상안정맥을 이용한 해면정맥동루의 색전술 치험례

문인선,신한경,김동일 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.2

Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia,decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment. (J Korean Cleft Palate Craniofac Assoc 11: 116, 2010)

상악전방분절절골술과 턱끝전진술 후 안면골격과 연부조직의 변화

김진우,신한경,정재학,김영환,선욱,윤창신,윤성호 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.5

Purpose: Mid and lower facial convexity is more common in Oriental people than in Caucasian. Bimaxillary dentoalveolar protrusion is characterized by procumbent teeth, protruding lips, acute nasolabial angle, gummy smile, receding chin, facial convexity. Especially, pure maxillary dentoalveolar protrusion is less frequent than bimaxillary dentoalveolar protrusion. Therefore, it is important to make an accurate decision for the operation throughout the history taking, cephalogram, dental cast to arrive at accurate diagnosis and surgical plan.Methods: From December 2002 to June 2004, ten patients with maxillary dentoalveolar protrusion and microgenia were corrected by maxillary anterior segmental osteotomy and advancement genioplasty. 10 patients were analyzed by preoperative and postoperative clinical photography, posteroanterior and lateral cephalograms.Results: No major complications were occurred throughout the follow-up period except one of the over- recessed, otherwise most of the patients were satisfied with the result.Conclusion: We could correct the occulusal relationship with teeth and improve lower facial profile, asthetically and functionally, by maxillary anterior segmental osteotomy and advancement genioplasty.

인중에 발생한 연골모양 땀샘종의 치험례

차정호,김진우,신한경,정재학,김영환,선욱 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.2

Purpose: Chondroid syringoma is a rare mixed tumor of the skin that was first described by Hirsch and Helwig (1961). Characteristically, it is composed of the proliferation of epithelial cells in a myxoid and chondroid matrix. Most lesions occur on the head and neck region, and their size may range from 0.5~3 cm. Since a chondroid syringoma presents similar characteristics to other masses on the head and neck region, it is significantly important to distinguish with other masses by a surgical biopsy. Methods: A 51-year old woman presented with a painless nodular mass (0.5 × 0.5 × 0.5 cm) on the philtrum, which appeared during the previous year. The mass was treated with a laser without a surgical biopsy. However, the size of the mass showed no changes. Surgical excision under local anesthesia was performed and sent for histopathology. Results: Gross examination showed a mass surrounded by a well developed capsule within the dermal layer. After complete excision without injury to the orbicularis oris muscle, the wound was covered with a local flap. The histology examination revealed numerous cuboid epithelial cells with tuboalveolar structures and keratinous cysts within a chondroid stroma. No recurrence or metastasis was observed at the follow-up visits. Conclusion: Chondroid syringoma is a rare mass on the face. An accurate diagnosis is essential for optimal treatment. This paper reports a case of a chondroid syringoma on the philtrum with a brief review of the relevant literature. (J Korean Cleft Palate Craniofac Assoc 11: 107, 2010)

상악동염이 있는 안와 하벽 골절에서 예방적 항생제의 중요성

성형우,김진우,신한경,정재학,김영환,선욱 대한두개안면성형외과학회 2008 Archives of Craniofacial Surgery Vol.9 No.2

Purpose: Orbital floor fracture has open wound to maxillary sinus and if the patient has chronic maxillary sinusitis, it may be have more risk of infection, complications. The purpose of this comparative study is to be the effectiveness of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis. Methods: We studied 20 patients who diagnosed as orbital floor fracture with chronic maxillary sinusitis from march, 2005 to may, 2006. Among them 16 were male, 4 were female and age was ranged from 15 to 68, average was 42. A day before operation, Prophylactic antibiotics were used to 10 patients. Prophylactic antibiotics were not used to 10 patients. We defined control group as prophylactic antibiotics injection group a day before operation. After surgery, we confined use of same antibiotic for 7 days in both group. After 6 month from surgery, we compare the degree of enophthalmos from healthy side to legion side with hertel exopthalmometry(Inami, Japan) in control group and non-prophylactic antibiotics injection group. Results: In control group, comparison of discrepancy between enophthalmic eyeball and normal eyeball with Hertel exophthalmometer was 1.1mm and non-prophylactic antibiotics injection group was 2.1mm. In independent sample t-test, control group was showed statistically significant difference with non-prophylactic antibiotics injection group(p=0.007). Received August 5, 2008 Revised September 12, 2008 Accepted September 19, 2008 Address Correspondence: Hook Sun, M.D., Department of Plastic and Reconstructive Surgery, College of Medicine, Inje University, Pusan Paik Hospital, 633-165 Gaegum-dong, Jin-gu, Busan 614-715, Korea. Tel: 051)890-6136, 6236/Fax: 051)894-7976/E-mail: sun443@hanmail.net * 본 논문은 제 63차 대한성형외과학회 포스트로 구연되었음. Conclusions: In orbital floor fracture with chronic maxillary sinusitis, bacteria in maxillary sinus can increase post-operative complication by infecting infraorbital soft tissue, and it is thought to be antibiotic prophylaxis is play a role in decrease in degree of enophthalmos. We feel the need to further study of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis.

