악골내 섬유조직성-골성병소에 관한 임상연구

김욱규,차승만,황대석,김용덕,신상훈,김종렬,정인교,Kim, Uk-Kyu,Cha, Seong-Man,Hwang, Dae-Seok,Kim, Yong-Deok,Shin, Sang-Hun,Kim, Jong-Ryoul,Chung, In-Kyo 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.3

The challenging task of classifying the fibro-osseous(FO) lesions has been previously attempted but only in the past 15 years has the entire spectrum of diversity been appreciated. For the clinicians, it is hard to clearly diagnose the lesions before operations. The purpose of this study was to review the literature about fibro-osseous lesions of the jaws and to analyse our clinical cases. As the results of the review of clinical features, radiography and histopathologic findings of sixteen cases of fibro-osseous lesions, we could elucidate diagnostic aids for treatment of benign FO lesion in jaws. Six patients involving fibrous dysplasia complained the facial swelling and facial asymmetry. The radiographic features of the lesions showed ground-glass radiopacity mostly and the histologic findings showed typically Chinese character-shaped trabeculae without osteoblastic rimming in the fibrous stroma. Six patients with ossifying fibroma were notified as swollen buccal cheek state. Their radiographic findings showed cortical expanded radiolucent lesion with sclerotic defined border, which was contrast to the normal adjacent bone. The lesions showed variant radiolucent lesions. Histological findings were revealed as cellular fibrous stroma with woven bones, variable patterns of calcifications. Three patients with cemental dysplasia didn't have specific complaints. Well circumscribed radiopaque lesions on mandibular molar area were observed. Cementum-like ossicles with fibrous stroma were found on microscopic findings. A osteoblastoma case with jaw pain was found. The radiographic feature was a mottled, dense radiopacity with osteolytic border on mandibular molar area. Under microscopy trabecule of osteoid with vascular network were predominantly found. Numerous osteoblast cells with woven bone were found. These clinical, radiographic and microscopic findings of benign fibrous-osseous lesions would suggest diagnostic criteria for each entity of FO lesions.

구강 결손부에 적용된 요골 유리전완 피부피판 적용례 분석

김욱규,이광호,송원욱,황대석,김용덕,신상훈,김종렬,정인교,Kim, Uk-Kyu,Lee, Kwang-Ho,Song, Won-Wook,Hwang, Dae-Seok,Kim, Yong-Deok,Shin, Sang-Hun,Kim, Jong-Ryoul,Chung, In-Kyo 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4

The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

상악동 거상술을 위해 알아야할 상악동의 해부학적 구조

김욱규 대한치과의사협회 2005 대한치과의사협회지 Vol.43 No.8

구강내 결손부에 적용된 연조직 재건술식들에 대한 임상적 고찰

김욱규,이승환,황대석,김용덕,신상훈,김종렬,정인교 부산대학교 병원 암연구소 2007 부산대병원학술지 Vol.- No.21

To evaluate criteria, indications, and prognosis of the various reconstructive methods on the patients with intraoral soft tissue defect who had been treated at Dept. of Oral and Maxillofacial Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows: 1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success. 2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation. 3. The application of free skin graft on entire maxilla site , palate was possible. The skin from thigh, abdomen could be applicable on fixed or movable tissues. The advantages of abdominal skin were easy harvest and direct donor site closure. 4. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients. 5. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. the design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained. 6. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla. The flap survival will be expected if the considerations for above reconstructivε methods on site, size, condition of defects primarily could be made.

악골내 섬유조직성-골성병소에 관한 임상연구

김욱규,차승만,황대석,김용덕,신상훈,김종렬,정인교 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4

구강내 결손부에 적용된 연조직 재건술식들에 대한 임상적 고찰

김욱규,이승환,황대석,김용덕,신상훈,김종렬,정인교,Kim, Uk-Kyu,Lee, Seung-Hwan,Hwang, Dae-Suk,Kim, Yong-Deok,Shin, Sang-Hun,Kim, Jong-Ryoul,Chung, In-Kyo 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.6

To evaluate criteria, indications, and prognosis of the various reconstructive methods on the patients with intraoral soft tissue defect who had been treated at Dept. of Oral and Maxillofacial Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows: 1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success. 2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation. 3. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients. 4. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. The design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained. 5. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla. The flap survival will be expected if the considerations for above reconstructive methods on site, size, condition of defects primarily could be made.

악안면 영역에서의 유리 전완피판술 적용례분석

김욱규,송원욱,황대석,김용덕,신상훈,김종렬,정인교 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

수축력과 신장력을 병용한 골신장술에서의 다양한 힘의 비와 부여시기에 따른 신연골 반응

김욱규,신상훈,정인교,김철훈,허준,윤일,Kim, Uk-Kyu,Shin, Sang-Hun,Chung, In-Kyo,Kim, Cheol-Hun,Huo, Jun,Yun, Il 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.5

The purpose of this study was to identify the effectiveness of the modified distraction osteogenesis (DO) method with the concept of overdistraction and compression stimulation which have been previously suggested by the authors in 2002 and to explore the optimal distraction-compression ratio and appropriate latency period for the compression force application during consolidation. The experimental specimens were assessed with radiography, histologic findings, and dual energy x-ray absorptiometry (DEXA) after the conventional DO method and the modified DO technique had been applied on rat mandibles. Total 60 rats were used for the study. In experimental group of 54 adult rats, mandibular osteotomies between the first and second molar areas were performed and customized external distractors were applied. The surgeries on 6 rats of control group also were done with same osteotomy technique and DO device application. Final amount of distraction was set-up as 2 mm on both groups. But, in a experimental group of 54 rats, distraction osteogenesis with a compression force were performed with the different distraction-compression ratio and variant latency periods for compression. The three ratio-subgroups were made as distraction 4 mm group with compression 2 mm, distraction 3 mm group with compression 1 mm, and distraction 2.5 mm group with compression 0.5 mm. In addition, The three subgroups with 3, 7, 11 days latency period prior compression were allocated on each ratio-subgroups. Total 9 subgroups consisted of 6 rats on each subgroup. In control group of 6 rats, conventional distraction technique were routinely performed. The rats of control groups were sacrificed on postoperative 3, 6 weeks after 2 mm distraction. The rats in the experimental groups also were sacrificed on the same euthanasia days of control groups to compare the wound healing. Final available specimens were 55 rats except 5 due to osteomyelitis, device dislodgement. Distraction-compression combined group on 6 weeks generally had showed increased bone mineral density than the same period group of conventional distraction technique on the DEXA study. More matured lamellar bone state and extended trabecular pattern in the combined group than those of control group were also observed in the histologic findings on 6 weeks. In the distraction-compression combined groups, the bone density of 2.5 mm distraction subgroups with 0.5 mm compression showed the highest value on the DEXA study among various force ratio groups. In the distraction-compression combined groups, the bone density of 3 day latency period subgroups showed the highest value on the DEXA study among various latency period groups for the compression application. From this study, we could deduce that 1/5 force ratio for the compression versus distraction, 3 day latency period prior compression application would be the most effective condition if modified distraction osteogenesis technique might be applicable. The modified DO method with a compression force may improve the quality of bone regenerate and shorten total treatment period in comparison with conventional DO technique clinically.

보철시술을 위한 효과적인 경조직 외래시술

김욱규 대한치과의사협회 1999 대한치과의사협회지 Vol.37 No.11

협점막부에 생긴 섬유성 강직증 해소 후 유리 전완요골피판의 적용

김욱규,황대석,김용덕,강영주,변준호,신상훈,정인교 대한악안면성형재건외과학회 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.6