• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.166-170
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• 2020

Background: The standard treatment of nasal bone fractures in pediatric patients is closed reduction. Conservative treatment is sometimes performed, but poses a risk of nasal deformity. The aim of this study was to evaluate the outcomes of bone remodeling in pediatric nasal fractures. Methods: Information was extracted from the medical records of patients under 12 years of age who received conservative treatment for a nasal bone fracture and underwent follow-up computed tomography (CT) examinations. The initial fracture and its outcomes over time were graded as excellent, good, or fair according to the malalignment, displacement, or irregularity of the fractured segments. The outcomes of remodeling were evaluated through changes in the grade of the fracture between initial and subsequent CT scans. Results: The review identified 16 patients between March 2015 and December 2019. Their mean age was 6.2 years, and the average follow-up period was 4.9 months. Three of the five patients with a plane I frontal impact showed improved outcomes of remodeling from good to excellent, and the remaining two patients, improved from fair to good. Eight of the 11 patients with plane I lateral impacts showed improved outcomes, from good to excellent, while one patient, improved from fair to good, one patient, improved from fair to excellent, and one patient showed no interval changes. Conclusion: In 15 of these 16 patients with non-severe fractures, the bony contour improved through remodeling, without surgical intervention. Therefore, we suggest that conservative treatment is a feasible option for mild pediatric nasal fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.33.1-33.11
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• 2018

Background: Bimaxillary orthognathic surgery with maxillomandibular setback is often accompanied by changes in airway space. We analyzed the changes in airway space before and after surgery and assessed their association with obstructive sleep apnea. Methods: This study is based on the cohort of 13 adult patients (9 males, 4 females, average age 23.85 years) who underwent bimaxillary orthognathic surgery with maxillomandibular setback. We performed computed tomography and portable polysomnography before and after the surgery to assess changes in airway space and Apnea-Hypopnea Index (AHI) values (total, supine, non-supine). Results: The oropharyngeal airway volume decreased by 29% after the surgery, which was statistically significant (p < .05). The upper airway volume and hypopharyngeal airway volume were decreased, but not significantly (4 and 19%, respectively). The changes in airway surface area were statistically significant at all levels examined (p < .05). Changes in the maximum anteroposterior width of the airway were also significant at all levels (p < .05). However, the changes in maximum lateral width were only statistically significant at C2 level (p < .05). AHI values were increased after the surgery but not significantly at any position. Conclusions: Although bimaxillary surgery with maxillomandibular setback significantly reduces the airway space, it does not affect AHI values or induce obstructive sleep apnea.

• Journal of Chest Surgery
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• 제40권1호
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• pp.60-62
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• 2007

폐 형성 저하증은 폐 무발생의 한 분류이다. 폐 무발생은 대부분 출생시 진단되는 매우 드문 질환으로, 심혈관계 기형과 같은 다른 기형이 흔히 동반된다. 소아기에 사망할 수도 있지만, 정상적인 성장을 하는 경우도 있다. 저자들은 수술 전 흉부 전산화 단층촬영에서 종격동의 심한 우측 편위와 우측 폐 실질의 허탈이 관찰되었던 폐 형성 저하증이 있는 젊은 여자에서 우측 측방 개흉술을 통한 승모판막 성형술을 시행하였다.

• 대한의용생체공학회:의공학회지
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• 제19권2호
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• pp.171-176
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• 1998

본 연구에서는 뼈의 특성을 파악하는 초음파감쇠 파라미터를 재평가하였다. 초음파 속도, 특정 주파수(0.5MHz)에서의 초음파감쇠 및 광역 밴드 초음파감쇠와 같은 초음파 파라미터들을 해면골 입방체 시편의 세 직교방향(전/후, 내/외, 상/하)에서 측정하였다. 그리고 컴퓨터 영상장치를 사용하여 골밀도를 측정했으며, 골 시편의 무게와 부피를 이용하여 외형밀도도 함께얻었다. 이와같이 구해진 외형밀도와 초음파 속도로부터 초음파 탄성영률을 계산하였다. 주파수 0.5MHz에서의 초음파감쇠와 광역밴드감쇠는 골밀도 및 세 직교방향의 초음파 영률과 서로 관련시켜 연관성을 조사하였다. 그 결과 특정 주파수 초음파감쇠가 골밀도 및 탄성영률을 평가하는 능력에 있어서 광역밴드 감쇠보다 우수함을 알 수 있었다. 따라서 광역밴드 초음파감쇠를 측정하여 골의 상태를 평가하는 형행 초음파 진단 기법이 재검토 되어야 하며 본 연구에서 증명된 특정주파수(0.5MHz) 초음파감쇠를 이용하여 골 다공증 진단 예측율을 향상시킬 수 있다.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.63-66
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• 2011

