Whistle deformity is deficiency of vermilion of the upper lip. It is a common sequelae of primary lip repair. Many methods have been devised to correct this deformity, most using neighbouring normal tissue of the upper lip. Methods such as Z-plasty, Double rotation, V-Y advancement flap, etc., have been commonly used for the correction of unilateral whistle deformity. We found that the V-Y advancement flap with transposition of deepithelialized tissue was more effective for the correction of whistle deformity than the original V-Y advancement flap. We named this new method 'Modified V-Y advancement flap'. The technique has been performed in 5 patients, 9 to 23 years of age, each with a whistle deformity. One years and six months was the longest follow-up period. Satisfactory results have been obtained and here the authors reported along with a review of the current literature.
Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Lip

The purpose of this article is to present the authors experience that simple calculating method of fracture area in blow out fracture. Authors set up a hypothesis that fracture shape is a isosceles triangle, rectangle or diamond shape. It was enable easily to calculating of fracture area with 2D facial CT scan only. Enophthalmos and fracture area of 22 patients was made inspection. We verified our experimental results with student t-test. We first concluded that new simple calculating method is usful but, need further evaluations and patients.
Diamond ; Enophthalmos ; Humans ; Orbit* ; Orbital Fractures* ; Tomography, X-Ray Computed

Malignant melanoma comprises 1.2% of all malignant tumors and more than 90% of malignant melanoma arises in the skin. About 1% of all malignant melanomas occur in the nasal cavity and paranasal sinuses. Mucosal melanoma of head and neck are rare and show poor prognosis. Although melanoma in the oral cavity sometimes tends to be neglected more than similar lesions on the skin and other locations, pigmented melanoma is usually easy to diagnose clinically because of its red to black or brown color and its irregular outline. However, amelanotic melanoma with lack of pigmentation, often defies correct clinical diagnosis initially before confirmation by biopsy. The authors have recently experienced a case showing good clinical result to the present, after total maxillectomy and split thickness skin graft and postoperative radiotherapy in the mucosal amelanotic melanoma involving the nasal cavity and right maxillary sinus, so report this case with a review of literature
Biopsy ; Diagnosis ; Head ; Maxillary Sinus* ; Melanoma ; Melanoma, Amelanotic* ; Mouth ; Nasal Cavity* ; Neck ; Paranasal Sinuses ; Pigmentation ; Prognosis ; Radiotherapy ; Skin ; Transplants

The lateral capsular ligament of temporomandibular joint(TMJ) prevents mandibular condyle from lateral displacement in case of fractures related with condyle. When the condylar fracture with lateral extracapsular displacement occurs, open reduction and reconstruction of capsular ligament must be considered. However, many patients exhibit limitation of functional movements of the TMJ after such surgery. This may be a result of myositis, myospasm, fibrosis of bilaminar zone, adhesion of TMJ capsule. When the joint problem occurs, non surgical treatment must be attempted firstly. But if it fails, the surgical reconstruction must be considered. We reconstructed the lateral capsular ligament of TMJ with E- PTFE(Expanded Polytetrafluoroethylene, Gore-tex(R)) patch after removing scar tissues and adhesions. This surgical method showed improvements in movement as well as the pain of the joint. No side effect has detected from occlusion for about 2 years. There was no foreign body reaction or irritation to the capsule, since E-PTFE was biologically inert. We believe that the E-PTFE patch could be used as primary material of capsular ligament of TMJ reconstruction, insertion material in high tensioned capsule and reinforcement material in weakened capsule.
Cicatrix ; Fibrosis ; Foreign-Body Reaction ; Humans ; Joints ; Ligaments* ; Mandibular Condyle ; Myositis ; Polytetrafluoroethylene ; Temporomandibular Joint*

Keloid is a benign proliferative disease of dermal collagen which extends beyond the original wound. Management of keloids is still controversial. Many different treatment modalities may be used for this purpose, however, no one method has been found completely successful. Therefore, we combined three techinques, which is surgical excision, lesional steroid injection and compression, to improve therapeutic outcomes for earlobe keloids. In the first session, surgical excision of the keloid was performed. It was followed with triamcinolone acetonide injetion to the surgical field on the postoperative one week, and then followed at two weekly interval for two months. Slight pressure was applied by earring for six months. The authors found that a combination of three techniques for treatment of ear lobe keloid is recommended even for the recurrent lesion.
Collagen ; Ear ; Keloid* ; Triamcinolone Acetonide ; Wounds and Injuries

Craniodiaphyseal dysplasia is a rare genetic disorder of bone due to modelling errors of long bones and skull bones. Facial and cranial thickening and distortion are particularly striking in this form. The genetic understanding of this disorder is unsatisfactory. We present one case of Craniodiaphyseal dysplasia involving facial bone, skull that causes nasal obstruction. This 3-year old female who was diagnosed of craniodiaphyseal dysplasia presented abnormal facial figuring, which is excessively thickened cortical bone resulting in very large craniofacial bony structure. The patient sufferred from respiratory difficulty due to complete obstruction of choana. We performed surgical recanalization of choanal atresia by transpalatal approach and gained good postoperative result.
Child, Preschool ; Choanal Atresia ; Constriction, Pathologic* ; Facial Bones ; Female ; Humans ; Nasal Obstruction ; Skull ; Strikes, Employee

