악골 골종 2례 : 증례보고

서창호,이두희,김형순,배정수,주현호,원동환,김일현,Suh, Chang-Ho,Lee, Doo-Hee,Kim, Hyung-Soon,Bae, Jung-Soo,Joo, Hyun-Ho,Weon, Dong-Whan,Kim, Il-Hyun 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.3

저자등은 Gardner 증후군과는 연관없이 단독으로 하악의 우각 하연부 내측에서 특이하게 발생한 치밀골 형태의 외골종과 상악의 잔존 치조능상에서 매우 드물게 전체적으로 균일한 해면골 형태의 조직학적 소견을 보이며 발생한 외골종을 치험 하였기에 문헌 고찰과 함께 증례들을 보고하였다. Osteoma is defined as a benign neoplasm of bony tissue. Osteomas are divided into two groups: central and peripheral by origin, compact and cancellous by histopathologic findings. Solitary osteoma of jaw bone, not related with Gardner syndrom, is relatively uncommon. We present two cases of huge solitary peripheral osteomas: compact type exophyting osteoma on the inferolingual side of mandibular angle and cancellous type on the residual ridge of posterior maxilla, which is extremely rare.

하악골 우각부 골절의 정복 및 고정을 위한 골정복 겸자의 사용

서창호(Chang Ho Suh) 대한구강악안면외과학회 1999 대한구강악안면외과학회지 Vol.25 No.1

Until now, many kinds of treatment modalities for mandibular angle fractures have been proposed. But among them, the semi-rigid fixation using miniplates has become a most popular procedure due to its simplicity and good clinical results in nowadays. When we use miniplates according to Champy s ideal osteosynthesis line principles for mandibular angle fracture treatment, we generally perform reduction and fixation procedures under the condition of maxillomandibular fixation(MMF) using arch-bars. But in so doing, due to various reasons, we occasionally observe gapping or torqueing of inferior border of mandibular angle after completion of miniplate fixation. In contrast to MMF state, we can observe intimate reduction of inferior border of mandibular angle due to compressive force and gapping of superior border due to tensile forces during wide mouth opening state. So we developed a new technique which uses bone reduction forceps(or modified towel clips) as a temporary fixation device during wide mouth opening state for intimate reduction and stability along the entire fracture line. By applying this new technique for mandibular angle fracture treatment, it was possible for us to perform easy and accurate miniplate fixation for last 1 year period with clinical success. This article presents some case reports of mandibular angle fracture patients who were treated by this new technique and discussions about the reliability and advantages of this technique.

변형의 대흉근피판을 이용한 구강악안면부위 재건술

서창호(Chang Ho Suh),차인호(In Ho Cha),이의웅(Eui Wung Lee),정제용(Je Yong Jung),김근석(Geun seuk Kim),김형준(Hyung Jun Kim) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.2

Pectoralis major myocutaneous flap has been used generally in functional and cosmetic reconstruction of and maxillofacial defects due to trauma or cancer surgery. The flap has many advantages with its relatively high success rates, but according to many authors, the complication rates of partial or total necrosis of skin paddle has been reported from 6% to 28% of cases. To reduce these complication rates, in 1990. Marx and Smith introduced new technique that preserved a greater vascular pedicle in flap s base with their higher success rates than those of conventional technique. By modifying Marx and Smith s new methods, authors also have achieved good clinical results and suggest its general use in head and neck reconstruction, especially in cases of osteoradinecrosis or patients who have known vascular disease, or who scheduled postoperative adjuvant radiotherapy.

UHD 제작 및 송수신 시연을 위한 테스트베드 구축

서영우(Suh, Young-Woo),전성호(Jeong, Sungho),서창호(Seo, Chang-Ho) 한국방송·미디어공학회 2018 한국방송공학회 학술발표대회 논문집 Vol.2018 No.6

MRI를 이용한 한국인 하악과두의 형태에 관한 연구

이두희,오순호,서창호,김준배,Lee, Doo-Hee,Oh, Soon-Ho,Suh, Chang-Ho,Kim, Joon-Bae 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.5

Objective: This study was prepared to figure out a certain dimension and morphology of the condyle at the central, medial and lateral aspects on MR images of asymptomatic volunteers, which could be comparable with those of the TMD patients' condyle. Materials: Sixty TMJs from 30 asymptomatic volunteers(15 male, 15 female) who had no clinical symptoms and no disc displacement on sagital and coronal view of MRI were served as normal. Method: MR images were taken from the asymptomatic volunteers and the dimension of the anteroposterior length, mediolateral width, height, convexities were measured through the images on the sagittal and coronal sections of mandibular condyle. Then, these data were collected and analyzed. Result: The mean value of anteroposterior length was $8.00{\pm}1.21mm$ at central section and mediolateral length was $21.40{\pm}2.32mm$ on coronal view. The anterior condylar length at medial side was the shortest and the convexity of anterior slop at the lateral side was proved to be the flattest among 3 sections. There were little dimensional and morphological differences at sagittal sections, but the mediolateral width of condyle at coronal section was significantly different between male and female. Conclusion: In sagittal sections, the anterior condyle length was shortest at medial side and the convexity of anterior slop was flattest at lateral side, and there were little dimensional and morphologic differences between male and female. In coronal section, male's condyle was more wider and flatter than female's.

