A Case of Crushing Burn Injury: A Case Report

Crushing burn injury on the hand is relatively rare these days. Still, the effect of the combined thermal and press damage is very severe, and, therefore, the deformity or disability of the hand is often the consequence of the accident. Early aggressive debridement or fasciotomy is preferred for the treatment after admission. We present an extremely severe burn case: the patient has had a full-thickness third-degree hot crushing injury on the hand with all dermal elements, muscles, and tendons destroyed.

The Treatment of Chronic Postburn Scar and Contracture: A Case Report

Postburn scar and contracture (PBSC) occur after severe burn injuries, and the deformity causes functional problems in the patients. The patients have difficulty even with simple everyday tasks, so their socioeconomic status seems to be limited or rather to be in a poor stage. This makes the quality of their daily life very low. Certainly, sooner or later, the postburn contracture release operation is performed to restore the functions such as flexion, extension, rotation, and other movements of the injured region. We present the case of a patient who has suffered PBSC for an extended period, and, at last, she has had a PBSC releasing operation with the composite skin graft, split-thickness skin graft with a dermal substitute.

Skin and Soft Tissue Loss of the Lip by Friction Burn: A Reconstruction Case with Composite Flap

Traumatic lip injury is one of the most common clinical conditions in facial injuries. Nonetheless, the degree of the convex and concave slopes on the vermilion border appears to be unique and dynamic; therefore, the reconstruction of the lip defect is always challenging for plastic surgeons [1]. We present a patient who fell off a motorcycle at speed and had a severe friction burn injury with a significant loss of the skin and soft tissue on the left lower lip.

Reconstruction of Postburn Nasal Alar Defect by Paramedian Forehead Flap

In the face, the nose plays an important role in both function and appearance. Among the subunits on the nose, the alar is a critical nasal structure of high aesthetic value. Previously, many surgeons have insisted that structural support should be added to the reconstruction of alar and particularly so in the case of a full-thickness defect. In a 58-year-old male patient who had a third-degree burn injury and full-thickness defect in most of the left nasal alar, forehead flap surgery alone was successfully performed without structural support.

A hemangioma in the masseter muscle: a case report

Intramuscular hemangiomas of the masseter muscle are uncommon tumors and therefore can be difficult to accurately diagnose preoperatively, due to the unfamiliar presentation and deep location in the lateral face. A case of intramuscular hemangioma of the masseter muscle in a 66-yearold woman is presented. Doppler ultrasonography showed a 34× 15 mm hypoechoic and hypervascular soft tissue mass in the left masseter muscle, suggesting hemangioma. The mass was excised via a lateral cervical incision near the posterior border of the mandibular ramus. The surgical wound healed well without complications.

A hemangioma in the masseter muscle: a case report

Intramuscular hemangiomas of the masseter muscle are uncommon tumors and therefore can be difficult to accurately diagnose preoperatively, due to the unfamiliar presentation and deep location in the lateral face. A case of intramuscular hemangioma of the masseter muscle in a 66-yearold woman is presented. Doppler ultrasonography showed a 34× 15 mm hypoechoic and hypervascular soft tissue mass in the left masseter muscle, suggesting hemangioma. The mass was excised via a lateral cervical incision near the posterior border of the mandibular ramus. The surgical wound healed well without complications.

Correction of Closed Outer Table Fracture of Frontal Sinus using Upper Eyelid Incision and Autogenous Bone Graft