Purpose: Cranial fasciitis is a rare type of benign tumor that occurs mostly in children younger than 6 years. It arises from the deep fascia, periosteum, or fibromembranous layer that covers fontanelles. The etiology is unknown, although prior trauma has been postulated to be an underlying cause. There is a 2:1 male predominance. Despite its rapid growth, this tumor has a benign clinical course and can be cured by total excision. Methods: A 16-year-old male presented with a 3 cm-sized palpable mass in the left lateral eyebrow region that he first noticed 4 months before presentation. The mass had grown rapidly since it was first noticed. Preoperative brain computed tomography showed a well-demarcated mass approximately 3 cm in size extending from the subcutaneous layer to the periosteum. Preoperatively, the presumed diagnosis was a dermoid cyst. An operation was performed with the patient under general anesthesia. The subcutaneous mass was completely excised by periosteal dissection. Results: Histological diagnosis revealed the presence of cranial fasciitis. After 20 months of follow-up, there have been neither complications nor evidence of local recurrence besed on clinical examination. Conclusion: Although cranial fasciitis is quite rare, it should be considered in the differential diagnosis for lytic skull lesions in patient whose clinical presentation suggests this possibility. This condition could be occasionally mistaken for malignant or locally aggressive lesions. To prevent local recurrence, curettage of the underlying bone is recommended for patients with bone involvement.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.114-120
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• 2018

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

• 대한안과학회지
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• 제59권12호
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• pp.1108-1113
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• 2018

목적: 결막 유피지방종의 임상 양상에 관해 알아보고자 하였다. 대상과 방법: 2016년 3월부터 2018년 3월까지 본원 안과에 방문하여 결막 유피지방종으로 진단받은 18명의 임상 소견을 후향적으로 분석하였다. 결과: 내원 당시 평균 연령은 61개월(3개월-45세)이었으며, 남자가 10명, 여자가 8명이었고, 각막윤부에서 평균 4.7 mm (2-8 mm) 거리의 이측, 안와연 앞쪽 눈알결막에 분홍색의 종괴가 관찰되었다. 시력 측정이 가능했던 8명의 종괴가 있는 눈의 평균 시력은 0.9(0.6-1.0)였다. 2안에서 제거 수술을 시행하였으며, 제거한 조직의 병리검사상 결막 유피지방종으로 진단되었고, 수술 후 시력 변화는 없었으며, 특별한 합병증도 관찰되지 않았다. 결론: 선천적으로 안구의 이측 결막하에 볼록한 종괴가 관찰되고 움직임이 없으면, 결막 유피지방종을 의심해 볼 수 있으며, 전산화단층촬영과 병리조직학적 검사를 통해 확진할 수 있겠다.

• 대한치과교정학회지
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• 제49권6호
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• pp.360-371
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• 2019

Objective: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. Methods: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. Results: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = -0.506, -0.494, and -0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = -0.900, p < 0.05). Conclusions: The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

• Journal of Korean Neurosurgical Society
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• 제62권6호
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• pp.712-722
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• 2019

Objective : Although magnetic resonance guided focused ultrasound (MRgFUS) has been used as minimally invasive and effective neurosurgical treatment, it exhibits some limitations, mainly related to acoustic properties of the skull barrier. This study was undertaken to identify skull characteristics that contribute to optimal ultrasonic energy transmission for MRgFUS procedures. Methods : For ex vivo skull experiments, various acoustic fields were measured under different conditions, using five non-embalmed cadaver skulls. For clinical skull analyses, brain computed tomography data of 46 patients who underwent MRgFUS ablations (18 unilateral thalamotomy, nine unilateral pallidotomy, and 19 bilateral capsulotomy) were retrospectively reviewed. Patients' skull factors and sonication parameters were comparatively analyzed with respect to the cadaveric skulls. Results : Skull experiments identified three important factors related skull penetration of ultrasound, including skull density ratio (SDR), skull volume, and incidence angle of the acoustic rays against the skull surface. In clinical results, SDR and skull volume correlated with maximal temperature (Tmax) and energy requirement to achieve Tmax (p<0.05). In addition, considering the incidence angle determined by brain target location, less energy was required to reach Tmax in the central, rather than lateral targets particularly when compared between thalamotomy and capsulotomy (p<0.05). Conclusion : This study reconfirmed previously identified skull factors, including SDR and skull volume, for successful MRgFUS; it identified an additional factor, incidence angle of acoustic rays against the skull surface. To guarantee successful transcranial MRgFUS treatment without suffering these various skull issues, further technical improvements are required.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.69-74
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• 2021

Background In inferomedially rotated zygomatic fractures sticking in the maxillary sinus, it is often difficult to achieve complete reduction only by conventional intraoral reduction. We present a new intraoral reduction technique using a Kirschner wire and its clinical outcome. Methods Among 39 inferomedially impacted zygomatic fractures incompletely reduced by a simple intraoral reduction trial with a bone elevator, a Kirschner wire (1.5 mm) was vertically inserted from the zygomatic body to the lateral orbital rim in 17 inferior-dominant rotation fractures and horizontally inserted to the zygomatic arch in nine medial-dominant and 13 bidirectional rotation fractures. A Kirschner wire was held with a wire holder and lifted in the superolateral or anterolateral direction for reduction. Following reduction of the zygomaticomaxillary fracture, internal fixation was performed. Results Fractures were completely reduced using only an intraoral approach with Kirschner wire reduction in 33 cases and through an additional lower lid or transconjunctival incision in six cases. There were no surgical complications except in one patient with undercorrection. Postoperative 6-month computed tomography scans showed complete bone union and excellent bone alignment. Four patients experienced difficulty with upper lip elevation; however, these problems spontaneously resolved after manual tissue lump massage and intralesional steroid (Triamcinolone) injection. Conclusions We completely reduced infraorbital rim fractures, zygomaticomaxillary buttresses, and zygomaticofrontal suture fractures in 84% of patients through an intraoral approach alone. Intraoral Kirschner wire reduction may be a useful option by which to obtain effective and powerful reduction motion of an inferomedially rotated zygomatic body.