PURPOSE: An osteoma is one of the common benign tumors that penetrate the nasal portion, paranasal and frontal sinus. This tumor is mostly found by radiation test accidentally, however in rare cases; it can be found to be touched or with its symptoms as the tumor grows. We report this case since we found and healed the benign tumor which was affecting orbit and the both sides of fronal sinus. METHODS: A 19 year old female patient visited to our hospital due to the mass on her forehead. The symptoms began 3 years ago but no special symptom was found except for touchable mass. She was diagnosed as the osteoma of superior orbital parts and both sides of frontal sinus using X-ray and CT scanning. The size of osteoma was 5x2.5x3.5cm and indicated the patterns penetrated to the right side of orbital region. The osteoma excision was conducted with coronal incision and wide area of defect part in frontal sinus and superior orbital part were reconstructed by cranial bone graft and resorbable fixation plates. RESULTS: The patient recovered without any postoperative infections or complications and symptoms. Dysaesthesia was found on her frontal area but improved in 1 month after the surgery. CONCLUSION: The occurrences of osteoma in frontal sinus are rare and can be treated with conservative methods if there are no infections and symptoms. We report this case since we found the benign tumor, which was affecting orbit and the both sides of fronal sinus and healed it with coronal resectomy without any complications.
Female ; Forehead ; Frontal Sinus ; Humans ; Orbit ; Organic Chemicals ; Osteoma ; Transplants

Cornelia de Lange syndrome was first described by Brachmann in 1916 and later reported by Cornelia de Lange in 1933. It is a rare malformation and retardation syndrome of unknown causes, with characteristic abnormalities including microcephaly, short stature, heavy eyebrows, long eyelashs, strabismus, small nose with anteverted nares, long philtrum, micrognathia, hypoplastic nipples and umbilicus, flexion contracture of elbows, micromelia and hirsutism. Rare cases of possible autosomal-recessive and autosomal-dominant inheritance have been reported. Severe growth and mental retardation are common. Aspiration, apnea, bowel obstruction, and cardiac defects constitute significant dangers during infancy. Failure to thrive is the rule. Also they have common anomaly of upper & lower extremity, example of proximally placed thumbs, clinodactyly of the fifth finger and syndactyly of the second and third toes. We present a case of Cornelia de Lange syndrome, associated with syndactyly of the great toes and the second toes.
Apnea ; Contracture ; De Lange Syndrome* ; Elbow ; Eyebrows ; Failure to Thrive ; Fingers ; Foot* ; Hirsutism ; Intellectual Disability ; Lip ; Lower Extremity ; Microcephaly ; Nipples ; Nose ; Strabismus ; Syndactyly* ; Thumb ; Toes ; Umbilicus ; Wills

PURPOSE: Varicella-zoster virus (VZV) infection is a common childhood disease. However, old and immune compromised patients are also at risk. Necrotizing fasciitis is a life threatening infection of the subcutaneous tissues, rapidly extending along the fascial planes. It is associated with a significant mortality rate, reported between 20% and 50%, and is therefore regarded as a surgical emergency. The authors treated a patient, who developed skin necrosis of her nose and left hemifacial area, following VZV infection. There are few literatures concerning this case; therefore, we present a rare case with review of literature. METHODS: A 39-year-old woman had shown a localized, painful, multiple bullae and eschar formation in her nose and left hemifacial area for several days. Her skin lesion had rapidly worsened in size and morphology. RESULTS: We diagnosed her as a necrotizing fasciitis, following herpes zoster, and then we performed a debridement of necrotic tissue and took a full thickness skin graft on her nose and left hemifacial area. Now, she was followed up with acceptable aesthetic result after 6 months. CONCLUSION: Secondary bacterial skin infection following VZV, can cause a result in a higher risk of complications. Among the complication, a necrotizing fasciitis of the head and neck is uncommon, and involvement of the nose is even more rare. Through this uncommon case report, we intend to emphasize the fact that early diagnosis of necrotizing fasciitis is very important, since it frequently necessitates surgical treatment which improves morbidity and leads to good recovery.
Adult ; Blister ; Debridement ; Early Diagnosis ; Emergencies ; Fasciitis, Necrotizing ; Female ; Head ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Neck ; Necrosis ; Nose ; Skin ; Subcutaneous Tissue ; Transplants

PURPOSE: To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. MATERIALS AND METHODS: Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal was selected and scanned with 600 DPI resolution. The width of the labial alveolar bone of the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1. The statistical analyses were carried out using SPSS 12.0.1. RESULTS: When the maxillary central incisors remained, the mean labial alveolar bone width were 6.81+/-1.41 mm, 6.46+/-1.33 mm, and 7.91+/-1.33 mm. When the maxillary central incisors were missed the mean width were 5.42+/- 2.20 mm, 6.23+/-2.29 mm, and 7.89+/-2.13 mm. CONCLUSIONS: The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to nasal cavity revealed statistically significant difference (P<0.05).
Alveolar Process ; Dental Implants ; Incisor ; Maxilla ; Mouth ; Nasal Cavity ; Radiography, Dental, Digital ; Specialization ; Tomography, X-Ray Computed

