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하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례
김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2
We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.
구강 악안면 연조직 결손 재건을 위한 진피 지방 이식의 이용 : 증례보고
김수관,박노승,이병준,황경곤,여환호,김영균 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.3
Soft tissue defects in oral & maxillofacial region caused by tumor resection, trauma, congenital deformities have been treated in autogenous soft tissue flap, allogenic material, free dermal graft, fascia graft. Of these methods, autogenous dermis graft had initially been applied in hernia treatment at the beginning of nineteenth century and have been applied in soft tissue augmentation coverage of vital structure, dead space removal and reconstruction of fascia. A fat graft is used in reconstruction of orbit at the enucleation, restoration of facial contours, etc. In this case, patient with chin soft tissue defect in traffic accident was treated in autogenous dermis-fat graft from patient's abdominal and gluteal region. Chin defect was recons ructed favorably. There was no severe atrophy of grafted area 12 months postoperatively. We will report the result that is favorable esthetically with literature review.
상악골에서 IMPLANT 매식을 위한 치조제 확대 골절단술
김수관,김영균,여환호,이기혁 大韓顎顔面成形再建外科學會 1997 Maxillofacial Plastic Reconstructive Surgery Vol.19 No.2
Ridge expansion osteotomy(REO) technique is a simple and more conservation method to widen a narrow alveolar ridge in the maxilla. This method is superior to drilling method in soft and narrow maxillary alveolar ridge and allows the surgeon to widen the ridge in routine office procedure. Therefore, it is the treatment of choice to implant the maxilla with narrow alveolar ridge. This article presents clinical cases and discusses the advantages, rationale and surgical protocol of REO technique.
Medpor 매식후 치유과정에서 Methylprednisolone 이 미치는 영향
김수관,정성수 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2
The purpose of this study is to evaluate the difference in healing of Medpor□ implants of two different thickness (1.5mm and 4.5mm) and the effects of methylprednisolone on the healing process. Light micro-scopic and scanning electron microscopic examinations, and hardness measurement were made in 100 rats 2, 4, or 8 weeks postoperatively. The 1.5mm thin implants were taken better than the 4.5mm thick implants. The inflammatory responses were reduced after application of methylprednisolone with arrangement and amount of bone matrix deposited being more irregular and reduced in bulk than in the control group. To hasten postoperative healing after Medpor□ implantation, the thinner material should be used and steroid injection should be avoided. Key Words : Medpor□, methylprednisolone
상악동에 발생한 낭종과 술후낭종에 대한 임상병리학적 연구
김수관,박정열,강태호,장현선 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5
The purpose of this study is to evaluate the frequency of cysts and postoperative cyst in maxillary sinus and compare between cysts and postoperative cyst in maxillary sinus. Of 3,218 biopsy cases, 23 cases of cysts and 9 cases of postoperative cyst in maxillary sinus were found. Males were affected significantly more than females. The age distribution of the 23 patients was in a range of 13 to 76 years. Most of them were in the second and third decades. The postoperative maxillary cyst was occurred most frequently during ten years after Caldwell-Luc operation. Females were affected more than males. The age distribution of 9 patients was in a range of 29 to 64 years. Most of them were in the 6th decade. The most common symptoms were pain and swelling, and the sites were the molar area and vestibule of the maxilla. Radiographically, the lesions occurred most frequently unilateral radiopaque. The cysts were treated surgically in all cases. The literatures were reviewed regarding etiology, frequency, and radiologic and microscopic findings of those cysts.
김영균,이기혁,여환호,김수관,박노승 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4
The coronal approach is a versatile surgical technique. This methos becomes particulary useful for exposure and internal fixation of midfacial fractures and the harvest of calvarial bone graft to manage the complex facial bone fractures. The rectrospective clinical study on the use of this technique in 10 patients was performes. The result shows that this technique provides the excellent exposure of fractures site, the ability to reduce the fragment accurately and good cosmetic results in incision area. We discussed with literatures review that anatomy, technique, indications, and potential complications of the coronal approach.
