Cranial Growth After Distraction Osteogenesis of the Craniosynostosis

Kim, Yong Oock,Choi, Jong Woo,Kim, Dong Seok,Lee, Won Jae,Yoo, Sun-Kook,Kim, Hee-Joong,Choi, Joong-Eun,Park, Beyoung yun Mutaz B. Habal, MD 2008 JOURNAL OF CRANIOFACIAL SURGERY - Vol.19 No.1

The authors describe the continuance of the growth of the distracted cranium after the reshaping of the cranium by distraction osteogenesis (DO) in children with simple symmetric and asymmetric craniosynostosis.From 2000 until 2002, 9 children with simple craniosynostosis underwent cranial reshaping by gradual distraction using an external distraction device. Four patients have symmetric deformities caused by bicoronal and sagittal craniosynostosis, and 5 patients have asymmetric deformities caused by unicoronal and unilambdoidal craniosynostosis. The distraction device was developed and applied by the author. Preoperative simulation surgery was done on the three-dimensional rapid prototyped model and on the three-dimensional computerized tomography scan to determine the favorable osteotomy line. The distraction rate was from 1 to 1.5 mm/d, and the latency period was from 1 to 5 days. The extent of distraction was determined on the basis of the results of simulation surgery and the change of external appearance. Evaluation of the growth of reshaped cranium was processed from the data of thereconstructed three-dimensional computerized tomography scans before operation, immediate end of distraction, and the last follow-up time. The anteroposterior length and bitemporal width were measured in symmetric synostosis cases, and the distance from supratrochlear notch to occiput was measured in asymmetric synostosis cases.The results showed that the immediate morphologic changes of cranium after DO were maintained in both symmetric and asymmetric synostosis up to the last follow-up without evidence of relapse. Cases of asymmetric deformity also showed that the affected side and the unaffected side had grown with the maintenance of the symmetry that was corrected at the immediate end of the distraction.The cranium modified by the DO was well maintained with the children's growth without any signs of recurrent restricted growth of the original disease. The corrected symmetry of asymmetric deformity was well maintained during a long-term follow-up period as well.

Evaluation of Masseter Muscle Volume after Contouring of Prominent Mandible Angle by Measurement of CT Scan Image

Kim, Yong Oock,Choi, Jong Woo International Society for Simulation Surgery 2014 Journal of International Society for Simulation Su Vol.1 No.2

Purpose The prominent mandible angle, otherwise known as "square face", has been recognized as an aesthetic problem that needs correction by many in the Asian community. Many surgeons considered that mandible angle ostectomy alone, brings about hypotrophy of the masseter muscle. However, it was only proven indirectly (by clinical experience and histological animal experiments) and not objectively. In this study, we evaluated the volume of masseter muscle to prove the effect, objectively. Materials and method Computed tomography (CT) images were used to measure the masseter muscle volume of normal female group (n=6), and of female patient group n=8, preoperative and early & late postoperative volumes) presenting the symptom of prominent mandible angle. The data was analyzed statistically by two-sample t-test and paired t-test using SAS (version 8.2). Results In normal female group, volume average was $16,142{\pm}2,829.8mm^3$. In patient group, preoperative volume averaged $24,447{\pm}4,544.5mm^3$ (p<0.0001), early postoperative volume measured average of $31,966{\pm}50,421mm^3$ which is a 30% increase from the preoperative volume (p<0.0001). Late postoperative measurement was $20,202{\pm}4,092.3mm^3$, which is a 20% decrease from the preoperative volume (p<0.0006). Conclusion The bone reduction of prominent mandible angle induce the hypotrophic effect of masseter muscle after long term follow up (5 more months). This result mean that the result of mandible angle contouring surgery can be considered as combined effect of bony angle reduction and subsequent masseter muscle hypotrophy.

Measurement of Orbit using Standardized Processing of CT Scan

Kim, Yong Oock 국제컴퓨터가상수술학회 2014 Journal of International Society for Simulation Su Vol.1 No.1

Purpose Surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these surgeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable reationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. Method Author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Results The method was allowed to evaluate inter-dacryon distance, inter-centroid distance, movement of the medial orbital wall, movement of the lateral orbital wall, alteration of thickness of the lateral periorbital fat as indicator of movement of the orbital wall and orbit in the patient with congenital periorbital anomaly and postoperative periorbital surgery. The goal of surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these sugeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable relationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. In this report, author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Conclusion The method suggested is objective and accurate method in measurement of the orbital contents. It takes time and is not easy to do, however, this kind of measurement for fine structures will be more easily available in near future.

편측관상봉합 조기유합증 환자에서 컴퓨터단층촬영을 이용한 두개 기저부의 술후 변화 예측

김영석,김진형,김용욱,유선국,이혜연,김기덕,박병윤 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.2

Virtual Reality and Augmented Reality in Plastic Surgery: A Review

Kim, Youngjun,Kim, Hannah,Kim, Yong Oock Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.3

Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed.

