• Title/Summary/Keyword: maxillofacial surgery

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A CLINICAL STUDY ON THE EFFECTIVENESS OF PATIENT-CONTROLLED ANALGESIA(PCA) AFTER ORTHOGNATHIC SURGERY. (악교정 수술후 자가통증조절장치(Patient-Controlled Analgesia)의 사용 효과에 관한 연구)

  • Yang, Byung-Eun;Song, Sang-Hun;Um, Ki-Hun;You, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.382-387
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    • 1999
  • The concept of PCA(Patient Controlled Analgesia) was first described in 1968, by Sechzer. The earliest descriptions of actual self-administered PCA machines were by Forrest et al. In gastric bypass surgery, cesarian section, orthopedic surgery etc, PCA is widely used in the control of postoperative pain. Previous Studies have shown that PCA provides effective pain-control for the postoperative patient. The postoperative pain-control is a problem that should be solved in surgery. Especially in orthognathic surgery, it is not same as in the case of maxillofacial trauma surgery or of tumor surgery: most orthognathic surgery patients are under operation not accustomed to pains, and difficulties in pain-complaint due to IMF(Intermaxillary fixation), postoperative nausea, and vomiting are additional problem. In this study, we have compared PCA and IM analgesics with respect not only to time request but also to the quality of postoperative pain control.

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REIMPLANTATION OF FREEZE-TREATED AUTOGENOUS BONE AFTER MANDIBULECTOMY;REPORT OF THREE CASES (하악골 절제술후 재이식된 동결자가골 재이식;치험 3례)

  • Kim, Sik;Kim, Su-Gwan;Kim, Woon-Kyu;Kim, Soo-Min;Ryu, Chong-Hoy;Lee, Jun-Gil;Cho, Gyeong-An;Kim, Soo-Heung;Chung, Tae-Young;Yeo, Hwan-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.2
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    • pp.185-190
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    • 2001
  • We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.

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Simultaneous Glossectomy with Orthognathic Surgery for Mandibular Prognathism

  • Jung, Young-Wook;On, Sung-Woon;Chung, Kyu-Rhim;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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    • pp.214-218
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    • 2014
  • Macroglossia can create dental and skeletal instability after orthodontic treatment or orthognathic surgery for mandibular prognathism. In relevant literature, partial glossectomy is suggested for a good post-treatment prognosis. Most of the published partial glossectomy cases are two-staged surgery, because of concern about postoperative airway obstruction. As orthognathic surgical techniques and fixation method develop, however, concerns about postoperative airway obstruction have lessened. In this case, mandibular setback surgery and partial glossectomy were performed simultaneously, leading to stable recovery without any postoperative respiratory problems. After surgical technique to preserve the tongue tip, we achieved good outcomes without postoperative side effects of lingual hypoesthesia, pronunciation disorder and dyskinesia. We report this case with a literature review.

Oral surgery under local anesthesia with dexmedetomidine sedation in a morbidly obese patient with aortic dissection

  • Seto, Mika;Matsuda, Michitaka;Narihira, Kyoichi;Kikuta, Toshihiro
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.162-165
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    • 2016
  • We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.

Application of 3D Simulation Surgery to Mandibular Asymmetry: Case Report

  • Lee, Sung-Hwa;Lee, Ho-Sung;Jung, Young-Soo;Park, Hyung-Sik;Jung, Hwi-Dong
    • Journal of International Society for Simulation Surgery
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    • v.1 no.2
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    • pp.95-98
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    • 2014
  • Two-dimensional cephalometric analysis has been used for diagnosis and treatment of correction of mandibular asymmetry by many maxillofacial surgeons. And 2D analysis showed excellent results in many cases, however 2D has some drawbacks in diagnosis and treatment planning because of its fundamental limitation like overlapping. Today many physicians use 3D diagnosis & treatment tools to expect better results and reduce possible errors. The aim of this report is to present treatment procedures using 3D analysis and treatment modalities for mandibular asymmetry patients.

