악안면(顎顔面) 외상환자에서 나타난 항이뇨(抗利尿)호르몬 분비장애증후군(分泌障碍症候群)

이상철,김여갑,류동목,이백수,최재용,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Baek-Soo,Choi, Jae-Yong 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.1

The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.

유리전완피부피판을 이용한 구강내 결손의 재건례

이상철,김여갑,류동목,이백수,권용대,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Baek-Soo,Kwon, Yong-Dae 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.3

본 증례는 우측 하악 후구치부위에 생긴 편평상피세포암종의 절제후 생긴 결손부를 미세혈관수술을 이용한 유리전완피부피판으로 재건한 증례로서 병소가 발생한 해부학적 위치 및 절제 후 생긴 결손부의 크기를 고려할 때, 전완피부피판을 이용하여 재건하였으며 현재까지 양호한 결과를 보이고 있다. 이와 같이 전완피부피판은 특성을 잘 이용하는 적절한 적응증에 사용된다면 어떤 다른 재건방법 보다도 성공적인 결과를 가져올 수 있으며 특히 구강악안면영역의 재건에서 그 효용성이 크다고 할 수 있다. With the recent progress of microsurgical techniques, radial forearm free flap has an established place in oral reconstruction. Providing thin, soft and pliable skin with a large and constant vascular pedicle, this flap is optimal for intraoral reconstruction. One of the disadvantages of the flap is donor site morbidity, therefore various methods can be used to reduce it. A male complained of palatal and retromolar area mass with ulceration, which was diagnosed as squamous cell carcinoma. He also complained of discomfort and mouth opening limitation, attributed to the location and characteristics of the mass. Because of mouth opening limitation, mandibular swing approach was performed to allow for the surgical approach to the mass. After the surgical excison of the lesion, the intraoral defect was successfully reconstructed with radial forearm free flap.

측두근-오훼돌기 피판을 이용한 안와저의 재건 예

이상철,김여갑,류동목,최재용,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Choi, Jae-Yong 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.1

The maxillary squamous cell carcinoma is major part of maxillary malignant tumor. The treatment of maxillary malignancy tumor is the maxillectomy in combination with radiation therapy and chemorherapy. When tumor invasion is occured to the orbit, orbital exenteration is required. But if the periosteum of the orbital floor is intact, the orbit can be preserved. There are many orbital floor reconstruction materials for the prevention of ptosis of the orbital content. The patients on this paper were diagnosised as squamous cell carcinoma on maxilla, we performed the partial maxillectomy including the orbital floor, and we used temporalis muscle-coronoid process flap for the reconstruction of the orbital floor after partial maxillectomy and obtained good esthetic and functional results, as followed. 1. We obtained sufficient flap width for defect of orbital floor. 2. It permits good blood supply and no necessary other donor site. 3. It gives a solid base for the support the globe and the orbital floor. 4. It gives minimal postoperative morphorogical defect and functional disturbance.

악하선(顎下線)과 협점막(頰粘膜)에 발생한 다형성(多形性) 선종(腺腫)의 치험례

이상철,김여갑,류동목,이백수,김병주,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Baek-Soo,Kim, Byung-Ju 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.2

Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50% of all cases of tumors of both major and minor salivary gland origin and approximately 90% of all benign salivary gland tumors. Of the major salivary glands, the parotid gland is the most common site of the pleomorphic adenoma. It may occur, however, in any of the major gland or in the widely distributed intraoral accessory salivary glands. The palatal glands are frequently the site of origin of tumors, and other parts of origins are as follows: upper and lower lip, buccal mucosa, tongue and occasionally other sites. The majority of the lesions are found in patients in the fourth to sixth decades, but they are also relatively common in young adults and have been known to occur in children. It is somewhat more frequent in women than men. The term "mixed tumor" has masquaeraded under a great variety of names throughout the years (e.g., enclavoma, branchioma, endothelioma, enchondroma), but the term "pleomorphic adenoma" suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The accepted treatment for this tumor is surgical excision. The intraoral lesions can be treated somewhat more conservatively by extracapsular excision. In general, Lesions of the hard palate should be excised with the overlying mucosa, while those in lining mucosa, such as the lips, soft palate and buccal mucosa often can be treated successfully by enucleation or extracapsular excision. In our hospital, we experienced two patients who were identified pleomorphic adenoma which occurred at buccal mucosa, submandibular gland. The lesions were successfully treated by surgical excision.

KIMURA'S DISEASE 치험례

이상철,김여갑,류동목,조선경,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Cho, Seon-Kyung 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.3

Kimura's disease is a chronic inflammatory condition producing subcutaneous tumor-like nodules mainly head and neck regions. Elevated serum Ig E levels and peripheral blood eosinophilia are common. Kimura's disease represents and aberrant immune reaction to an as yet unknown stimulus. This case presented is 27 year old female whose chief complaint were painful swelling on Rt cheek and temporal area and diagnosed as Kimura's disease. We preformed surgical excision of the mass on Rt. cheek and temporal area and reconstructed with temporal flap and about 100 cc of free fat graft on the defect of Rt. cheek.

