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V-Y Advancement Flap: Aesthetic Reconstruction for Auriculotemporal Keloid Excision
SEOBOMMIEFLORENCE,고효선,권호,정성노 대한미용성형외과학회 2017 Archives of Aesthetic Plastic Surgery Vol.23 No.3
Keloid scars are commonly found on the ears. Treatment modalities include compression, intralesional steroid injection, and surgical excision with or without radiotherapy, depending on the size and location of the keloid scar. Excision may be a curative solution, but it always requires the immediate reconstruction of the excised defect. Herein, we report the case of a keloid scar located at the helical base of the auriculotemporal sulcus that was treated by excision and a V-Y temporal advancement flap.
Successful replantation of an amputated helical rim with microvascular anastomosis
SEOBOMMIEFLORENCE,최혁준,이민철,정성노 대한두개안면성형외과학회 2018 Archives of Craniofacial Surgery Vol.19 No.4
Replantation using microvascular anastomosis is considered to be the optimal method in treating the amputated ear in terms of resulting color, texture, and shape. Only a few cases of ear replantation have been reported because it is anatomically difficult to identify suitable vessels for anastomosis. We successfully replanted the amputated helical rim of the ear using single arterial anastomosis. A 37-year-old man had his helical rim amputated by a human bite. The amputee was about 4× 1 cm in dimension, composed of skin and soft tissue including auricular cartilage. Replantation was performed anastomosing a small artery of the amputee with a terminal branch of the posterior auricular artery. After replantation, intravenous heparinization was performed and prostaglandin E1 and aspirin were administered. Venous congestion was decompressed by stab incisions applied with heparin solution soaked gauze. Venous congestion of the amputee slowly began to resolve at 4 days after the operation. The amputated segment of the helical rim survived completely with good aesthetic shape and color. The authors propose that performing microvascular anastomosis should be attempted especially if it is possible to detect vessels on cut surfaces of ear amputee and stump. Proper postoperative care for venous congestion, arterial insufficiency, and infection should be followed for amputee survival.
Skeletal cavernous hemangiomas of the frontal bone with orbital roof and rim involvement
SEOBOMMIEFLORENCE,강교준,정성노,변준희 대한두개안면성형외과학회 2018 Archives of Craniofacial Surgery Vol.19 No.3
Skeletal cavernous hemangiomas are rare, benign tumors that may involve the supraorbital rim and orbital roof. However, such involvement is extremely rare. We report a case of skeletal cavernous hemangioma of the frontal bone involving the orbital roof and rim. En bloc excision and reconstruction, using a calvarial bone graft for the orbital roof and rim defect, was performed. It is important not only to perform total excision of skeletal cavernous hemangiomas, but to properly reconstruct the defects after the total excision since several complications can arise from an orbital roof and rim defect.
Spindle Cell Lipoma: A Rare, Misunderstood Entity
SEOBOMMIEFLORENCE,오득영 대한두개안면성형외과학회 2014 Archives of Craniofacial Surgery Vol.15 No.2
Spindle cell lipoma, a rare variant of lipoma, is a benign tumor found in the posterior neckand shoulder. A 24-year-old man with a close family history of malignant lymphoma hadpresented with a large, firm, nodular mass found in the right supraclavicular area. Excisionof the deeply located mass revealed a pale yellow, rubbery nodule which grosslyresembled an enlarged lymph node, with a variant of lymphoma as a primary suspect. However, pathological studies revealed the lesion to be a spindle cell lipoma. Althoughatypical in location, spindle cell lipoma should always be kept in differential diagnosis of anewly-noted soft tissue mass, as this entity may be easily cured by simple excision.
Unusual Sjögren’s Syndrome with Bilateral Parotid Cysts
SEOBOMMIEFLORENCE,오덕영,곽성기,Rock Kuen Ju 대한두개안면성형외과학회 2014 Archives of Craniofacial Surgery Vol.15 No.2
Sjögren’s syndrome is a chronic autoimmune exocrinopathy that destroys salivaryand lacrimal gland tissue. We report an unusual case of this disease in a 54-year-oldwoman who presented with multiple and bilateral parotid cystic masses. The multiple,small, bead-like cysts were clearly evident in the computed tomography sections inthis patient, a visible reminder that this may be the initial presentation in a patient withSjögren’s syndrome. As the case illustrates, Sjögren’s syndrome should be included inthe differential diagnosis of multiple and bilateral cystic parotid lesions.
