구순ㆍ구개열 환자에서 악골교정 수술후의 두개계측치의 변화 및 임상적 고찰

황세휘,엄기일 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.5

Individuals with cleft lip and palate often require orthognathic surgery to estabilish facial harmony and optimal occlusal function because cleft induced secondary deformities of maxilla and mandible have been taken for the worse as growing up. During operation many problems as like residual oronasal fistula, bony defects, soft tissue-scarring from previous surgery, and the congenital absence of the maxillary lateral incisor teeth with cleft-dental gap are encountered and interfere the operation. In this retrospective study 16 patients who were performed orthognathic surgery from the January. 1991 to the March 1997, could remind the clinically important problems of the orthognathic surgery and suggest more easy, safety, and accurate methods to solve these problems. The preperative and postoperative cephalometric skeletal and soft tissue data were compared and many problems which could encounter during operation were checked and reviewed many historical experiments and newly suggested articles, so some results can be suggested as like: 1. The sum of maxillary advancement(mean 5.14mm) and mandibular retrusion(mean 6.71mm) is about 11.85mm. Two-jaw surgery is recommended because the scar of upper lip and palate limit the maxillary advancement. 2. Upper lip tightness interfere the soft tissue movement after bone segment mobilization, release of tightness improve the soft tissue profile. 3. Soft tissue profile is most important in orthognathic surgery. 4. Soft tissue response to orthognathic surgery is not different in secondary cleft deformities and simple malocclusion patient but amount of soft tissue response is not constant in many experimental study. 5. Camouflage mandibular surgery is benefit in some maxillary deformity patient.

동양인 언구 돌출증의 치료 및 추적 관찰

황세휘,최희윤,류재만 대한미용성형외과학회 1996 Archives of Aesthetic Plastic Surgery Vol.2 No.1

Orbital decompression in exophthalmos has been tried for more than 100 years but there was no definite procedure falling to achieve the desired result, and yet these operations have not gained broad acceptance. Basic principles in orbital decompression were the concept of the axis of the eyeball, procedure without change of visual axis as possible and the preservation of continuity of paranasal sinus mucosa. The axis of the globe extends from the lateral orbital wall to the lamina papyracea and the position of the globe was affected by the volume change behind the global axis. Unidierctional orbital decompression changes the visual axis and the patient suffers from the diplopia. Discontinuity of paranasal sinus mucosa has chances of postoperative infection or extraoculr muscle dysfunction. So we corrected exophthalmos as follows: Blow out fracture of the medial wall and orbital floor was done with blunt osteotome without tearing of maxillary and ethomid sinus mucosa. Lateral wall halving osteotomy and valgus pivoting of the posterior portion of the lateral orbital wall were done without increase in the bitemporal or bimalar width. The orbital fat was removed behind the global axis mainly in upper half of the orbit, which could take effect of the orbital roof decompression. The combination of each method enabled to decompress in all direction and preserve the original visual axis. Total reductin geffects of exophthalmos by operation were resulted from the expanded capacity of the bony orbit and the removed amount of orbital soft tissues. We evaluated the result with exophthalmometer, global axis to cornea distance and orbital volume before and after operation.