악관절장애환자의 하악과두 크기에 관한 연구

이두희,오순호,서창호,김준배,Lee, Doo-Hee,Oh, Soon-Ho,Suh, Chang-Ho,Kim, Joon-Bae 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.5

Objective: In many TMD cases, deformed and reduced condyle heads were frequently observed. This study was prepared to compare the dimensions between normal and symptomatic condyles, using MR images. Materials: One hundred and twenty one patients with clinical signs and MRI-confirmed diagnosis of disc displacement were selected for this study. Thirty eight TMJs from nineteen asymptomatic volunteers who had no clinical symptoms and no disc displacement on sagittal and coronal view of MRI, were served as normal. Methods: Symptomatic condyles were classified according to the severity of the anterior disc displacement. The amount of anterior disc displacement was evaluated at sagittal section, and they were classified into 4 groups as normal(N), little(G0), mild(G1), moderate(G2) and severe displacement(G3). The dimentions of condyle were measured at the 200% magnified view, by digitizing program. All dimensions were compared among each groups on the central section of sagittal and coronal views, and the statistical analysis was performed. Results: The mean value of anteroposterior length of normal condyle was $0.79{\pm}0.13cm$ at sagittal section and mediolateral length was $2.12{\pm}0.22cm$ on coronal section. The mean value of anteroposterior length of symptomatic condyle was $0.67{\pm}0.16cm$ at sagittal section and mediolateral length was $1.97{\pm}0.28cm$ on coronal section. Conclusions: The size of symptomatic condyle was smaller than normal TMJ. The size of condyle was decreased as the amount of the disc displacement was increased. The dimensional change was found on the anterior articular surface of condyle at the mild or moderate disc displacement. And at the case of severe disc displacement, dimensional change was found on the superior articular surface.

경부의 괴사성 근막염 치험례

유재하(Jae Ha Yoo),최병호(Byung Ho Choi),서창호(Chang Ho Suh) 대한구강악안면외과학회 1993 대한구강악안면외과학회지 Vol.19 No.2

Necrotizing fasciitis is characterized by widespread necrosis of the superficial fascia with extensive undermining of the surrounding tissues. It occurs frequently in the abdominal wall, perineum and lower extremities after surgery or trauma but the occurrence in head and neck region is rare, possibly because of the abundant vascularity of the area. The involved microorganisms are represented by mixed synergistic infections involving both aerobes and anaerobes, such as, Staphylococcus aureus, Pseudomonas aeruginosa, Bacteroides melaninogenicus, and Klebsiella aerobactor. The predisposing factors producing necrotic lesion are thought as the diabetes mellitus, atherosclerosis, alcoholism, drug abuser, trauma and recent surgery in immunosuppressive states. It s treatment requires early recognition, prompt and aggressive surgical debridement and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. The patient, 57-year-old man, was diagnosed as acute cervical necrotizing faciitis by odontogenic infection and it was successfully treated by early wide surgical debridement, consistent wound cleansing and drainage and systemic supportive cares.

소아 악골 골절의 치료에 대한 임상적 고찰 및 증례보고

서창호,김준배,배정수 東國大學校醫學硏究所 1997 東國醫學 Vol.4 No.-

소아에서는 골 및 주위 조직의 특성상 성인의 경우와는 다른 안면골 골절의 양상을 띄며 따라서 치료 방법도 각 증례에 적합한 방법이 선택되어져야 하므로 진단 및 치료계획 수립시 이러한 특징들이 잘 파악되고 있어야 한다. 저자들은 1996년 5월 1일 1997년 6월 30일까지 동국대학교병원에 내원한 3차례의 소아 악골 골절 환자들을 각각의 증례에 적합한 보존적인 방법으로 치료하여 만족할 만한 결과를 얻었기에 임상적 고찰과 함께 각각의 증례들을 보고하는 바이다. Compared to adult facial bones, growing chidren have their unique characters of bone and its surrounding structures in maxillofacial region. SO, in diagnosing, treatment planning and treating the maxillofacial injuries in children, these characters would be fully considered and adapted carefully in each separate cases. We experienced and successfully managed 3 cases of maxillofacial injuries in children during 1 year period (from May, 1996 to June, 1997) and present these cases with clinical considerations.

