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이상철(Sang Chull Lee),류선열(Sun Youl Ryu) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.4
It is so difficult to treat carcinoma of the maxillary sinus because of difficulty in early diagnosis, more advanced lesion at the first examination, complexity of the surrounding anatomic structures, and technical problems of the extensive radical resection. Although treatment of carcinoma of the maxillary sinus has been performed commonly by the conventional surgical or radiation therapy or combined therapy of both, multidisciplinary therapy has been introduced with improvement of chemotherapy and immunotherapy. Triple therapy, to has being widely performed in Japan nowadays, is composed of proper preoperative and postoperative radiation therapy, regional intraarterial chemotherapy and surgery. And significant increasement of 5-year survival rate has been reported. So we think that this method can be recommended to treatment of carcinoma of the maxillary sinus.
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김영운(Young Woon Kim),정숭룡(Soong Rhyong Jung),박준아(Jun A Park),정종철(Jong Cheul Jung),오희균(Hee Kyun Oh),이종호(Jong Ho Lee),류선열(Sung Youl Ryu) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.4
Necrotizing fasciitis is a rapidly progressing necrotizing process which affects subcutaneous tissue and fascia and is accompanied by severe systemic toxicity. Although necrotizing fasciitis can affect any part of the body including the back and neck, it is rather a rare entity in the head and neck. The rate of spread is remarkably rapid, with the tendency towards systemic toxicity related to delayed initiation of treatment. The infection process may be caused by any type of trauma. The infectious process usually begins 2 to 4 days after the initial insult. The skin becomes smooth, tense, and shiny: no sharp demarcation is seen between normal and affected skin. As the disease progresses, the pathognomonic sign of necrotizing fasciitis appears: a dusky discoloration of the skin as small purplish patches with ill-defined borders. An early exploration and drainage of all the involved fascial planes is important. We have had much difficulty in differentiating necrotizing fasciitis from other infections diseases. When infection is present in the oral & maxillofacial area, we thin abscess and cellulitis first of all. With failure of the lesion to respond to conventional treatment, we have to rule out the necrotizing fasciitis due to its alarming toxicity. Successful treatment of necrotizing fasciitis is bases on the early recognition of the infection process, aggressive surgical intervention systemic medical and supportive therapy, and intensive antibiotic therapy, with emphasis placed on early surgical care. The early exploration and drainage of al the involved fascial planes is critical. We experienced two cases of necrotizing fasciitis of the face. With early recognition of the infection process, aggressive fasciotomy and various medically supported therapy, we resolved the edema and exudate with offering the best chance for core. The patient was treated successfully.
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