얼굴 파열 분류의 재조명

서미현,조윤주,김성민,명훈,이종호,이석근 대한구순구개열학회 2015 대한구순구개열학회지 Vol.18 No.1·2

Craniofacial cleft deformity is a partial or total defect of craniofacial tissues. Most craniofacial malformations are identified by their appearance. The severity of this deformity can range from slight skin excavation, hair loss, to wry mouth, skewed eyes, and absence of nose and face. The majority of the classification systems are mainly clinical or anatomical. In 1976, Tessier first emphasized the relationship between soft tissues and the underlying bone stating that “a fissure of the soft tissue corresponds, as a general rule, with a cleft of the bony structure.” He introduced a cleft numbering system around the orbit from 0 to 14 depending on its relationship to the zero line. In this paper, we revisited classification system of craniofacial cleft focusing on Tessier’s classification system with other updates.

관골궁 골절의 정복시 수술 중 C-Arm 사용의 유용성: 증례보고

서미현,천강용,윤준용,유충규,이은경,이원덕,서제덕,Seo, Mi-Hyun,Cheon, Kang-Yong,Yun, Jun-Yong,Yoo, Chung-Kyu,Lee, Eun-Kyung,Lee, Won-Deok,Suh, Je-Duck 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4

The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography, CT to evaluate preoperative state. Gilles approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.

구강악안면재건을 위한 외측상완피판의 해부학적 고찰

서미현,김성민,강지영,명훈,이종호,Seo, Mi Hyun,Kim, Soung Min,Kang, Ji Young,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.4

The lateral upper arm flap (LUAF) was initially described by in 1982 by Song et al. as a simple skin flap, addressing the availability of cutaneous nerves for anastomoses. Katsaros et al., reported the use of a lateral upper arm skin flap, but also considered using it as a composite graft. The LUAF for the oral and maxillofacial reconstruction has several advantages over other flaps, such as constant anatomy, good color match and texture, thin design and plasticity. There is no functional limitation in the donor arm, such as strength and extension, and donor defects can be closed primarily with a linear scar, even when a flap of up to 8 cm in width is taken. For a better understanding of LUAF as a routine reconstructive option in moderate defect of maxillofacial region, the constant anatomical findings must be learned and memorized by young doctors during the specialized training course for the Korean national board of oral and maxillofacial surgery. This article review the anatomical basis of LUAF with Korean language.

반안면왜소증 환자의 안면비대칭 해소를 위한 늑연골 이식 및 악교정 수술의 동시 이용: 증례보고

서미현,천강용,윤준용,유충규,이은경,이원덕,서제덕 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4

The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography,CT to evaluate preoperative state. Gilles` approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.

혈관 비틀림이 백서 천층하복부 동맥의 초미세문합에 미치는 효과

서미현,김성민,어미영,강지영,명훈,이종호,Seo, Mi-Hyun,Kim, Soung-Min,Eo, Mi-Young,Kang, Ji-Young,Myoung, Hoon,Lee, Jong-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.5

Purpose: The advent of microsurgical technique and instruments, particularly in the field of perforator flap and supermicrosurgery, which have expanded the scope of microsurgery. However, supermicroanastomosis without any compression, tension, or distortions must be achieved to reach successful outcomes. Small-caliber vessels, such as those with an internal diameter less than 0.2 mm, are susceptible to inadvertent twisting of the anastomosis. In this study, using the superficial inferior epigastric artery (SIEA)-based flap model in Sprague-Dawley (SD) rats, we evaluated the acceptable limits of twisting effects on supermicroanastomotic sites. Methods: A total of 20 supermicroanastomoses were performed using the SIEA-based flap model in 10 male SD rats, 10-weeks-of-age, weighing 300~350 g. Rats were divided into five groups of two with four flaps as follows: 1) sham, 2) control group with end to end SIEA arterial supermicroanastomosis, 3) experimental I (EA1) with $90^{\circ}$ twisting, 4) experimental II (EA2) with $180^{\circ}$ twisting, and 5) experimental III (EA3) with $270^{\circ}$ twisting of the supermicroanastomosis. Each SIEA was anastomosed using six 11-0 $Ethilon^{(R)}$ (Ethicon Inc. Co., NJ, USA) stitches except in the sham group where the SIEA was only clamped with Supermicro vascular $clamps^{(R)}$ (S&T, Neuhausen, Switzerland) for 20 minutes. Results: The anastomosed arterial patency showed no remarkable changes according to doppler waveforms measured with a Smardop 45 Doppler System (Hadeco Inc., Kawasaki, Japan). The pulsatility index (PI) was increased at postoperative day 10 in the EA2 and EA3 groups, and the resistance index (RI) showed no statistically significant difference between preoperative and postoperative values at 10 days. Histologic specimens from the EA3 group showed increased tunica media necrosis, convolution of the internal elastic lamina, densely packed platelets, fibrin, and erythrocytes. Flap viability and anastomosed vessel patency were not significantly affected by the degree of arterial twisting in this study, other than in the EA3 group where minor effects on arterial patency of the microanastomoses were encountered. Conclusion: It appears that minor twisting on small caliber arteries, used in supermicroanastomoses, can be tolerated. However, twisting should be avoided as much as possible, and more than $180^{\circ}$ twisting must be prevented in clinical practice.

