• 대한기관식도과학회지
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• 제4권1호
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• pp.79-84
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• 1998

Benign symmetric lipomatosis was initially described in 1846 by Sir Benjamin Brodie. In 1888, Otto Madelung presented 33 cases of benign symmetric lipomatosis and described the classic“horse collar”cervical distribution of the lipomatous tissue. Launois and Bensaude described benign symmetric lipomatosis as a distint syndrome characterized by a diffuse, symmetric, fatty accumulation in the cervical region. This disease is rare condition affecting mostly middle aged alcoholic men and associated with many systemic diseases such as diabetes mellitus, hyperuricemia, renal tubular acidosis, liver enzyme abnormality etc. The condition does not spontaneously involute and surgical excision is the only proven method of treatment, and recurrence is frequent. We experienced six patients of benign symmetric lipomatosis who underwent surgical excision via collar incision which afford wide exposure of the entire cervical area. We report them with the review of literature.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.16-19
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• 2007

Objective : This report describes the clinical study of the surgical method of lateral third infraclavicular implantation of vagal nerve stimulation (VNS) generator through the axillary wrinkle incision. Methods : In a retrospective study, the data for 20 patients with medically intractable epilepsy treated by this approach were examined. The mean age was 31.4 years (range : 14-50), and the mean follow-up period was 12.15 months (range : 4-21 months). The male to female ratio was 2.3 : 1. The subcutaneous pocket for the generator was located in the lateral third infraclavicular area through the axillary wrinkle. Our method was a modification of the standard VNS generator implantation in the mid-infraclavicular pocket through anterior axillary incision. Results : There were the excellent or good cosmetic satisfaction in 95% of the cases and fair in 5%. The generator was located outside the lung field in 15%, periphery of the lung field in 45%, and crossed over the lung field in 40%. Discomfort from shoulder motion occurred transiently in 35% of cases. Other complications were minimal. Conclusion : These results demonstrate that the lateral third infraclavicular apporach will offers cosmetic benefits and reduction of obscuration of the lung field without serious complications. Thus, this technique provides an attractive alternative among the surgical techniques for the vagal nerve stimulation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.171-177
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• 1993

The prominent malar region has been recognized a sign of youth and beauty in caucasian who generally have a dolichocephalic and long face. But in the orients, especially Koreans who generally have a mesocephalic or brachycephalic face, it is considered an agressive, unesthetic facial appearance. So many patients require the shaving of prominent malar eminence and arch, and many methods of its reduction have been devised. For the exposure of malar complex, infraorbital skin incision, intraoral approach, preauricular approach, supraauricular scalp incision, and coronal approach have been used. And for the reduction of bony structure, direct shaving, contouring and repositioning of the malar complex after extirpation, and medially fracture of zygomatic arch have been used with its own merits. We performed the reduction malarplasty through intraoral approach. After two parallel oeteotomy at medial part of the zygomatic bone, the midsegment is removed. The posterior arch of zygoma was bended or green stick fractured. When more correction was required, the posterior arch was fractured medially through the step incision at skin. This method has a some advantages. Compared with the method for extirpation of malar complex, the infection rate is diminished, the resorption is small because of no free bone graft. And cheek drooping is prevented. Compared with the method of coronal approach, the surgical trauma is minimal. Now we report some cases of reduction malarplasty performed through intraoral approach and disscus the surgical technique and results.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.17-21
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• 2011

