상악골 악성종양에 대한 외과적 처치

장세홍(Se Hong Chang),안재진(Jye Jynn Ann),박성배(Seong Bae Park) 대한구강악안면외과학회 1986 대한구강악안면외과학회지 Vol.12 No.1

Surgical treatment is the choice of treatment for the maxillary malignant tumors. Conventional maxillectomy technique dosen t allow the easy approach to the pterygomaxillary plate area and leads to the troublesome problems such as the ptosis of oribital content. Through some technical modifications of the maxillectomy as preservation of the infraorbital rim and use of zygomaticomasseter and coronoidotemporalis flaps, we obtained good results as follows; prevention of the ptosis of the oribital content, easy exposure of the pterygoid plate, reduction of the interoperative bleeding and easy ligation of the internal maxillary artery under direct vision.

늑연골 이식술을 이용한 하악관절 유착증 치험례

장세홍(Se Hong Chang),안재진(Jye Jynn Ann),황경룡(Kyung Ryong Hwang) 대한구강악안면외과학회 1987 대한구강악안면외과학회지 Vol.13 No.1

Trismus and disharmony of facial growth were the usual results of injury to the mandibular condyle in growing children. Early replacement of ankylosed condyle with a costochondral joint was recommended as best approach to management of such problems. A detailed review of the literature supports the principle that cartilagenous growth site was responsible for the growth and maturation of facial skeleton. A case of true bony ankylosis of the TMJ was treated by condylectomy and autogenous costochondral grafting. Results were encouraging functionally and esthetically, but continued observation of this patient is necessary to evaluate the growth of transplanted graft.

원발병소불명의 경부임파절 전이암

장세홍(Se Hong Chang),안재진(Jye Jynn Ann),김도균(Doe Gyeun Kim) 대한구강악안면외과학회 1988 대한구강악안면외과학회지 Vol.14 No.1

Metastasis to the lymph nodes of the head and neck is not an unusual occurrence. In most cases, the primaiy will be found, Occasionally, however, in approximately 5 per cent of cases, even the most exhaustive history and physical examination as well as special roentgenologic studies and even biopsies of all suspected sites will not disclose the primary tumor. Metastatic cervical malignancy with an unknown primary source is termed occult primary. The treatment of cervical lymph node metastases in patients with unknown primary lesions has long been controversial. But even though the primary lesion remained occult, definitive treatment to the cervical metastases was advocated and carried out. Treatment modality for metastatic cervical lymph nodes with an unknown primary tumor may be surgery, radiotherapy, chemotherapy, or a combination of the three. The selection is based on the histologic findings, site, and clinical stage of the cancer. We report a case of squamous cell carcinoma in the right submandibular lymph node. Even with thorough clinical and radiological examinations, it was not possible to find the primary in any other part of the body. The lesion was removed by radical neck dissection and there is no evidence of the primary and/or recurrence for 11 months.

하악골 골절에 대한 정확한 방사선적 진단

장세홍(Se Hong Chang),안재진(Jye Jynn Ann),소재정(Jae Jung Soh) 대한구강악안면외과학회 1990 대한구강악안면외과학회지 Vol.16 No.4

Proper radiographic evaluation is essential to confirm the presence and location of a mandibular fracture. There are several radiographic methods available to evaluate the mandible, including plain film roentgenograms, panoramic tomography and computed tomographic scanning. The plain film radiographs commonly used to evaluate the mandible are the mandiblar series that includes two oblique lateral views a posteroanterior view and Towne s view. Panormanic view is superior to the mandibular series for the diagnosis of mandibular fractures. But, nine cases of mandibular fractures are presented in which a panoramic view failed to demonstrate fractures of the mandible. Therefore, the combination of the mandibular series with the panoramic view provides increased diagnostic information that should enable accurate diagnosis of fractures in all areas of the mandible.

자가장골 및 늑연골의 복합이식을 통한 하악골 재건술

장세홍(Se Hong Chang),안재진(Jye Jynn Ann),소재정(Jae Jung Soh),박지희(Chi Hee Park) 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.1