PURPOSE: The bicoronal incision, traditional procedure to correct the frontal sinus fracture, could remain a long scar, alopecia etc. Hence, the authors introduce the procedure to fix the outer table fracture of the frontal sinus through the upper eyelid incision as a concealed scar. MATERIAL & METHODS: From November, 2007 to December, 2010, five patients who suffered from outer table fracture of frontal sinus fracture underwent operation to correct the depressed contour of forehead. Instead of the reduction of depressed outer wall, autogenous bone was grafted trough the upper eyelid incision. The result of operation was evaluated with VAS score system(score arrange 0 to 5). VAS score was taken from patients as well as 4 plastic surgeons. RESULTS: Both patients and surgeons were satisfied about result of operation. The overall average score from plastic surgeon was 4.2. Especially to the scar of upper eyelid incision, the score was 4.7. Average score from the patients was 4.1. And there were no other complications as follow-up periods. CONCLUSION: This technique could be one of good options to correct the depression after the outer table fracture of the frontal sinus. And this technique has some benefits to overcome the disadvantage of previous introduced methods.

Prevalence of Midfacial Creases according to Aging of the Korean

The tear trough deformity and the palpebromalar groove are characteristic appearances in midface aging. The aim of this study is to suggest the direction of aging process in midface by sampling survey in the Koreans. Sampling survey was conducted to 480 subjects who had preoperative pictures of the midface in Koreans. The excluding criteria of the subjects were with prior oculoplastic surgery, facial bone fracture, facial palsy, previous rejuvenation procedure, Grave's oculopathy and some medical history affecting eyelid position. Prevalence of tear trough deformity and palpebromalar groove in each subject, and age-related change in prevalence were analyzed. Prevalence of the tear trough deformity and the palpebromalar groove was 57.92% and 44.58%, respectively. Prevalence of tear trough deformity was higher than that of palpebromalar groove in both males and females(Chi-Square test, p<0.05). The tear trough deformity and the palpebromalar groove showed a strong positive correlation with age. All the subjects with the palpebromalar grooves had the tear trough deformities. From the results of survey, it suggested that the aging process of midface of the Korean, from medial to lateral direction, differed from that in westerns.

Change on Vertical Height of Palpebral Fissure between Sitting and Lying Position

We tried to check the vertical palpebral height when the patient sit up as well as when one lie down respectively. Measurements of the vertical palpebral height and corneal diameter were taken in pictures of both eyes of 96 Koreans. They consisted of 59 males and 37 females of average age 25.3. The picture was taken in the position of primary eyeball, and the measured values were adjusted by the known photometrical average value of corneal diameter. During adjustment, the ruler tool in the software Adobe(R) Photoshop(R) was used. They were divided into 4 groups: females with same or larger(group 1, n=20) and with smaller(group 2, n=17) than 11.3mm, and males with same or larger (group 3, n=28) and with smaller(group 4, n=31) than 11.6mm during sitting position. There was no statistical difference in the rate of respective postural effect on vertical height according to sex and the covering amount of cornea. However, the changing amount was meaningful statistically(p=0.000) through two samples t-test. The average ratio of vertical palpebral height was 1:0.929(sitting:lying). We introduce the objective way to compare postural change of vertical dimension of palpebral fissure through the photometrical method.

Correction of Problems after Eyelid Surgery using Various Techniques

Many techniques for prevention and correction of complication after blepharoplasty have been developed, however, satisfactory method has not yet been documented. The purpose of this article is to review common unfavorable complications after Asian cosmetic eyelid surgery, and to propose several methods of treatment for effective correction. From 1988 to 2008, authors reviewed 364 cases(480 eyes) of complications after cosmetic eyelid surgery. Follow-up period ranged from 6 months to 16 years. The results of treatments were classified into excellent, good, fair and unsatisfactory by operating surgeons, other surgeons, and by patients. About 40% of complications requiring revisional surgeries were treated early within 2 weeks after first operation. Other 60% of complications were treated by late reoperations, at least 6 months after first surgery. Majority of patients were satisfied with the results. However, a few patients reported unsatisfactory outcomes which required additional revisional procedures. The correction of complications following cosmetic eyelid surgery remains a difficult task. The strategies for successful Asian upper blepharoplasty include not only careful preoperative evaluation and delicate operative technique, but also, proper postoperative interventions such as early secondary blepharoplasty.