bone density both showed stable outcomes. 6. 10-year cumulative survival rate of implants with maxillary sinus augmentation by lateral window approach appeared to be 96.60%. Low survival rate(75%) was shown when there were more than two complications combined. Height of grafted bone remained stable above the implant apex. Conclusions : Rough surfaced implants showed stable outcomes in most of the situation including poor bone density and additional therapy combined.

Open Reduction and Non-fixation Method for the Zygoma Body Fracture (비고정 방법을 사용한 관골 체부 골절 정복술)

  • Park, Bo Young;Kim, Yang Woo;Kang, So Ra
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.76-80
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    • 2009
  • Purpose: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. Methods: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. Results: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. Conclusion: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.

ORTHODONTIC APPROACH TO THE CEREBRAL PALSY PATIENT WITH MAXILLARY PROTRUSION IN THE MIXED DENTITION : A CASE (혼합치열기 뇌성마비환자의 상악전돌에 대한 교정치료 : 치험례)

  • Kim, Jongsoo;Jo, Anna;Kim, Jiyeon;Jeong, Taesung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.43-46
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    • 2014
  • Cerebral Palsy is a genetic term referring to abnormalities of motor control caused by damage to a child's brain early in the course of development. Due to the impairment of balanced perioral muscle development, the prevalence of malocclusions in patients with cerebral palsy such as maxillary protrusion is high. But most clinicians may feel uncomfortable to treatment of these problems. Here a case report about mitigation of maxillary anterior teeth protruded in patient with cerebral palsy. 8y 4m old boy who have cerebral palsy visited our dental hospital. He showed severely protrusive maxillary anterior teeth with mouth breathing and could not close his mouth. He and his mother wanted to improve dental and facial esthetic problem. Specially designed or modified intraoral fixed appliance and rubber elastic chain was used in the therapy. Treatment carried out for 8 months and we could observe maxillary incisor angle was improved and mouth breathing habit was stopped. In conclusion, modified fixed appliance therapy for the patients with cerebral palsy might be useful. Continuous rehabilitation training of lips should be followed after treatment to correct imbalance of muscle tone.

FIBROUS DYSPLASIA ON LEFT MAXILLA AND ZYGOMA (좌칙(左則) 상악골(上顎骨) 및 협골(頰骨)에 발생(發生)한 섬유성(纖維性) 골이형성증(骨異形成症)의 치험례(治驗例))

  • Kim, Ki-Won;Kim, Byung-Min;Park, Sang-Jun;Kim, Jong-Ryol;Yang, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.68-73
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    • 1990
  • Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced and disturbed by poorly organized, structually unsound fibroosseous tissue, which may produce cortical expansion. When facial bones are involed, 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 arises as a resujlt of trauma. It occurs predominantly in infant, adolescent females and runs a variable clinical course. When several bones are involed, it tends to be unilateral. Involements of alveolar bone may produce displacement of teeth with malocclusion, or loss of teeth, or both. Radiographycally, it shows an indistinctly delimited osteolytic defect with a bubble - like pattern, but without a sclerotic rim. The preferred treatment is almost always surgery. If the lesion is extensive, surgical intervention with use of recontouring procedures aimed at the correction of esthetic or funtional disturbances is preferred treatment. Now, we present a case of fibrous dysplasia on the left maxilla and the zygoma treated by bony contourign via hemicoronal flap and intraoral approach with good results.

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A Case Report of Eagle's Syndrome (Eagle씨 증후군 치험례)

  • Jeon, In-Chul;Kwon, Dae-Gun;Yoo, Dae-Hyun;Lee, Jun;O, Se-Ri;Kim, Hyong-Woo;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.62-65
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    • 2011
  • Eagle's syndrome occurs when an elongated styloid process or calcified stylohyoid ligament causes recurrent throat pain or foreign body sensation, dysphagia. It is supposed that this symptoms and signs are due to the compression of the styloid process on some neural and vascular structures. More uncommonly, symptoms such as dysphagia, tinnitus, and otalgia may occur in patients with this syndrome. It may also cause stroke due to the compression of carotid arteries. The compression depends on the size, shape, and orientation of the ossified styloid process Besides, degenerative or inflammatory changes in the tendinous portion of the styloid ligament insertion or rheumatic styloiditis may also cause this syndrome. Diagnosis can usually be made on physical examination by digital palpation of the styloid process in the tonsiller fossa. Three-dimensional computed tomography can utilized for supporting diagnosis. The treatment of Eagle's syndrome is primarily surgical. The styloid process can be shortened through an intraoral and extraoral approach. We report a 62-years-old man with the symptomatology of Eagle's syndrome and literature reviews.