외상이나 감염 또는 종양의 적출에 의해 발생한 하악골 결순부는 심미적, 기능적으로 많은 문제를 야기한다. Sykoff 가 1900 년에 자가골 이식으로 하악골 결손부를 수복한 이후 현재까지 많은 이식물과 이식방법이 이용되어져 왔으며 특히 늑연골은 1920 년에 Gillies 에 의해서 TMJ 수복에 처음 사용된 이후 성장기 아동의 과두결손부 수복에 많이 이용되고 있다. 또한 자가장골은 안면부의 수복에 보편적으로 이용되고 있는 공급부위이며 특히 많은 양의 망상골이 필요한 경우에는 후방 접근법을 이용함으로서 충분한 양의 골을 얻을 수 있다.수복의 시기는 환자마다 차이가 있어서 나이, 과거력, 초기질병의 상태, 성장발육정도 및 심미적, 정신적인 면을 고려하여야 하며 악성종양의 제거시에는 재발여부와 방사선 치료 등을 고려하여 적절한 시기를 선택하여야 하나, 일반적으로 술후 약 1 - 2 년 후에 시행할 수 있다.본원에서는 하악골 골육종으로 진단된 15 세 남자 환자에서 과두를 포함하는 좌측 하악골 절단술후 임시로 레진수복물을 장착한뒤 약 20 개월간의 주기적인 검진결과 재발의 기미가 없어 늑연골과 장골의 복합이식을 통하여 심미적, 기능적으로 양호한 결과를 얻었기에 그 증례를 보고하는 바이다. Loss of mandibular continuity due to neoplasm, trauma, or infection results in major esthetic and biologic compromise. The use of costochondral grafts for reconstruction of temporomandibular joint, described first by Gillies in 1920 has been accepted as a suitable method for replacing the mandibular condyle, especially in growing children. Autogenous iliac bone graft has been a satisfactory source of mandibular reconstrucion since Sykoffs report in 1900. Autogenous bone grafts the posterior aspects of the ilium provide large amount of PMCB with acceptable donor site morbidity. In timing of reconstruction, initial disease, age, medical history, growth and development esthetic and psychlogic factors. should be considered. We present a case of osteosarcoma in the mandible that was treated by a hemimandibulectomy and the defect was reconstructed 20 months later with composite method of costochondral and posterior iliac bone graft.

하순에 발생한 각화극 세포증

장세홍(Se Hong Chang),강대원(Dae Won Kang) 대한구강악안면외과학회 1984 대한구강악안면외과학회지 Vol.10 No.1

Keratoacanthoma is a rapidly growing cutaneous neoplasm that resembles squamous cell carcinoma morphologically but behaves in a biologically benign manner. The lesion is uncommon in dark-skinned people and Orientals and is largely confined to Caucasians, Solitary keratoacanthoma is seen most frequently on exposed areas of the hands, wrists, and forearms. Rarely reported sites include the oral mucosa and conjunctiva. Keratoacanthoma found on the lips are nearly always in contact with the vermilion border and adjacent skin. A case of keratoacanthoma of the lip in a woman is presented with a review of the literature.

상악에 발생한 선낭포성암

장세홍(Se Hong Chang),김용달(Yong Dal Kim) 대한구강악안면외과학회 1983 대한구강악안면외과학회지 Vol.9 No.1

Adenoid cystic carcinoma is an uncommon tumor of the salivary and mucous gland which has been recognized for more than one hundred years. It is a slow growing malignant neoplasm which is always fatal and one of the most biologically deceptive and frustrating in management. We have experienced an advanced adenoid cystic carinoma of the maxilla in a 48-year-old male. The tumor was resected by total maxillectomy with orbital exenteration for protracted palliation. The patient also received postoperative irradiation for five weeks. Although the disease still persists the patient is leading a normal life now. We therefore report our experience with review of literatures.

口腔內 Candida의 分布 및 抗眞菌劑에 對한 感受性

Se Hong Chang(張世洪),Chong Soo Byun(卞鍾秀),Dong Taek Cho(趙東澤) 대한구강악안면외과학회 1985 대한구강악안면외과학회지 Vol.11 No.2

The distribution of Candida in oral cavity was studied in 473 patients with various oral disorders. A total of 261 strains of Candida were isolated and tested for the susceptibility to 4 antifungal drugs. Of 473 patients, 163 (34.5%) carried Candida in oral cavity. Isolation frequency of Candida was higher in females (42.3%) than in males (22.3%) and increased with ages from 14.6% to 50%, but children under ten years of age carried with high frequency (43.8%). The distribution of Candida in oral cavity was higher in specimens from tongue than from gingiva. The incidence by site was 32.5% from tongue, 10.4% from gingiva, and 57.1% from both sites. Of 261 Candida isolated, 94.6% were identified as C. albicans and 5.4% as C. tropicalis. The specimens from females produced greater number of colonies than those from males, but there was no correlation with ages. The incidence of Candida was 43.3% in patients with oral disease and dental caries, 41.2% with dental caries, 32.1% with oral disease and these incidence were higher than in normal group (23.7%). There was no correlation with various oral disorders in number of yeast colonies formed. In denture wearers, Candida were isolated with high frequency (53.6%) and with the tendency of producing greater numbers of colonies. Concentrations required to inhibit 90% of strains (MIC₉₀) of amphotericin B, nystatin, miconazole nitrate (MCN), and ketoconazole (KCZ) were 0.1 ㎍/㎖, 1.6, 12.5, and 25 to C. albicans and 0.2 ㎍/㎖, 3.1, 25, and 25 to C. tropicalis, respectively. MIC₉₀ of drugs to C. tropicalis were twofold higher than to C. albicans, while MIC₉₀ of KCZ were the same to both Candida species. MIC₉₀ of KCZ to Candida was twofold lower in buffered casein-yeast extract-glucose agar (CYGA), pH 7.0, than in CYGA, pH 6.0, whereas there was no difference between both media with MCN. MIC₉₀ of MCN to C. albicans was twofold lower in Sabouraudglucose agar (SGA) than in CYGA, yeast morphology agar (YMA), and yeast nitrogen base medium added agar (YNA), and MIC₉₀ to C. tropicalis was in SGA, YMA, and YNA than in CYGA. MIC₉₀ of KCZ to C. tropicalis was twofold lower in YMA, YNA than in CYGA and SGA, whereas there was no difference among 4 media in those of C. albicans.

