Benign Mass after Reduction Mandibular Angleplasty

There have been various methods of reduction mandibular angleplasty. 21-year old woman with prominent mandibular angle and body was done curved angle ostectomy with tangential ostectomy. In operation, we had used bone wax for controlling of bone bleeding. After 1 year, the patient revisited to our clinic because she had a mass with tenderness on Lt. mandibular angle area. The mass had been gradually increasing in severity after reduction mandibular angleplasty. Computed tomography of the patient showed inflammatory lesion in Lt. mandibular angle area with focal cortical bony destruction and adjacent soft tissue thickening. After surgical removal of mass, clinical pathology revealed that the mass was chronic inflammatory fibrosis around foreign body(bone wax). The postoperative course was uneventful, the patient was satisfied for her shape. If possible we must avoid using a bone wax in reduction mandibular angleplasty, because bone wax can induce inflammatory reaction and fibrosis.

Internal Fixation using Tension Wire Band in Mandibular Fractures

In mandibular fractures basic principle of treatment for rapid healing are accurate reduction and secure immobilization. Till now many kinds of operative techniques have been mentioned. But each method has several disadvantages such as inaccurate reduction, immature operative technique and long operative time. To overcome these disadvantages, tension wire band secured to monocortical screws for open reduction and internal fixation of mandibular fractures were applied. From March, 2000 to August, 2002 tension wire band and intermaxillary fixation with occlusal splint for 1-2 weeks had been applied in total 63 patients. The operative technique is as follows. The first, two pieces of monocortical screws, which have 1.5-2.0 mm diameter and 5-7 mm length is fixed on each fracture site through outer cortex. Second, tension wire is twisted appropriately between two screws to reduction of fracture site. No cases of infection, malunion, or malocclusion occurred. Compaired with other operative techniques, this technique is more useful because of short operative time, accurate reduction and secure immobilization.

A Case of Malignant Lymphoma of Lateral Rectus Muscle

Orbital mass is about 17% of orbital disease and only 7-8% of mass is lymphoma. Lymphoma involved extraocular muscles are unusual. Lymphoma occurred in lateral rectus muscle, rarely. The authors experienced a case of malignant lymphoma occurred in the lateral rectus muscle in 17-year-old male. His main symptom was exopthalmos and diplopia. The patient was treated with excision via bicoronal approach and radiation. We report the unusual case of malignant lymphoma occurred in lateral rectus muscle.

The Use of Tumescent Solution in Bicoronal Incision

The bicoronal incision, popularized by Tessier, provides wide access to the orbits, nose, and zygomas as well as the cranium. But blood loss is unavoidable. We attempt to reduce the blood loss and the transfusion with tumescent technique. Athors had performed 17 cases of bicoronal incision between June, 2002 and march, 2003. 8 cases of them underwent the procedure with tumescent solution(Group A). 9 cases was done by usual manner(Group B). We analyzed 23 cases undergiong bicoronal incision for the blood loss and the transfusion amount. Intraoperative blood loss, postoperative transfusion was reduced at Group A. And the dissecting was easy. We think that tumescent technique contributes to reduce the bleeding, additionally reduce the postoperative transfusion.

Facial Rejuvenation Surgery Combined with Malarplasty or Angleplasty

In general, Oriental people have thicker facial skin with more subcutaneous adipose tissues than Caucacian people. These differences result in characteristic Oriental aging face combined with squared facial contours. Conventional face lift essentially consists of facial wrinklinges and reducing flaccidity of facial skin but squared facial contouring is not considered. Flat and squared face can be improved by reduction malarplasty and mandibular angleplasty, thoses are the common facial bone contouring surgeries performed in the Orient. If patients, who have aging face, also have flat and squared face, it is necessary to be performed face lift and facial bone contouring surgery simultaneously. We have experienced 18 cases of patients with aging face and squared face who were operated face lifting procedures combined with maloplasty or angleplasty(from Apr.1997 to Mar. 2001). And We have satisfactory results on most patients(16 cases of patients were satisfied with results).

A Study on the Clinical and Statistical Analysis of the Zygoma Fracture

The zygomatic bone is a major portion of the midfacial skeleton, forms the malar eminence and the four adjacent bony articulation, when the zygomatic bone was fractured, the patient was suffered from not only esthetic facial contour problem but also functional disturbance such as eyeball movement and masticatory action. This retrospective study comprised 269 patients who had 280 zygoma fractures by various accidents and treated in Pusan Paik hopital between October 1994 and October 1999. The medical records of these 269 patients with zygoma fracture were reviewed and analysed. The studied items are the time of the accidents, the age and sex distribution, the causes of the injuries, anatomical types of the fractures, associated maxillofacial and non- maxillofacial trauma, the treatment methods and fixation materials and the days of hospitalization and complications. The results were obtained. The most patients with zygomatic bone fracture were injured between 22:00 and 04:00. The incidence of zygomatic bone fracture was shown to be decreased annually. The monthly incidence was the highest in January, May and October. The highest incidence in age distribution was the second and third decade(45%) and male to female ratio was 4.7:1. And the most common cause of the zygomatic bone fracture was motor vehicle accident(51%) followed by fall down, assault, industrial accident and sports accident. The most common anatomical site of the zygomatic bone fracutre was group III type fracture(33%) by Knight and North Classification. Associated maxillofacial bone fracture was mainly maxilla, followed by nasal bone, mandible, and frontal bone. The most prevalent time interval between onset and surgical intervention was within the 10 days and the prevalent interval time between the surgical intervention and discharge was within the 14 days. Postoperative compliction was malocclusion(2 cases).

Clinical Applications of Modified Superficial Sural Fasciocutaneous Island Flap

In case of soft-tissue defects with bone and tendon exposure on foot, ankle and lower leg, it is often impossible to achieve wound closure by a simple skin graft. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of the defects, we operated 30 cases using modified superficial sural fasciocutaneous island flap based on the proximal or distal. and we covered convoluted wound site with this flap with plicated fascia. We reconstruct complicated skin defects on the foot region(13) and the distal portion of the leg(17). The size of flap varied from 3 x 4 cm2 to 10 x 9 cm2. All 30 flaps survived completely, but minor complications, such as venous congestion, hematoma disappeared after a few days. The main advantage of this flap is a constant and reliable blood supply without sacrifice of a major artery. but disadvantage of this flap is hypoesthesia at the lateral part of the foot. In conclusion, dissection of the superficial sural fasciocutaneous island flap is quite easy and requires less time, and involves less risk to the patient. The nonbulky fasciocutaneous island flap appearance particularly indicated small to medium sized defects with or without convoluted wound surface. The contours of the recipient and donor sites are acceptable aesthetically.