Review of Delivery System using Lipid Nanoparticle

서미현,김현철 한국공업화학회 2022 한국공업화학회 연구논문 초록집 Vol.2022 No.1

급성림프모구성 백혈병의 조기진단 시 구강병변 양상을 통한 감별의 중요성

서미현,하지영,허경회,조영아,김성민,최진영,Seo, Mi Hyun,Ha, Ji Young,Huh, Kyung Hoe,Cho, Young Ah,Kim, Soung Min,Choi, Jin Young 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.2

Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition, and allow for early diagnosis and treatment. Examination should include evaluation for mucosal changes, periodontal inflammation and bleeding, and general condition of the teeth. A 12-year-old man visited for molar pain during 3 months. He was diagnosed with having a possibility of hematopoietic malignancy, showing the loss of lamina dura, destruction of bony crypt, and high attenuation in the bone marrow. He was referred to department of pediatrics, additional study, including peripheral cell morphology and bone marrow exam, were performed, and diagnosed as acute lymphoblastic anemia. Despite chemotherapy to cure leukemia, he was expired 8 months after initial diagnosis. The purpose of this report is to promote and evoke the awareness regarding an initial examination of the dentist to make an effort to acquire accurate knowledge and information about life-threatening disease in usual dental practice.

구순열의 초음파 진단

서미현,김성민,오진실,명훈,이종호,최진영 대한구순구개열학회 2011 대한구순구개열학회지 Vol.14 No.1·2

The frequency of fetal malformations accounts for around 3-5% and evaluation of the health of the fetus and screening for fetal malformations has become an important part of prenatal care. Improvements in prenatal diagnosis have allowed identification of malformation in fetuses during first and second trimesters of pregnancy. Prenatal ultrasonography has become routine part of antenatal examination. For development of imaging, the accuracy of diagnosis is getting higher and earlier diagnosis of congenital malformation, such as cleft lip and palate, can provide to parent counseling, and opportunity to prepare the further treatment. For the better understanding of congenital cleft lip diagnosis to the oral and maxillofacial surgeons, as healthcare providers, we reviewed around 19 english-written articles and summarized some knowledges of ultrasound findings in the prenatal cleft lip fetus.

치조정 골 소실이 심한 경우와 치간 사이 공간이 부족한 경우에서의 미니 임프란트 식립

서미현,유충규,이은경,정다운,서제덕,정일혁,Seo, Mi-Hyun,Yoo, Chung-Kyu,Lee, Eun-Kyung,Jung, Da-Unn,Suh, Je-Duck,Chung, Il-Hyuk 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.1

Purpose: This study presents the use of mini implants for fixed restoration and implant supported overdenture to enable the practitioner to overcome the anatomic obstacles of ridge width and narrow interdental space. Patients and methods: This study consisted of 9 patients who required single implants for one or two teeth replacement and 1 patient who required implant supported overdenture after mandiblectomy, iliac bone graft due to ghost cell tumor. The ages ranged from 29 to 70 years (mean 51). All patients were in good health. Clinical and radiographs were taken pretreatment, postoperatively, during rehabilitation, and at follow ups. Results: Total implant survival rate was 94.7%. One implant was removed due to its mobility as a result of bad bone quality (Type IV) and patient's carelessness (Heavy smoker). All patients except one reported complete satisfaction regarding to function, aesthetics, and phonetics. Radiographic follow up every 3months postoperatively showed success in achieving function and maintaining marginal bone level. Conclusion: Clinician can overcome both severe ridge deficiency and small interdental space with mini implant.

치아 외과적 발거 전 혈액검사의 필요성과 이의 정책적 제시

서미현,김성민,오진실,명훈,이종호,Seo, Mi Hyun,Kim, Soung Min,Oh, Jin Sil,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.5

Purpose: The third molar extraction is one of the mostly performed procedures in the department of oral and maxillofacial surgery. In most of dental clinic or hospital, the third molar extraction used to be frequently performed in an office-based surgery, and most patients did not have specific medical history with young ages. Medical history taking are dependent on the only way by asking to the patients about their individual conditions. Therefore, as the specialists of the oral and maxillofacial surgery in the field of dentistry, we suggest a new policy that the preoperative lab must be performed routinely before extraction of the third molar. Methods: This study is based on 1,096 patients who have been managed with third molar extractions, from March 2008 to September 2011 by a single surgeon. The preoperative lab, including complete blood count, coagulation panel, chemistry and serology, was performed before any surgical procedures. The results were informed to the patients regardless of their abnormalities, and any abnormalities related to the surgical procedures, such as platelet count and coagulation factors, were checked and corrected safely. Results: Through the preoperative blood test, systemic diseases that the patients had not recognized before, such as anemia, leukopenia, fatty liver and chronic renal disease, were identified. Patients with acute or chronic leukemia, Hepatitis B, and HIV positive, were also detected as a small number. Also, the possibilities of the cross-infection between dentists and patients or between patients and patients, and any other emergency situations can be prevented; as well as the public health condition can be improved, too. The patients were satisfied with low cost preventive blood test and high quality of medical services. Conclusion: Therefore, routine medical lab testing, including history taking are needed before an office-based minor surgery, such as third molar extractions, and these results were suggested as a new policy in the field of dentistry.