SURGICAL MANAGEMENT OF VELOPHARYNGEAL INCOMPETENCE USING SUPERIORLY BASED PHARYNGEAL FLAP

안재진,장세홍,박지희,우성도,Ann, Jye-Jynn,Chang, Se-Hong,Park, Chi-Hee,Woo, Sung-Do Korean Association of Maxillofacial Plastic and Re 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.3

선천성 혹은 술후성 기형으로 발생하는 구개인두 부전증은 구강과 비강사이의 부적절한 폐쇄기능으로 인해 과비음 등의 발음장애를 초래한다. 그 원인으로는 구개파열, 인두비대증, 편도선절제술후의 구개와 인두의 비율 부조화, 구개인두 괄약근의 기형, 구래부전마비, 연구개 결손, 상악골 전진 절단술 등이 있다. 구개인두 부전증의 진단에는 임상적, 방사선학적 검사와 더불어 섬유광학 비내시경을 이용한 구개인두의 기능검사가 강조된다. 수술방법으로는 구개성형술, 인두증강술, 인두성형술, 인두피판술 등이 있다. 근자에는 상부기저형 인두피판술이 널리 사용되고 있는데, Hogan등이 개선시킨 술식에 의하면, 넓고 긴 피판을 얻을 수 있고 피판의 Raw surface를 연구개의 비강측 점막으로 덮을 수 있으며 측방 통로를 조절할 수 있다는 장점이 있다. 이에 저자등은 본인에 내원한 구개인두 부전증 환자 7례에서 상부기저형 인두피판을 이용하여 구강과 비강 사이의 측방 통로를 적절히 조절함으로서 발음을 개선시켜 본 바 양호한 임상성적을 얻었기에 보고하는 바이다. Velopharyngeal incompetence (VPI) is a condition of inadequate functional valving between the oral and nasal cavities that results in hypernasal speech and nasal air escape. VPI is caused by the following factors ; cleft palate, soft palate defect, pharyngomegaly, velopharyngeal sphincter muscle anomaly and maxillary advancement surgery, etc. Velopharyngeal function is assessed by a variety of measures that include speech evaluation, cephalogram, airflow study, videofluoroscopy and nasoendoscopy. The management of VPI is classified into four main groups ; prosthesis, insertion of implant, palatoplasty and pharyngoplasty. Pharyngeal flap is the most common surgical procedure for correcting VPI since Schoenborn's report in 1875. We report seven cases of VPI which were treated by modified modified superiorly based pharyngeal flap with good results.

외상으로 절단된 안면신경의 재건

안재진(Jye Jynn Ann),장세홍(Se Hong Chang),박지희(Chi Hee Park),우성도(Sung Do Woo) 대한구강악안면외과학회 1992 대한구강악안면외과학회지 Vol.18 No.1

Although a major cause of facial nerve lesion is surgical removal of extracranial and intracranial tumors, injuries to the skull or facial tissues may also place this nerve at considerable risk. Extratemporal facial nerve damages result mainly from deep injuries to the lateral face region including the parotid gland. In the past there was much discussion on the question of the best time for neural intervention during treatment of deep injuries in the lateral face region with facial nerve damage. In contrast to immediate primary nerve reconstruction early secondary reconstruction is also successfully carried out 3 to 4 weeks after the accident. A 35 year old woman came to our emergency room after having sustained the deep laceration injury in her left face, and primary closure of the soft tissue injury was done immediately. It was evident that her left upper lip and cheek lost their mimic muscular function 1 month after the accident. She underwent secondary reconstruction of facial nerve using transplantation of the greater auricular nerve to bridge a gap in the buccal branch of this nerve. In 12 months of follow-up the buccal smile muscles of injured side restored their mimic muscular function.