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RISS 인기검색어
- 검색키워드
- 저자 : Masae Yamamoto (검색결과 2 건)
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Iwamoto, Masashi,Watanabe, Miki,Yamamoto, Masae,Narita, Masato,Kamio, Takashi,Takaki, Takashi,Shibahara, Takahiko,Katakura, Akira Korean Association of Maxillofacial Plastic and Re 2019 Maxillofacial Plastic Reconstructive Surgery Vol.41 No.-
Background: Le Fort I osteotomy is one of the surgical procedures now routinely and safely performed. It is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus. Therefore, with surgery, maxillary sinus mucosal thickening occurs. By knowing the changes in the sinus mucosa after surgery and the factors affecting it, it is possible to better predict the outcomes of surgery and contribute to safer surgery. In this study, thickening of maxillary sinus mucosa before and after surgery in Le Fort I osteotomy was evaluated using multidetector-row computed tomography (MDCT) images, and the changes in mucosal thickening and the related factors were examined. Methods: Using MDCT images, the maxillary sinus mucosa of 125 patients who had undergone Le Fort I osteotomy was retrospectively evaluated before surgery, 1 month after surgery, and 1 year after surgery. On the MDCT images, the maxillary sinus was judged as mucosal thickening and classified into three grades according to the proportion occupying the maxillary sinus. In the evaluation of factors related to mucosal thickening, the following eight factors were examined: sex, age, diagnosis, operating time, amount of postoperative bleeding, with/without bone graft, with/without multisegmental osteotomy, and with/without macrolide therapy after surgery. Results: The mean age at the time of surgery was 25.6 ± 8 years. Of all 125 patients, 66 had bilateral thickening, 19 had unilateral thickening, and 40 had no thickening. Factors that were significantly related to mucosal thickening were the operative time for the maxilla, bone grafts, and macrolide therapy after surgery. Conclusions: Operative time for the maxilla, bone grafts, and macrolide therapy after surgery were found to be related to mucosal thickening. In addition, MDCT scanning 1 month after surgery was considered to be appropriate for evaluation of maxillary sinus mucosal thickening.
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Clinical investigation of patients with jaw deformity with comorbidities
Kiyohiro Kasahara,Teruhide Hoshino,Kei Sugiura,Yuki Tanimoto,Masahide Koyachi,Masae Yamamoto,Keisuke Sugahara,Masayuki Takano,Akira Katakura 대한악안면성형재건외과학회 2022 Maxillofacial Plastic Reconstructive Surgery Vol.44 No.-
Background: With improvements in the safety and stability of surgeries, the number of orthognathic surgeries isincreasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeriesfor patients with comorbidities is also increasing. We report a survey and clinical investigation of patients withcomorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathicsurgery. Results: The participants included 296 men and 712 women, with a mean age of 28 years (13?19 years, n=144;20?29 years, n=483; 30?39 years, n=236; 40?49 years, n=102; 50?59 years, n=39; ≥60 years, n=4). In total, 347patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwentSSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent othersurgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases(n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologicdiseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrinediseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases(n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses(hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder),and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia wasmanaged with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetesmellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventfulcourse. Conclusions: The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacialsurgeons should adequately manage cases requiring cautious perioperative control and highlight the importance ofpreoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oralsurgeons should adopt appropriate additional preventive measures for patients with comorbidities.
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