하악골 우각부 골절의 외과적 치료시술중 임시 고정방법 : 증례 및 임상적 고찰 Case reports and clinical considerations

서창호 동국대학교 경주대학 1998 東國論集 Vol.17 No.1

하악골 우각부 골절은 구강악안면 외과 영역에서 가장 흔히 접할 수 있는 골절의 하나이며 그 치료법은 현재 관혈적 정복과 함께 소형 금속판을 사용한 내고정을 시행하여 빠른 기능 회복을 시켜 주는 것이 일반화 되어 있다. 저자는 지난 2년간 동국 대학교 경주 병원에서 하악골 골절로 진단 받고 관혈적 정복술을 시행 받은 26례의 환자들에서 술 중 악간 고정을 하지 않으면서도 bone reduction forcep이나 superior border wiring technique, screw-wire technique등의 방법을 사용하여 소형 금속판 고정을 위한 골절선 전체의 효과적인 임시 정복 및 고정을 시행할 수 있었으며 양호한 임상적 결과를 얻을 수 있었다. 이에 다소간의 지견을 얻었기에 대표적은 증례들의 보고 및 임상적 고찰을 통하여 각 술식들의 타당성 및 장, 단점들을 고찰해 보고자 한다. Mandibular angle is one of common fracture sites in oral and maxillofacial region and nowadays, early functional recovery by menas of open reduction and internal fixation using miniplate becomes the aim of the treatment. During the last 2 years, I have used several methods for temporary fixation (the use of bone reduction forcep, superior border wiring technique, screw-wire technique, etc) during open reduction and miniplate fixation of mandibular angle fractures without the need of maxillomandibular fixation with good clinical results in Dongguk university, Kyongju hospital. So I present 4 case reports with discussions for reliabilities and advantages of these various temporary fixation methods.

하악골절의 임시 고정을 위한 골정복 겸자 사용의 최신지견

서창호,이소영 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.1

금속판이나 흡수성판으로 하악골절부위의 안정된 3차원적인 고정을 얻으려면 최종적인 내고정전에 골편들을 정확하게 정복시키는 것이 중요하다. 또한 정확한 정복에 더해 골편들간에 예비압박력(precompression)이 가해진다면 골절부위의 안정도 증가와 함께 치유도 촉진될 것이다. 이렇게 최종적인 내고정전에 임시로 정복, 고정 및 예비 압박력을 담당하는 기계로서 골정복겸자(bone reduction forcep)가 효과적으로 사용될 수 있다. 이에 저자등은 하악의 치열부분인 중앙부와 골체부, 우각부 골절의 내고정시 임시 정복, 고정 장치로서 골정복 겸자를 사용할 때의 유용성 및 기계적인 특성 등을 고찰하였다. 하악 정중부(symphysis) 및 부정중부(parasymphysis)에서는 형태적인 특성상 골정복 겸자의 사용이 매우 효과적이며 이러한 사실은 하악골의 광탄성 모델을 사용한 실험에서도 확인할 수 있었다. 반면 골체부(body)의 경우 부정중부가 포함되도록 겸자가 위치된다면 어느정도 효과적일 수 있으나 단순히 편평한 골체부 내에만 국한되어 골정복 겸자가 사용될 경우에는 중앙부만큼 효과적이지 못하며 전통적인 임시 정복, 고정방법인 Arch-bar를 사용한 악간고정을 수술중에만 일시적으로 시행한 상태에서 보조적으로 겸자를 사용하는 것이 더 효율적일 수 있겠다. 한편 우각부(angle)의 경우 일반적인 골정복겸자를 사용할 수도 있겠으나 우각부의 형태적 특성에 맞게 개발된 겸자를 사용하는 것이 더 효과적일 수 있겠으며 이는 광탄성 모델 실험으로도 확인할 수 있었다. 이와 같이 하악골절의 내고정에 있어 골정복겸자의 사용은 악간고정이 필요없이 조기에 악골기능을 회복할 수 있도록 해주며 골절부위의 빠른 치유를 도와주는 장점이 있으나 하악골의 해부학적 특성과 각 증례에 맞춰 적절히 사용하는 것이 중요하다고 사료된다. In the management of mandibular fractures, it is important to achieve a correct reduction of fractured fragments for a stable three-dimensional fixation using a plate system In addition, the technique of pre-compressing fractures has been shown to aid stability and healing of the fracture site, as it leads to increased bony surface contact. In preparation for plating, bone reduction forceps are used for holding and compressing mandibular fractures. In the mandibular symphysis and parasymphysis areas, the reduction forceps could be used effectively due to the convex shape of these regions and the clinical advantage was confirmed by photoelastic stress analysis. In the mandibular body area, it is difficult to apply the reduction forceps, as it is nearly flat along its lateral aspect. Bone reduction forceps are not recommended for compressing fragments in the flat surface of mandibular body. Therefore, in body fractures, maxillomandibular furation for temporary reduction and fixation and adjunctive use of reduction forceps for plating should be considered. In the mandibular angle area, reduction forceps could be applied effectively around the external oblique ridge but the use of new reduction forceps which were designed for application in the mandibular angle area via a transoral approach is highly recommended. The effectiveness of this newly designed reduction forceps were also confirmed by photoelastic stress analysis. Correct method in using reduction forceps helps to provide a precise three-dimensional reduction of mandibular fractures.