• Archives of Plastic Surgery
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• 제33권6호
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• pp.688-694
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• 2006

Purpose: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load-bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. Methods: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from $1.0{\times}1.5cm$ to $12{\times}10cm$. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. Results: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. Conclusion: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.339-342
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• 2009

Adenoid cystic carcinoma(ACC) is the second most common malignant neoplasm in the salivary gland. In spite of ACC shows slowly growing nature, it is sometimes highly detrimental that it readily invades adjacent tissues and metastasize to distant organs at the early stage of disease. Hence, treatment outcome may be misfortunate due to wide regional infiltration, pathognomonic perineural spread and the tendency of hematogenous metastasis. We present a unusal case of ACC of the scalp in which the patient initially presented with bumpy mass of the scalp who had been diagnosed as the primarily developed ACC of the right hard palate that extended to infratemporal fossa, nasal cavity, and paranasal sinuses and had been treated by total excision and post-operative chemotherapy and radiation therapy for 10 years ago. Although this lesion occured at the scalp, which is a frequent site of primary dermatologic ACC, its histomorphology was the same with that of previous tumor. Complete clinical examination showed no recurrence sign at the primary site and suggested the scalp as a sole treatment failure site. Accordingly, it would be reasonable to consider the present case as either a scalp metastasis or a second primary lesion of salivary gland ACC.

• 대한두경부종양학회지
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• 제3권1호
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• pp.97-105
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• 1987

Chondrosarcoma of the head and neck is very rare tumor and this incidence was reported to be about 10% of all chondrosarcomas. Maxilla is the most common site of involvement and mandible, paransal sinus, nasal cavity and base of skull in that order. In general, chondrosarcoma has been known to be radioresistant, however since the Princess Margaret Hospital reported that it was radioresponsive tumor in 1980, the role of radiotherapy has been emphasized in terms of local control, especially in head and neck regions where complete excion is often difficult to achieve. The authors experienced 4 cases of chondrosarcoma of head and neck among all 29 chondrosarcoma patients from 1971 to 1985. The clinical and pathologic feature of this disease, it's treatment and prognosis were reviewed along with the literatures.

• 대한소아치과학회지
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• 제28권2호
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• pp.310-315
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• 2001

신생아에서 흔히 발생하는 연조직 종양으로는 신생아의 구개 및 치은 낭종(palatal & gingival cyst of the newborn), 선천성 치은종(congenital epulis), 혈관종(hemangioma), 기형종(teratoma), 화농성 육아종 및 자극성 섬유종(pyogenic granuloma & irritation fibroma)이 있다. 이렇게 신생아의 치조제에서 발생한 연조직 종양은 대부분 외과적으로 절제하여 치료하며, 치료하지 않는 경우 흡인(aspiration)으로 인한 기도 폐쇄 및 호흡 곤란, 구강으로 수유시 불편감, 비강으로 수유시 구토가 불가능해 흡인폐렴(aspiration pneumonia) 유발 가능성이 있다. 본 증례는 신생아의 치조제에 발생한 연조직 종양으로, 외과적으로 절제하여 치료하였으며, 조직 검사 소견상 화농성 육아종 및 자극성 섬유종과 유사하였지만 다핵형 거대세포(multinucleated giant cells)가 관찰되었고 선천적으로 발생하였다는 점에서 차이가 있었다. 이 종물의 병리 기전은 아직까지 명확하지 않으며 어떤 특정 질환으로 포함시키는 데 문제점이 있으므로 이에 보고하는 바이다.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.504-507
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• 2007

Purpose: Chondroid syringoma, previously known as 'mixed tumor of the skin', is a rare benign tumor. It usually presents an asymptomatic solitary firm intradermal or subcutaneous slowly growing nodule. It occurs frequently in the head and neck region of middle-aged men. We would like to report an uncommon chondroid syringoma about the clinical and histologic presentation. about the clinical and histologic presentation. Methods: We experienced two cases of chondroid syringoma on the nose and the upper lip, each other. Both masses were totally excised with clear margin. Results: On histologic examination, the masses showed a biphasic pattern-an epithelial component exhibiting apocrine/eccrine differentiation and a stromal component exhibiting myxoid/collagenous change-consistent with the diagnosis of chondroid syringoma. There have been no evidence of recurrence and malignant transformation during postoperative follow-up. Conclusion: There is no one distinctive clinical feature that is specific for chondroid syringoma. However, it should be included in the differential diagnosis of a solid nodule in head and neck region with long standing duration, such as epidermal inclusion cyst, pilomatrixoma, dermoid cyst, sebaceous cyst, neurofibroma, and basal cell carcinoma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

