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Myxoid Solitary Fibrous Tumor on the Scalp.

Ji Hyun KIM ; Dong Chul KIM ; Ryun LEE ; Chi Ho SHIN ; Yea Sik HAN ; Sang Hun CHUNG ; So Ya PAIK

Archives of Craniofacial Surgery.2017;18(4):269-272. doi:10.7181/acfs.2017.18.4.269

Myxoid solitary fibrous tumor (SFT) is very rare soft tissue neoplasm. It is microscopically composed of spindle cells which is individually separated by delicate band of collagen fibers. And this tumor cells are immunohisto-chemistrically highlighted by CD34. Myxoid SFT has indolent clinical course and a good prognosis, so it is important to make a diagnosis because of its morphological similarities to myxoid spindle cell neoplasms that have different prognoses and treatment. We report the case of a 20-year-old female with a myxoid SFT found in the left temporo-parietal scalp. This case report appears to be the first reported scalp occurrence of this rare tumor.
Collagen ; Diagnosis ; Female ; Humans ; Prognosis ; Scalp* ; Soft Tissue Neoplasms ; Solitary Fibrous Tumors* ; Young Adult

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Malar Relocation with Reverse-L Osteotomy and Autogenous Bone Graft.

Se Hoon YOON ; Euicheol JEONG ; Jee Hyeok CHUNG

Archives of Craniofacial Surgery.2017;18(4):264-268. doi:10.7181/acfs.2017.18.4.264

The zygomaticomaxillary complex (ZMC) functions as a buttress for the face and is the cornerstone to a person's aesthetic appearance, by both setting the midfacial width and providing prominence to the cheek. Malar deficiency is often acquired by blunt injury incurred in a traumatic accident, resulting in ZMC fracture. A 48-year-old male patient presented a right ZMC fracture after contusion injury by a baseball. He only received conservative management and later he suffered discomfort during mouth opening at the moment of mastication, due to trismus involving the temporomandibular joint. In the current case, we describe a surgical technique, by which the malar body is shifted anteriorly and laterally after combined oblique-vertical osteotomy. The technique presented, eventually restored the former aesthetic position of the malar complex and symmetry, and, moreover, improved mastication function.
Baseball ; Cheek ; Contusions ; Fractures, Malunited ; Humans ; Male ; Mastication ; Middle Aged ; Mouth ; Osteotomy* ; Temporomandibular Joint ; Transplants* ; Trismus ; Wounds, Nonpenetrating

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Anisakiasis Involving the Oral Mucosa.

Sang Kyu CHOI ; Cheol Keun KIM ; Soon Heum KIM ; Dong In JO

Archives of Craniofacial Surgery.2017;18(4):261-263. doi:10.7181/acfs.2017.18.4.261

Anisakis is a parasite with life cycles involving fish and marine mammals. Human infection, anisakiasis, occurs with the ingestion of raw infected seafood and usually presents with acute or chronic gastrointestinal symptoms from esophageal or gastric invasion. We report a rare caseinvolving the oral cavity. A 39-year-old male presented with oral and sub-sternal pain of one day duration after eating raw cuttlefish. Physical examination revealed areas of erythema and edema with a central white foreign particle on the labial and buccal mucosa. With microscopic field we could remove the foreign material from the lesions. The foreign material was confirmed to be Anisakis. Anisakis was also removed from the esophagus by esophagogastroduodenoscopy. The patient was discharged the following day without complication. Anisakiasis is frequently reported in Korea and Japan, countries where raw seafood ingestion is popular. The symptoms of acute anisakiasis include pain, nausea, and vomiting and usually begin 2–12 hours after ingestion. The differential diagnosis includes food poisoning, acute gastritis, and acute pancreatitis. A history of raw seafood ingestion is important to the diagnosis of anisakiasis. Treatment is complete removal of the Anisakis to relieve acute symptoms and prevent chronic granulomatous inflammation.
Adult ; Anisakiasis* ; Anisakis ; Decapodiformes ; Diagnosis ; Diagnosis, Differential ; Eating ; Edema ; Endoscopy, Digestive System ; Erythema ; Esophagus ; Foodborne Diseases ; Gastritis ; Humans ; Inflammation ; Japan ; Korea ; Life Cycle Stages ; Male ; Mammals ; Mouth ; Mouth Mucosa* ; Nausea ; Pancreatitis ; Parasites ; Physical Examination ; Seafood ; Vomiting

