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두부규격 방사선 사진을 이용한 미소 시의 중안면부 연조직의 변화량 측정
천강용,신동환,전원배,김수호,김유진,박형욱,조진용,윤준용,서미현,이원덕,서제덕,이호,Cheon, Kang-Yong,Shin, Dong-Whan,Chun, Won-Bae,Kim, Soo-Ho,Kim, Eu-Gene,Park, Hyong-Wook,Cho, Jin-Yong,Yun, Jun-Yong,Seo, Mi-Hyun,Lee, Won-Deok,Suh, Je-D 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.6
Purpose: The aim of this study is to compare the soft tissue changes of the midfacial area at the repose position and the natural smiling position for the improvement of evaluation and planning in the orthognathic surgery. Methods: The total of 30 subjects, 15 male and 15 female, were included in this study. The metal point landmarks were placed at the cheek, orbital rim, subpupil, and nasal base. The movements of the landmarks were evaluated at the repose position and smiling position in the lateral and posteroanterior cephalograms. Paired t test and correlation analysis were used for the evaluation of the soft tissue changes statistically. Results: In the lateral cephalograms, the cheek point (4.49 mm in female, 4.87 mm in male) showed the most distant movement. All points presented significant movements, except the orbital rim and nasal base point in male. Cheek point presented significant positive correlation between the horizontal and vertical change in male. Subpupil point presented significant positive correlation between horizontal and vertical change in both male and female. In the posteroanterior cephalograms, the nasal base point (5.41 mm in female, 6.30 mm in male) showed the most distant movement. Subpupil point and nasal base point presented significant movements in both female and male. Nasal base point presented significant negative correlation between the horizontal and vertical change in both male and female. In the lateral and posteroanterior cephalograms, the positional changes of all points presented significant positive correlation with each other in both female and male. Conclusion: The cheek point in the sagittal view and the nasal base point in the frontal view showed the most distant movement on smile. In the sagittal view, the subpupil point and cheek point moved anteriorsuperiorly on smile. In the frontal view, the nasal base points moved laterosuperiorly on smile. In both the sagittal and frontal view, the positional changes of all point were highly correlated to each other. These results may be used in the soft tissue references for the treatment planning of the dentofacial deformity patients.
김유진,천강용,김수호,박형욱,황순정 대한구순구개열학회 2012 대한구순구개열학회지 Vol.15 No.2
Le Fort 1 osteotomy or maxillary advancement with distraction osteogenesis (DO) is main treatment strategy for cleft palate patients with maxillary hypoplasia. Maxillary DO allows greater maxillary advancement within physiological limit than Le Fort 1 osteotomy. Moreover, it is better for velopharyngeal function. However, there is a greater tendency for an increase in nasal sound when maxilla is advanced excessively. Therefore, the advancement of anterior maxillary segment using DO has been utilized. It offers advantages such as an increase in the length of the palate, a prevention of the change in palatopharyngeal depth, and a preservation of the velopharyngeal function. Moreover, it will obliterate the necessity of bone graft, and it prevents the occurrence of oronasal or oroantral fistula. Finally, it stimulates the regeneration of the soft and hard tissue of alveolus, and subsequently makes possible to place implant.
관골궁 골절의 정복시 수술 중 C-Arm 사용의 유용성: 증례보고
서미현,천강용,윤준용,유충규,이은경,이원덕,서제덕,Seo, Mi-Hyun,Cheon, Kang-Yong,Yun, Jun-Yong,Yoo, Chung-Kyu,Lee, Eun-Kyung,Lee, Won-Deok,Suh, Je-Duck 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4
The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography, CT to evaluate preoperative state. Gilles approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.
반안면왜소증 환자의 안면비대칭 해소를 위한 늑연골 이식 및 악교정 수술의 동시 이용: 증례보고
서미현,천강용,윤준용,유충규,이은경,이원덕,서제덕 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4
The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography,CT to evaluate preoperative state. Gilles` approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.
편측성 구순구개열 환자에 있어 구순성형술과 동반한 서골피판법 치험례
박형욱,송인석,김유진,김수호,천강용,서병무 대한구순구개열학회 2012 대한구순구개열학회지 Vol.15 No.2
Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard s rotation advancement flap method has its advantage in designing the flap using the patient’s anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard s rotation advancement method and vomer flap.
비인강폐쇄기능부전의 치료에 있어서 Furlow 이중 Z-성형술의 효과
김수호,김유진,박형욱,천강용,황순정 대한구순구개열학회 2012 대한구순구개열학회지 Vol.15 No.2
Velopharyngeal insufficiency (VPI) is improper closure of velopharynx during the phonation and swallowing due to various causes, especially appeared in cleft palate patients. The several surgical techniques and speech therapy can be considered in treatment of VPI. The surgical techniques such as Furlow’s double opposing Z-plasty, pharyngeal flap, push-back palatoplasty, etc. have been widely used when the speech therapy is not so much effective. However, there is considerable variability in the methods for evaluation and in success criteria making difficult to compare among surgical techniques. This article reviewed the recent articles about comparing the surgical techniques in treatment of VPI. Although there is no significant difference in speech assessment by speech pathologist, Furlow’s double opposing Z-plasty is a useful technique especially diminishing hypernasality and nasal emission.