Management of Alveolar Cleft

경현우,강낙헌 대한두개안면성형외과학회 2015 Archives of Craniofacial Surgery Vol.16 No.2

The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.

상이개동맥 도상피판을 이용한 이개상부 및 그 주변부의 재건

경현우,서영준,김동운,오상하 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.3

Purpose: The retroauricular flap has many advantages for facial reconstruction and is performed by many surgeons. However, it is difficult to perform due to limited rotation arc and length of pedicle. We successfully reconstructed the upper region of the auricle and its surroundings with retroauricular flap by using the superior auricular artery as a supplying pedicle. The purpose of this study is to present an anatomic study about the superior auricular artery and its clinical application. Methods: We investigated the relationship between the superior auricular artery and its surrounding structures through anatomic studies with 7 fresh cadavers and then applied the findings clinically. From February to December 2008, we performed 7 cases of the superior auricular artery island flap to reconstruct the defects in patients operated on skin cancer. Sizes of the defects varied form 0.8×0.8cm to 3.5×3.0cm. Results: We found that the superior auricular artery is a reliable pedicle for the retroauricular flap, based on anatomical studies. All wounds of the patients were successfully closed. The flap donor site was primary closed except in one patient with a large defect. The aesthetic outcomes of the donor and recipient sites were satisfactory. Conclusion: The superior auricular artery island flap has several advantages. Therefore, we suggest that the superior auricular artery island flap is a treatment of choice for reconstructing soft tissue defect at the upper region of the auricle and its surrounding area.

Adult-Type Intrathoracic Xanthogranuloma: Excision and Reconstruction Using a Latissimus Dorsi Muscle Flap

송승한,경현우,강낙헌,오상하,김경희 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.1

미용코성형술에서 코뼈자름술의 적용

정재용,경현우,오상하,강낙헌,유용아 대한미용성형외과학회 2010 Archives of Aesthetic Plastic Surgery Vol.16 No.1

Nasal osteotomy for aesthetic results is required in patients who have broad nasal bone. Since the procedure is difficult, many operators hesitate the surgery. From January 2007 to July 2009, we performed 77 cases of nasal osteotomy, consisting of paramedian oblique medial osteotomy or median oblique-medial osteotomy and percutaneous lateral osteotomy. Most of the patients had satisfying results, however three patients had asymmetric shape and inappropriate inward movement of nasal bone which required revision with percutaneous lateral osteotomy. Osteotomy procedure varies,depending on surgeon’s preference and experience, however, each surgeon should be aware of good and weak points of those procedures and use the most suitable method. In order to achieve maximal satisfying results, preoperative analysis of patients and minimal invasive handling should be done. Based on these efforts, this method could broadly be used in the aesthetic field. (J Korean Soc Aesthetic Plast Surg 16: 15, 2010)

Recurrent Chondroid Syringoma of the Alar Rim

윤영묵,신승호,경현우,송승한,강낙헌 대한두개안면성형외과학회 2016 Archives of Craniofacial Surgery Vol.17 No.1

Chondroid synringoma (CS), pleomorphic adenoma of skin, is a benign tumor found in the head and neck region. CS was first reported in 1859 by Billorth for the salivary gland tumor. The usual presentation is an slowly growing, asymptomatic mass. A 53-year-old female with a history of chondroid synringoma had presented with multiple firm, nodular masses found in the left nostril area. The lesion had been excised 8 years prior and was diagnosed histopathologically, but had gradually recurred. Excision of the mass located in subcutaneous layer revealed four whitish, firm tumors surrounded with capsular tissue. Neither recurrence nor complications occurred during the 18 months follow-up period. In the head and neck region, chondroid syringoma should always be considered in differential diagnosis of soft tissue masses despite its rare incidence. For that reason, excisional biopsy with clear margin is the optimal diagnostic as well as therapeutic choice. We report a case of recurred chondroid syringoma on the nose in female patient.

Delayed Orbital Hemorrhage around Alloplastic Implants after Blowout Fracture Reduction

류용아,박재범,경현우,송승한,강낙헌 대한두개안면성형외과학회 2015 Archives of Craniofacial Surgery Vol.16 No.1

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbitalhemorrhage is a rare complication of these implants and has been reported rarelyin Korea. The purpose of this article is to report a late complication case focusing ontheir etiology and management. A 20-year-old male patient underwent open reductionwith Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. Theinitial symptom occurred with proptosis in the right side as well as vertical dystopia,which had started 4 days earlier, 8 months after surgery. Any trauma history after thesurgery was not present. We performed an exploration and removal of hematoma withMedpor titanium meshed alloplastic implant. A case of delayed orbital hematoma followingalloplastic implant insertion was identified. It occurred within the pseudocapsuleof the implant. One week after surgery, overall symptoms improved successfully, andno complications were reported during the 11-month follow-up period. Although rare,orbital hemorrhage is a potential complication of alloplastic orbital floor implants, whichmay present many years after surgery. As in the case presented, delayed hematomashould be included in the differential diagnosis of late proptosis or orbital dystopia.