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A Comparison of the Local Flap and Skin Graft by Location of Face in Reconstruction after Resection of Facial Skin Cancer.

Kyung Suk LEE ; Jun Oh KIM ; Nam Gyun KIM ; Yoon Jung LEE ; Young Ji PARK ; Jun Sik KIM

Archives of Craniofacial Surgery.2017;18(4):255-260. doi:10.7181/acfs.2017.18.4.255

BACKGROUND: Surgery for reconstruction of defects after surgery should be performed selectively and the many points must be considered. The authors conducted this study to compare the local flap and skin graft by facial location in the reconstruction after resection of facial skin cancer. METHODS: The authors performed the study in patients that had received treatment in Department of Plastic Surgery, Gyeongsang National University. The cases were analyzed according to the reconstruction methods for the defects after surgery, sex, age, tumor site, and tumor size. Additionally, the authors compared differences of aesthetic satisfaction (out of 5 points) of patients in the local flap and skin graft by facial location after resection of facial skin cancer by dividing the face into eight areas. RESULTS: A total of 153 cases were confirmed. The most common facial skin cancer was basal cell carcinoma (56.8%, 87 cases), followed by squamous cell carcinoma (37.2%, 57 cases) and bowen's disease (5.8%, 9 cases). The most common reconstruction method was local flap 119 cases (77.7%), followed by skin graft 34 cases (22.3%). 86 patients answered the questionnaire and mean satisfaction of the local flap and skin graft were 4.3 and 3.5 (p=0.04), respectively, indicating that satisfaction of local flap was significantly high. CONCLUSION: When comparing satisfaction of patients according to results, local flap shows excellent effects in functional and cosmetic aspects would be able to provide excellent results rather than using a skin graft with poor touch and tone compared to the surrounding normal skin.
Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Methods ; Skin Neoplasms* ; Skin Transplantation ; Skin* ; Surgery, Plastic ; Transplants* ; Treatment Outcome

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The Reliability of the Transconjunctival Approach for Orbital Exposure: Measurement of Positional Changes in the Lower Eyelid.

Sung Ho YOON ; Jin Hoon LEE

Archives of Craniofacial Surgery.2017;18(4):249-254. doi:10.7181/acfs.2017.18.4.249

BACKGROUND: Lower eyelid incisions are widely used for the orbital approach in periorbital trauma and aesthetic surgery. In general, the subciliary approach is known to cause disposition of the lower eyelid by scarring the anterior lamella in some cases. On the other hand, many surgeons believe that a transconjunctival approach usually does not result in such complications and is a reliable method. We measured positional changes in the lower eyelid in blowout fracture repair since entropion is one of the most serious complications of the transconjunctival orbital approach. METHODS: To measure the positional changes in the lower eyelids, we analyzed preoperative and postoperative photographs over various time intervals. In the analysis of the photographs, marginal reflex distance 2 (MRD2) and eyelash angle were used as an index of eyelid position. Statistical analyses were performed to identify the significance in the positional changes. All patients underwent orbital reconstruction through a transconjunctival incision by a single plastic surgeon. RESULTS: In 42 blowout fracture patients, there was no statistical significant difference in the MRD2 and eyelash angle. Furthermore, there were no clinical complications, such as infection, hematoma, bleeding, or implant protrusion, during the follow-up periods. CONCLUSION: The advantages of the transconjunctival approach for orbital access include minimal scarring and a lower risk of eyelid displacement compared with other approaches. Based on these results, we recommend the transconjunctival approach for orbital exposure as a safe and reliable method.
Cicatrix ; Conjunctiva ; Ectropion ; Entropion ; Eyelids* ; Follow-Up Studies ; Hand ; Hematoma ; Hemorrhage ; Humans ; Methods ; Orbit* ; Orbital Fractures ; Plastics ; Reflex ; Surgeons

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Versatility of Modified Nasolabial Flap in Oral and Maxillofacial Surgery.

