개교를 동반한 Ⅲ급 부정교합 환자의 수술 : 교정 복합 치료 증례

서병무,박은주,이수정,이주아 乙支病院 1998 乙支醫報 Vol.21 No.1

양측성 구순구개열 환자의 이차적 비성형술에 대한 고찰

서병무,명훈,정필훈,김명진,염광원,남일우,민병일 대한구순구개열학회 1998 대한구순구개열학회지 Vol.1 No.2

구순구개열 환자에 있어 직선봉합법의 역할

서병무 대한구순구개열학회 2008 대한구순구개열학회지 Vol.11 No.1

The variations of cleft lip deformities imposed the difficulty to the surgical correction for them. Straight line technique for cleft lip surgery has been ignored quite long since other techniques were developed. Initially the straight line technique was introduced and widely accepted because it is simple and easy to perform during the period of no adequate anesthetics. But it was abandoned for its several shortcomings such as tighten lip, vermilion notching, anatomical distortion, and wound contractures. Recently, some groups advocated the usefulness of straight line technique which has a significant modification from its original form. Additionally the variable degree of cleft lip deformity allows simple straight line closure for those patients. Here a case of simple straight line technique was presented and discussed for its reliability and plausible results as well.

구개점막과 협점막의 절개에 사용되는 칼의 개선을 위한 기초 연구

서병무,최진영,이종호,김명진,정필훈,Seo Byoung-Moo,Choi Jin-Young,Lee Jong-Ho,Kim Myung-Jin,Choung Pill-Hoon 대한구순구개열학회 2001 대한구순구개열학회지 Vol.4 No.1

Disposable blade is widely used for palatal and oral mucosal incision in oral and maxillofadal surgery nowadays, But its design and durability need for improvement, Especially, there are so many hard tissues intraoral area, such as bone and tooth, therefor the sharpness of the surgical blade was easily destroyed, The purpose of this study was to make basic data for developing new design of surgical blade using in oral and maxillofacial area including for the patients who have cleft lip and palate deformities, Some questionnaires about the usefulness of currently used surgical blades were sent to 150 dentists, the 54 of them made a reply, Secondly, The used-once blade and fresh new blade were examined under the scanning electron microscope with the 4000-times magnification, Lastly, the tissue reaction following the surgical incision with a fresh-new and a used blade on rat buccal cheek mucosa and hard palate was evaluated with light microscope with hematoxilin-eosin staining, The time interval from the surgical trauma to taking a sample were 1 day, 3 days, 7 days, and 14 days, At each time schedule, 2 Sprague-Dawley rats were sacrificed, Many dentists were agreed to need for changing the design of the surgical blades and also demand to improve the durability of the blades, They were also eager to adopt the new design of blade if it was available, The blade used in surgical extraction procedure was heavily damaged in its sharpe edge of number 15 blade, The histological differences were not prominent, but the delayed healing was detected in buccal mucosal defects especially in the surgical group with used blade, There are slight different changes in hard palatal defects between a used and a new blade group, In this study, we could find that there are imperative demanding on improvement of surgical blade design and durability for oral and maxillofadal area, The blade currently using in surgical extraction was easily damaged, The animal model of this study was not perfect for the purpose of this study.

구개점막과 협점막의 절개에 사용되는 칼의 개선을 위한 기초 연구

서병무,최진영,이종호,김명진,정필훈 대한구순구개열학회 2001 대한구순구개열학회지 Vol.4 No.2

Disposable blade is widely used for palatal and oral mucosa! incision in oral and maxillofacial surgery nowadays. But its design and durability need for improvement. Especially, there are so many hard tissues intraoral area, such as bone and tooth, therefor the sharpness of the surgical blade was easily destroyed. The purpose of this study was to make basic data for developing new design of surgical blade using in oral and maxillofacial area including for the patients who have cleft lip and palate deformities. Some questionnaires about the usefulness of currently used surgical blades were sent to 150 dentists, the 54 of them made a reply. Secondly The used-0nce blade and fresh new blade were examined under the scanning electron microscope with the 4000-times magnification. lastly, the tissue reaction following the surgical incision with a fresh-new and a used blade on rat buccal cheek mucosa and hard palate was evaluated with light microscope with hematoxilin-eosin staining. The time interval from the surgical trauma to taking a sample were 1 day, 3 days, 7 days, and 14 days. At each time schedule, 2 Sprague-Dawley rats were sacrificed. Many dentists were agreed to need for changing the design of the surgical blades and also demand to improve the durability of the blades. They were also eager to adopt the new design of blade if it was available. The blade used in surgical extraction procedure was heavily damaged in its sharpe edge of number 15 blade. The histological differences were not prominent, but the delayed healing was detected in buccal mucosa! defects especially in the surgical group with used blade. There are slight different changes in hard palatal defects between a used and a new blade group. In this study, we could find that there are imperative demanding on improvement of surgical blade design and durability for oral and maxillofacial area. The blade currently using in surgical extraction was easily damaged. The animal model of this study was not perfect for the purpose of this study.