• 대한두경부종양학회지
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• 제16권2호
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• pp.228-234
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• 2000

Objectives: Esthesioneuroblastoma is a rare malignant neoplasm that originates from the olfactory sensory cells. This tumor grows from the upper nasal cavity and ethmoid sinus and invades surrounding structures through the cribriform plate into intracranium or orbit in advanced stage. Even though there has been some controversies in determining standard treatment due to rarity of this tumor, the combination treatment of surgery and adjuvant radiation has been recommended for the locally advanced esthesioneuroblastomas. However, the recent clinical experiences of advanced cases showed that combination chemotherapy is highly effective to reduce tumor mass and improve clinical outcomes. Materials and Methods: The authors conducted a retrospective analysis of 6 esthesioneuroblastoma patients who were treated in our hospital from 1986. Results: The age of these patients was between 19 and 86 year-old. Among the 6 cases, 2 were diagnosed at stage B and 4 at stage C, according to Kadish classification. Anti-tumor treatments were performed in 5 patients. One patient refused active treatment and was lost to follow-up. Better survival outcome were observed in 3 patients who were treated with combination chemotherapy alone or combined modality treatment including chemotherapy. Conclusion: Based on our retrospective study, the combined treatment consisting of surgery, radiotherapy, and combination chemotherapy should be used to improve treatment results. And furthermore, innovative clinical approaches such as neoadjuvant chemotherapy, high-dose chemotherapy and autologous peripheral stem cell transplantation, which have been reported to have good therapeutic results, should be considered and applied actively.

• 치과방사선
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• 제22권2호
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• pp.375-385
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• 1992

This is a report of adenoid cystic carcinoma occurred in the palate in 30-year-old patient with a complaint of exophytic mass. The authors diagnosed it as adenoid cystic carcinoma by the clinical examination, radiographic findings and histopathological findings. The obtained results are as follows: 1. In clinical examination, asymptomatic exophytic mass of palate was observed. 2. In radiographic findings, soft tissue mass infiltrated the left maxillary sinus, nasal cavity, infraorbital fossa, hard palate, pterygopalatine fossa and pterygoid plate, and enhanced soft tissue mass was also observed in CT. 3. In histopathological findings, tubular and solid patterns of glandular structures were observed and the infiltration of tumor cells into the nerve fibers was also observed. 4. Two years after radical surgery, radiation therapy and chemotherapy, the perineural spread to orbital area was observed. 5. Much longer follow-up than 5 years is needed for early diagnosis of recurrence and distant metastasis.

• Imaging Science in Dentistry
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• 제31권3호
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• pp.181-184
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• 2001

Thirteen-year-old girl complaining of the swelling and pain on the left midface visited our dental hospital. On the radiographic examination, well-defined radiolucent lesion with hyperostotic border was found in the left maxilla accompanying with the external root resorption of the involved teeth and the displaced second molar. CT showed calcified bodies, thinning of hard palate, inferior orbital wall and lateral wall of nasal fossa, and thinning and perforation of the buccal plate of the maxilla. Enucleation and curettage of the lesion and nasoantrostomy was carried out and histopathologic examination mainly showed a solid tumor tissue composed of odontogenic epithelium and pulp tissues admixed with dentin and enamel formation. And some part of reduced follicular epithelium of tooth germ showed a change mimicking calcifying odontogenic cyst. Taken together, we concluded the lesion is an ameloblastic fibro-odontoma with a change of calcifying odontogenic cyst.

• Journal of Pharmaceutical Investigation
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• 제40권spc호
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• pp.33-43
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• 2010

Hyaluronic acid (HA) is a biodegradable, biocompatible, non-toxic, non-immunogenic and non-inflammatory linear polysaccharide, which has been used for various medical applications including arthritis treatment, wound healing, ocular surgery, and tissue augmentation. Because of its mucoadhesive property and safety, HA has received much attention as a tool for drug delivery system development. It has been used as a drug delivery carrier in both nonparenteral and parenteral routes. The nonparenteral application includes the ocular and nasal delivery systems. On the other hand, its use in parenteral systems has been considered important as in the case of sustained release formulation of protein drugs through subcutaneous injection. Particles and hydrogels by various methods using HA and HA derivatives as well as by conjugation with other polymer have been the focus of many studies. Furthermore, the affinity of HA to the CD44 receptor which is overexpressed in various tumor cells makes HA an important means of cancer targeted drug delivery. Current trends and development of HA as a tool for drug delivery will be outlined in this review.