구순열 교정 수술에서의 전층 혹은 복합이식의 유용성

황세휘,엄기일 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.5

Lack of upper lip tissues are the characteristic features of cleft lip patient, therefore, deficiency of local flap tissues are the important limitations in cleft lip repair. Various kinds of operation techniques using local flap such as triangular flap and Millard method technique around the cleft site have been developed and the result of each methods are acceptable, but in wide cleft lip cases, deficiency of tissues around the cleft site are important limitations in cleft lip repair operation. In those cases, vertical tissue deficiency of cleft lip should be replaced especially in cleft side lip. And when we make a point same as the normal side lateral lip length on the cleft side lip white line, the vertical length from the ala groove to the white line is very short in wide cleft lip compared to contralateral normal side. Any kinds of cleft lip repair operation techniques to solve this limitations have not been suggested until nowadays. So, we thought that the most effective and benefitial method to solve this limitations were tissue graft as much as amount of tissue deficiency in cleft lip repair. New methods suggested by us according to this concepts are ; 1. For the lengthening of upper lip vertical length in cleft side, full thickness skin from the posterior auricular area is onto the redraped muscle of cleft side muscle bulge. 2. For the columella lengthening full thickness skin or composite tissue is grafted in columella after open rhinoplasty incision. 3. For the augmentation of nostril sill, A-P dimension of nasal lining in nostril sill is enlongated with full thickness skin.

구순열 비변형에서 비익연골의 해부학적 재조명 및 비익연골간 지방조직 제거가 비익연골의 재배치에 미치는 영향

백두흠,황세휘,엄기일 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

Previous anatomic concepts in cleft lip nose deformity have following characteristics: 1. Obtuse angle between medial and lateral crus in affected alar cartilage; and 2, Cleft side alar cartilage is hypoplastic. The purpose of this study was to review the anatomy of alar cartilage in cleft lip nose deformity and to find out the effects of removal of intercartilagenous soft tissue on the effects of removal of intercartilagenous soft tissue on relocation of alar cartilage. There were 97 cleft lip nose corrections from Oct. 1996 to March When the affected alar cartilage was dissected, redundant intercartilagenous fibro-fatty tissue was found. After removing this redundant soft tissue, we found that the cleft side alar cartilage was better adjusted to the normal position. In addition, the plicavestibularis was more improved. Alar cartilage suture fixation was subsequently performed. Alar cartilage suture fixation was subsequently performed. After this procedure, we found that subsequently performed. After this procedure, we found that the affected side of alar cartilage was more normally positioned than before. The summary of the author's view on affected alar cartilage is as follows: 1. An acute angle between the medial and lateral crus was noted in affected alar cartilage; 2. Redundant intercartilagenous fibro-fatty tissue was present in cleft lip nose deformity;3.The terminal portion of the lateral crus of alar cartilage makes a plica vestibularis in the cleft side; 4. The position of the medial crus of alar cartilage was lower in the cleft side with the lateral crus was lower and cephalic in the cleft side; 5. The cleft side of alar cartilage is not hypoplastic.

흰쥐 구개발생중 E-candherin의 발현에 관한 연구

김원규,황세휘,류재만,정호삼,김잉곤,이신규,엄기일 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.7

As E-cadherin is essential molecule in early developmental process, differentiation and growth of tissue, the investigator has undertaken this study for demonstrating the expression of E-cadyherin during the palatal development in rat. In this study fetuses at the 13th, 14th, 15th, 16th and 18th day of gestation were used as experimental animals. The specimens were stained with hematoxylin and eosin for normal developmental process of the palate, and E-cadherin immunohistochemistry was performed. The results obtained were as follow; 1. At the 13th day of gestation, palatal processes protruded from the maxillary prominence are visible, and the oral cavity has wide communication with the nasal cavity. In E-cadherin immunohistochemistry medial edge epithelium of the palatal process is shown trace reactivity, and epithelium faced with the oral cavity is revealed weakly positive reactivity. 2. At the 14the day of gestataion, palatal processes are elevated above the tongue, and oral cavity is begun to be divided from the nasal cavity by this processes. In E-cadherin immunohistochemistry medial edge epithelium and nasal part epithelium are shown weakly positive reactivity, epithelium faced with the oral cavity is revealed moderately positive reactivity. 3. At the 15th day of gestation, both palatal processes are fused in the midline, and oral cavity is completely divided from the nasal cavity. In E-cadherin immunohistochemistry midline fused epithelium is shown trace reactivity, and epithelium faced with the oral cavity is revealed weakly or moderately positive reactivity. 4. At 16th day of gestation, fusion line is disappeared. In E-cadherin immunohistochemistry palatal epithelium is revealed moderately or strongly positive reactivity. 5. At the 18th day of gestation, mesenchyme in the palate is begun to condense. In E-cadherin immunohistochemistry palatal epithelium is shown strongly positive reactivity. According to the above results at the 13th and 14th day of gestation medial edge epithelium in the tip of palatal process was shown trace or weakly positive reaction, and epithelium faced with oral cavity was revealed weakly or moderately positive reactivity. Palatal epithelium faced with oral cavity was shown moderately or strongly positive reaction from the 15th day to the 18the day of gestation. Consequently it is suggested that the epithelium faced with the oral cavity may play more important role in the process of palate fusion.

