점막 결손부에 대한 Collagen membrane TERUDERMIS^�의 임상적 적용례

윤옥병 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.3

Most of Oral & Maxillofacial surgeon used to take free skin graft on the large postoperative mucosal wound which could not be dissolved with primary closure. However, there were many difficulties such as the presence of new scar formation on the donor site, discomforts caused by to the presence of hair and fetid odor intraorally, and especially difficulty of choice of the donor site in the case of young patients. Therefore author tried to primary closure by use of collagen menbrane on the mucosal defects caused by the palatal pathologic lesion, mucosal dehiscence followed by the bone graft on the alveolar cleft, and vestibuloplasty on the area of vestibular flattening caused by trauma. Author could induce good healing processes and results without additional scar formations and further discomforts.

다형성 선종에 대한 미세구조적 연구

윤옥병,김여갑 慶熙大學校 齒科大學 1989 慶熙齒大論文集 Vol.11 No.-

The purpose of this study was to observe the origin and nature of the salivary gland mixed tumor. Using 4 specimens, after final diagnosis as pleomorphic adenoma was decided under light microscope, ultrastructural and histological examination on it was done under H-600 electron microscope. The results were as followed: 1. The tumor cell was composed of epithelial and myoepithelial cells. 2. In the epithelial cells, polygonal or avoid tubular structures were observed and squamous epithelial cells and keratin pearls were present, and they were embedded on fibrous Or myxoid stroma. In the tubular structures, eosinophiiic coagu um was observed. 3. The abundant cytoplasm had microvillous projections and well developed rough endoplasmic reticulums were dilated, and numerous vacuoles were observed in the cytoplasm. 4. The nuclei of epithelial cells were round, irregular, dispersed and also had occasionally nucleoli. 5. The myoepithelial cells had endoplasmic fibrilloid structures, and intermixed with epithelial cells. 6. The eosinophilic material and hyalinized connective tissues were characteristic, and stroma was uniform, dense, and composed of fibrilloid and myxoid elements, chiefly fibrilloid.

점막 결손부에 대한 Collagen Membrane TERUDERMIS(R) 의 임상적 적용례

윤옥병(Ok Byung Yoon) 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.3

N/A

안와하연 및 측벽 ( frontozygmatic sutrue ) 에 대한 lateral canthotomy - conjunctival approach 를 이용한 협골체 골절의 치료

윤옥병(Ok Byung Yoon),이태영(Tae Young Lee),김현철(Hyoun Chull Kim),변숙(Sook Byun),강기성치(Seiji Esaki),구산충광(Tadamitsu Kameyama) 대한악안면성형재건외과학회 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1

협골체 골절시 접근방법은 안와하연에 대해 섬모하절개, 하안검절개, 안와하연절개 및 결막절개등이 사용되고 안와측벽, frontozygomatic suture에 대해서는 lateral brow incision, 상안검절개등이 사용되며 관상절개술은 frontozygomatic suture 와 협골궁에 접근할 수 있다. 관상절개술을 제외한 접근방법은 한가지 절개술로 단지 한부위의 정복과 고정술이 가능하므로 결국 협골체 골절시 2점이상 고정을 할 경우 2가지 이상의 절개가 필요하게 된다. 이에 저자들은 관상절개술의 적응증이 아닌 협골체 골절에 lateral canthotomy-conjunctival incision을 사용하여 안와하연 및 측벽의 골절부에 대한 정복술과 고정술을 시행하여 양호한 결과를 관찰하여 이에 보고하는 바이다. Various extraoral and intraoral approaches to reduction and fixation of zygomatic complex fractures were used. The method for exposure of inferior orbital area include the subciliary, inferior eyelid, infraorbital rim and conjunctival incisions. For exposure of frontozygomatic suture, lateral brow, coronal and blephaloplasty incisions were used. It is necessary that the usual approaches to the inferior and lateral orbit have two incisions. However, lateral canthotomy-conjunctival approach presented on this paper provide optimal exposure to lateral and inferior orbit.

하악과두골절시 Arthrocentesis와 Lavage를 이용한 치험에 관한 연구

윤옥병(Yoon Ok-byung) 대한구강악안면외과학회 2002 대한구강악안면외과학회지 Vol.28 No.4

In the treatment of mandibular condylar fractures, arthrocentesis, lavage and selective intermaxillary fixation were performed after closed reduction. In this lavage group, the physiotherapy performed for 3-6 months after injury. in control group, continuous intermaxillary fixation was done for 1-3 weeks, and physiotherapy followed in the same method of the lavage group. In the comparative study of the both groups, the following results are shown. 1. Compared to control group, the lavage group had a slightly superior result at range of motion, joint pain and occlusal deviation, from I day after arthrocentesis to 6 months after injury. 2. The significant differences between both groups were seen at range of motion and joint pain in 1 month after injury. 3. At 6 months after injury, the differences between both groups were not significant at range of motion, joint pain and occlusal deviation. From this study, in the mandibular condylar fracture, the arthrosentesis, lavage and selective intermaxillary fixation after closed reduction can improve symptoms such as joint pain and occlusal deviation, also increase range of motion. in this therapeutic way, intracapsular hemarthrosis which can cause TMJ ankylosis or dysfunction can be removed effectively. in addition, patient’s discomfort such as swallowing disturbance, speech disturbance and emotional stress can be reduced signuficantly.

