The Efficacy of Coblator in Turbinoplasty

BACKGROUND: Turbinate hypertrophy is one of the common causes of chronic nasal obstruction. In principle, therapeutic guidelines recommend medical treatment. Failure to treat turbinate thickening despite drug therapy may indicate the need for surgery. The main aim of this study was to determine the effect of radiofrequency surgery, among various other surgical procedures, on people with both nasal septal deviation and turbinate hypertrophy. METHODS: Among people with nasal deviation who visited the subject hospital between July 2008 to July 2014, 21 people with nasal septal deviation and severe turbinate hypertrophy before their surgery had undergone septoplasty with turbinoplasty using radiofrequency combined with septoplasty. The degree of the turbinate's hypertrophy was appraised in all the patients before and after the surgery using the rhinoscopy, and acoustic rhinometry was objectively carried out. The subjective effect of the turbinoplasty using radiofrequency was explored through the visual analog scale (VAS) score. RESULTS: The degree of contraction of the nasal mucosa after the rhinoscopy changed from Grades 3 and 4 (100%) to Grades 1 and 2 (95.2%) and Grades 3 (4.8%). The minimal cross-sectional area significantly increased from 0.44±0.07 to 0.70±0.07 cm² (p<0.05). The nasal cavity volume increased from 4.79±0.49 to 6.76±0.55 cm² (p<0.05). The subjective symptoms evaluated with VAS score a year after the surgery significantly improved (p<0.05). CONCLUSION: Turbinoplasty using Coblator with septoplasty is an effective treatment method because it expands nasal cavity, has a low incidence of complications, subjectively improves symptoms, and has short treatment duration.

Overview of Mandibular Condyle Fracture

The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

Reliability of Reconstructed Breast Flap after Chemotherapy and Radiotherapy in Immediate Breast Reconstruction

BACKGROUND: Postmastectomy adjuvant therapy is used to prevent locoregional recurrence and improve overall breast cancer specific survival rates. However, it can adversely affect the cosmetic results of reconstruction. Therefore, the authors examined flap stability and patients' satisfaction with immediate breast reconstruction after adjuvant therapy. METHODS: We retrospectively reviewed the medical records of 204 patients from January 2006 to November 2011. For complication rates, the authors categorized the patients who underwent the immediate breast reconstruction into 4 groups: adjuvant chemotherapy and radiotherapy group, adjuvant chemotherapy only group, adjuvant radiotherapy only group, and the group that did not undergo adjuvant therapy. For comparison of patients' satisfaction, the study was performed with an additional 16 patients who had undergone delayed breast reconstruction. RESULTS: Regarding complication rates, the group that had undergone adjuvant therapy showed no significant difference compared to the group that did not undergo adjuvant therapy. In evaluating the patients' satisfaction, there was no significant difference. CONCLUSIONS: Even after adjuvant therapy, immediate breast reconstruction showed good results with respect to flap stability and patients' satisfaction. Immediate breast reconstruction and adjuvant therapy is a safe and useful option for breast cancer patients.

The Long Term follow up of Blepharoptosis Treated by Fronto-orbicularis Oculi Muscle Advancement

The blepharoptosis is due to weakness of the levator palpebrea superioris. Many operative procedures were designed to correct blepharoptosis according to the patient's levator function. Author has treated 17 cases of blepharoptosis using fronto-orbicularis oculi muscle advancement technique in the 12 patients from September 1999 to August and followed up for this patient during mean 3 years about result of correction and complication. In long term follow up period, blepharoptosis is naturally corrected and other complication such as lagophthalomos, undercorrection are rare. In undercorrection case, it is easy to re-correct blepharoptosis because of easy dissection and simple advancement of previously dissected fronto-orbicularis oculi muscle flap. Fronto-orbicularis oculi muscle advancement technique is more advanced method to correct mild to severe blephatoptosis.

