Anthropometric Analysis on Facial Profile Alterations Following Augmentation Rhinoplasty with Nasal Tip Plasty

There are various nasal measurement parameters for rhinoplasty, so it is difficult for surgeons to decide which measurements to place more emphasis on. Among many, we searched for measurements that are significantly altered after the augmentation rhinoplasty with nasal tip plasty to figure out which measurements are most required in preoperative preparation. From January, 2006 to July, 2008, a total of 85 patients underwent augmentation rhinoplasty with nasal tip plasty and 40 were selected for comparative analysis of preoperative and postoperative photographs. Among many measurement factors reflecting changes of a face and a nose, we measured and compared following parameters, 1) nasofrontal angle, 2) nasofacial angle, 3) nasolabial angle, 4) nasal tip angle, 5) columella-lobular angle, 6) nasal length to tip projection, 7) alar slope angle, 8) nostril axis angle, 9) lobule-to-nostril ratio before and after operations. The result was analyzed using paired t-test. The measurement parameters most significantly altered after augmentation rhinoplasty with nasal tip plasty were the increase in nasolabial angle, the decrease in nasofacial angle, and the decrease in nostril axis angle. Therefore, surgeons should place more emphasis on these parameters in preoperative planning and postoperative evaluation.

A Case of MALT Lymphoma in Parotid Gland Duct

PURPOSE: Primary malignant lymphomas of the salivary glands are uncommon. The parotid gland was most frequently involved, followed by the submandibular gland, minor salivary gland and sublingual gland. The most common subtype is mucosa-associated lymphoid tissue (MALT) lymphoma. We experienced a case of salivary MALT lymphoma involving parotid gland duct, so report a case with a review of the literature. METHODS: A 65 year old female presented with a palpable mass on the left side of her cheek. There was no clinical or laboratory evidence of pre-existing autoimmune disease. Preoperative facial and neck CT with contrast showed 2.1x1.7cm sized, ill defined, homogeneous low density mass near left masseter muscle, and no evidence of other enlarged lymph nodes. RESULTS: At operation, a yellowish oval shaped mass was found slightly adhered to middle portion of the parotid gland duct, measuring 2x1.5x0.7cm. Microscopic finding showed that centrocyte-like cells, monocyte B cells and plasma cells were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. CONCLUSION: We report a very rare case of MALT lymphoma involving parotid gland duct in 65 year old female patient with clinical characteristics, histologic features and references.

A Case Report of the Chemical Burns Due to Sodium Hypochlorite(NaOCl)

PURPOSE: Chemical burn accounts for a small proportion of burns in burn patient population. However, chemical injuries own importance to their deep tissue destruction which continues long after the initial exposure. YUHANROX(R) is a domestic bleach which has been widely used in Korea. Chemical burn by the domestic bleach is an unusual case. METHODS: A 70 yrs old female soiled with stool, her husband wiped the mess with YUHANROX(R). Skin edema, erythematous lesion was developed the second day, and she was admitted to our hospital via emergency department. RESULTS: Complete epithelization was done after 3 times STSG but, severe scar was formed. CONCLUSION: We report this case to warn about the dangers of domestic bleaches chemical substances and to emphasize that they should be used with caution. Public relation of the primary care of the chemical burn injury is needed.

Long Term Follow Up of Surgical Treatment of Axillary Osmidrosis and Hyperhidrosis by Instrumental Shaving and Manual Shaving

PURPOSE: Axillary osmidrosis is caused by excessive apocrine gland secretion, which causes an unpleasant odor. Axillary osmidrosis causes difficulty in social activities and personal handicap. We studied the long term follow up results of our surgical procedures and sought to find a best surgical treatment methods. METHODS: From January 1991 to December 2006, a total of 1864 patients(587 men, 1277 women) had been treated with this procedure for axillary osmidrosis and hyperhidrosis. Follow up periods varied from 10 to 15 years. We used the subdermal excision technique, using two small incisions over the axilary folds and using a Kawata dissector(instrumental shaving) and additional manual subdermal excision(manual shaving). RESULTS: Among the total patients, 782 patients were followed up. Except a pure hyperhidrosis patients, 759 osmidrosis patients was included. 588 patients(77.4%) had a good results, 148 patients(19.5%) had a moderate results and 23 patients(3.1%) had a recurrence. Complication developed in 189 patients(10.1%): hematoma or seroma in 25 patients, wound dehiscence in 86 patients, partial skin necrosis in 45 patients, and infection in 28 patients. CONCLUSION: We conclude that our method has several advantages such as 1) short operation time, 2) minimal scaring, 3) lower complication rates, 4) high satisfactory rates.

Experience with Various Scars after Treatment of Axillary Osmidrosis

The goal of osmidrosis operation is not only to be free from odor, but also to leave a minimal operation scar. In practice, however, many patients suffer from unfavorable axillary operation scars. Therefore, we herein report various postoperative axillary scars which we experienced. From January 1991 to December 2006, a total of 270 patients(74 men and 196 women) whose axillary osmidrosis had been treated by various methods more than once were included. We observed pre-existing operation scars of recurred patients who wanted revisional operation. Among the total patients, 118 patients had been treated once, 138 patients less than 5 times, and 14 patients more than 5 times. Previous treatment methods included excision in 216 cases, laser in 188 cases, subdermal excision in 63 cases, ultrasonic liposuction in 25 cases, Kobayashi insulated needles in 29 cases, and botulinum toxin injection in 1 case. We observed irregular scar, wide spread scar, hypertrophic scar, postburn scar, depressed scar, and pigmented scar. Pre-existing operation scars were not improved enough by revisional operation. We propose that it is important to select a proper method to effectively get rid of an axillary odor, leaving a minimal operation scar, because axillary area is not optimal for scar revision.