• Korean Journal of Cleft Lip And Palate
• /
• v.11 no.2
• /
• pp.77-82
• /
• 2008

The harmonious lip length, residual scar and Cupid's bow width and peak with a normal side are the aims of a unilateral cleft lip repair. Also, long term amelioration without necessary of revisional surgeries may be the ideal conditions. No one method can satisfy the wide varieties of cleft lip deformities. Recently with rearrangement of paraoral muscle and some modifications, a straight line repair technique has been concerned again. Straight scar line, simplicity, and short learning curve are the advantages of the straight line technique. Here two cases of the simple straight line technique were presented and discussed for its usefulness and reliability with short reviews of previous reports.

• Korean Journal of Cleft Lip And Palate
• /
• v.4 no.2
• /
• pp.9-18
• /
• 2001

Cleft lip and palate is the most frequent congenital facial deformity of the orofacial area. Successful management of patients with cleft lip and palate requires a multidisciplinary approach from birth to adult stage. The early surgical intervention of lip and palate induces a significant incidence of maxillary growth restriction that produces secondary deformities of the jaws, and the severity of the skeletal discrepancies tends to increase with growth. The early growth modification treatment to utilize the patient's growth potential is necessary in the cleft lip and palate patients, and we must consider not only the existing skeletal discrepancies but the residual growth amount and the direction. However, once we have obtained good results with orthopedic treatment in mixed dentition stage, we must pay special attention to maintain the treatment results because of high relapse tendencies and the alterations of jaw relationships due to residual growth.

• Journal of International Society for Simulation Surgery
• /
• v.3 no.1
• /
• pp.28-32
• /
• 2016

Background Congenital muscular torticollis (CMT) is a benign condition. With early diagnosis and appropriate management, it can be cured completely, leaving no residual deformity. However, long-standing, untreated CMT can lead to permanent craniofacial deformities and asymmetry.Methods Nineteen patients presented to the author with congenital muscular torticollis. Three dimensional computed tomography (3-D CT) scans was obtained upon patient’s admission. Adjustment of skull’s position to Frankfort horizontal plan was done. Cervical vertebral segmentation was done which allowed a 3D module to be separately created for each vertebra to detect any anatomical or positional changes.Results The segmented vertebrae showed an apparent anatomical changes, which were most noticeable at the level of the atlas and axis vertebrae. These changes decreased gradually till reaching the seventh cervical vertebra, which appeared to be normal in all patients. The changes in the atlas vertebra were mostly due to its intimate relation with the skull base, while the changes of the axis were the most significantConclusion Cervical vertebral segmentation is a reliable tool for isolation and studying cervical vertebral pathological changes of each vertebra separately. The accuracy of the procedures in addition to the availability of many software that can be used for segmentation will allow many surgeons to use segmentation of the vertebrae for diagnosis and even for preoperative simulation planning.

• The Journal of the Korean dental association
• /
• v.53 no.7
• /
• pp.468-475
• /
• 2015

In cleft lip and palate (CLP) patients, there are various degree of residual maxillofacial deformities in adolescent period. Usually, orthoganthic surgery for the cleft patients needs Le Fort I osteotomy and/or mandibular set-back surgery. Previous report from other institute had been shown that there is significant relapse after maxillary movement after Le Fort I osteotomy when the surgical advancement of the maxilla was over than 5 or 7mm in average. Recent comphrehensive report showed that most of the relapse was happened within 1 year and the total horizontal relapse of the maxilla was as high as 30% in average. Therefore, overcorrection is needed in maxillary surgery for cleft patients. Another concerns for cleft orthognathic surgery is the anatomical variation in pterygomaxillary region in cleft patients compared to control patients. Patients with CLP had larger and thicker pterygomaxillary dimensions, and the results imply that careful attention to pterygomaxillary anatomy is needed in patients with CLP undergoing Le Fort I surgery. This article reviews the pre and postoperative considering factors for orthognathic surgery for CLP patients.