흰쥐 발가락의 형태형성과 방사선 조사에 따른 세포자멸사의 변화

김원식,김수일,한승로,송승택,경현우,노정호 대한체질인류학회 2006 대한체질인류학회 학술대회 연제 초록 Vol.49 No.-

Propeller Dorsal Intercostal Artery Perforator Flap for an Extensive Defect on the Back Following Malignant Peripheral Nerve Sheath Tumor Resection: A Case Report

송승한,권혁동,김순제,김주학,경현우,오상하,양호직,하유석 대한수부외과학회 2021 대한수부외과학회지 Vol.26 No.1

Posterior trunk defects have been a challenging anatomical area to cover in reconstructive surgery. The use of local myocutaneous flaps has been described extensively in the literature to cover these defects, but these techniques are associated with significant donor-site morbidity, including functional loss of muscle units. Freestyle perforator flaps enable local tissue recruitment with skin of a similar color and texture in diverse anatomic areas, but there is a shortage of case series on posterior trunk defects using propeller dorsal intercostal artery perforator (DICAP) flaps, particularly when the defects are extensive. In this report, the authors present a successful case of a DICAP propeller flap for an extensive defect on the upper back following a malignant peripheral nerve sheath tumor resection.

흰쥐에서 발가락 발생중 방사선조사에 의한 세포자멸사의 변화

김원식,김수일,조문준,조근자,한승로,차달선,송승택,경현우,노정호 대한체질인류학회 2006 대한체질인류학회지 Vol.19 No.2

Ionizing radiation exerts harmful effect during the limb development, but the exact mechanism is still largely unknown. In this study, 2 Gy of X-ray irradiated to the rat fetuses on gestation day of 13.7 when the hindlimb buds appear, and sacrificed at GD 14.7, GD 15.7 and GD 16.7, respectively. To reveal the changes of apoptotic figures between control and experimental groups, TUNEL immunohistochemistry and confocal laser scanning microscopy were carried. Mean body weight of fetuses of irradiated groups were decreased significantly compared to the control group. Numerical digit anomalies and asymmetries between right and left sides were increased significantly in the irradiated group compared to control group. Some digit anomalies were increased significantly in the right side. Radiation-induced decrement of the density of apoptotic figures on GD 14.7 was presumed to be related with foot and digit anomalies. 이온화방사선은 사지발생에 유해로운 영향을 미치는 것으로 알려져 있으나, 그 기전이 무엇인가는 아직 까지 확실하게 알려져 있지 않다. 본 실험에서는 뒷다리 발생이 개시되는 시기인 임신 10.7일에 2Gy의 방사선을 조사하고, 임신 14.7일, 15.7일 및 16.7일에 희생시켜 대조군과 실험군간의 차이를 비교하여 세포자멸사의 변화를 경시적으로 비교 관찰하여 방 사선에 의한 발가락 기형형성 기전의 일부를 알아보았다. 그 결과 방사선을 조사한 실험군이 대조군에 비해 평균 태아체중은 현저하게 감소하였으며, 기형의 발생빈도는 현저히 증가하였다. 출현한 발가락 기형은 발가락 수의 감소와 비대칭 등 형태이상으로, 임신 15.7일군에서는 오 른쪽 뒷다리 발가락과 왼쪽 뒷다리 발가락에서 동일한 수의 기형이 발생하였으나, 기형의 정도가 오른쪽이 더 심 하게 나타났고, 임신 16.7일군에서는 오른쪽 뒷다리 발가락 기형이 좀 더 많이 나타났으나 기형의 정도에는 차이가 없었다. 또한, TUNEL 면역조직화학 및 공초점 레이저 주사현미경(confocal laser scanning microscope) 관찰을 실시한 바 세포자멸사가 정상적인 발가락 형태형성에 중요하며 이것의 이상이 발가락 기형형성과 밀접한 관련이 있음을 알 수 있었다.

Minimally invasive removal of facial foreign body granulomas

최재익,고건일,권혁재,하유석,김순재,경현우,오상하,송승한 대한미용성형외과학회 2022 Archives of Aesthetic Plastic Surgery Vol.28 No.1

Background Various materials, commonly called fillers, have been developed and are now used for cosmetic and reconstruction purposes. Indiscriminate injections of illegal and unknown substances have various side effects, among which foreign body granulomas are particularly difficult to treat. Surgical resection can be considered for small and well-defined foreign body granulomas, but complete resection is often impossible for wide facial granulomas, and postoperative deformities may occur. Therefore, this study presents cases where foreign bodies were evaluated using imaging studies and removed through minimally invasive procedures depending on their characteristics. Methods Thirty-five patients with chronic granulomas after illegal filler injections treated from 2012 to 2019 were enrolled. Clinically, these granulomas were classified into cystic and infiltrating groups according to the imaging study patterns. Patients in the cystic group underwent puncture and drainage, and those in the infiltrating group were first treated with intralesional laser treatment and then suctioned. If the results were insufficient, surgical removal combined with a lifting procedure was performed. Results All 35 patients were women, and their average age was 51 years. Surgery was successful in almost all cases, but four cases of insufficient removal and contour deformity were encountered during follow-up. Two patients underwent reoperation and two patients improved naturally. Conclusions In this study, we classified the characteristics of granulomas using preoperative imaging studies. Aesthetically favorable results were obtained using puncture and drainage and tumescent suction, along with, if necessary, surgical removal accompanied by a lifting procedure when removing facial foreign body granulomas.