Usefulness of Muscle Plication and Synthetic Mesh in Breast Reconstruction Using TRAM Pedicled Flap

PURPOSE: The transverse rectus abdominis myocutaneous(TRAM) flap has become a mainstay of breast reconstruction. The chief disadvantage of the TRAM flap is its potential to create a weakness in the abdominal wall. Nowadays true hernia is less frequent, but bulging that appears at the muscle donor site, or at the contralateral side, or at the epigastric area is still remained as a problem. To prevent this complications, we have used synthetic mesh as well as abdominal muscle plication. Now we report the result of our methods. METHODS: We started to use synthetic mesh and muscle plication as supplementary reinforcement for entire abdominal wall, after TRAM flap harvesting, in an attempt to stabilize it and achieve a superior aesthetic result since 2002. We observed complications of TRAM flap donor site, and compared our results (from January, 2002 to January, 2006) with other operator's result (before 2001) at the same hospital in aspect of incidence of abdominal complications. RESULTS: 42 consecutive patients have been performed routine reinforcement with the extended mesh technique and muscle plication from January, 2002 to January, 2006. Mean patient follow up was 25.2 months. No hernia or mesh related infection were encountered and only one patient had a mild abdominal bulging. Nevertheless the our good results, there were no significant statistical differences were observed between two groups. CONCLUSION: We recommend the using of synthetic mesh and muscle plication for donor site reconstruction after TRAM flap breast reconstruction to improve strength as well as aesthetic quality of the abdominal wall.

The Correction of Inverted Nipple by Modified Elsahy and Broadbent-Woolf Methods

An inverted nipple may have both functional and aesthetic problems such as loss of lactability and hygiene. The inverted nipple may be congenital or caused by trauma, mastitis, mammmoplasy and breast cancer. Many procedures have been described for creating the normal anatomic configuration of the retracted nipple. For correcting the inverted nipple, the authors choose surgical procedure according to the grade of inverted nipple and the need of lactation. A total 37 nipples in 20 patients were operated on from February of 2001 to February of 2005. The patients were classified into 3 grades according to Han and Hong's grading system of inverted nipple. We applied modified Elsahy method to the group of patients in Grade I and patients in Grade II with need of lactation, and we applied Broadbent-Woolf method to the group of patients in Grade III and Grade II with need of lactation. Recurrence was found in 1 case corrected by modified Elshay method and no recurrence was found in those corrected by Broadbent-Woolf method. The patients' satisfaction score was 4.6 points in 5 points perfect score system. We prevented recurrence of inverted nipple with patients' satisfaction by applying different operative procedures according to the grade and patients' need of lactation.

EXPERIMENTAL STUDY OF PERI-IMPLANT TISSUE REACTION IN OVARIECTOMIZED OSTEOPOROTIC RATS / 대한치과보철학회지

This study was designed to investigate the peri-implant tissue reaction in ovariectomized osteoporotic female rats, and to evaluate effects of estrogen, calcitonin, parathyroid hormone on the bone - implant interface in osteoporotic rats. 120 Sprague - Dawley rats were used in this experiments. Osteoporosis was induced by bilateral ovariectomy. They were divided 5 groups ; sham-operated control group(Sham), ovariectomized group (OVX), OVX and estrogen treated group (OVX+E), OVX and PTH treated group (OVX+PTH), and OVX and calcitonin treated group (OVX+CT). Eight weeks after ovariectomy, two titanium screw implants were inserted into the left tibia of each rat. Eight weeks after the insertion of the implants, the periotest values (PTV) of implant were examined, and the rats were sacrificed, and examined the reaction of bone tissue surrounding the implant both histologically and histomorphometrically. The bone density and ash weight of opposite right tibia were examined. Over 40 rats were fractured on left tibia that was implant inserted. On histologically finding, all groups were osseointegrated well, especially in OVX+PTH group. In OVX group, tibial cortical bone showed many large harversian canal and microfracture lines. The OVX+PTH group showed the lowest mean PTV (-2.33) (p0.05). But the OVX+CT group showed the highest mean bone density (5.45mg/cm3) and ash weight (56.12%) (p<0.05). The results indicate that PTH treatment enhances osseointegration of implant in OVX rats, and CT treatment depresses bone turnover and prevent the development of osteopenia in OVX rats.