Thermal injury to free flap site can be severe and distressing injuries both for the patients and the surgeon. Thermal injuries to insensate free flaps are known complications often reported. But thermal injuries to free flaps are also occurred in the perioperative period. This study focused on the various factors associated with these injuries. We reported a 36-years old male patient with scalding burn in using warmed saline irrigation who underwent anterolateral thigh perforator free flap due to diabetic foot ulcer on dorsum of left foot. The clinical characteristics of thermal injuries during the free tissue transters are 1) Warmed saline irrigation is often too hot and a temperature excess 48degrees C should be considered very hot saline during the operation. 2) The direct exposure of the microscope light often causes iatrogenic burn, so copiously irrigating the surgical field and readjusting the light source's position or its output intensity are important. Surgeon must be aware that warmed saline irrigation & surgical microscope can cause thermal injury to free flap during the free tissue transfer.
Burns ; Diabetic Foot ; Foot ; Free Tissue Flaps* ; Humans ; Male ; Perioperative Period ; Thigh ; Ulcer

No abstract available.

PURPOSE: Neurofibromas of neuroectodermal origin are commonly found in Von Recklinghausens disease or neurofibormatosis type 1. It is an autosomal dominant disease caused by mutation of the long arm of chromosome 17. It can present from small nodules to disfiguring giant tumor. Plexiform neurofibroma is benign in most cases, but it could be transformed into malignant tumor, which requires surgical excision. To cover the defects after the excision, a number of surgical correction methods are available. This study is to report a surgical correction of disfiguring plexiform neurofibroma using anterolateral thigh free flap for extensive defects after surgical excision of neurofibrona. METHODS: Data of five neurofibroma patients with an average age of 39 including medical history, physical examination, computed tomography, and magnetic resonance imaging were checked. No disease other than neurofibroma were detected. Biopsy on the excised tissues was performed. The follow-up period was 7 to 27 months. RESULTS: The average size of defects after complete excision of neurofibroma was 13x10~25x15cm. Defects were covered by anterolateral thigh free flap, while donor sites were covered by local flap, split thickness skin graft and regional flap. Throughout follow-up, there were no complication, relapse, or any abnormalities. CONCLUSION: Despite various surgical correction methods are applicable to defects after excision on disfiguring plexiform neurofibroma, coverage of massive defects is still challenging in plastic and reconstructive surgeon. We have made five successful cases of surgical correction of disfiguring plexiform neurofibroma using anterolateral thigh free flap.
Arm ; Biopsy ; Chromosomes, Human, Pair 17 ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Magnetic Resonance Imaging ; Neural Plate ; Neurofibroma ; Neurofibroma, Plexiform ; Neurofibromatosis 1 ; Physical Examination ; Plastics ; Recurrence ; Skin ; Thigh ; Tissue Donors ; Transplants

No abstract available.
Carcinoma, Squamous Cell*

No abstract available.
Hypohidrosis* ; Pain Insensitivity, Congenital*

PURPOSE: Self-inflicted wrist laceration is a common injury in the department of hand surgery. The aim of this study was to investigate the clinical characteristics and psychiatric features of self-inflicted wrist laceration using categorization according to wound severity. METHODS: We reviewed 71 patients from 2002 through 2012. All of the patients were grouped into four groups. Data regarding the following characteristics were collected: age, gender, size, structure involved, instruments used, history of previous self-inflicted injury, comorbidities in psychiatric and presentation of follow-up outpatient appointment to the department of plastic surgery and psychiatry. RESULTS: In these patients, approximately 64% of patients were female. About 80% of patients cut their wrist using a knife. And in grade 3-4 injury, percentage of glass injury was relatively high (22%), compared with other grades (3%). Unlike previous studies, patients in grade 3-4 tended to cut their wrist repeatedly. Focusing on psychiatric problems, approximately one quarter of patients had a previous history of self-infliction. In all patient groups, mood disorder was the most common disorder in patients who had a previous psychiatric disorder. But after operation, more than two thirds of patients had not visited department of psychiatry again. CONCLUSION: We identified some other differences among their characteristics. All patients in group also should be evaluated and surgically treated properly. A multidisciplinary approach is required for patients with wrist laceration due to self-injury in comparison to those with laceration due to other causes. Because many of them have previous self-injury experiences and psychiatric disease.
Comorbidity ; Female ; Follow-Up Studies ; Glass ; Hand ; Humans ; Lacerations* ; Mood Disorders ; Outpatients ; Retrospective Studies* ; Self Mutilation ; Suicide ; Surgery, Plastic ; Wounds and Injuries ; Wrist*