In this article, the measurement unit of CSF cell count was given incorrectly. It should be “cells/mm³” instead of “cells/cm³”.

This correction is being published to correct the order of the last authors' name in the above article.

Intraoral approach for mandible angle contouring has been popularized because it can avid external scars on the face. However it is difficult to perform safe and precise as condylar fracture, asymmetry, undercorrection, and overcorrection. Among these complications, the main reason of condyle fracture and asymmetry may be caused by the wrong perception of the pathway of osteotomy. To be free form such wrong perception of the osteotomy pathway, we designed guiding instrument for osteotomy of the mandible angle and used this guiding instrument in 14 patients successfully.
Cicatrix ; Humans ; Mandible ; Osteotomy

There is more incidence of epicanthal fold in oriental and sometimes the epicanthal fold serves as an unacceptable appearence, so many seek cosmetic improvement in the medial canthal area to eliminate the epicanthal folds. Epicanthoplasty can give the aesthetic improvement by lenthening the palpebral fissure, thus producing the image of a larger and open-eye and especially it can enhance the aesthetic result of the double-lid procedure, but the epicanthal area is delicate and prone to produce a noticeable scar after epicanthoplasty, which is due to multiple incision and undue tension during the epicanthoplasty. We present a simple, tension free, and reproducible method of Z-epicanthoplasty based on our experience with 84 cases performed during the past 10 months in oriental eyelids. The advantages of this procedure are simplicity in design and minimal scaring produced in the medial canthal area without fear of hypertrophic scar as compared with complexed W-plasty, four flap, or Y-V plasty, which require multiple incision or undue tension and often creates unsightly scarring.
Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Incidence

"Low-set" ear is the deformity which is related with the gentic diseases such as hemifacial microsomia, Turner's syndrome, neurofibromatosis and with the old hemangioma. Much attention is paid to correction of congenital or posttraumatic external ear deformity, but there is little description about the techniques for repositioning of the malpositioned ear. We successfully corrected 2 cases of the "low-set" ear deformity associated with neurofibromatosis using a strip of fascia lata; 1. As a suspension from concha cartilage to pericranium and deep temporal fascia. 2. As a sling form around the auricular cartilage fixating to pericranium and deep temporal fascia. With the above techniques, we can get good results of relatively permanent repositioning of the malpositioned ear even after 6 months or more postoperatively.
Cartilage ; Congenital Abnormalities ; Ear ; Ear Cartilage ; Ear, External ; Fascia Lata ; Fascia ; Goldenhar Syndrome ; Hemangioma ; Neurofibromatoses ; Turner Syndrome

Blowout fracture is frequently encountered in facial bone trauma. It used to be reduced through, so called, subcilliary or transconjunctival incisions. Although these incisions facilitate to explore the bony orbital walls, they can induce some unwilling changes of soft tissues due to skin incision itself. The soft tissue of lower lid area may be more susceptible to trauma, even surgical than the lateral canthal area due to its fine structure. Seven patients with blow out fractures were treated by endoscopic surgery through small incision of lageral canthal area. They have variable degree of orbital fat herniation, diplopia, and bony defect. Through small lateral canthal skin incision, endoscopy was easy to identify fracture site and made it possible to introduce the sealing material for bony defect. This procedure left inconspicuous scar in the lateral canthal ares. Moreover, it seemed to be avoidable the possible hazardous external changes over the lower orbital area, and to be simultaneous successful treatment.
Cicatrix ; Diplopia ; Endoscopy ; Facial Bones ; Humans ; Orbit ; Orbital Fractures ; Skin

Oculopharyngeal muscular dystrophy is a hereditary, autosomal dominant, slowly progressive disorder with middle age onset, major symptoms are ptosis and dysphagia mainly due to selectively involved levator palpebrae and the pharyngeal muscles. Progressive, usually symmetric blepharoptosis with or without dysphagia appears in middle age. Limb muscular weakness can be noted in some patients. This report describes 4 cases of oculopharyngeal muscular dystrophy in one family. All patients presented with slowly progressive bilateral ptosis and slight weakness of facial and bulbar muscles. The ptosis was severe in all cases at the time of surgery and levator resection was done via transcutaneous approach. The surgical result was satisfactory with all patients after 1 year follow-up.
Blepharoptosis ; Deglutition Disorders ; Extremities ; Follow-Up Studies ; Humans ; Middle Aged ; Muscle Weakness ; Muscles ; Muscular Dystrophy, Oculopharyngeal ; Pharyngeal Muscles

