It is difficult to treat the complete cleft lip because of wide cleft and malaligned alveolar process, outward rotation of greater(medial) alveolar segment, and severe nasal deformity. Lip adhesion without presurgical orthopedic appliance was performed on 8 consecutive infants with unilateral complete cleft of the primary palate before denfinitive lip repair with Millard I procedure. Among 8 patients, 6 patients had complete unilateral cleft lip with alveolar cleft only and 2 patients were accompanied with complete cleft palate. All patients had more than a 10-mm-wide lip cleft with alveolar arch discrepancy. Lip adhesions were performed at 1-2 months of age and definitive repair was done at 5-6 months of age. Lip adhesions were performed by Randall's method and cheiloplasty was done by Millard I technique. Satisfactory results of lip and nose were obtained aesthetically in 8 cases after an average follow-up of 32 months. The vertical height of the medial and lateral lip segment were a symmetric appearance, while the vermilion tubercle, philtrum, and Cupid's bow were natural. Disadvantages included increased operating time and the sacrifice of same-lip tissue. In conclusion, preliminary lip adhesion can have better functional, esthetic and emotional results since the disadvantages are minor compared to the advantages.
Alveolar Process ; Cleft Lip* ; Cleft Palate ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Infant ; Lip* ; Nose ; Orthopedics ; Palate

Endoscopic technique have become very popular in plastic and reconstructive surgery. They have provided advantages over previously closed techniques by minimizing scars, soft tissue manipulation and access with excellent visualization and magnification. More than twenty cases of facial bone surgery were performed over the past 3 years by endoscopic assistance. Our series consist of 3 cases of frontal bone contouring, 1 zygoma contouring, 3 fracture of zygoma, 9 fracture of orbit, 4 rhinoplasty for deviated nose. To accomplish this technique, a rigid 4 mm, 30 degree down angled endoscope was used. The frontal bone or zygomatic arch is approached endoscopically through two or three small incisions on the temporoparietal scalp. All endoscopic instrument are then manipulated through these incisions. The approach for zygoma complex, maxilla and mandible needs intraoral incision. Recontouring by a power bur and osteotomy using a small saw are done with endoscopic visual assistance. Rigid fixation requires an additional small incision over the plate for trocar method. The other technique was same with routine standard rhinoplasty procedures. The duration of follow-up ranged 3 months to 27 months. The postoperative course were satisfactory with fewer complication than conventional technique. The extra-time need for the endoscopic procedures was about 1 hour Endoscopically assisted facial bone recontouring, osteotomy and plate fixation can be performed with adequate visualization and direct manipulation of all facial bone. Complications usually associated with extensive incisions and pool visualization may be avoided. This technique may prove to be ideal for aesthetic surgery for facia skeleton with smaller scars and less morbidity.
Cicatrix ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Frontal Bone ; Mandible ; Maxilla ; Nose ; Orbit ; Osteotomy ; Plastics ; Rhinoplasty ; Scalp ; Skeleton ; Surgical Instruments ; Zygoma

From May 1988 to January 1997 authors had experienced 13 cases of recurred blepharoptosis. Previous operative procedures were frontalis muscle suspension in 10 cases and levator resection in 3 cases. Follow up period ranged from 11 months to 9 years. We have treated recurred blepharoptosis using frontalis myofascial flap, orbicularis oculi muscle flap and levator resection in accordance with the postoperative levator function and degree of ptosis of patient and considering previous operative technique. The results were that 12 patients have gained the levator excursion over 7 mm and reduced the height difference between both palpebral fissures less than 2 mm after reoperation (good in 6 cases and satisfactory in 6 cases). From these results we might conclude that the frontalis myofascial flap technique is a good secondary blepharoptosis operation for patient with less than 2 mm of levator function, orbicularis oculimuscle flap technique with 2-4 mm of levator function, levator resection with over than 4 mm of levator function. The expert technique and experience are also important factor for the treatment of recurred blepharoptosis.
Blepharoptosis* ; Follow-Up Studies ; Humans ; Reoperation ; Surgical Procedures, Operative

The extensive knowledge of accurate anatomical morphology and acceptable proportion of the eyelid and orbit should be needed for plastic surgeons. The normal morphological and functional values of eyelids and orbits are variable according to races, sex and ages, and there are a few articles concerning them in Korea yet. The author measured eigt items of morphological and functional values of eyelids in Koreans and statistically analyzed them in 498 individuals including 234 males and 264 females. We divided them into nine age-related groups and measured the values. Especially, we subdivided 10 to 19 year-old group into three subgroup concretely because most of the values in the 10 to 19 year-old group reach the peak level of growth. The mean values in adults were recorded as follows: The horizontal dimension of the palpebral fissure was 27.0 +/- 1.8 mm in males and 26.8 +/- 1,7 mm in females and the vertical dimension of the palpebral fissure was 8.0 +/- 1.0 mm in female. The slant of the palpebral fissure was 7.9 +/- 2.4 degrees in males and 8.8 +/- 2.3 degrees in females and the height of the opened upper eyelid was 12.4 +/- 2.4 mm in males and 12.0 +/- 1.9 mm in females. The height of double fold in closed eye was 6.6 mm in males and 6.5 mm in femals and the intercanthal distance was 38.4 +/- 3.0 mm in males and 38.2 +/- 2.8 mm in females. The interpupillary distance was 64.6 +/- 2.9 mm in males and 63.6 +/- 2.9 mm in females. A double fold was seen in 36.1% of Korean. The average height of the double fold in closed eye was about 6.5 mm. The epicanthus present in 58.6% of Korean eyes and the most commom type was epicantus tarsalis. The growth of eyelids reached the peak level at teenager in a great portion. After the peak level, the changing pattern of eyelids could be divided into 3 groups; the first one was increasing more, the second was stationary, and the third was decreasing gradually. The peak levle of growth reached at 10 to 13-year-old in the vertical dimension of the palpebral fissure, at 14 to 16-year-old in the intercanthal distance, at 17 to 19-year-old in the horizontal dimension of the palpebral fissure.
Adolescent ; Adult ; Continental Population Groups ; Eyelids* ; Female ; Humans ; Korea ; Male ; Orbit* ; Vertical Dimension ; Young Adult