Virtual Reality and 3D Printing for Craniopagus Surgery

Kim, Gayoung,Shim, Eungjune,Mohammed, Hussein,Kim, Youngjun,Kim, Yong Oock International Society for Simulation Surgery 2017 Journal of International Society for Simulation Su Vol.4 No.1

Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.

Transport Distraction Osteogenesis With Recombinant Human Bone Morphogenic Protein-2 for Large Calvarial Defect Reconstruction

Song, Seung Yong,Sik Yun, In,Kim, Chung Hun,Woo, Dae Gon,Kim, Yong Oock by Mutaz B. Habal, MD. 2014 JOURNAL OF CRANIOFACIAL SURGERY - Vol.25 No.2

BACKGROUND: Transport distraction osteogenesis (TDO) has been used in attempts to treat large calvarial defects but has, until now, lacked consistency and reliability. To achieve sufficient bone formation, the effect of TDO was compared to the effect of TDO combined with recombinant human bone morphogenic protein-2 (rhBMP-2). METHODS: Fourteen dogs were divided into 2 groups; 6 animals in the control group received TDO only, and 8 received TDO combined with rhBMP-2. A calvarial defect 33 × 35 mm in size was generated, and the drug-delivering internal distractor was applied. After a 5-day latency period, distraction with rhBMP-2 at 10 μg/day was initiated at a rate of 2 mm/day. This was followed by a consolidation period of 3 months, after which areas of osteogenesis and strength were measured and histologic examinations were conducted. RESULTS: The average area of osteogenesis was higher in the experimental group (P < 0.01). Regenerated bone of the experimental group showed increased strength (P < 0.05). Histological examination showed typical mature bone in the experimental group. Prominent osteoblastic rimming was observed in the bone marrow of the experimental group. CONCLUSIONS: TDO with an internal distraction device delivering rhBMP-2 can enhance bone regeneration of large calvarial defects in a dog model. These results suggest the potential for human clinical testing of TDO combined with rhBMP-2.

두개골의 3차원 영상 분석을 위한 전산화단층촬영 방법의 비교 : 상층 두께가 3차원 영상의 계측에 미치는 영향

정호걸,김기덕,박혁,김동욱,정해조,김희중,유선국,김용욱,박창서 대한구강악안면방사선학회 2004 Imaging Science in Dentistry Vol.34 No.3

Purpose : To evaluate the quantitative accuracy of three-dimensional (3D) images by means of comparing distance measurements on the 3D images with direct measurements of dry human skull according to slice thickness and scanning modes. Materials and Mathods : An observer directly measured the distance of 21 line items between 12 orthodontic landmarks on the skull surface using a digital vernier caliper and each was repeated five times. The dry human skull was scanned with a Helical CT with various slice thickness (3, 5, 7 mm) and acquisition modes (Conventional and Helical). The same observer measured corresponding distance of the same items on reconstructed 3D images with the internal program of V-works 4.0 (Cybermed Inc., Seoul, Korea). The quantitative accuracy of distance measurements were statistically evaluated with Wilcoxons’ two-sample test. Results : 11 line items in Conventional 3 mm, 8 in Helical 3mm, 11 in Conventional 5 mm, 10 in Helical 5 mm, 5 in Conventional 7 mm and 9 in Helical 7 mm showed no statistically significant difference. Average difference between direct measurements and measurements on 3D CT images was within 2 mm in 19 line items of Conventional 3 mm, 20 of Helical 3 mm, 15 of Conventional 5 mm, 18 of Helical 5 mm, 11 of Conventional 7mm and 16 of Helical 7 mm. Conclusion : Considering image quality and patient’s exposure time, scanning protocol of Helical 5 mm is recommended for 3D image analysis of the skull in CT.

주축기반 강체변환을 이용한 다중 CT 영상의 정합

兪善國(Sun Kook Yoo),金容旭(Yong-Oock Kim),李惠姸(Hye-Yeon Lee),金熙中(Hee-Jung Kim),金起德(Kee-Deog Kim),金南鉉(Nam-Hyun Kim) 대한전기학회 2003 전기학회논문지 D Vol.52 No.8

두개골막피판 및 역측두근피판을 이용한 전두동 골절의 치료

김용욱,이영수,이정훈,이영섭 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.3

Frontal sinus fracture associated with cerebrospinal fluid rhinorrhea often neccessitates definitive treatment to prevent grave complications such as mucocele, mucopyocele, brain abscess, and other life-threatening ascending infection of intracranium. The treatmen should comprise ablation of frontal sinus, obliteration of dead space and existing intracranial-nasopharyngeal communication, and restoration of bony barrier for protection of intracranial-nasopharyngeal communication is the most crucial aspect of the treatment because serious as cending intracranial infection such as intracranial abscess or meningitis is a frequent outcome. In 7 patients with frontal sinus fracture, the authors used pericranial flap or reverse temporalis muscle flap based on the superficial temporal vessels to obliterate the dead space and existing intracranial-nasopharyngeal communication after the ablation of frontal sinus and cranialization of posterior wall of frontal sinus. The patients were followed for 4-20 months, and both pericranial and reverse temporalis muscle flaps were effective to prevent the complications of frontal sinus fracture.