소아 안면 열상 시 리본 모양 매듭법을 이용한 봉합법

성형우,김진우,신한경,정재학,김영환,선욱 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.1

Purpose: Stitching out in facial simple laceration on children, we use No.11 blade. But the procedure is technically demanding to take care of the uncooperative pediatric patient. When we suture a laceration on the pediatric patients, we apply this method using ribbon shaped knot. On stitching out, We pull on the edge of a stitching fiber easily without injury about normal tissue. Methods: From May 2006 to December 2007 we studied 54 pediatric patients under six years of age, who had facial lacerations in Plastic Surgery department Emergency room. Among them 35 were male, 19 were female and the average age was 3.9. Results: For following up dressing, ribbon shaped knots were not loosened. After stitching out in facial laceration on children, Major complications of infection, hematoma, dehiscence were not found. Conclusion: The advantage of this operation method using ribbon shaped knot when stitching out the fiber on the uncooperative pediatric patients, is easy to perform and to reduce the stitching time, without sedation.

하악각 축소술 시 내측으로 편위된 절골 골편 제거에 대한 고안

김진우,선욱,신한경,정재학,김영환 대한미용성형외과학회 2007 Archives of Aesthetic Plastic Surgery Vol.13 No.1

Oriental women, in general, have prominent mandibular angles and short chins that are thought to be unattractive, square and muscular appearance. Therefore, mandibular ostectomy is one of the most common aesthetic facial bone contouring surgery in oriental and intraoral approach has been used commonly. After the angle ostectomy via intraoral approach, it is not easy for unexperienced surgeons to remove the involuted bony fragment due to the limited view and operation access. This report describes a new method for removal of involuted bony fragment in reduction mandibular angleplasty Thirty eights Case of reduction mandibular angleplasty has been operated from February 2003 to June 2005. We have experienced the involuted bony segment in 12 cases after angle ostectomy. We have adopted periosteal cottle elevator and 18 gauze spinal needle as new methods of extracting the involuted bony fragment. The institutes were used to push the involuted bone segment.We could easily extract the bony fragment with new methods involuted 12 patients mandibular angle within 5 minutes. No major complications were occurred.

우측 관골체부에 발생한 골연골종의 치험례

우상민,김진우,김영환,선욱,신한경,정재학 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.2

Purpose: An osteochondroma, also known as osteocartilaginous exostosis, is a common bone tumor, but rarely occurs in the facial bone, especially in the zygoma body. Because most of the craniofacial bones develop from intramembranous ossification, osteochondromas are relatively infrequent in mesenchymal bones of the head and neck. The osteochondroma of the facial bone is a slow growing, painless mass, and causes facial asymmetry. In spine and other extremities, it rarely changes malignant, but until now, there is no evidence of malignant change in facial bone. We herein describe a rare case of osteochondroma occurring on zygoma body with review of the literature. Methods: A 50-year-old male has painless, slowly growing mass on a right cheek for several years. For a diagnosis, CT and whole body bone scan were done and a diagnosis, osteochondroma was made. The tumor was removed with osteotome under general anesthesia. Results: Radiography showed a well-defined calcified mass attached to the anterior aspect of the right zygoma body. And pathologic exam showed degenerative chondocyte and cancellous bone. As a result, this appearance is that of an osteochondroma. Conclusion: An osteochondroma is a common bone tumor, but rarely occurs in the facial bone. To the authors knowldege, this is the first case of osteochondroma occuring on zygoma in korea, body. For this case, we reviewed literature related to this topic.