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Dong Ju YOON ; So Min HWANG ; Yong Chan BAE

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):147-150.

Kimura's disease is a rare chronic inflammatory condition characterized by proliferation of vascular endothelial cells, lymphoid infiltration, and mixed inflammatory cells infiltrated with numerous eosinophils. That was known in Western literature as angiolymphoid hyperplasia with eosinophilia and many reports have used the terms synonymously. But the histological features between the 2 disorders have been proved to be distinctive and the 2 terms should not be used synonymously. A case of huge sized(24x12x10cm) Kimura's disease, the patient was 20-year-old male who has painless soft mass on his right cheek. Preoperatively, proteinuria(2+), serum eosinophilia(27.7%), increased serum Ig E(above 2500 IU) were noted in laboratory tests. Histologically, mixed inflammatory cells infiltrated with numerous eosinophils and reactive lymphoid follicles with germinal center were observed, and the proliferation of typical high endothelial venules was observed, also. He was treated by surgical excision of mass, systemic steroid therapy, and focal radiotherapy. During the follow-up of 3 years, the lesion was not recurred and no proteinuria, decreased serum eosinophilia and serum Ig E were noted in laboratory test. We experienced the treatment of huge sized Kimura's disease without recurrence and a case is presented with the review of literature.
Angiolymphoid Hyperplasia with Eosinophilia ; Cheek ; Endothelial Cells ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Germinal Center ; Humans ; Male ; Proteinuria ; Radiotherapy ; Recurrence ; Venules ; Young Adult

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A Case of Atypical Cavernous Hemangioma Arising from the Parotid Gland.

Sang Seop SOHN ; Han Koo KIM ; Seung Han KIM ; Seung Hong KIM ; Tae Jin LEE

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):143-146.

Cavernous hemangioma is about one-tenth as common as capillary hemangioma, although congenital, is often not apparent at birth and may undergo a rapid growth phase during the 6 months of life. It arises from skin layers to muscles, bones or central nervous system. Cavernous hemangioma is much less likely to undergo spontaneous involution and tends to have a more aggressive course, and may result in complications related to its location. The authors experienced a case of atypical cavernous hemangioma which arose from the left parotid gland at adult onset, its size was wax and wane without any symptoms or complications and its shape was characteristically dumbbell-like, so report this case with a review of literatures.
Adult ; Central Nervous System ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Humans ; Muscles ; Parotid Gland* ; Parturition ; Skin

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Clincal Experience of the Median Mandibular Facial Cleft.

Hee Dong SON ; Kyoung OH ; Keun Cheol LEE ; Jung Min PARK ; Jeong Tae KIM ; Seok Kwun KIM

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):139-142.

A median mandibular facial cleft(Tessier 30) is a rare congenital anomaly. It was first described by Couronne' in 1819, and classified by Tessier as a type 30 craniofacial cleft in 1976. Recently, Oostrom et al have reported a new embryologic hypothesis and subdivision. They reported that the hypoplasia of the mandibular processes during the early embryonic period will lead to the severest cleft of mandible which extends into the neck, whereas during the late embryonic period, the less severe median cleft will develop. The authors have experienced one case of the median cleft of the lower lip and mandible with associated bifid tongue and ankyloglossia. And the double inlet single ventricle at heart lesion was also present. She was operated at 3 month of age. Our procedure consisted of a one-stage correction of the clefts of the lip, tongue, and mandible(repair a cleft of lower lip using w-plasty and a cleft of mandible by manual reduction and internal fixation with 6-hole plate and screws).
Bays ; Heart ; Lip ; Mandible ; Neck ; Tongue

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External Fixation for Inappropriate Closed Reduction of Nasal Bone Fracture.

Wan Kee MIN ; Dong Wan SEO ; Sung Jun LEE ; Joon Pio HONG ; Yoon Kyu CHUNG ; Jeong Pyo BONG ; Sug Won KIM

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):134-138.

Nasal bone fracture is the most common fracture among facial fractures. The nasal bone fracture has a very complex and infinitive variety but often is undermanaged only by closed reduction. The prognosis and outcome after operation had been reported by many surgeons and it's result is dependant upon many factors such as etiology, experience of surgeons, type of anesthesia and maintenance of fixation after surgery. In our study, we have grouped our fractures as favorable and unfavorable fractures. Favorable fractures are simple fractures that are easily reduced by closed reduction, whereas unfavorable fractures were fractures that remain unstable after reduction. In our opinion, the method of reduction and fixation after reduction plays an important role in unfavdrable fracture. We applied a new method of external fixation for unfavorable fractures After closed reduction to gain optimal reduction and maintenance.
Anesthesia ; Nasal Bone* ; Prognosis

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A Clinical Analysis and Appropriate Management of Pediatric Facial Bone Fractures: 6 Years Survey.