하악지시상분할골절단술 시행 후 von-Miese 항복강도에 대한 유한요소법적 연구

윤옥병(Ok-Byung Yoon),김여갑(Yeo-Gab Kim) 대한구강악안면외과학회 2002 대한구강악안면외과학회지 Vol.28 No.3

For the study of its stability when the screw has been fixed after sagittal split ramus osteotomy(SSRO) of the mandible, the methods of screw arrangement are classified into two types, triangular and straight. The angles of screws to the bone surface are classified as perpendicular arrangements, the 60o anterioinferior screw, known as triangular, and the most posterior screw, called straight arrangement, thus there are four types. The finite element method model has been made by using a three dimensional calculator and a supercomputer. The load directions are to the anterior teeth, premolar region, and molar region, and the bite force is 1 Kgf to each region. The distribution of stress, the von-Mises yield strength, and safety of margin refer to the total sum of transformed energy have been studied by comparison with each other. The following conclusion has been researched : 1. When shear stress is compared, in the triangular arrangement in the form of “ㄱ“, the anterosuperior screw is seen at contributing to the support of the bone fragment. In the straight arrangement, substantial stress is seen to be concentrated on the most posterior angled screw. 2. When the von-Mises yield strength is compared, it seemed that the stress concentration on the angled anteroinferior screw is higher, it shows a higher possibility of fracture than any other screw. In the straight arrangement, stress appeared to be concentrated on the most posteriorly angled screw. 3. When the safety margins of the transfomed energy are compared, the energy conduction is much greater in the case of the angled screw than in the case of the perpendicular screw. The triangular arrangement in the form of “ㄱ“ shows a superior clinical sign to that of the straight arrangement. Judging from the above results, when the screw fixation is made after SSRO in practical clinical cases, two screws should be inserted in the superior border of mandibular ramus and a third screw of mandibular inferior border should be inserted in the form of triangular. All screws on the bony surface should be placed perpendicularly-90o angles apparently best promote bony support and stability.

점막유표피암종의 치험례

신민철,윤옥병,오승환,김여갑,이상철,신민철 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

Mucoepidermoid carcinomas, first reported by Volkman(1895), form 6% to 9% of all salivary tumors. Two thirds affecting the parotid gland and the remaining third, the minor glands. As we could know from its name, mucoepidermoid carcinomas originate from ductal epithelium including squamous, mucous-secreting, and undifferentiated intermediate cells. Histologically, it is classified as well-differentiated (low grade), moderately-differentiated(intermediate grade), and poorly-differentiated (high grade) types and the treatment method and prognosis are influenced from its histological grade. We have experienced two cases of mucoepidermoid carcinoma treated surgically with good results and now would like to report these with review of literatures.

Eagle씨 증후군의 치험례

오승환,이상철,윤옥병,지유진,김여갑,류동목 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.3

Eagle's syndrome is the term given to symtomatic elogation of the styloid process or mineralization of the stylohyoid or stylomandibular ligament. Since ossification of stylohyoid ligament at cadeva was fist described by De Manchetics in 1652 and Weinlecher described clinical symptom which produced by elongated styloid process and osteotomy of styloid process in 1872, Clinical symptom which include sensation of a foreign body on the pharynx, dysphagai, dysphonia, referred pain, and mouth opening disturbance was termed by Eagle as Eagle's syndrome. then, case reports of Eagle's syndrome are presented. in these cases, the patient's chief complaints included periauricular radiating pain, mouth opening disturbance, foreign body sensation, dysphagia, tenderness on the neck. Through vairous X-ray examination and palpation of tonsillar fossa, elongted styloid process were confirmed. Under the general anesthesia there were successfully removed out via transoral approach technique, described by Eagle. after resented styloid process, they were freed from the symptoms without further complication. Therefor we reported these cases treated by surgical resection of styloid process with good results.

상악골에 발생한 악성섬유성조직구종의 치험례

이상철,김여갑,류동목,이백수,윤옥병,신민철 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

A CASE REPORT AND RIVIEW OF LITERATURE ON OSSIFYING FIBROMA IN MAXILLA

Ryu,Dong Mok,Lee,Sang Chull,Kim,Yeo Gab,YooN,Ok Byung 大韓顎顔面成形再建外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.2

Ossifying fibroma is a relatively slow growing tumor, and likely to have presented for some years before its clinical diognosis. The usually well circumscribed nature of ossifying fibroma in jaws lends itself to relative ease of excision and hence the favorable therapeutic results. On occasion, however, particulary in juvenile patient, if maxilla the tumor assumes an aggressive behavior. In that case, because the tumor grows invasively, resection with a margin of healthy tissue is indicated. The case presented is 34 - year old female. The patient had noticed a gradual swelling of the right side of the face approximately 2 months in duration correlation with a intermittent pain on the right maxillary molar area. Palpation disclosed firm swelling on the right anterior and lateral walls of the maxillary sinus extended to the maxillary tuberosity area. The radiographic examination revealed soft tissue mass with multiple dense round calcifications with destruction of anterior and posterolateral wall of the right maxillary sinus and right alveolar process, and hard palate. The mass totally obliterated maxillary sinus and extended to the pterygopalatine fossa. The histologic diagnosis from the biopsied specimen revealed ossifying fibroma. The tumor mass was resected by subtotal maxillectomy procedure due to a recent rapid infiltrative growth. In 5 months of postoperative follow - up period, the patient has favorable prognosis.