Cervical chondrocutaneous branchial remnants are rare and one of several maformations resulting from abnormal development of the branchial apparatus. These lesions are usually located over or near the insertions of the sternocleidomastoid muscles in the lower neck. It is important to recognize that they may be a visible marker for other malformations and/or anomalies. Treatment is complete surgical removal as promptly as possible in order to get an exact histopathological diagnosis. In this article, we report a rare case of cervical chondrocutaneous branchial remnants and some reviews of the literature.
Diagnosis ; Muscles ; Neck

Retrobulbar hematoma is a rare condition caused by direct trauma and postopertive complication. But, if prompt treatments delayed, retobular hematoma can cause catastrophic loss of vision. Proposed mechanism of visual loss by retrobulbar hematoma are increased intraocular pressure, retinal ischemia secondary to central artery occlusion, optic nerve compression and resultant ischemia. When retobulbar hematoma is suspected, medical and surgical treatment are needed. Which includes intravenous osmotic agents, acetazolamide, and beta-blocker eyedrops and prompt surgical exploration, such as lateral canthotomy. We report a case of retrobular hematoma occurred in closed reduction on zygoma fracture of 56-years-old female. In operation, abrrupt mydriasis, exophthalmos, and chemosis are detected and eyeball movement restriction observed. so we consulted these situation to ophthalmologist. He examined the patient and diagnosed as retrobulbar hematoma. So we ceased operation and incised lateral canthotomy promptly and solumedrol 500mg, 15% mannitol 500ml injected intravenously. Postoperative 2 days later, periorbital swelling and chemosis still remained, but mydriasis and eyeball movement restriction are disappeared.
Acetazolamide ; Arteries ; Exophthalmos ; Female ; Hematoma* ; Humans ; Intraocular Pressure ; Ischemia ; Mannitol ; Methylprednisolone Hemisuccinate ; Mydriasis ; Ophthalmic Solutions ; Optic Nerve ; Retinaldehyde ; Zygoma*

The fixation of zygomaticomaxillary complex fracture is accomplished by the various internal placement of interosseous wiring, miniplates, microplate and even absorbable miniplate across properly reduced fracture lines to resist torsional rotation and masticatory force. However, in cases of comminuted compound fracture which makes zygomaticomaxilary complex fixed unstably, asymmetric malar height due to incomplete intraoperative reduction and predictable re-depression of zygoma postoperatively, we can hardly solve the malar asymmetry only by internal fixation device. So we employ the new external traction device which is made of hard board paper, cast, Steinmman pin, and rubber band. It is easy to make and apply it to the patient and morever, it is a dynamic traction method because it can control of traction force by rubber band and control of traction vector variously depending on degree of placement of fracture segment and fracture location, respectively. And it has less limitation to patient's hospital activity. Whereas it makes tiny traction pain during the traction device applied and the patient can feel uncomfortable head tightness. In summary, The authors' external rubber tration device can be used as a simple and convenient method in combination with internal fixation method in the postoperative management of malar symmetry.
Bite Force ; Fractures, Open ; Head ; Humans ; Internal Fixators ; Rubber ; Traction* ; Zygoma

The epiopathogenesis of craniosynostosis remains obscure. According to the studies involved, the conditions observed at birth are very different. In case that a deformity is obvious or the risk of brain compression is possible, strip craniectomy, frontal bone advancement and cranial vault remodeling methods are used. These direct reshaping or remodeling methods are time consuming and require greater use of physical resources and still are not uniformly successful in making skull shape to normal. Distraction of the cranial bone has been studied to solve this problem. This study subsequently included 30 white rabbits aged about 25 weeks. The rabbits were divided in three groups. In group I, a 0.25mm distraction was done every other day after 3 day latency period. In group II, there was a 7 day latency period with the same rate of distraction as in group I. There was a 3 day latency period with a 0.5mm distraction every other day in group III. The contralateral side underwent a sham operation as a control group. During distraction and after consolidation periods, histologic and ultrastructural studies were carried out. And a serial radiologic study was done. As a result, group I and group II showed successful distraction osteogenesis, and we demonstrated the biological and mechanical factor associated with distraction osteogenesis. In group I, despite the short latency period, there was successful bone regeneration. Group III, it also showed successful ossification. During the distraction period, there was a remarkable increase of TGF-beta1 in both groups, especially in periosteum osteoid and newly developed connective tissue. In conclusion, we have demonstrated a useful model of distraction osteogenesis in rabbit skulls, and attempted to evaluate associated biological and mechanical factors.
Bone Regeneration ; Brain ; Congenital Abnormalities ; Connective Tissue ; Craniosynostoses ; Frontal Bone ; Latency Period (Psychology) ; Osteogenesis, Distraction ; Parturition ; Periosteum ; Rabbits ; Skull* ; Transforming Growth Factor beta1