We report 2 cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap. In these cases, the main points to cover the defects were as follows: 1. For the contour of zygoma and maxilla, it was well preserved without bone graft which was not used for second stage reconstruction. In first case, for application of artificial eyes and in second case, for operation after full development. 2. For the drainage of paranasal sinuses, we made the nostril with skin graft, and it was well preserved without any complications during follow up. 3. It was sufficient to cover the defect with latissimus dorsi muscle well designed before surgery and thick enough to fill the defect. 4. In second case, the remained defect of palate and maxilla was not covered for the appropriate reconstructions after full development. In conclusions, we experienced two cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap without any complication and with good results.
Drainage ; Eye, Artificial ; Follow-Up Studies ; Free Tissue Flaps* ; Maxilla ; Palate ; Paranasal Sinuses ; Skin ; Superficial Back Muscles* ; Transplants ; Zygoma

Augumentation rhinoplasty using autogenous cranial bone graft (outer table) can be used more successfully than other methods. In patients with congenital or posttraumatic severe saddle nose deformity and lateral deviation, cranial bone graft is an excellent method of augumentation. The advantages of cranial bone graft compared with traditional method of bone graft are summarized as follows; 1. Easy to reach donor site 2. Abundance of material 3. Little pain and functional disability 4. Shorter hospitalization period 5. Inconspicuous donor scar 6. No secondary deformity of donor site 7.Appropriate curvature can be obtained by proper selection of donor site. With the above advantages, we conclude that augumentation rhinoplasty using split cranial bone graft is a good method in correction of congenital or posttraumatic deformity of nose.
Cicatrix ; Congenital Abnormalities ; Hospitalization ; Humans ; Methods ; Nose ; Rhinoplasty* ; Tissue Donors ; Transplants*

Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diagnosis and treatment for more functional results.
Adult ; Child ; Diagnosis ; Hand Injuries* ; Hand* ; Humans ; Parents ; Skin ; Tendon Injuries ; Transplants

No abstract available.
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Soft-tissue expansion is a new surgical technique of providing donor tissue in modern reconstructive surgery. This technique provides a quantity of tissue of similar color, texture, and hair-bearing qualities for reconstruction of adjacent defects. It is known that the expanded skin shows several constant histologic changes including the increase in collagen fibers and vascularity within dermis, and thinning of subcutaneous tissue and dermis. In this study, the author observed serial histologic changes of rabbit skin induced by progressive tissue expansion up to excessive expansion of 6 times. The results are as follows: 1. Changes in the thickness of the epidermis was minimal until 3 times of expansion, but slight thinning was observed at excessive expansion state. 2. The thickness of the dermis was progressively decreased, and collagen fibers in the dermis was rapidly increased in early phase of expansion. 3. The vascularity in the dermis was also progressively increased. 4. The skin appendages showed no structural changes even in excessive expansion. 5. The panniculus carnosus showed no atrophic changes and the thickness was maintained in excessive expansion.
Collagen ; Dermis ; Epidermis ; Humans ; Skin* ; Subcutaneous Tissue ; Tissue Donors ; Tissue Expansion*

Horizontal Mattress Suture Technique on Microvascular Anastomosis of rat (body weight: 200-250 gm) femoral artery was evaluated. The present study was conducted to compare the horizontal mattress suture with simple interrupted suture on the suture time, patency rate of the sutured vessels, and the histological changes of surgical site of the vessel wall during wound healing period. The mean suture time of the vessel wall with horizontal mattress suture technique was 15 min 49 sec ± 2.14, which is significantly shorter than that of simple interrupted suture technique. The patency rate of the sutured vessel in both groups was statistically not different each other till post-operative 3rd day but patency rate of horizontal mattress suture was higher than that of simple interrupted suture at post-operative 3rd week. The histological findings such as intimal noss, medial degeneration and intimal regeneration were similar in both groups.
Animals ; Femoral Artery ; Rats ; Regeneration ; Suture Techniques* ; Sutures* ; Wound Healing

No abstract available.

PURPOSE: Facial paralysis is an uncommon but significant complication of chronic otitis media (COM). Surgical eradication of the disease is the most viable way to overcome facial paralysis therefrom. In an effort to guide treatment of this rare complication, we analyzed the prognosis of facial function after surgical treatment. MATERIALS AND METHODS: A total of 3435 patients with COM, who underwent various otologic surgeries throughout a period of 20 years, were analyzed retrospectively. Forty six patients (1.33%) had facial nerve paralysis caused by COM. We analyzed prognostic factors including delay of surgery, the extent of disease, presence or absence of cholesteatoma and the type of surgery affecting surgical outcomes. RESULTS: Surgical intervention had a good effect on the restoration of facial function in cases of shorter duration of onset of facial paralysis to surgery and cases of sudden onset, without cholesteatoma. No previous ear surgery and healthy bony labyrinth indicated a good postoperative prognosis. CONCLUSION: COM causing facial paralysis is most frequently due to cholesteatoma and the presence of cholesteatoma decreased the effectiveness of surgical treatment and indicated a poor prognosis after surgery. In our experience, early surgical intervention can be crucial to recovery of facial function. To prevent recurrent cholesteatoma, which leads to local destruction of the facial nerve, complete eradication of the disease in one procedure cannot be overemphasized for the treatment of patients with COM.
Adult ; Aged ; Chronic Disease ; Facial Nerve/surgery ; Facial Nerve Diseases/*etiology/*surgery ; Facial Paralysis/*etiology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/*complications ; Retrospective Studies ; Young Adult

Actinomycosis is a chronic suppurative and granulomatous bacterial infection characterized by contiguous spread, abscess formation and sinus tract formation. There are four clinical forms according to the lesional site, as 1) cervicofacial, 2) thoracic, 3) abdominal, and 4) disseminated form. Recently, we experienced a case of 54 year-old patient with left mandibular actinomycosis. The pathognomonic findings of actinomycosis is sulfur granule with multiple filaments in Gram-stain and the treatment of actinomycosis is surgical excision of mass or sinus tract with massive antibiotics (esp. Penicillin) therapy for 6 to 12 months.
Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Bacterial Infections ; Humans ; Penicillins ; Sulfur

Tono-Pen was portable, miniaturized digital electronic tonometer. We compared Tono-Pen with Goldmann applanation tonometer through the mass screen studies on 634 eyes of 317 patients to evaluate the reliability of the Tono-Pen in determining intraocular pressure(IOP). We found 60% of the Tono-Pen readings to be within +/-1.5 mmHg of the Goldmann applanation tonometry readings and 85% to be within +/-2.5 mmHg difference. The correlation coefficient between the readings of the two instruments was 0.85. The Tono-Pen tonometry corresponded well to the Goldmann applanation tonometry in the 11 to 20 mmHg interval. We concluded that Tono-Pen tonometry is very useful in screening test to measure the intraocular pressure.
Humans ; Intraocular Pressure ; Manometry* ; Mass Screening ; Reading