Purpose: It is difficult to objectively evaluate the outcomes of plastic surgical procedures. The combination of aesthetic and medical factors makes outcome quantification difficult. In this study, fracture reduction accuracy was objectively evaluated in patients with zygomatic complex fractures. Patients satisfaction with the accuracy was also examined. In addition, the patients' overall satisfaction and discomfort due to complications were analyzed. Methods: Eighty-five patients who had surgeries via bicoronal incision for zygomatic complex fracture from March 2006 to December 2009 were included in this study. Two plastic surgeons evaluated the accuracy of the fracture reduction with postoperative computed tomography. A survey questionnaire was administered to evaluate the patients' overall satisfaction and the impact of symptoms associated with the procedure on the patients' daily lives. Results: The overall patient satisfaction rate was $82.1{\pm}10.9%$ (range, 45~100%). The level of deformation was $6.7{\pm}10.9%$, the levels of discomfort in daily life due to pain, paresthesia, scar, and facial palsy were $8.5{\pm}13.2%$, $5.8{\pm}8.9%$, $4.4{\pm}9.9%$, and $1.9{\pm}9.2%$, respectively. According to the visual analogue scale, paresthesia was found to be the most frequent symptom (43.5%), and pain was the most troublesome symptom. Conclusion: The use of bicoronal incision for treating zygomatic complex fractures can cause various complications due to wide incision and dissection. However, this technique can provide optimized reduction and rigid fixation. Most of these postoperative complications can cause significant discomfort in the patient. It is thought that the use of correct surgical technique and the accurate knowledge of craniofacial anatomy will result in a reduction of complications and significantly increase patient satisfaction.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.245-249
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• 2005

Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

• 대한족부족관절학회지
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• 제13권1호
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• pp.23-27
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• 2009

Purpose: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. Materials and Methods: Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. Results: The length of the gap after debridement was $5.4{\pm}2.0$ cm. The VAS improved from $4.1{\pm}0.9$ to $1.5{\pm}0.8$ at last follow up (p<0.05). The AOFAS score increased from $38.9{\pm}12.2$ to $91.5{\pm}8.9$ at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. Conclusion: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.22-28
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• 2012

Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

• Journal of Chest Surgery
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• 제55권1호
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• pp.44-48
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• 2022

Background: Although classical multi-port video-assisted thoracic surgery has been widely performed, single-incision thoracoscopic surgery (SITS) is a popular surgical technique for the treatment of primary spontaneous pneumothorax (PSP). However, the inconvenient alignment of instruments and the limited field of view occasionally make surgeons convert from SITS to multi-port surgery or extend the incision. This study aimed to present an easy and safe SITS technique for PSP using a spinal needle. Methods: In total, 139 patients underwent SITS between May 2011 and December 2017. We used a spinal needle to hook the bulla or bleb, and wedge resection was performed through a small incision. Patients' medical records were reviewed retrospectively, and a telephone survey was conducted to investigate the recurrence rate. Results: The mean age of the 139 patients was 23.62±9.60 years. The mean operative time was 36.69±14.64 minutes, and multi-port conversion was not performed. The mean postoperative hospital stay was 3.00±0.78 days, and the mean indwelling chest tube duration was 1.97±0.77 days. No complications were observed. In the mean follow-up period of 86.75±23.20 months, recurrence of pneumothorax was found in 3 patients. Conclusion: We suggest that SITS for PSP with the aid of a spinal needle to replace a grasper is a safe and easy technique that only requires a small incision.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.679-685
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• 2014

Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

• Journal of Yeungnam Medical Science
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• 제13권1호
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• pp.22-31
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• 1996

본 교실에서는 1994년 11월부터 1996년 4월까지 수상 후 혹은 일차 교정 후 평균 3.2개월 경과한, 7명의 환자에서 제한된 접근방식으로 2차석 교정술을 시행하여 평균 4.5개월의 추적 조사한 후 만족할 만한 결과를 얻었으며 다음과 같은 결론을 내렸다. 1. 술전에 X-ray 검토, 사고 전의 사진, 충분한 대화 등을 토대로 가능한 정확한 절골선과 변형정도 등의 교정을 위한 계측이 필요하다. 2. 관골의 삼각골절 후 안면변형인 경우는 반드시 광범위 노출법보다는 제한적 방법으로 교정이 가능했다. 3. 절골된 관골은 내측 및 전상방으로 과교정해야 한다. 4. 절골 및 재배치시 저작근을 포함하여 주위 연부조직을 분리시키는 것이 중요하다. 5 안구함몰의 교정을 위해서 안와기저부 및 측부에 자가 골이식이나 고밀도 폴리에틸렌($Medpor^{(R)}$)의 삽입 후 결과의 차이는 발견할 수 없었다.