Slimming of Lower Face by Contouring of the Mandibular Body in Orthognathic Surgery Patients

  • Park, Bong-Wook;Kang, Young-Hoon;Choi, Mun-Jeoung;Kim, Si-Yeob;Kang, Hea-Gea;Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.5
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    • pp.325-330
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    • 2013
  • The patient's appearance can be dramatically enhanced as a result of orthognathic surgery. However, esthetic contouring of the mandibular body portion is often overlooked in the surgery. Restoring a more beautiful jaw line is important and directly affects surgical results. From December 2010 to February 2012, we performed mandibular body contouring for the slimming of the third lower part of the face in 37 patients who had undergone either 1-jaw surgery or 2-jaw surgery. The third lower part of the facial contour was improved in all the patients after at least 3 months follow-up. Mandibular body contouring is a simple method that can be additionally used for the slimming of the third lower part of the face in patients who require orthognathic surgeries. It makes the lower face look more attractive from both the anterior and lateral perspectives.

CLINICAL STUDY ON TIBIAL BONE GRAFT (경골이식에 관한 임상 연구)

  • Kim, Sik;Kim, Su-Gwan;Kim, So-Young;Kim, Soo-Min;Park, In-Soon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.540-543
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    • 2000
  • The purpose of this retrospective study was to evaluate the treatment outcome of proximal tibial graft. Thirty-nine patients were grafted with proximal tibia for the repair of maxillofacial defect. Complications can be considered incidental and neglectable clinical significance. It is concluded that the proximal tibial metaphysis offers a promising alternative sources of cancellous bone for the repair of maxillofacial defect.

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ENDOSCOPIC-ASSISTED OPEN REDUCTION AND INTERNAL FIXATION (EAORIF) FOR CONDYLAR FRACTURE (내시경을 이용한 하악골 과두경부 골절의 정복 및 견고 고정술)

  • Paeng, Jun-Young;Ok, Yong-Ju;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.474-481
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    • 2006
  • The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.

Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study

  • Chang, Je-Shin;Yoo, Kil-Hwa;Yoon, Sung Hwan;Ha, Jiwon;Jung, Seunggon;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.4
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    • pp.175-181
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    • 2013
  • Objectives: This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods: Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Department of Oral and Maxillofacial Surgery, from January 2007 to February 2009. Results: Compared to patients without diabetes, patients with diabetes were presented with the following characteristics: older age (diabetic patients: 62.9 years, non-diabetic patients, 47.8 years), more spaces involved (diabetic patients, 60%; non-diabetic patients, 27.3%), more intense treatment, longer hospitalization (diabetic patients, 28.9 days; non-diabetic patients, 15.4 days), higher white blood cell and C-reactive protein values, higher incidence of complication (diabetic patients, 40%; non-diabetic patients, 7.7%), and distinctive main causative microorganisms. Conclusion: These results suggest that the prognosis of diabetic patients is poorer than that of non-diabetic patients in secondary space infections since they had greater incidence rates of involved spaces, abnormal hematologic findings, more complications, and additional procedures, such as tracheostomy.

THE EFFECT OF EARLY REMOVAL OF THE FIXATION PLATES AND ACTIVE MOUTH OPENING EXERCISE ON THE TEMPOROMANDIBULAR DYSFUNCTION AFTER MANDIBULAR SETBACK SURGERY (하악골 전돌증 환자에서 하악지 시상분할골절단술후 금속고정판의 조기제거 및 기능운동이 턱관절장애에 미치는 영향)

  • Jeon, Joon-Hyuk;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Oh, Jung-Hwan;Kwon, Yong-Dae;Yoon, Byung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.545-551
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    • 2005
  • Purpose: The effect of orthognathic surgery on the temporomandibular dysfunction has been controversial. The purpose of this study is to prove statistically that early removal of fixation plate at postoperative 2 weeks with active exercise of mouth opening could relieve preoperative temporomandibular dysfunction and reposition of temporomandibular joint. Patients and Methods: All 28 subject patients underwent mandibular setback with BSSRO in Kyunghee medical center by one surgeon. The fixation plates used for rigid fixation were removed at postoperative 2 weeks and we had the patients excercise active mouth opening with intermaxillary rubber rings for the guiding proper postoperative occlusion. Temporomandibular symptoms were checked and radiographs were taken before surgery, within a month after surgery, six to twelve months after surgery respectively. Results: The temporomandibular dysfunction symptoms were relieved after the surgery and the condyle was displaced inferior-posteriorly immediate after surgery and repositioned toward its original position during follow-up periods. Conculusion: Orthognathic surgery may benefit temporomandibular joint dysfunction by obtaining a postoperative stable occlusion and more physiologic neuromuscular function. The early removal of fixation plates after BSSRO could reposition the temporomandibular joint to physiologic position and relieve the symptoms of temporomandibular dysfunction by permitting movement of proximal segment.