Retinoic Acid가 모낭의 Laminin 1 발현에 미치는 영향

이예진,황세휘,류재만,정호삼 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.5

Microform Cleft Lip 환자의 분류에 따른 수술적 치료

박철수,엄기일,황세휘,안덕균,김잉곤 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

The microform cleft lip is the mildest expression of cleft lip and nose deformity, but it has no specific definition, classification, and few methods have been reported for its correction. It is characterized by deformity of the nostril, skin striae of the upper lip, notching of peaked Cupid's bow, deformity of the vermilion, and anomaly of the upper lateral incisior and alveolar ridge on the affected region. Sixty-three microform cleft lip patients were operated on between Dec. 1993 and Sep. 1998 in our department(29 males and 34 females). The age of the patients ranged from 5 months to 30 years(Mean 9 years). We classified and treated the microform cleft lip as follows: Class Ⅰ: Cleft lip nose with very slight lip deformity Class Ⅱ: Minimal lip deformity without vermilion notching ClassⅢ: Mild lip deformity with slight vermilion notching. The goals in the correction of a microform cleft lip are to obtain an esthetically pleasing upper lip and nose, and to reestablish muscle continuity for improved function. To attain these goals, we used the above classification and satisfactory results were obtained by treating the microform cleft according to the classification.

台湾における地域資源を活用した学校給食

牛井?展子(Goibuchi Noriko),黃世輝(Hwang Shyh-Huei),黃淑?(Huang Shu-Chen),翁徐得(Ueng Shyu-Der),宮崎?(Miyazaki Kiyoshi) 한국디자인학회 1997 디자인학연구 Vol.- No.22

융비술에 관한 설문지 결과: 코 성형연구회 보고

홍성택,송선호,김덕우,윤을식,동은상,황세휘,정재용,김재훈,박성근 대한미용성형외과학회 2011 Archives of Aesthetic Plastic Surgery Vol.17 No.2

Rhinoplasty is one of the most popular surgical procedures in plastic surgeries. Good results depend not only on the surgical technique but also on individual preference and philosophy of the surgeons. This article reports on the survey of the attitude, preference, and philosophy of surgeons, and finally to elicit the evidence based consensus of current trends mainly dealing with the primary rhinoplasty. The Korean Society of Rhinoplasty Surgeons (KSRS) prepared a questionnaire composed of 20 questions asking about the primary esthetic rhinoplasty. A total of 77 out of 450 plastic surgeons attending the rhinoplasty symposium, 2009, Korea replied and the answerswere assessed. Twenty questions were about operation techniques, preference of alloplastic implant, autologous materials and trivia about the complications rates, etc. Many plastic surgeons preferred silicone to Gore-tex . In cases of autologous cartilage grafts, experienced plastic surgeons were more likely to use septal cartilage. But generally, ear cartilages were more frequently used when it is concomitantly used with alloplastic implants. Among silicone implants, boat-shape implant was preferred to L-shape regardless of their surgical experiences. Many Korean plastic surgeons prefer open rhinoplasty to closed rhinoplasty and routinely use boat shape silicone with auricular cartilage when they are doing simple primary rhinoplasty. (Archives of Aesthetic Plastic Surgery 17: 99, 2011)