Geeti Vajdi MITRA ; Sarwpriya Sharma BAJAJ ; Sushmitha RAJMOHAN ; Tejas MOTIWALE

Archives of Craniofacial Surgery.2017;18(4):243-248. doi:10.7181/acfs.2017.18.4.243

BACKGROUND: To evaluate the versatility and reach of modified nasolabial flap used in reconstruction of defects created in and around the oral cavity. METHODS: A total number of 20 cases were selected. Out of which 13 were males and 7 females. The age of these patients ranged from 24–63 years. 29 modified nasolabial flaps were raised in twenty patients. Based on clinical and histopathological examination, out of 20 patients, 14 patients were diagnosed with oral submucous fibrosis, 3 with verrucous carcinoma, 1 with squamous papilloma, 1 with oro-antral fistula and 1 with traumatic loss of lower lip. RESULTS: Minimum preoperative interincisal distance (IID) was 0 mm and maximum was 15 mm with mean of 6.00±4.76 mm in patients with oral submucous fibrosis and 12 months postoperatively minimum IID was 16 mm and maximum was 41 mm with mean of 28.00±8.96 mm. In one case, dehiscence (3.4%) was noted on the anterior tip for which tip revision was done. Bulky appearance of the flap intraorally was observed in 2 cases (6.9%). Five (17.2%) among the 29 flaps had visible scar at the donor site postoperatively up to 3 months. CONCLUSION: Numerous reconstructive techniques have been employed in the reconstruction of small to intermediate sized defects of oral cavity. Modified nasolabial flap is a versatile flap which has robust vascularity and can be successfully used with minimal complications. It can be rotated intraorally to extend from the soft palate to the lip. Thus, it can be used efficiently to treat the small defects of the oral cavity as well as recreating lost lip structure.
Carcinoma, Verrucous ; Cicatrix ; Female ; Fistula ; Humans ; Lip ; Male ; Mouth ; Oral Submucous Fibrosis ; Palate, Soft ; Papilloma ; Precancerous Conditions ; Reconstructive Surgical Procedures ; Surgery, Oral* ; Surgical Flaps ; Tissue Donors

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Reduction of the Isolated Anterior Wall of the Maxillary Sinus Fracture with Double Urinary Balloon Catheters and Fibrin Glue.

Jaehee KIM ; Ho Jik YANG ; Jong Hwan KIM ; Su Jin KIM

Archives of Craniofacial Surgery.2017;18(4):238-242. doi:10.7181/acfs.2017.18.4.238

BACKGROUND: Conservative treatment is performed for isolated anterior wall of the maxillary sinus fractures, in many cases when the fracture is clinically not severe and asymptomatic. Despite the absence of symptoms, complications such as sinusitis, rhinitis, and chronic purulent secretion may develop; therefore, successful reduction is required. We attempted to reduce the risk of complications using an alternative technique: reduction of the fracture with two urinary balloon catheters inserted through the maxillary ostium and fixation using fibrin glue, which minimizes the damage to the bony fragments and sinus mucosa. METHODS: In this study, 38 patients who were diagnosed with an isolated anterior wall of the maxillary sinus fracture at our hospital between January 2014 and January 2017 were enrolled. The fracture site was exposed via the Caldwell-Luc approach followed by reduction through the insertion of two urinary balloon catheters using a nasal endoscope and fixation with fibrin glue. The sex, cause of fracture, physical examination, and presence of complications were examined and patient's medical records and facial bone computed tomography scans were analyzed. RESULTS: Radiological evaluation showed that there was no evidence of collapsed reduction fragments. Although some patients had remaining symptoms of hypoesthesia (15%; 3 patients), there were no complications such as infection, rhinitis, sinusitis, and chronic purulent secretion at the surgical site. CONCLUSION: In this study, we present an alternative surgical technique using two urinary balloon catheters and fibrin glue for the successful reconstruction of an isolated anterior wall of the maxillary sinus fracture. This technique enables precise restoration with a reduced risk of complications.
Catheters* ; Endoscopes ; Facial Bones ; Fibrin Tissue Adhesive* ; Fibrin* ; Humans ; Hypesthesia ; Maxillary Sinus* ; Medical Records ; Mucous Membrane ; Physical Examination ; Rhinitis ; Sinusitis

