Appropriate follow-up period for odontogenic keratocyst: a retrospective study

정휘동,임정환,김형준,남웅,차인호 대한악안면성형재건외과학회 2021 Maxillofacial Plastic Reconstructive Surgery Vol.43 No.-

Purpose: The aim of this study was to conduct epidemiologic investigations on the pattern of the lesion anddifferences between treatment modalities in terms of recurrence by reviewing follow-up records to form a basis forplanning patient follow-up visits. Materials and methods: In this retrospective, single-center cohort study, 266 patients diagnosed with odontogenickeratocyst between 1993 and 2013 were included. Medical records and radiographic images were analyzed for agedistribution, occurrence site and size, treatment modalities, and recurrence. Results: The average age at first diagnosis was 33.1 years, and the male to female ratio was 1.33:1.00. The highestrate of incidence was in the third decade followed by the fourth, second, and fifth decades. The incidence in themaxilla was 34%, and 66% in the mandible. Mandibular ramus was most commonly involved. Lesions between 3and 6 crowns were the most common, and the rate of recurrence increased with size. Enucleation afterdecompression had higher rate of recurrence (35.8%) than enucleation (27.1%), but there was no statisticalsignificance. Conclusion: The recurrence of odontogenic kerotocyst (OKC) was significantly associated with large size,multilocular form, and surgical procedure. A 10-year follow-up period is recommended to determine any recurrenceof OKC.

선천성 기형환자에서의 악교정수술 적용과 수술 증례 분석

정휘동(Hwi-Dong Jung),정영수(Young-Soo Jung) 대한치과의사협회 2012 대한치과의사협회지 Vol.50 No.11

Distraction osteogenesis and orthognathic surgery are the widely used surgical methods for treating hemifacial microsomia and cleft lip and palate, the representative forms of congenital deformity. Distraction osteogenesis is an outstanding treatment of choice when more traction is needed than what can be achieved by general orthognathic surgery. However, the stability of distraction osteogenesis has not yet been established, and in most of the cases, additional orthognathic surgery is mandatory. Moreover, the difficulty in precise control of the traction directions is another disadvantage of distraction osteogenesis. Therefore, it would be desirable not to conduct distraction osteogenesis when the patient is suitable for an orthognathic surgery. Also, distraction osteogenesis should be recognized as an accessorial method of treatment, and be used restrictively.

편측 구순열비의 교정술: Rotation Advancement 원칙에 근거한 Mulliken의 방법

정영수,이규태,정휘동,Jung, Young-Soo,Lee, Gyu-Tae,Jung, Hwi-Dong,Mulliken, John B. 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.2

모든 환자들은 구순접합술을 시행 받았고 구순 및 구개열 유아들은 악정형장치인 Latham을 사용하였다. 수술의 기술적 변화들은 앞서 설명하였다. Columella 부위의 높은 rotation과 releasing incision은 내측 입술 부위를 충분히 길게 해주고, advancement flap이 phitral column 상방으로 최소로 침범되게 하여 균형적인 입술을 만들 수 있다. 또한 구륜근을 외번시켜 philtral ridge를 형성하고, 작은 unilimb Z-plasty을 구순측 Cupid's bow handle 높이에 맞게 시행 후, vermilion-cutaneous junction에서부터 상방으로 cutaneous closure 시행한다. 변위된 alar cartilage는 nostril rim incision을 통해 동측 upper lateral cartilage에 매달며, Alar base는 anterior-caudal septum의 위치, sill의 설정 그리고 외측 vestibular web 제거를 포함하여 3차원적으로 설계하여 치료해야 한다. 이번에 소개한 Mulliken의 치료법이 환자들과 외과의사들에게 많은 도움이 되기를 바란다. This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

편측성 불완전 소구순열의 치료

박혜정,정휘동,정영수,Park, Hye Jeong,Jung, Hwi-Dong,Mulliken, John Butler,Jung, Young-Soo 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.3