가토에서 관절원판을 전방변위시킨 후 두개하악관절의 조직병리학적 변화
김문수,여환호,김수관,강태호,박정열,장현석 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5
To investigate the histopathologic changes of the rabbit craniomandibular joint (CMJ), anterior disc displacement (ADD) was surgically induced. Of 15 rabbits, 9 were classified as experimental group, 3 as control of group, and 3 as sham-operation group, respectively The experimental group (9 rabbit) was subdivided into 6 weeks, 12 weeks, and 20 weeks group, respectively 3 rabbits. In experimental group, the disc was displaced anteriorly at the right side(operation side) and left CMJ was not operated(non-operation side). Both CMJs were harvested at 6, 12, and 20 weeks following surgery in experimental group. The CMJ was harvested at 6 weeks following surgery in sham-operation group. The specimens were examined under light microscope after hematoxylineosin and verhoeff staining. The obtained results were as follows: 1.In midsagittal view of control and sham-operation group, there were no degenerative and hyperplastic changes in the CMJ including articular disc, mandibular condyle, and temporal fossa. 2.Disc was shortened anterior-posteriorly and deformed of biconcave shape in all experimental group. In 20 week experimental group, intermediate zone of disc width was almost same as the width of posterior band of disc. 3.Soft tissue hyperplasia at the posterior attachment area of the disc and condylar hyperplasia were seen in the all experimental groups, but the degree of the hyperplasia was greater at 12, 20 weeks than at 6 weeks. 4.The number of elastic fiber in the disc proper was decreased and the direction and morphology was chanced in all experimental groups compared with those of control of groups. 5.Fatty degeneration was shown in non-operation side of 20 weeks experimental group. These results suggest that induced ADD in craniomandibular joint of rabbits could lead to a reparative and degenerative changes of the affected joint similar to those described for osteoarthrosis and osteoarthritis in human.
김수관 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3
Superior orbital fissure syndrome is characterized by ophthalmoplegia, ptosis of the eye, reflex dilation of the pupil, and anesthesia of the upper eyelid and forehead. This syndrome may be the result of craniofacial fractures as well as neoplasms of the retrobulbar space, hematomas in the orbital muscle cone and retrobulbar space, and hematoma and infection of the cavernous sinus. A case of superior orbital fissure syndrome is described.
변형 LeFort Ⅲ 골절단술을 이용한 중안면 성장부전을 동반한 하악전돌증의 치험례
김문수,김수관,류종회 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2
Maxillary-malar deficiency is the most frequently occurring midface dentofacial deformity. Clinicaly patients with maxillary-malar deficiency exhibit malar and infraorbital rim deficiency and class III malocclusion. For treatment of these deformities, modified LeFort III osteotomy have been used. Modified LeFort III osteotomy advances maxilla with orbital rims and zygomatic bone anteroposteriorly. This is a case of patient who had severe mandibular prognthism with midface deformity. We performed modified LeFort III osteotomy for maxillary-malar advancement and simultaneous bilateral sagittal split ramus osteotomy for mandibular prognathism and autogenous iliac bone graft.
김상렬,김수관,여환호 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4
The purpose of this retrospective study is to investigate the effects of conscious sedation in an outpatient setting. Data from 292 patients (154 males, 138 females), sedated for minor oral surgery, were studied using various parameters including age and sex distribution, as well as according to procedures and each drug group. Results show that this intravenous conscious sedation technique is a safe and effective method of controlling behaviour, but one has to be prepared to deal with any emergencies or complications. The specific results are as follows : 1.Most procedures (265/292) were used to Valium mixed with Demerol and Midazolam mixed with Demerol. 2.Valium revealed a high incidence of pain upon injection and symptoms limited to daily activity and thrombophlebitis. 3.Nausea and vomiting manifested in the procedure using Demerol. 4.The patient manifested comfort similar in response to the same drugs used in another treatment.