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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 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3
Superior orbital fissure syndrome is characterized by ophthalmoplegia, ptosis of the eye, reflex dilation of the pupil, and anesthesia of the upper eyelid and forehead. This syndrome may be the result of craniofacial fractures as well as neoplasms of the retrobulbar space, hematomas in the orbital muscle cone and retrobulbar space, and hematoma and infection of the cavernous sinus. A case of superior orbital fissure syndrome is described.
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.
김상렬,김수관,여환호 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4
The purpose of this retrospective study is to investigate the effects of conscious sedation in an outpatient setting. Data from 292 patients (154 males, 138 females), sedated for minor oral surgery, were studied using various parameters including age and sex distribution, as well as according to procedures and each drug group. Results show that this intravenous conscious sedation technique is a safe and effective method of controlling behaviour, but one has to be prepared to deal with any emergencies or complications. The specific results are as follows : 1.Most procedures (265/292) were used to Valium mixed with Demerol and Midazolam mixed with Demerol. 2.Valium revealed a high incidence of pain upon injection and symptoms limited to daily activity and thrombophlebitis. 3.Nausea and vomiting manifested in the procedure using Demerol. 4.The patient manifested comfort similar in response to the same drugs used in another treatment.
구강점막섬유화에 의한 개구제한 : 증례보고 A CASE REPORT
김 훈,김수관,하정완 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.2
Oral submucous Fibrosis(OSF) is an insidious chronic disease affecting the mucosa of the oral cavity and occasionally extending into the pharynx and esophagus. It is associated with a genetic predisposition and alterations, infectious and viral agents, carcinogens, nutritional and immunological factors. the etiology is obscure but it is correlated with a hypersensitivity to capsaicin, secondary to chronic iron and/ or vitamin B complex deficiencies or exposure to cashew kernel oil. We report a patient who had a month opening limitation caused by a fall when he was 8 years old despite several treatments at other hospitals. Excellent results were obstained by releasing the scar tissue using a standard split-thickness skin graft(STSG) which obtained from the thigh. It is important to recognize as a precancerous condition and to inspect the excision site and the remaining oral mucosa during long-term follow-up on a regular basis.
가토에서 관절원판을 전방변위시킨 후 두개하악관절의 조직병리학적 변화
김문수,여환호,김수관,강태호,박정열,장현석 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5
To investigate the histopathologic changes of the rabbit craniomandibular joint (CMJ), anterior disc displacement (ADD) was surgically induced. Of 15 rabbits, 9 were classified as experimental group, 3 as control of group, and 3 as sham-operation group, respectively The experimental group (9 rabbit) was subdivided into 6 weeks, 12 weeks, and 20 weeks group, respectively 3 rabbits. In experimental group, the disc was displaced anteriorly at the right side(operation side) and left CMJ was not operated(non-operation side). Both CMJs were harvested at 6, 12, and 20 weeks following surgery in experimental group. The CMJ was harvested at 6 weeks following surgery in sham-operation group. The specimens were examined under light microscope after hematoxylineosin and verhoeff staining. The obtained results were as follows: 1.In midsagittal view of control and sham-operation group, there were no degenerative and hyperplastic changes in the CMJ including articular disc, mandibular condyle, and temporal fossa. 2.Disc was shortened anterior-posteriorly and deformed of biconcave shape in all experimental group. In 20 week experimental group, intermediate zone of disc width was almost same as the width of posterior band of disc. 3.Soft tissue hyperplasia at the posterior attachment area of the disc and condylar hyperplasia were seen in the all experimental groups, but the degree of the hyperplasia was greater at 12, 20 weeks than at 6 weeks. 4.The number of elastic fiber in the disc proper was decreased and the direction and morphology was chanced in all experimental groups compared with those of control of groups. 5.Fatty degeneration was shown in non-operation side of 20 weeks experimental group. These results suggest that induced ADD in craniomandibular joint of rabbits could lead to a reparative and degenerative changes of the affected joint similar to those described for osteoarthrosis and osteoarthritis in human.
치아회분과 석고 혼합매식물 이식에 관한 임상적 연구 : 장기간 추적 연구 LONG-TERM FOLLOW UP STUDY
김영균,여환호,김수관 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4
This study was undertaken to access the effect of toothash combined with plaster of Paris in the filling of jaw defect and the substitution as new bone during the follow up period. We used the toothash and plaster after the cyst enucleation, the apicoectomy, the extraction of supenumerary tooth with ratio of 2 : 1 by weigh. 15 consecutive patients were evaluated retrospectively. Complications were swelling, perforation, infection and treated without problems using incision & drainage, aspiration, antibiotic treatment, 2ndary buccal flap. The follow0up period ranged from 28 to 35 months. Based on radiographic and clinical observation, it may be concluded that toothash and dental plaster of Paris(CaSo₄ 1/2H₂0) are useful for bone substitute.
김수관,김영균,여환호,박인순 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.2
The purpose of this study was to investigate the epidemiology of midface fratures. We observed clinically 71 patients with midface fracture who visited the Department of oral and maxillofacial-surgery, Chosun University, Dental Hospital, from 1991 to 1994. The results obtained were as follows. 1. There was the highest age incidence in the third decade(29.6%). 2. There was the highest incidence in the summer(36.6%). 3. The most etiologic factor of midface fracture was traffic accidents(43.6%) and next factor was fall down(38.0%). 4. The highest incidence fracture was zygomatic arch(38.7%) and next fracture was ZMC fracture(31.5%). 5. Most midface fracture was treated within 2 weeks(86.7%). 6. Midface fractures was most frequently combined with mandibular fracture(15.5%), head injuries(14.1%),orthhopedic injuries(8.5),thorax & abdomen(5.6%). 7. The highest complication was the nerve injury(8명), and next complications were infection(3명), epiphora(3명) etc.
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.
변형 LeFort Ⅲ 골절단술을 이용한 중안면 성장부전을 동반한 하악전돌증의 치험례
김문수,김수관,류종회 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2
Maxillary-malar deficiency is the most frequently occurring midface dentofacial deformity. Clinicaly patients with maxillary-malar deficiency exhibit malar and infraorbital rim deficiency and class III malocclusion. For treatment of these deformities, modified LeFort III osteotomy have been used. Modified LeFort III osteotomy advances maxilla with orbital rims and zygomatic bone anteroposteriorly. This is a case of patient who had severe mandibular prognthism with midface deformity. We performed modified LeFort III osteotomy for maxillary-malar advancement and simultaneous bilateral sagittal split ramus osteotomy for mandibular prognathism and autogenous iliac bone graft.