Cleft lip arises from congenital underdevelopment with various degrees and patterns. Mulliken named a unilateral incomplete cleft lip with no severe cleft as a lesser-form cleft lip and categorized it into three subgroups. Anatomically categorized subgroups are minor-form, microform, and mini-microform cleft by the extent of vermilion-cutaneous dysjuntion. The vermillion cutaneous notch is more than 3 mm from the regular Cupid's bow peak for minor-form, less than 3 mm for microform, and almost no gap with discontinuity on the vermillion cutaneous border for mini-microform. The treatments are rotational advancement flap for minor-form, double unillimb Z-plasty for microform, and vertical lenticular excision for mini-microform, respectively. This article aims to present the literature review about the incomplete lesser form cleft lip classified by Mulliken and to report our experiences.

입천장내근육성형술을 동반한 Two-Flap Palatoplasty를 이용한 구비누공 폐쇄

정서연,정승원,정휘동,정영수 대한구순구개열학회 2014 대한구순구개열학회지 Vol.17 No.1·2

The purpose of cleft palate repair surgery is to recover normal mastication, swallowing and phonation function. In cleft palate patients, soft palate muscles are abnormally arranged and attached posteriorly to the hard palate. Intravelar veloplasty for reconstruction of muscle sling is required for these patients for separation of oral cavity from nasal cavity and the sphincter function of the pharynx. Closure of large oronasal fistula is very challenging for Oral & Maxillofacial surgeons, and the rate of recurrence after surgery has been reported to be 11-25%. Various methods for closure of oronasal fistula have been reported. The most important technical principle is to perform tension-free sutures of the mucoperiosteal flaps. We report 2 cases oronasal fistula closure using of two-flap palatoplasty with intravelar veloplasty with discussion on the surgical keys of this procedure.

화상에 의한 소구증 환자의 구각부 재건 - 증례보고 -

최영달,변성수,정휘동,남웅,김형준,Choi, Young-Dal,Byun, Sung-Soo,Jung, Hwui-Dong,Nam, Woong,Kim, Hyung-Jun 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.6

The lips and corners of the mouth are not only important for appearance but are also essential for facial expression, speech, and nutrition. Defects in these areas can be caused by congenital clefts of the lip and face, trauma, infection, cysts, and excision of benign or malignant tumors. Numerous techniques have been introduced for reconstruction of the lips and corners of the mouth, and in particular, techniques such as the Kazanjian Roopenian I and II, Converse method, Zisser method, Platz and Wepner method. Gillies and Millard method are commonly utilized for elongation and reconstruction of the mouth corner. Few reports exist in the oral and maxillofacial surgery literature regarding correction of microsomia and reconstruction of the corners of the mouth. As such, the authors report a case of the corners of the mouth elongation in a patient with burn-induced microstomia using the Converse flap which yielded a satisfactory outcome.

회전-신전법의 Mulliken 변형을 이용한 편측 구순열 수술

이규태,임재석,정휘동,정영수 대한구순구개열학회 2012 대한구순구개열학회지 Vol.15 No.1

Unilateral cleft lip is not a simple and independent problem in all aspects. nasal deformity results from the cleft lip, maxillary hypoplasia, and abnormal muscular pull on the nasal structures, including abnormal muscular tension on the alar base and abnormal position of the orbicularis oris muscle. Its gross and histopathologic characteristics include widening of the alar base, a midline deviation of the columella and septum to the noncleft side, dorsal displacement of the dome, lateral rotation of medial crura, buckling of the alar cartilage, and underdevelopment of the pyriform aperture. Since Dr. Millard first presented his method for repair of the unilateral cleft lip and nasal deformity in 1955, no other technique has gained as much popularity as the rotation-advancement principle. Principles established more than 50 years ago and techniques are evolving continuously. Unlike earlier procedures, this repair gives the surgeon the opportunity to manipulate the individual cleft elements through various modifications while maintaining Millard’s original surgical and anatomical goals. Although this strategy is applied worldwide, successful execution is variable and highly operator dependent. Millard and many other surgeons have made technical variations to adjust the procedure to each specific patient, to address some of its faults, and to gain new advantages. We will review the Mulliken’s modifications that Dr. Millard made to his original rotation-advancement principle and inform cases applied modifying the rotation-advancement principle.

