• Archives of Plastic Surgery
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• v.48 no.3
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• pp.282-286
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• 2021

Recent reports have described several cases of double muscle transfers to restore natural, symmetrical smiles in patients with long-standing facial paralysis. However, these complex procedures sometimes result in cheek bulkiness owing to the double muscle transfer. We present the case of a 67-year-old woman with long-standing facial paralysis, who underwent two-stage facial reanimation using two superficial subslips of the serratus anterior muscle innervated by the masseteric and contralateral facial nerves via a sural nerve graft. Each muscle subslip was transferred to the upper lip and oral commissures, which were oriented in different directions. Furthermore, a horizontal fascia lata graft was added at the lower lip to prevent deformities such as lower lip elongation and deviation. Voluntary contraction was noted at roughly 4 months, and a spontaneous smile without biting was noted 8 months postoperatively. At 18 months after surgery, the patient demonstrated a spontaneous symmetrical smile with adequate excursion of the lower lip, upper lip, and oral commissure, without cheek bulkiness. Dual-innervated muscle transfer using two multivector superficial subslips of the serratus anterior muscle may be a good option for long-standing facial paralysis, as it can achieve a symmetrical smile that can be performed voluntarily and spontaneously.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.189-195
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• 2013

Purpose: We investigated a statistical difference of tibial-articular surface (TAS) angles between radiographs of standing ankle anteroposterior (AP) and whole lower extremity view, and evaluated whether the tibial axis obtained from the standing ankle AP view reflects the original mechanical axis of lower extremity. Materials and Methods: Both the standing ankle AP and whole lower extremity view were taken from 60 legs of 30 healthy volunteers without a history of ankle surgery or deformity of lower limb. To determine the tibial axis, Takakura's and Hintermann's method were employed in the standing ankle AP view. To compare these results with the original TAS angle, ANOVA and multiple comparison test were used. Results: The mean TAS angle was 88.3 degrees(from hip joint to ankle), 89.5 degrees (from knee joint to ankle), 88.5 degrees (Takakura's method), and 90.2 degrees(Hintermann's method). Although there was a statistical significance (p=0.000) between these results, Takakura's method had no significant difference, compared to the results of whole extremity view by the multiple comparison test. Conclusion: The tibial axis obtained by Takakura's method reflects the original mechanical axis of lower extremity. When a surgical procedure is planned, however, it is necessary to consider that the ankle radiographs do not provide any information on the proximal deformity without the whole lower extremity view.

• The Journal of the Korean dental association
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• v.17 no.12 s.127
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• pp.923-926
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• 1979

In patient of long standing malunited maxillary fracture, maxillary osteotomy or refracture seems to be justifiable. This is a case of the patient, a 60 year old Korean female patient, presented a long-standing malunited maxillary fracture with dish-type face and functional disturbance in mouth opening. We performed upon her Le Fort I osteotomy only via labial-buccal horizontal incisions in one-stag operation. The result was good in esthetics and function.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.1
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• pp.16-20
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• 2014

Mandibular condylar hyperplasia is an uncommon condition of excessive unilateral growth of the condyle causing facial asymmetry and occlusal alterations. The etiology of condylar hyperplasia is unclear, but several factors are suspected, including previous trauma, hormonal disturbances, and abnormal functional loadings. Acute or chronic recurrent dislocation of temporomandibular joint (TMJ) is common, but long-standing dislocation is rare. We present two cases of the exophytic condylar hyperplasia that lasted for over 20 years with TMJ dislocation. In both cases, we performed a condyloplasty to restore normal occlusion and facial symmetry, with satisfactory results.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.39-44
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• 2013

Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.20-23
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• 2012

Objective : To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor. Methods : Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.8 years. An independent observer assessed whole lumbar lordosis (WL) and segmental lordosis (SL) between L1 and S1 using the Cobb's angle on lateral radiographs of the lumbar spine obtained from normal individuals when standing, sitting on a chair, and sitting on the floor. WL and SL at each segment were compared for each position. Results : WL when sitting on the floor was reduced by 72.9% than the average of that in the standing position. Of the total decrease in WL, 78% occurred between L4 to S1. There were significant decreases in SL at all lumbar spinal levels, except L1-2, when sitting on the floor as compared to when standing and sitting on a chair. Changes in WL between the positions when sitting on a chair and when sitting on the floor were mostly contributed by the loss of SL at the L4-5 and L5-S1 levels. Conclusion : When sitting on the floor, WL is relatively low; this is mostly because of decreasing lordosis at the L4-5 and L5-S1 levels. In the case of lower lumbar fusion, hyperflexion is expected at the adjacent segment when sitting on the floor. To avoid this, sitting with a lordotic lumbar curve is important. Surgeons should remember to create sufficient lordosis when performing lower lumbar fusion surgery in patients with an oriental life style.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.3
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• pp.121-126
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• 2013

Temporomandibular joint (TMJ) dislocation is an acute paintful condition that causes severe functional limitation. So, manual reduction is the treatment of choice and should be performed as early as possible. Long-term dislocation of the TMJ that has persisted for more than 1 month is comparatively rare. This may include severe illness, neurological diseases and prolonged intensive care hospitalization with oral intubation and sedation. A joint that remains prolonged dislocated undergoes morphological change which is also true for periarticular tissue, especially in ligaments and muscles. Treatment of long-term TMJ dislocation should be different from acute TMJ dislocation, as simple reduction is difficult to achieve and it's likely to redislocate. The prevention of redislocation after reduction should be considered. This is a case report of about manual reduction of temporomandibular joint long-standing dislocation under general anesthesia.

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

• Journal of Veterinary Clinics
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• v.35 no.4
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• pp.161-165
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• 2018

A 12-year-old gelding Warmblood Horse was presented with a corneolimbal mass in the right eye (OD) of 6 months duration. Clinical signs included ocular discomfort, persistent mucoid ocular discharge, and conjunctival hyperemia. The mass was excised by superficial keratectomy under sedation in a standing position, followed by a topical application of 0.04% mitomycin C (MMC), and a placement of a conjunctival advancement graft. The histopathological diagnosis was squamous cell carcinoma. One month after surgery, recurrence of the mass was suspected upon examination of the eye. Topical MMC and 5-fluorouracil followed by cryotherapy were applied as adjunctive therapies after debulking of the mass. The surgical site healed without complications and with a cosmetically acceptable result. No recurrence of the mass was noted four years following the second procedure.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.140-143
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• 2006

Purpose: To present tibial axis-talar ratio and tibia-ankle surface angle in lateral measured on standing ankle lateral radiographs of adults who did not have specific ankle pathology. Materials and Methods: On Fifty-six radiographs without ankle osteoarthritis and malalignment, radiographic measures were performed with use of a custom dizitizing program based on $PV-WAVE^{(R)}$. AP ankle alignment was quantified by tibia axis-talar ratio (TTR) and tibia ankle surface angle in lateral (TLS angle). The data was compared with previously reported american data and analyzed using a t-test. Results: The average TTR and TLS angle of our series were $33.9{\pm}3.3%$, and no significant difference compared with reported american adults (p=0.152). Conclusion: The T-T ratio and TLS angle measured on standing ankle lateral radiographs of our series were $33.9{\pm}3.3%$ and $80.4{\pm}3.3^{\circ}$. This measures appear to be a useful measure for determining AP ankle alignment.