Deficiencies of the tubercle, philtral ridges and philtral dimple are common secondary deformities after cleft lip repair, and the reconstruction of these three elements are important for an aesthetically pleasing upper lip. Although various techniques have been described to deal with tubercle deficiency, absence of phitral ridges and phitral dimple, a technique which is simple and can create the tubercle, phitral ridges and philtral dimple in a single operation is rare. We present a technique which contains (1) V-Y mucosal advancement flap, (2) vertical rearrangement of the central portion of the orbicularis oris muscle, (3) adhesion of skin to the created dimple in orbicularis oris muscle for reconstruction of the philtral dimple and (4) in some cases, submucosal graft for reconstruction of the philtral ridge. This technique was performed in eighteen patients who had mild to moderate deficiency of the tubercle and produced satisfactory results.
Cleft Lip ; Congenital Abnormalities ; Humans ; Lip ; Skin ; Transplants

The authors had been operating on bilateral cleft lip, alveolus, and nose by the mulliken method to correct the synchronous nasolabial repair without producing a fork flap, but found several problems with this method when applied to oriental infants. To create a more appropriate surgical technique for Korean infants, we made several modifications in the Mulliken method. There are six parts of modified method. First, the dislocated alar cartilages were approached through the base of prolabial flap instead of alar rim and vertical tip incisions. Second, we made short incision of lateral lip segments between both alae. Third, the dissection of the orbicularis oris muscle was conservatively. Fourth, we sutured the alar cartilages to one another and suspended them to the upper lateral cartilage by means of cinching. Fifth, the prolabial flap was made larger than suggested by Mulliken. Sixth, we sutured the prolabial flap to lateral lip segments, lower by as much as 1 mm. We corrected bilateral cleft of 8 males and 6 females aged between 3 and 6 months(mean 4.4 months) with modified Mulliken method. A technique for primary lip and nasal correction are detailed. An aesthetically almost definitive lip and nose were obtained in all cases after an average follow-up period of 25.5 months.The nasal length, nasal tip projection, and columella width were appropriate, median vermillion tubercle was well formed, and the shape of the philtrum was natural. However, the tip of the nose pointed cranially so that it made the nasolabial angle large, and the interalar base distance had the tendency to become wider with time.
Cartilage ; Cleft Lip ; Female ; Follow-Up Studies ; Humans ; Infant ; Lip ; Male ; Nose

Submucous cleft palate is defined as a bifid uvula, palatal muscle diastasis, and a notch in the posterior surface of the hard palate. Since submucous cleft palate is presently felt to be of clinical relevance only in the presence of velopharyngeal inadequacy, the evaluation and diagnosis of occult submucous cleft palate are only pursued if the patient has velopharyngeal incompetency. The age for surgical correction of submucous cleft palate is one of the most important factors determining the speech outcome of surgical treatment. The available evidence suggests that earlier repairs yield better speech results than late repairs and that later treatment is associated with a higher rate of velophryngeal incompetency. But, treatment of patients with submucous cleft palate depend on the diagnosis of the velopharyngeal incompetency and therefore nearly always occurs later than the time for optimal treatment. Twenty submucous cleft palate patients aged 5 to 12 years with normal hearing and intelligence who visited Yonsei university plastic and reconstructive surgery department from January 1993 to January 1996 were evaluated as an experimental group and nineteen children aged 7 to 12 years with normal hearing and intelligence who randomly selected from the Hyosung elementary school were evaluated as a control group.In this study we analyzed the cranial base and soft tissue structures in submucous cleft palate using velopharyngogram. The results are summarized as follows: 1. The survey of the nasopharynx with submucous cleft palate indicated that the angle of cranial base was outside the range toward the obtusity considering analysis of covariance. 2. The pharyngeal angle(Ba-S-PNS) exceeds normal limits and the ratio of anteroposterior distance of nasopharynx with submucous cleft palate is larger in submucous cleft palate group considering analysis of covariance. 3. The patients with submucous cleft palate have relatively short soft palate in the neutral state and during phonation. 4. The soft palate of submucous cleft palate patients has lessened mobility in submucous cleft palate group. 5. The distance between both lateral pharyngeal wall shows shorter in submucous cleft palate group only during "Su" phonation. From these result, the submucous cleft palate patients have relatively obtuse cranial base and wide nasopharynx of deficient velum with limited mobility, so velopharyngeal incompetency is inevitable.
Child ; Cleft Palate ; Diagnosis ; Hearing ; Humans ; Intelligence ; Nasopharynx ; Palatal Muscles ; Palate, Hard ; Palate, Soft ; Phonation ; Plastics ; Skull Base ; Uvula