이차 구순열비변형의 비성형술시 비주 지지대 확보를 위한 allogenic dermis 사용

이용빈,조은,정휘동,정영수 대한구순구개열학회 2016 대한구순구개열학회지 Vol.19 No.2

Rhinoplasty of cleft lip patients is often unsatisfactory because of problems resulting from cartilage weakness and shortness of the columella. The columella must have a balanced position in relation to the adjacent alar rim and edial crura. Construction of the columella by cartilaginous strut can provide structural support for the lower lateral cartilage. The columellar strut is a popular and effective form of graft. For most surgeons, an autogenous artilage graft is the first choice in rhinoplasty because of its resistance to infection and resorption. On the other hand, an allogenic dermal graft not only has the advantage of averting donor site morbidity but also are resistant to infection, resembling autogenous cartilage grafts. In this article, we report 2 cases of rhinoplasty using allogenic dermis(MegadermTM) in secondary cleft lip nasal deformity patients.

완전 편측성 구순열 및 불완전 구개열 신생아에서 술전 비치조 정형장치를 이용한 치료 - 증례보고

홍석환,이용빈,정휘동,정영수 대한구순구개열학회 2016 대한구순구개열학회지 Vol.19 No.2

Cleft lip and palate are the most common congenital facial deformities. Surgical approach alone cannot resolve all the various problems in patients with cleft lip and palate. The concept of presurgical infant orthopedics (PSIO) was first introduced by McNeil to reduce the interval of the cleft and to facilitate surgery. In addition to the traditional PSIO concept, Grayson et al. also reported that a presurgical nasoalveolar molding appliance (PNAM), capable of non-surgically expanding short columella and correcting nasal tip cartilage deformities. The newborn with unilateral cleft lip and palate was referred from the department of Neonatology to the department of Oral & Maxillofacial Surgery(OMFS) for evaluation & treatment. The PNAM was applied 19 days after birth. Then the PNAM was applied for 99 days before the operation and the primary lip and nose repair was performed at 118 days after birth. From the result of this case, we could see that preoperative application of PNAM may provide improvement in the esthetics of nasolabial complex and can minimize the scar tissue after surgery by reducing tension on the surgical area. It can also be helpful to normalize the shape of the nose through correcting of the nasal cartilage and extension of columella.

편측성 완전 구순열에서 악정형 장치로서 Latham 장치와 PNAM 장치의 순차적 이용- 증례보고

임재석,박진후,정휘동,정영수 대한구순구개열학회 2017 대한구순구개열학회지 Vol.20 No.1

Severe cleft forms are associated with severe nasolabial deformities, and present a significant surgical challenge in order to achieve functional and aesthetic outcome. The aim of presurgical infant orthopedics (PSIO) is to reduce the severity of the cleft (e.g., nasal deformity, cleft size), thereby improving surgical results, reducing the need for lip and nose revisions. Since the concept of Presurgical infant orthopedics (PSIO) was first introduced by McNeil in 1950, various forms of orthopedic devices with different mechanics have been developed. The Latham device applies active force which align the maxillary segments and reduce the cleft size prior to definitive surgery. The Presurgical Nasoalveolar Molding (PNAM) device corrects the position of the nasal tip, alar base, philtrum, and columella improving nasal appearance, which can minimize the need for secondary nasal surgery. In this article we report sequential use of Latham device and Presurgical nasoalveolar molding (PNAM) device in unilateral complete cleft lip and palate patient