ABSTRACT
For the aeshetic contouring of prominent mandibular angle, conventional resection of mandible angle through intraoral approach has been used commonly. And the sagittal resection of lateral cortex is being performed recently to reduce the lower width of square face in some cases. That is to say, the prominent mandibular angle is meant by not only posteroinferior projection as well as lateral bulging. But intraoral approach corrects the former more efficiently than the latter because of limited operation field. And sometimes, the conventional resection of the mandibular angle yields obtuse, unnatural angle. Still more, postoperative complications such as bleeding, swelling, pain are inescapable. Through extraoral approach, authors were simultaneously able to accomplish precise, sufficient resection of angle and sufficient burring of lateral cortical bone without difficulty and complication. With the incision along relaxed skin tension line and meticulous everted sutures, scars are acceptable. One patient needed scar revision afterward. And so it is reported with review of literatures.
Subject(s)
Humans , Cicatrix , Hemorrhage , Mandible , Postoperative Complications , Skin , SuturesABSTRACT
In this experiment, pregnant Sprague-Dawley rats were treated with 100mg/kg of alltrans retinoic acid at 10th day of gestation. Pregnant rats were sacrificed at gestation day 14, 15, 16 and 18. Fetuses were delivered, and palatal processes were dissected. The specimens were prepared with fibronectin immunohistochemical stain, and mesenchymal changes were observed with electron microscope. The results were as follows. 1. In the findings fo fibronectin immunohistochemial stain, a part of the mesenchyme of the palatine process of the control group showed weak positive reaction at 14th gestation day, and the reactivity increased progressively by each day. In retinoic acid treated group, the positive reaction was trace at 14th day of gestation, and the reactivity increased progressively, but it was weaker than that of the control group. 2. Examination under transmission electron microscopy revealed well-developed rough endoplasmic reticulum, Goigi apparatus, mitochondrias which were found at the palatine process of the control group. In the retinoic acid treated group, at 16th and 18th day of gestation, the mesenchymal cells of the elevated palatine process had fragmented, sacculated rough endoplasmic reticulums, their mitochondrias were swollen and dissolved, In all cases with retinoic acid treated group, mitotic cells at various stages were more frequently found than in control group. In conclusion, the retinoic acid induces alterations of the intracytoplasmic organells. This finding suggests that retinoic acid is ditectly cytotoxic to mesenchymal cells. Positive fibronectin reaction was demonstrated before palatal elevation at th 15th day of gestation. Therefore, it could be postulated that mesenchymal cells synthesize and release the fibronectin. In the retinoic acid treated group, fibronectin showed positive reaction before and after palatal elevation, and it suggests that fibronectin would be involved in palatal elevation.
Subject(s)
Animals , Pregnancy , Rats , Endoplasmic Reticulum, Rough , Fetus , Fibronectins , Mesoderm , Microscopy, Electron, Transmission , Mitochondria , Rats, Sprague-Dawley , TretinoinABSTRACT
Many methods have been developed for the reduction of the isolated zygomatic arch fracture. Even though the reduction of isolated zygomatic arch fracture can be made well according to the various methods, the Gillies' method has been selected as the 1st choice. But long term follow-up study of this method was not reported. So long term follow up of zygomatic arch fracture was performed in 35 patients who were treated by Gillies' method. Authors divided isolated zygomatic arch fractures into three classes (Type A : a simple fracture with one fracture line and one greenstick fracture, TyPe B : medially depressed fracture with three fracture lines, Type C : a medially depressed fracture segment with two fracture lines) and followed up the reduced isolated zygomatic arch fracture cases using Gillies' method by radiographes and interview. The depression of lesion site was estimated by comparing with tracing the zygomatic arch shadow of normal side. The results were as follows: 1. The mean follow up time was 33.4 month. 2. The isolated zygomatic fractures were classified by three group. A: a simple fracture (16 cases) B: the central fracture point was a medially depressed fracture (14 cases) C: fracture with a medially depressed segment (5 cases) 3. The mean depression of lesion site was 2.3 mm. (Type A: 2.0 mm, Type B: 3.2 mm, Type C: 2.4 mm and difference between A and B was significant statistically (p < 0.037)). 4. The mean depression of zygomatic arch fracture was 2.1 mm in excellent group, 2.4 mm in good group and 5.2 mm in poor group and difference between excellent and poor, and between good and poor group were statistically significant (p < 0.0001). 5. On result of subjective satisfaction, number of excellent case was 17(48.6%), it of good case was 15(42.9%) and it of poor case was 3(8.6%) (Type A: 9, 7, 0, Type B: 5, 7, 2 and Type C: 3, 1, 1 excellent, good and poor in sequence). 6. The mean depression of overcorrection group(17, 8, 1 excellent good and poor in sequence) and nonovercorrection group(2, 5 and 2 in excellent, good and poor in sequence) was 2.26 and 3.6 mm in each other(p < 0.004). After reviewing all of results, it is concluded that Gillies' method is acceptable as the 1st choice for the reduction method of an isolated zygomatic arch.
