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상안검성형술 후 발생한 후천성 유사 브라운증후군과 안검하수의 치험례
도언록,하원호,박대환,Do, Eon Rok,Ha, Won Ho,Park, Dae Hwan 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.2
Purpose: Brown syndrome is motility disorder of the eyeball which shows limited elevation in adduction and occurs very rarely after eye surgery. The authors have experienced a case of strabismus-like Brown syndrome combined with blepharoptosis and report this case with the review of literatures. Methods: A 28-year-old female suffered from hypotropia in the primary gaze and severe blepharoptosis with diplopia of the right eye after upper blepharoplasty. Rotation showed an inability to elevate the adducted right eye. She underwent extraocular muscle surgery about the 7 mm tucking of the right superior rectus muscle and 6 mm recession of right inferior rectus muscle. Intraoperatively, injury of the superior rectus muscle and foreign body were observed. Seven months after the extraocular surgery, the patient underwent frontalis muscle transfer on the right upper eyelid for the correction of blepharoptosis. Results: Postoperatively, the patient was orthophoric in the primary gaze, and she had improvements in the correction of blepharoptosis and eyeball movement. Conclusion: Repeated eyelid surgeries increase the risk of ocular motility disorder. Careful approach is essential for the proper treatment and successful outcome in secondary surgeries.
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얼굴이식을 위한 운동과 감각신경을 가진 중하안면피판 모델 (파노라마 얼굴피판)에 대한 연구
김찬우,김홍태,도언록 대한두개안면성형외과학회 2011 Archives of Craniofacial Surgery Vol.12 No.2
A New Facial Composite Flap Model(Panorama Facial Flap) with Sensory and Motor Nerve from Cadaver Study for Facial Transplantation Peter Chan Woo Kim, M.D.1, Eon Rok Do, M.D.1, Hong-Tae Kim, M.D.21Department of Plastic and Reconstructive Surgery, Daegu Catholic University Medical Center,2Department of Anatomy, School of Medicine, Daegu Catholic University, Daegu, Korea Purpose: The purpose of this study was to investigate the possibility that a dynamic facial composite flap with sensory and motor nerves could be made available from donor facial composite tissue. Methods: The faces of 3 human cadavers were dissected. The authors studied the donor faces to assess which facial composite model would be most practicable. A "panorama facial flap" was excised from each facial skeleton with circumferential incision of the oral mucosa, lower conjunctiva and endonasal mucosa. In addition, the authors measured the available length of the arterial and venous pedicles, and the sensory nerves. In the recipient, the authors evaluated the time required to anastomose the vessels and nerve coaptations, anchor stitches for donor flaps, and skin stitches for closure. Results: In the panorama facial flap, the available anastomosing vessels were the facial artery and vein. The sensory nerves that required anastomoses were the infraorbital nerve and inferior alveolar nerve. The motor nerve requiring anstomoses was the facial nerve. The vascular pedicle of the panorama facial flap is the facial artery and vein. The longest length was 78mm and 48mm respectively. Sensation of the donor facial composite is supplied by the infraorbital nerve and inferior alveolar nerve. Motion of the facial composite is supplied by the facial nerve. Some branches of the facial nerve can be anastomosed, if necessary. Conclusion: The most practical facial composite flap would be a mid and lower face flap, and we proposed a panorama facial flap that is designed to incorporate the mid and lower facial skin with and the unique tissue of the lip. The panorama facial composite flap could be considered as one of the practicable basic models for facial allotransplantation. (J Korean Cleft Palate Craniofac Assoc 12: 86, 2011)
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김태섭,한동길,도언록,박대환 대한미용성형외과학회 2013 Archives of Aesthetic Plastic Surgery Vol.19 No.1
Blepharoptosis patients use frontalis muscle unconsciously to widen eye, and it results in several aesthetic problems-such as forehead wrinkling and elevated eyebrow. So forehead wrinkling and elevated eyebrow can be resolved with correction of blepharoptosis. We evaluated the change of eyebrow height in 30 patients who were corrected blepharoptosis through photogrammetry. The mean age of the patients was 36.8 years old and the mean follow up periods were 6 months. Horizontal line passing medial and lateral canthal corner in both eyes was drawn in Photopshop. From the horizontal line, 3 vertical lines perpendicular to this line were drawn passing medial and lateral canthal corner and the vertically oriented center of the pupil. Eyebrow height was measured through these 3 vertical lines. The average length of decreased value of the eyebrow height were 3.64 mm in H1, 3.31 mm in H2, 2.79 mm in H3. In unilateral cases, 2.42 mm in H1, 2.86 mm in H2,2.78 mm in H3, and in bilateral cases, the decreased values were 4.25 mm in H1, 3.53 mm in H2, 2.79 mm in H3. From this study, the author would like to introduce the method to calculate the changes of eyebrow height after blepharoptosis correction and the values objectively.
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Platelet Function Analyzer(PFA®)-100을 이용한 술전 출혈경향 평가 및 임상적 적용
Jihu han,도언록,김태섭,Chen Zhang,박대환 대한미용성형외과학회 2013 Archives of Aesthetic Plastic Surgery Vol.19 No.1
Routine preoperative tests such as BT/CT, PT/PTT and CBC, could not test abnormal hemostasis that take drugs and health functional food. We used platelet function analyzer (PFA®)-100, to evaluate preoperative bleeding tendencies. From November 2008 to February 2010, 306 surgical patients were tested preoperative PFA in our hospital. There are 2 tests in PFA®-100. The Pre Operative EPI (collagen/epinephrine) assay tests extrinsic platelet function, whereas the Pre Operative ADP (collagen/adenosine diphosphate) assay tests intrinsic platelet function. We divided normal and abnormal groups by the PFA®-100 assay tests. If either of results were abnormal in the two tests, the patient was divided to the abnormal group. 306 surgical patients were observed with hemorrhagic complications. All of the patients were divided normal and abnormal groups by the PFA®-100 test result. The normal group was made up of 286 (93.5 %) patients, the abnormal group was made up of 20 (6.5 %) patients. We observed each group hemorrhage complication including sever echymosis and hematoma, and analyzed each group complication rate. There were 9 (3.1 %) cases of complication in the normal group. There were 3 (15.0 %) cases of complication in the abnormal group. To evaluate preoperative bleeding tendency, PFA®-100 can be complementary examination with previous routine blood coagulation tests.
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