두개하 Le Fort III 골절단술에 의한 중안면 발육부전 환자의 치험례

이상철,김여갑,류동목,이백수,최유성,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Baek-Soo,Choi, You-Sung 대한악안면성형재건외과학회 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

저자등은 중안면 발육부전으로 인한 심미적 및 기능적 장애를 주소로 경희대학교 치과대학 구강악안면외과에 내원한 23세 남자에 대해 관상절개술만을 통하여 두개하 Le Fort III 골절단술을 시행하여 중안면부의 심미성을 증진시키고 안구돌출증의 해소 및 반대교합의 개선등 양호한 결과를 얻었기에 이에 대한 문헌고찰과 함께 보고하는 바이다. The midfacial deficiency is usually accompanied with congenital craniofacial synostosis, such as Crouzon, Apert, Pfeiffer, Carpenter, Saethre-Chotzen syndrome, and so on. But sometimes isolated midfacial deficiency without cranial malformations may appeared, the cause of which is congenital, hereditary, or secondary to developmental factors, such as infection and trauma to middle face. Since Sir Harold Gillies reposted the first high maxillary osteotomy that alleviated the problems of total midfacial deficiency, the various operative methods were developed by many clinicians, such as Longacre and Tessier. These procedures can enlarge the orbital volume and decreases exorbitism. As middle face was moved forward, these functional, esthetic, and psychologic advantages were resulted from this. This is a case of midfacial deficiency corrected by the subcranial Le Fort Ⅲ osteotomy through only coronal approach.

석회화 치원성 낭종의 치험례

이상철,김여갑,류동목,이완기,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Wan-Kee 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.3

The calcifying odontogenic cyst was identified as a pathological entity by Gorlin & his associates in 1962. This lesion is one of the rarest and most disputable cysts in the oral region. The calcifying odontogenic cyst has variable clinical and radiological features. We review the previous literatures and report 2 cases of calcifying odontogenic cyst at Department of Oral and Maxillofacial Surgery, Kyung-Hee University. The 1st case was as follows. The patient vas 22 year old female. The past dental history revealed extraction of prolonged retained #73 tooth about 15days ago. She complained a painful swelling on the lower anterior teeth area. There were chin and vestibular swelling on the lower anterior teeth area, tenderness and missing of #33 tooth. The radiograph revealed well-demarcated unilocular radiolucency containing radiopaque calcific flecks around impacted #33 tooth. The clinical diagnosis was COC, so surgical enucleation was done. There was no recurrence and COC was confirmed by pathologist. The second case was as follows. The patient was 72 year old male. The past history revealed inactive tuberculosis, bronchial asthma and denture construction. The chief complaint was rapidly growing mass on the lower left anterior edentulous area. The clinical findings were chin swelling protruding mass with surface ulceration, fluctuation and a few bloody fluid in aspiration. The radiograph revealed well-demarcated radiolucency mimiking the residual cyst. The biopsy result was COC. The surgical excision was done, but the lesion was recurred 10 months later. The treatment was surgical excision with aggressive peripheral bone grinding and FTSG form groin area. There was no problem during the postoperative period.

하악전돌증의 악교정수술후 연조직 변화에 관한 연구

이상철,김여갑,류동목,이완기,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Wan-Kee 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.3

The purpose of this paper is to investigate changes in soft tissue in 22 patients treated by vertical ramus osteotomy and sagittal split ramus osteotomy for the correction of mandibular prognathism. 22 individuals, 12 males and 10 females, were selected from the patients with mandibular prognathism at the Department of Oral and Maxillofacial Surgery, Colledge of Dentistry, Kyung Hee University. Patient were analyzed with cephalogram taken 1 week before and at least 6 weeks after surgery under the same condition. Measurements were made constructed hard tissue and sop tissue points located on each before-and-after film tracing. Comparision were made of these figures to estimate the amount that the soft tissue followed the hard tissue structures in each surgical procedure : ratio of sop and hard tissue changes were formulated. The results were as follows. 1. The horizontal changes of Pogs and Bs as a ratio of the horizontal changes of Pog and B point were 1.02 and 1.16 respectively. 2. One millimeter of posterior changes at Pog resulted in 0.86mm of posterior change at Li and 0.09mm of posterior change at Ls. The greatest amount of sop tissue change occurred at Pogs, with substantially less posterior displacement at Bs, even less at Li and at least at Ls. 3. The ratio of LI to Li was 1:0.81 and the ratio of LI to Ls was not significant.(1 : 0.17) 4. The ULA(Cm-Sn-Ls) and the relative lower lip projection (LLP) was incnease4 but the relative upper lip projection (ULP) was slightly decreased 5. The angular change of the upper lip inclined angle (Ls-Sn/ANS-PNS) and lower lip inclined angle(Li-Pogs/Me-Go) expressed as a ratio of the posterior change of Pog were 0.57 and 0.20 respectively. 6. The ratio of the lower anterior facial height change of the soft tissue(Sn-Mes) to the hard tissue(ANS-Gn) were 0.78 and and the ratio of vertical height changes of the hard tissue and sop tissue to the posterior change of the Pog were 0.18 and 0.19 respectively. 7. The sop tissue angular change of facial convexity(G-Sn-Pogs) expressed as a ratio of the angular change of the hard tissue angle of facial convexity(N-A-Pog) was 1.24.

이하선에 발생한 양성 섬유성조직구종의 치험예

이상철,김여갑,류동목,이완기,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Wan-Kee 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.3

Fibrous histiocytomas are commonly occurred in the skin of the extremeties and rare in the head and neck region. Fibrous histiocytomas in general are considered benign tumors. But deep fibrous histiocytomas have more poor prognosis than cutaneous counterparts and tendency of local invasion and recurrence. Wide surgical excision is the treatment of choice due to high recurrence rate and potential malignancy. We presented a rare case of benign fibrous histiocytoma occurred in the superficial lobe of the right parotid gland, showing palpable mass with pain.

액상 Famprofazone함유제제(Apagan<SUP>Ⓡ</SUP>)의 구강외과 수술후 진통효과에 대한 임상적 연구

이상철(Sang Chull Lee),김여갑(Yeo Gab Kim),류동목(Dong Mock Ryu),이백수(Baei Soo Lee) 대한치과의사협회 1987 대한치과의사협회지 Vol.25 No.8