Jung Keun OH ; Ing Gon KIM

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):125-133.

As significant increase in the pediatric accidents becomes socially and morally concerned, reviewing over the statistical analysis of the pediatric accidents was needed especially in their facial bone traumas, in order to deduce a preventive and so to speak, protocols of treatments. This retrospective study comprise 73 pediatric patients who sustained facial bone fractures through various accidents and treated in the department of Plastic and Reconstructive Surgery, Seoul Hospital, Hanyang Medical Center during past 6 years from January 1993 to December 1998. The medical records of these 73 patients (91 fractures) were reviewed and analyzed retrospectively in order to obtain the clinical pattern and understand the therapeutic modalities. The statistical items were the prevalent time, age, sex and cause distribution, fracture sites, accompanying injuries, intervals among accident, arrival and operation, treatment methods with fixation materials, and complications were reviewed as following results. An increment of 5.1% per year of pediatric facial bone fractures was noted where 5.4% reduction of the population during the same periods. The mean age of patients was 10.5 years and the range of age was 3 to 15 years with males predominating over females in 3.1:1 ratio as in 3.5:1 in adults. Traffic accidents(43.9%) were responsible for the majority of facial bone fractures followed by violence(26.4%), fall(18.7%) and 91 facial fractures in 73 patients were classified where most common sites were nasal bone (56.1%) followed by blow-out fracture excluding other orbital fractures(17.6%), mandible(15.4%), zygoma(5.5%), orbital rim(2.2%), maxilla (2.2%) and frontal sinus(1.1%). Associated soft tissue injuries were combined in 52 patients(71.2%) and fractures other than facial bone were developed in 12 patients (16.4%) and treatment for facial bone fracture consisted of open reduction(40.6%), closed reduction(54.9%) and conservative treatment(5.5%). The complication rate was 9.4% and the most common complication was local infection followed by ophthalmologic problems and facial asymmetry. All data were analyzed based on the charts, medical records, and X-ray findings and presentation of the goals and optimal course of the entire management was made.
Adult ; Facial Asymmetry ; Facial Bones* ; Female ; Humans ; Male ; Maxilla ; Medical Records ; Nasal Bone ; Orbit ; Orbital Fractures ; Plastics ; Retrospective Studies ; Seoul ; Soft Tissue Injuries

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Repair of Medial Orbital Wall Fracture.

Yoo Kyung KIM ; Heung Sik PARK ; Chin Ho YOON

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):119-124.

From March 1997 to August 2001, Titanium mesh screen 1.0 (SYNTHES(R)) were applied to the repair of 29 medial orbital fractures; 18 patients with orbital inferior wall fracture, 16 patients with nasal bone fracture and 6 patients with pure medial wall fracture. Clinically, the periorbital ecchymosis and subconjunctival hemorrage were sensitive indications of orbital wall fracture. Even though there are no sign of diplopia or enophthalmos, in cases of simple nasal bone fracture with periorbital ecchymosis and subconjunctival hemorage, the evaluations of medial orbital wall fracture were strongly recommended because the medial orbital wall fractures occurred frequently combined with simple nasal bone fractures. Titanium mesh screen 1.0 was used as onlay implant to fit the anatomical shape on the fracture portion needed to be reconstructed and 1.3mm microscrews (SYNTHES(R)) were used to fix titanium mesh screen. The patients were followed up for 18 months with no significant enophthalmos or diplopia.
Diplopia ; Ecchymosis ; Enophthalmos ; Humans ; Inlays ; Nasal Bone ; Orbit* ; Orbital Fractures ; Titanium

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Reconstruction of the Cheek using Various Methods.

Rong Min BAEK ; Jae Don SEO ; Sang Baek HAN ; Ra Yong KO ; Kap Sung OH ; Se Min BAEK

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):114-118.

