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김운규,김수관,Kim, Woon-Kyu,Kim, Su-Gwan 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.2
Horner's syndrome as a complication of orthognathic surgery is given little attention of head and neck surgery and is a relatively benign and transient condition. A 18-year-old male referred to our department with long and anteriorly projected chin. The cephalometric evaluation revealed a skeletal Class III relationship. A 10-mm setback of the mandible to eliminate Class III relationship and 4-mm vertical reduction genioplasty were performed. Three weeks after operation, the patient was recognized anhidrosis in left face and the head, and ptosis of left eye. The trauma to cervical sympathetic nerve during left sagittal split ramus osteotomy was thought to be the cause of Horner's syndrome. Patient was treated by dermatologic and opthalmologic care. Follow-up examination 8 months later, he was recovery of horner's symptom.
탈지방탈회우골분말과 Polymethyl Methacrylate(PMMA) Bone Cement 혼합제에 관한 연구
김운규,김수관,조세인,고영무,윤정훈,안종모,Kim, Woon-Kyu,Kim, Su-Gwan,Cho, Se-In,Ko, Young-Moo,Yoon, Jung-Hoon,Ahn, Jong-Mo 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.6
Polymethylmethacrylate(PMMA) is currently commonly used material for the reconstruction of bone defects and fixation of joint prosthetics following congenital and acquired causes. Although PMMA has widespread use, it does not possess the ideal mechanical characteristics with osteoconductivity and osteoinductivity required. In order to overcome these problem, addition of bovine bone drived defatting demineralized bone(BDB) powders to a PMMA bone cement was done for improvement of physical property and bone forming characteristics of composite. In order to investigate the influence of BDB reinforcement on the PMMA, we measured physical property of compressive, tensile, flexural strength, and scanning electron microscopic examinations. The results were obtained as follows: 1. The PMMA forms a solid cellular matrix with open cells about $100{\mu}m$ in variable size and incorporating BDB. BDB aggregates inside the cells form a porous network that is accessible from the outer surface. 2. The physical properties were compressive strength of mean $22.74{\pm}1.69MPa$, tensile strength of mean $22.74{\pm}1.69MPa$, flexural strength of mean $77.53{\pm}6.93MPa$. Scanning electron microscopic examinations were revealed that there was DBD particles form a highly porous agglomerates. BDB can be added PMMA in the form of dried powders, the composites are applicable as bone substitutes. BDB and PMMA mixture is shown to produce a class of composites that due to their microstructure and improved mechanical properties may be suitable for application as bone subsitutes. The mechanical and material properties of the BDB-PMMA bone substitute composites are competitive with those properties of a porous ceramic matrix of other hydroxyapatite and with those of natural bones.
하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례
김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2
We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.
김수관,김운규,장현선 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4
Odontogenic fibromyxomas are extremely rare benign odontogenic tumors that probably arise from interstitial portion of jaw bone. The plain X-ray showed osteolytic destructive lesions in the molar root area. CT scans demonstrated osteolytic expansile lesions with mild enhancement of the solid portion of the mass. Histologically, the tumor is composed of fibrous tissue and myxoid tissues. In this paper a case of odontogenic fibromyxoma of the maxilla and a review of the literature is presented.
김수관,김운규,김봉균,장현선 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.6
The purpose of this study was to investigate the mean cranial bone thickness at various points of the bone and to serve as a clinical guide for choosing a bone graft. Twelve bones were obtained from 6 Korean adult skulls for this study. The mean bone thickness at each point of the 17 points of the bone and at the corresponding points of the opposite bone was obtained in all skulls studied. The thinnest part of the parietal bone was 5.92mm. The thickest part of the parietal bone was 7.58mm. The mean bone thickness at each point of measurements on two opposite bones was compared using the paired Student's t-test. The mean thickness did not differ significantly. The thickness in the same bone varied widely depending on the points of measurement.
Rapid Prototyping 모델을 이용한 골삭제을 위한 외과적 지표 : 섬유성 골이형성증 치료를 위한 기술적 제안
김운규 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.4
Bone shaving for surgical correction is general method in facial asymmetrical patient with fibrous dysplasia. Therefore, decision of bone shaving amount on the preoperative planning is very difficult for improvement of ideal occlusal relationship and harmonious face. Preoperative planning of facial asymmetry with fibrous dysplasia is generally confirmed by the simulation surggery based on evaluation of clinical examination, radiographic analysis and analysis of facial study model. However, the accurate postoperative results can not be predicted by this method. By using the computed tomography based RP(rapid prototyping) model, simulation of facial skeleton can be duplicated and 3-dimensional simmulation surgery can be perfomed. After fabrication of postoperative study model by preoperactive bone shaving, preoperative and postoperactive surgical index was made by omnivaccum and clear acrylic resin. Amount of bone shaving is confirmed by superimposition of surgical index at the opertation. We performed the surgical correction of facial asymmetry patients with fibrous dysplasia using surgical index and prototyping model and obtained the favorable results.