흰쥐 상악과 치아에서의 골형성단백질 mRNA 발현에 관한 연구

서병무 대한구강악안면병리학회 1998 대한구강악안면병리학회지 Vol.22 No.2

하악전돌증 환자의 하악지 시상분할법에 의한 악교정 수술후 재발에 관한 연구

서병무(Byoung moo Seo),민병일(Byong Il Min) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.2

In a study of 20 cases have been investigated clinically and radiologically long term results (6 months and over) of the sagittal split osteotomy technique (Obwegeser - Dal Pont 1961). The overall relapse rate was 30% but reoperation is not required. A statistical analysis of cephalometric radiographs was done and possible causes of relapse was discussed. The results were as following. 1. There are 6 cases of relapse in 20 patients (30%). 2. There are significant correlationship between amount of setback and long term horizontal relapse (p<0.01). 3. There are significant correlationship between surgical change of mandibular plane angle and long term horizontal relapse(p<0.01). 4. The direction and amount of vertical changes are irregular and there are no statistical correlationship. 5. The duration of fixation and patients age at operation are not correlated to horizontal relapse. 6. In preoperative cephalometric measurements, mandibular plane angle and gonial angle are not correlated with horizontal relapse. 7. Wire osteosynthesis is inadequate comparing rigid fixation in the aspect of positional stability.

악관절부 수술에서의 후이개접근법에 대한 고찰

서병무,김종원,김명진 大韓顎顔面成形再建外科學會 1990 Maxillofacial Plastic Reconstructive Surgery Vol.12 No.2

There are some methods of approach to the temporomandibular joint. The preauricular, the endaural and the postauricular incision are frequently used among those. The preauricular incision necessiates a preauricular scar, possible postopertive facial nerve damage and is the least cosmetically desirable incision. The endaural incision is more esthetic than preauricular incision, but it is not sufficient. The postauricular approach allows adequate exposure with decreased occurence of injury to facial nerve and excellent cosmetic results. The purpose of this report is to discuss the surgical approach of postauricular incision to the cases of TMJ ankyloses, internal derangement and condylar fracture of mandible.

폐쇄성 수면무호흡환자에서 확대 구개수구개피판을 이용한 치험례

김지연(Ji-Youn Kim),김성민(Soung-Min Kim),명 훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo)이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim),최진영(Jin-Young Choi) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.1

The uvulopalatal flap (UPF) technique is a modification of uvulopalatopharyngoplasty (UPPP) for the surgical treatment of obstructive sleep apnea. In the UPF technique, an uvulopalatal flap is fabricated and sutured to the residual mucosa of the soft palate to expand the antero-posterior dimensions of the oropharyngeal inlet. In the extended uvulopalatal flap (EUPF) technique, an incision at the tonsillar fossa is added to the classical UPF technique followed by the removal of mucosa and submucosal adipose tissue for additional expansion of the lateral dimension. The EUPF technique is more conservative and reversible than UPPP. Therefore, complications, such as velopharyngeal insufficiency, dysphagia, dryness, nasopharyngeal stenosis and postoperative pain, are reduced. In the following case report, the patient was diagnosed with obstructive sleep apnea and treated with the EUPF technique. The patient’s total respiratory disturbance events per hour (RDI) was decreased to 15.4, the O 2 saturation during the sleep was increased, and the excessive daytime sleepiness had disappeared after the surgery without complications. The authors report this case with a review of the relevant literature.

연구개내근성형술 및 서골피판을 동반한 2개 점막성골막판을 이용한 완전 양측성 구개열 환자의 치험례

이의룡,서병무,정필훈 대한구순구개열학회 2009 대한구순구개열학회지 Vol.12 No.1

구개열이 있으면 언어장애 음식섭취의 어려움, 구개범장근의 기능장애로 인한 이관의 개폐기능부 전으로 중이의 액체고임, 부정교합등 여러 문제가 생길 수 있다. 따라서 구개성형술은 갈라진 경구개 와 연구개를 막아주며 동적인 연구개를 만들어 주어 충분한 구개인두폐쇄를 하여 정상적 발음을 하 는데 그 목표가 있다. 그 외에도 음식물을 정상적으로 섭취할 수 있고 중이염 및 난청을 일으킬 수 있는 기능을 개선시키고 정상적인 교합을 만들어주는데 있다. 위의 목표를 이루기 위해 지금까지 많 은 수술 방법이 개발되었고 개선되어 왔다. 하지만 아직도 가장 효과적인 수술방법, 수술시기에 대하 여 논쟁거리가 되고있다. 언어를 분명하게 하려면 연구개는 인두벽에 닿기 위해 후상방으로 올라가 고 인두의 후벽과 측벽은 올라온 연구개에 닿으려고 수축함으로써 비인두와 구인두 사이의 공간이 좁아지게 됨으로써 가능하다. 따라서 발음이 정확하려면 비인두괄약(nasopharyngeal sphincter)을 합리적으로 만들어주어 비인두와 구인두를 분리해 주어야 한다. 비인두괄약을 조성해 주는 방법에는 구개범거근이 괄약기능을 할수 있도록 연구개내근성형술(intravelar veloplasty)을 시행하여 양편구 개범거근을 횡위로 옮겨 연결하여 올림근 걸이(levator muscle sling)을 만드는 방법, 구개 연조직을 후방으로 밀어 구개 길이를 연장하는 방법, 인두 피판술을 하는 방법등이 있다. 구개범거근의 주행방 향과 부착이 잘못되어 있는 것으로, 정상에서는 구개범거근이 횡으로 주행하여 연구개의 정중봉선 (median raphe)에 부착하는 데 반해 구개열에서는 구개범거근이 전방으로 주행하여 개열 가까이에 있는 구개열 후연과 골선 개열연에 부착되어 있고 구개인두근과 구개수근이 연구개를 그냥 지나쳐 직접 구개열 후연에 붙는다. 저자등은 완전 양측성 구개열을 연구개내근성형술 및 서골피판을 동반 한 2개 점막성골막판을 이용한 구개성형술로 수술을 시행하여 다소의 지견을 얻었기에 문헌고찰과 함께 보고하는 바이다.