Twenty-five Le Fort fractures accompanying palatal fracture or malocculsion had been studied from October 1990 to May 1997. The patients were analyzed on the basis of classification causes, operative procedure treatment of fracture, status of malocclusion and complication. The most common cause of fracture was a traffic accident and diagnosis was performed by history, physical examination, reontgenogram, and computed tomography. The follow-up period ranged from 5 months to 5 years, averaging 17 months. Internal fixations with plates and screws were performed in 22 cases and external fixations with halo apparatus were used in 3 cases. Intermaxillary fixations with arch bar were applied during the preoperative and postoperative period in all cases. In 6 cases of Le Fort fractures, acylic splints were applied. In 3 cases of palatal fractures, transverse wiring of the palatal arch were also used. Overall 19 of 25 patients were satisfied with the results. Six patients complained about depression of the midface because of undercorrection 4 patients had persisting hypoesthesia of the infraorbital nerve for more than 6 months postoperative. In summary, the dental plast and acrylic splint are very helpful in correcting malocclusion in severe maxillary fractures. Also, in cases of palatal fracture, it is important to minimize maloccusion by rigid fixation or transverse wiring of the palatal arch.
Accidents, Traffic ; Classification ; Depression ; Diagnosis ; Follow-Up Studies ; Humans ; Hypesthesia ; Malocclusion* ; Maxillary Fractures* ; Physical Examination ; Postoperative Period ; Splints ; Surgical Procedures, Operative

No abstract available.
Heel* ; Molluscum Contagiosum* ; Weight-Bearing* ; Zea mays

Marcus Gunn described for the first time a syndrome consisting of unilateral, congenital ptosis and rapid, exaggerated elevation of the ptotic eyelid on movement of the mandible to the contralateral side. The clinical findings and management of 2 patients with Marcus Gunn phenomenon had been reviewed. Preoperative measurement of ptotic amount, levator function by Berke's method, and marginal limbal distance were evaluated. The amount winking of the upper eyelid on primary gaze was graded on as scale from I to III. The operation was performed two patients under local anesthesia, one by unilateral levator resection, one by orbicularis oculi muscle flap. As a result, the correction of blepharoptosis was possible without severe complications. However, moderate degree of jaw-winking, slight undercorrection, transient lagophthalmos was inevitable. The management of patients with Marcus Gunn phenomenon is a challenging endeavor. Therefore, a comprehensive medical and ophthalmological evaluation of the patient and a detailed history are mandatory before undertaking the successful treatment of patients with this syndrome
Anesthesia, Local ; Blepharoptosis ; Blinking ; Eyelids ; Humans ; Mandible ; Mortuary Practice

No abstract available.
Animals ; Rats* ; Vitamin A* ; Vitamins* ; Wounds and Injuries*

PURPOSE: To investigate the clinical and radiological results after primary or revision total knee arthroplasty using fresh frozen femoral head strut allograft for severe bone defect. SUBJECTS AND METHODS: Seventeen patients (18 cases) with severe bone defect were taken primary or revision TKA from 1997 to 2001 using fresh frozen femoral head allograft. 12 cases of revision TKA and 6 of primary TKA were conducted. The average age was 66 years old(55~74) and the follow up period was 29 months(12~63 months). Bone defects were found at proximal tibia in 10 cases, distal femur in 2 and both sites in 6 cases. PCL substituting TKA with extension rod were 15, and PCL retaining TKA were 3. The clinical result was assessed with the knee score of Hospital for Special Surgery(HSS) and for assessment of allograft, simple X-ray film was employed. RESULTS: Average range of motion was increased from 71 degrees to 103 degrees and HSS score was increased from 46(18 ~68) to 83(68 ~91). With 17 of 18 femoral head strut allograft, union was seen and no clinical collapse was present. In one, partial allograft absorption was occured. The preoperative alignment was an average of 7 degrees varus(range 5 degrees~15 degrees) and postoperative alignment was averaged 6.1 degrees valgus(range 3 degrees ~7 degrees). No radiolucent lines were 2 mm or more in width, and there was no case of infection or fracture of allograft. CONCLUSIONS: Femoral head strut allograft was a satisfactory method of managing severe bone defect in primary or revision TKA.
Absorption ; Allografts* ; Arthroplasty* ; Femur ; Follow-Up Studies ; Head* ; Humans ; Knee* ; Range of Motion, Articular ; Tibia ; X-Ray Film

A 7-year-old female was presentd with two black papules and linear pigmentation between papules on the vulva. No other abnormalities were found in her personal and family history. Histopathological examination was consistent with the apocrine hidrocystoma and the pigment in the luminal cells was iron negative and Fontana Masson positive, confirming its melanin nature. We herein report a 7-year-old female patient with pigmented apocrine hidrocystoma occuring on the vulva with the evidence of melanin as the underlying mechanism of the pigmentation.
Child ; Female ; Hidrocystoma* ; Humans ; Iron ; Melanins ; Phenobarbital ; Pigmentation ; Vulva*