• Archives of Craniofacial Surgery
• /
• v.15 no.2
• /
• pp.82-88
• /
• 2014

Background: The chin shape and position is important in determining the general shape of the face, and augmentation genioplasty is performed alone or in combination with other aesthetic procedures. However, augmentation genioplasty using osteotomy is an invasive and complex procedure with the potential to damage mentalis muscle and mental nerve, to affect chin growth, and prolonged recovery. Our aim was to present our experience with a modified augmentation genioplasty procedure for hypoplastic chins using a Gore-Tex implant. Methods: Two vertical slit incisions were made at the canine level to create a supra-periosteal pocket between the incisions, preserving the periosteum and mentalis muscle. Minimal sub-periosteal dissection was performed lateral to the incisions along the mandibular border. The both wings of implant were inserted under the periosteum to achieve a stable dual plane implantation. Results: In total, 47 patients underwent dual plane chin augmentation using a Gore- Tex implant between January 2008 and May 2013. The mean age at operation was 25.77 years (range, 15-55 years). There were 3 cases of infection; one patient was treated with antibiotics, the others underwent implant removal. Additionally, two patients complained of postoperative parasthesia that spontaneously improved without any additional treatment. Most patients were satisfied with the postoperative outcomes, and no chin growth problems were observed among the younger patients. Conclusion: Dual plane Gore-Tex chin augmentation is a minimally-invasive operation that is simple and safe. All implants yielded satisfactory results with no significant complications such as mental nerve injury, lower lip incompetence, or chin growth limitation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.14 no.1_2
• /
• pp.135-142
• /
• 1992

This study was performed to define the anatomical position of the mandibular canal and the findings during the sagittal split ramus osteotomy of the mandible. The mandibles of 20 adult Korean were used. The dimension of mandibular canal from the mandibular foramen to the 1st molar was measured at 4 specific coronal-sectional location by CT scan. The results were as follows ; 1. The distance from the mandibular canal to the medial aspect of the buccal cortical plate was greatest($4.5{\pm}1.1mm$) at 2nd molar area and was not significantly greater than at any other section. 2. Buccal cortex was thickest($3.8{\pm}0.9mm$) at 2nd molar and thinnest ($2.5{\pm}0.3mm$) mandibular foramen um 3. The distance from the mandibular canal to the medial aspect of the lingual cortical plate was not significant at any sections. 4. The distance from the mandible canal to the inferior border of mandible was greatest at the mandibular foramen($20.7{\pm}3.9mm$). The canal was located more closely to the inferior border at 1st, 2nd molar area 5. The diameter of the mandibular canal was between $2.5{\pm}0.3mm$ and $2.8{\pm}0.6mm$. 6. The total mandibular thickness was greatest($21.1{\pm}2.6mm$) at 2nd molar area and narrowest($17.2{\pm}3.2mm$) at mandibular foramen area.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.4
• /
• pp.376-381
• /
• 1999

A variety of materials and procedures such as sinus floor elevation, sinus-lift graft, inlay bone graft using Le Fort I osteotomy, and onlay graft have been used to create adequate bone volume in the maxillary sinus for placement of endosseous implants in the posterior atrophic maxilla. Because of the frequent lack of bone in the posterior maxilla, sinus lift procedure has become a commonly practiced treatment modality. The 138 endosseous implants of 36 patients with sinus augmentation procedures performed in Korea University Hospital from January 1991 to December 1998 were summarized and analysed. The result of this study were as follows: 1. Age ranged from 39 to 57, with a mean of 50.7. 2. The mean survival rate for 138 implants with maxillary sinus lift procedure was 80.4%. 3. There was no corelationship between the fixture length, width and the survival rate. 4. The result showed that the healing period for 8-12 months was necessary if the residual alveolar bone height was less than 5mm. 5. Autogenous iliac corticocancellous block graft showed the most favorable survival rate(95%).

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.1
• /
• pp.17-25
• /
• 1996

There are many reports of the surgical management for the craniofacial abnormalities arising from the irradiation of the head and face for treatment of childhood cancers. Since the mordern combined-modality theraphy for childhood cancers began in the late 1960s and the early 1970s, recent reports have described the occular, dental and maxillo-facial abnormalities after irradiation in long-term survivors of cancers of the head and face. The resultant deformities may be known to be difficult to reconstruct with surgical techniques. This paper describes the late reconstructive surgery for the unilateral orbital and malar hypoplasia after eyeball enucleation and irradiation during childhood to correct the facial asymmetry and expand the contracted orbital socket into the functional dimension for the retaining eyeball prosthesis with spherical implant. We reports the satisfactory preliminary results from the midfacial osteotomy through the supero-lateral orbital rim and malar bone and the antero-lateral repositioning with the autogenous bone grafting in 26 year-old female patient who will be planned to make the new eyeball prosthesis by the department of ophthalmology.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.2
• /
• pp.202-207
• /
• 1994