• Clinics in Shoulder and Elbow
• /
• v.24 no.1
• /
• pp.9-14
• /
• 2021

Background: Recent studies about completely displaced midshaft clavicle fractures have reported that their nonunion/malunion rates were significantly higher in conservatively treated patients compared to surgically treated patients. The purpose of this study was to evaluate the factors associated with treatment decisions for midshaft clavicle fractures and also the factors that affect patient satisfaction with their treatment choice. Methods: We retrospectively reviewed the records of 75 patients who had been diagnosed with a midshaft clavicle fracture and were treated conservatively at a single institution between March 1, 2013, and December 31, 2014. Their medical records were reviewed to investigate the severity of the initial vertical displacement. A telephone survey was carried out to identify the presence of any patient-perceived deformity and determine if the patient eventually underwent surgery and whether the patient would prefer surgery if the injury recurred. Results: Significantly more patients with vertical displacement ≥100% (9/28) eventually underwent surgery compared to patients with vertical displacement <100% (3/32, p=0.028). Patients with vertical displacement ≥100% (13/28) were significantly more likely to prefer surgery compared to patients with vertical displacement <100% (7/32, p=0.044). Among the conservatively treated patients, nine of 32 participants with a patient-perceived deformity and one of 16 without a patient-perceived deformity responded that they would prefer to receive surgery in same situation in the future (p=0.079). Conclusions: Patients with a midshaft clavicle fracture with vertical displacement of ≥100% may eventually require surgical treatment. When conservative treatment is carried out, the long-term patient results may be unsatisfactory due to perceived residual deformities.

• Archives of Plastic Surgery
• /
• v.48 no.1
• /
• pp.91-97
• /
• 2021

Background In postaxial polysyndactyly of the foot, the choice of which toe to excise is controversial. It is often treated by resection of the fifth toe to save the lateral neurovascular bundles of the sixth toe. However, the sixth toe is often short and laterally deviated, which may require wedge osteotomy, potentially shortening the phalanx and compromising circulation. This study outlines an individualized method to spare the length and axis of the fifth toe in polysyndactyly with a short and deviated sixth toe. Methods We retrospectively analyzed 38 patients who underwent surgery between 2006 and 2019. The fifth toe was spared in 18 cases, and the sixth toe in 20 cases. The ratios of the forefoot width, angle difference, and toe length were compared between the affected and unaffected sides postoperatively. Complications and subjective judgments on cosmetic results were recorded and compared. Results No significant between-group differences were observed for sex, age at surgery, or the follow-up period. The forefoot width ratio did not significantly differ between the groups. However, the angle difference and toe length ratios showed significantly better results in the fifth toe-spared group than in the sixth toe-spared group (P<0.05 and P<0.01, respectively). There were no cases of impaired circulation, and subjective evaluations revealed satisfactory results in the fifth toe-spared group. Conclusions In cases with short and deviated sixth toes, sparing the fifth toe is an effective method of cosmetic treatment. The surgical results were satisfactory, with an improved appearance and no residual deformities.

• Clinical and Experimental Otorhinolaryngology
• /
• v.11 no.4
• /
• pp.275-280
• /
• 2018

Objectives. Middle vault deviation has a significant effect on the aesthetic and functional aspects of the nose, and its management continues to be a challenge. Spreader graft and its modification techniques have been focused, but there has been scarce consideration for removing surplus portion and balancing the upper lateral cartilage (ULC). This study aimed to report the newly invented triangular-shaped resection technique ("triangular resection") of the ULC and to evaluate its efficacy for correcting middle vault deviation. Methods. A retrospective study included 17 consecutive patients who presented with middle vault deviation and underwent septorhinoplasty by using triangular resection at a tertiary academic hospital from February 2014 and March 2016. Their outcomes were evaluated pre- and postoperatively including medical photographs, acoustic rhinometry and subjective nasal obstruction using a 7-point Likert scale. Results. The immediate outcomes were evaluated around 1 month after surgery, and long-term outcomes were available in 12 patients; the mean follow-up period was 9.1 months. Nasal tip deviation angle was reduced from $5.66^{\circ}$ to $2.37^{\circ}$ immediately (P<0.001). Middle vault deviation also improved from $169.50^{\circ}$ to $177.24^{\circ}$ (P<0.001). Long-term results were $2.49^{\circ}$ (P=0.015) for nasal tip deviation and $178.68^{\circ}$ (P=0.002) for middle vault deviation. The aesthetic outcome involved a complete correction in eight patients (47.1%), a minimally visible deviation in seven patients (41.2%) and a remaining residual deviation in two patients (11.8%). Pre- and postoperative minimal cross-sectional areas (summation of the right and left sides) were 0.86 and 1.07, respectively (P=0.021). Fifteen patients answered about their nasal obstruction symptoms and the median symptom score had alleviated from 6.0 to 3.0 (P=0.004). Conclusion. Triangular resection of the ULC is a simple and effective method for correcting middle vault deviation and balancing the ULCs without complications as internal nasal valve narrowing.