A New Method of Umbilical Transposition
SEOBOMMIEFLORENCE,김성연,한현호,문석호,이종원,안상태,오득영 대한미용성형외과학회 2017 Archives of Aesthetic Plastic Surgery Vol.23 No.1
Background Creating a natural-looking umbilicus during closure of the donor-site in abdominally based free flap breast reconstruction is a factor of satisfaction for both the patient and surgeon. We present a simple method of umbilical transposition that results in an aesthetic, natural-looking umbilicus. Methods From March 2011 to November 2014, fifty three consecutive female patients received abdominal flap breast reconstruction. Twenty patients (from March 2011 to February 2013) underwent umbilical transposition through a cross like incision in the abdominal flap, with fascial fixation sutures but no dermal flaps. Thirty three patients (March 2013 to November 2014) received umbilical transposition in the following method. An oval-shaped incision is made at the location of the new umbilicus on the abdominal flap. This oval is deepithelialized, and full-thickness incisions are made at the 2, 6, and 10 o’clock directions to create three triangular dermal flaps. These are pulled down to the abdominal fascia using sutures that pass through the umbilical stalk and the abdominal fascia at the 3, 9, and 12 o’clock directions. This results in an umbilical stalk lined with dermal flaps, creates a natural periumbilical concavity, and anchors the abdominal flap inward to minimize tension. The cranial flap enhances superior hooding. Results Patient and surgeon satisfaction, surveyed 2 months after surgery with a satisfaction scoring system, were higher in the dermal flap group. Conclusions The technique using three dermal flaps in an oval skin incision is simple, relatively easy to learn, and results in an aesthetic, natural-looking umbilicus.
이준용,서정화,정성노,SEOBOMMIEFLORENCE 대한두개안면성형외과학회 2021 Archives of Craniofacial Surgery Vol.22 No.6
Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at followup 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.
최종윤,서정화,차원진,SEOBOMMIEFLORENCE,정성노 대한두개안면성형외과학회 2021 Archives of Craniofacial Surgery Vol.22 No.6
Reconstruction of submental defects is a challenge that needs to be approached carefully, since many important anatomical structures are located in this small space. Both aesthetic and functional outcomes should be considered during reconstruction. In this report, we describe a case where a superficial branch of the transverse cervical artery (STCA) perforator propeller flap was applied for coverage of the submental area. An 85-year-old woman presented with a 3-cm ovoid mass on her submental area. We covered the large submental defect with a STCA rotational flap in a 180° propeller pattern. The flap survived well without any complications at 1 year of followup. A STCA propeller flap is a useful surgical option in reconstruction for defect coverage of the submental area.
간내 담관암 및 총간동맥 절제술 후 대복재정맥편을 이용한 좌간동맥 재관류 증례
최종윤,정이룸,최장연,김기환,정성노,SEOBOMMIEFLORENCE 대한수부외과학회 2020 대한수부외과학회지 Vol.25 No.2
담관암의 수술적 절제 시, 통상 간내 혈관에 대한 절제를 같이 시행하는 경우가 많다. 절제 후 간의 즉각적인 재관류가 필수적이지만, 기존의 혈관이 손상되었을 경우, 이에 대한 재건에 어려움이 있다. 본 증례의 경우 종양 절제 시 총간동맥의 일부가 같이 절제되었으며, 잔존하는 혈관내피조직 또한 손상되어 있었다. 이에 저자는 대복재정맥편을 이용하여 잔존하는 좌간동맥과 위십이지장동맥 사이의 성공적인 재관류를 회복하였기에 이를 보고하고자 한다. Resection of biliary tract malignancies may require resection of the hepatic vasculature. While immediate revascularization of the liver is necessary, reconstruction is difficult when the original vessels are unavailable. We document a case in which a segment of the common hepatic artery was excised during tumor resection and the remaining proximal vessel displayed intima dissection. A greater saphenous vein was placed as a bridge between the remaining left hepatic artery and gastroduodenal artery for successful revascularization.