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Reduction of Closed Frontal Sinus Fractures through Suprabrow Approach.

Hyung Min HAHN ; Yoo Jung LEE ; Myong Chul PARK ; Il Jae LEE ; Sue Min KIM ; Dong Ha PARK

Archives of Craniofacial Surgery.2017;18(4):230-237. doi:10.7181/acfs.2017.18.4.230

BACKGROUND: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. METHODS: From March 2007 to October 2016, the authors identified patients with anterior wall frontal sinus fractures treated by open reduction through a suprabrow incision. Only cases with photographic/radiographic documentation and a minimum follow-up of 6 months were included. The incision line was designed to be at the upper margin of the eyebrow. Medical records and radiographic data were retrospectively reviewed. Surgical outcomes, cosmetic results, and complication were assessed. The patient scale of the patient and observer scar assessment scale was used to assess patient satisfaction for incisional scar at the 6-month follow-up. RESULTS: Thirty-one patients underwent fracture reduction through a suprabrow approach during the study period, with a mean follow-up of 41 months. No patients showed any recurrent displacement, eyebrow asymmetry, or infection during follow-up. Thirteen patients reported their forehead paresthesia postoperatively, and 12 of them had preoperative symptom. One patient complained of incisional scar and underwent scar revision. All patients were satisfied with their eyebrow and forehead contour. CONCLUSION: The suprabrow approach allowed for an accurate reduction of the fractures in the anterior wall frontal sinus by providing direct visualization of the fracture. This transcutaneous approach can effectively restore forehead contour with acceptable postoperative complications and patient satisfaction.
Cicatrix ; Eyebrows ; Follow-Up Studies ; Forehead ; Frontal Sinus* ; Hair ; Humans ; Medical Records ; Minimally Invasive Surgical Procedures ; Paresthesia ; Patient Satisfaction ; Postoperative Complications ; Retrospective Studies ; Skull Fractures

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Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask.

Anubhav JANNU ; Ashim SHEKAR ; Ramdas BALAKRISHNA ; H SUDARSHAN ; G C VEENA ; S BHUVANESHWARI

Archives of Craniofacial Surgery.2017;18(4):223-229. doi:10.7181/acfs.2017.18.4.223

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.
Airway Management ; Airway Obstruction ; Anesthesia ; Beauty ; Intubation ; Laryngeal Masks ; Larynx ; Masks* ; Neck ; Oropharynx ; Pharynx ; Surgery, Oral

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A Guide to Designing a Case Series in Plastic Surgery.

Tae Gon KIM ; Il Kug KIM

Archives of Craniofacial Surgery.2012;13(1):1-3. doi:10.7181/acfs.2012.13.1.1

The case series is a descriptive study that follows a group of patients who have a similar diagnosis or who are undergoing the same procedure and is the most prevalent type of research in the field of plastic surgery. Results of case series can generate hypotheses that are useful in designing further studies, including randomized controlled trials or a prospective cohort study. However, no causal inferences should be made from case series regarding the efficacy of the investigated treatment. The authors provide a guide to the design and report on the case series.
Cohort Studies ; Humans ; Surgery, Plastic

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