Subcutaneous emphysema on the head, neck, and pneumomediastinum are, abnomal but well-documented, presence of air in the subcutaneous tissue and mediastinum, and can be diagnosed by palpation of the soft tissues, lateral or crosstable cervical radiograph and upright chest radiograph. The common clinical features of cervical emphysema and pneumomediastinum were facial and cervical swelling, presence of crepitation on palpation of the soft tissue, and retrosternal pain. Subcutaneous emphysema may arise from use of high-speed air turbine drills, facial trauma, trachea bronchial tear, endotracheal intubation, mechanical ventilation, chest injury, tracheostomy, following Lefort I osteotomy, and spontaneously. Symptoms of subcutaneous emphysema and pneumomediastium are generally self-limiting and eventually subside with conservative therapy. As we report a case of traumatic subcutaneous emphysema and pneumomediastinum after facial injury with clinical presentation and treatment consideration.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.6
• /
• pp.604-607
• /
• 2008

The technique of submental intubation in patient with multiple facial fracture and skull base fracture was originally described by Altemir. Not only is intermaxillary fixation feasible when using this surgical technique but a good field of vision is acquirable, and postoperative complications due to tracheostomy can be prevented. After Altemir presented submental intubation, many modified techniques were reported, applicable not only to trauma patients but also to elective surgeries such as orthognathic surgery including Lefort II or III osteotomy. This technique is easy to use, rapid and free of complications compared to alternative intubation method especially tracheostomy for multiple facial trauma patients.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.4
• /
• pp.359-369
• /
• 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.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.6
• /
• pp.584-588
• /
• 2008

Facial asymmetry is particularly associated with mandible among other facial bones and it could be either congenital or acquired. Congenital factors are related to Treacher Collin syndrome, Pierre Robin syndrome, hemifacial microsomia and other various syndromes. Acquired factors are such as damaged or diseased growing condyles, hormonal disorder, oral mal-habit, muscular force, tumor, infection and so on. Diagnosis and treatment of facial asymmetry are complicated due to differences in sizes and positions of mandibles. The aspects of facial asymmetry is various and complicated upon each individual. Depending on causes of the facial asymmetry, there also are morphological differences. For such reasons, precise anatomical analysis and diagnosis of the facial asymmetry are essential before any surgical procedure followed by the appropriate treatment plan. This case is regarding a 21-year old patient diagnosed as the facial asymmetry due to an infantile maxillofacial surgery. Employing various morphological evaluations, potential problems during the procedure are predicted beforehand. This case reports a favorable result of sagittal split ramus osteotomy performing the oblique vertical bone cutting in posterior-superior of the mandibular second molar.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.2
• /
• pp.158-166
• /
• 2009

The application of CT with basis on 3 dimensional-reconstruction is getting more widely practiced. With the data obtained from cone-beam computed tomography(CBCT), not only the diagnosis of the patient with skeletal abnormality but also the virtual simulation of the orthognathic surgery were performed and its application would be popular in orthodontic field. We reported a case, a 19-year old man who was diagnosed mandibular prognathism and required orthognatic surgery. In this case, the virtual orthognathic surgery was simulated and surgical wafer was fabricated by using CBCT data. That wafer was applied the actual orthognathic surgery. After preoperative orthodontic treatment, we prepared surgery as follows. : (l)Acquisition of 3D image data, (2)Reconstruction of 3-dimensional virtual model, (3)Virtual model surgery, (4)Extraction of stere-olithographic image, (5)Check-up for occlusal interference, (6)Fabrication of surgical stent by stereolithography. Bilateral sagittal split ramus osteotomy was operated and used stereolithographic surgical stent. 1 month later, we superimposed CBCT datas of virtual surgery and that of actual surgery, and then compared the result. CT data's application for othognathic surgery yielded satisfactory outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.39
• /
• pp.32.1-32.5
• /
• 2017

Background: Osteochondroma is a benign tumor that tends to develop in mandibular condyle and coronoid process in the craniofacial region. If tumor mass has grown from condyle into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses. Case presentation: This study reports on a case of osteochondroma on mandibular condylar head where we treated with surgical excision via preauricular approach with 3D analysis. After the local resection, there were no surgical and post-operative complications until 8-month follow-up period. Conclusions: In local excision of osteochondroma, our method is a minimally invasive method. It is a good example of osteochondroma treatment.