The reconstruction of the cheek area is a complex problem because the cheek is the most broad area of the face and is close to the aesthetically important region such as eyelids, nose, and mouth. The ultimate purpose of the cheek reconstruction is the restoration of the original shape and function, and establishment of the harmony with the adjacent structure in terms of color, nature and thickness. Various procedures such as skin graft, local flap, free flap, and local flap using skin expansion have been performed for cheek reconstruction. However, no golden principal or indication has been clarified to be imperative. Analyzing our clinical experiences of the cheek reconstruction, we intend to present a general guide of the cheek reconstruction and to assess the advantages and/or disadvantages of the operative methods. Between march of 1989 and August of 1999, we have experienced 154 cases of the cheek reconstruction. There were 52 males and 73 females, and their ages ranged from 3 to 89 years (mean 28.1 years). Preoperative diagnosis were post-burn deformity(n=74), Romberg disease (n=9), post-traumatic deformity(n=7), hemangioma(n=7), nevus(n=7), neurofibroma(n=5), hemifacial microsomia (n=3), lymphangioma(n=3), cancer(n=6), post-hemimandibulectomy(n=1), radical maxillectomy(n=1). The procedures were one stage cervicofacial flap(49 cases), cervicofacial flap following skin expansion(42 cases), local cheek flap (14 cases), deltocervicopectoral flap(2 cases), skin graft(29 cases), free flap(18 cases). Follow up period ranged from 3 to 72 months(mean 11.8 months). Advantages and disadvantages of each procedures were explained. The satisfaction rate was higher in one stage cervicofacial flap and free flap when assessed by both patients and surgeon. There were 3 cases of the ectropion of lower eylids, 4 cases of partial flap necrosis, and 1 case of exposure of tissue expander. The local flap is always the preferred method for the cheek reconstruction and the free flap is the treatment of choice for the cheek contour reconstruction. Selection of the most suitable flap is mandatory depending on the location and size of the defects.
Cheek* ; Diagnosis ; Ectropion ; Eyelids ; Facial Hemiatrophy ; Female ; Follow-Up Studies ; Free Tissue Flaps ; Goldenhar Syndrome ; Humans ; Male ; Mouth ; Necrosis ; Nose ; Skin ; Tissue Expansion Devices ; Transplants

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A Quilting Suture Technique for the Correction of Prominent Ears.

Jae Don SEO ; Sang Baek HAN ; Kap Sung OH

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):111-113.

A great number of operative techniques has been described about the correction of the prominent ears. The most primary deformity of the prominent ears comes from an underdeveloped or unfolded antihelix, which results in widening of the conchoscaphal angle and/or flattening of the superior crus, and which, in severe forms, involves antihelical body and inferior crus. Most authors manage the prominent ear deformity by excising, suturing, scoring, or sculpturing the auricular cartilage. We carried out a modified quilting suture technique in order to produce an antihelix. This technique provides several advantages; 1) it prevents the bowstring of the suture material during the formation of the helix; 2) the procedure is easy and time-saving; 3) the reconstructed ear shows reliable results in firmness and stability against external force or trauma; 4) the recurrence rate is not more than that of the conventional methods.
Congenital Abnormalities ; Ear Cartilage ; Ear* ; Recurrence ; Suture Techniques* ; Sutures*

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A Study on the Morphologic Change of the Tongue Muscle in Down Syndrome Children.

Yong Sam PARK ; Won Yong YANG ; Bub Min KO ; Moon Ho YANG

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):107-110.

Anatomy of oral cavity in Down syndrome is characterized by hypotonic macroglossia, small oral cavity, narrow palate with high-arch shape and hypertrophy of tonsil and adenoid. Because of such a anatomic characteristics, they show difficulty in respiration, mastication, swallowing and articulation. So far we operated on 135 children with Down syndrome for partial glossectomy in average volume of 4.6cc. This study is histopathologic finding of partially resected tongue in 4 cases, analyzed by histochemical stain and electron microscopy. The results of histochemical study showed predominant of Type 2 myofiber and interstitial edema, fibrosis and chronic nonspecific inflammation. In the study of electron microscope, the size and number of mitochondria were increased, but structural abnormality was not showed.
Adenoids ; Child* ; Deglutition ; Down Syndrome* ; Edema ; Fibrosis ; Glossectomy ; Humans ; Hypertrophy ; Inflammation ; Macroglossia ; Mastication ; Microscopy, Electron ; Mitochondria ; Mouth ; Palate ; Palatine Tonsil ; Respiration ; Tongue*

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Frontal Cranioplasty by using Multiple Osteotomy.

Sang Suk LEE ; Dae Hyun LEW ; Beyoung Yun PARK

Journal of the Korean Cleft Palate-Craniofacial Association.2001;2(2):103-106.

Cranioplasty is a method of the correction of defects and deformities of the bony walls protecting the brain. If defects and deformities are located in the frontal region, the correction is often necessary for cosmetic reasons. Rib, iliac bone and calvarium may be used for frontal cranioplasty. Rib bone and iliac bone have the donor morbidity and may result in cosmetically unacceptable contour. Calvarium is superior to the ilium and rib for it causes less donor site morbidity, it's consistency is harder than others and postoperative bone resorption is less. But it is difficult to mold and shape at the operative table, because the contour of parietal bone is different from that of frontal bone. For the last recent two years, we have performed frontal cranioplasty in five patients with frontal defect or deformity, by using calvarial bone graft that is molded with multiple osteotomy and microplate. Follow-up period ranged from 6 to 18 months with a mean of 12 months. There were no complications. This technique was simple and we could get aesthetically good contour on the frontal area.
Bone Resorption ; Brain ; Congenital Abnormalities ; Follow-Up Studies ; Frontal Bone ; Fungi ; Humans ; Ilium ; Osteotomy* ; Parietal Bone ; Ribs ; Skull ; Tissue Donors ; Transplants

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