Subject(s)
Humans , Depression , Follow-Up Studies , Zygoma , Zygomatic FracturesABSTRACT
Many methods have been developed for the reduction of the isolated zygomatic arch fracture. Even though the reduction of isolated zygomatic arch fracture can be made well according to the various methods, the Gillies' method has been selected as the 1st choice. But long term follow-up study of this method was not reported. So long term follow up of zygomatic arch fracture was performed in 35 patients who were treated by Gillies' method. Authors divided isolated zygomatic arch fractures into three classes (Type A : a simple fracture with one fracture line and one greenstick fracture, TyPe B : medially depressed fracture with three fracture lines, Type C : a medially depressed fracture segment with two fracture lines) and followed up the reduced isolated zygomatic arch fracture cases using Gillies' method by radiographes and interview. The depression of lesion site was estimated by comparing with tracing the zygomatic arch shadow of normal side. The results were as follows: 1. The mean follow up time was 33.4 month. 2. The isolated zygomatic fractures were classified by three group. A: a simple fracture (16 cases) B: the central fracture point was a medially depressed fracture (14 cases) C: fracture with a medially depressed segment (5 cases) 3. The mean depression of lesion site was 2.3 mm. (Type A: 2.0 mm, Type B: 3.2 mm, Type C: 2.4 mm and difference between A and B was significant statistically (p < 0.037)). 4. The mean depression of zygomatic arch fracture was 2.1 mm in excellent group, 2.4 mm in good group and 5.2 mm in poor group and difference between excellent and poor, and between good and poor group were statistically significant (p < 0.0001). 5. On result of subjective satisfaction, number of excellent case was 17(48.6%), it of good case was 15(42.9%) and it of poor case was 3(8.6%) (Type A: 9, 7, 0, Type B: 5, 7, 2 and Type C: 3, 1, 1 excellent, good and poor in sequence). 6. The mean depression of overcorrection group(17, 8, 1 excellent good and poor in sequence) and nonovercorrection group(2, 5 and 2 in excellent, good and poor in sequence) was 2.26 and 3.6 mm in each other(p < 0.004). After reviewing all of results, it is concluded that Gillies' method is acceptable as the 1st choice for the reduction method of an isolated zygomatic arch.
Subject(s)
Humans , Depression , Follow-Up Studies , Zygoma , Zygomatic FracturesABSTRACT
The survival of skin flap has vital importance in plastic surgery. Many clinical and experimental researches have been carried out to increase the survival of skin flap. As a result of these researches, many drugs have been used clinically and experimentally for increasing the survival of skin flap, and prostaglandin E1 is known to be used for improving peripheral circulatory disturbance. The pharmacophysiologic mechanisms of the effect of prostaglandin E1 are 1) increasing blood flow by dilatation of smooth muscle of small sized vessels, 2) inhibition of aggregation of platelets, 3) increasing arteriolar blood flow by improving fluidity of erythrocytes, 4) preclusion of free-radical formation, 5) decreasing the endothelial cell damage by down- regulation of sensitivity for eosinophils, 6) making the endothelial cell be refractory to adrenergic stimulation, and 7) promotion of secretion of erythropoietin in the kidney. In this terms, in order to validate effectiveness of preoperative administration of prostaglandin E1 as a pharmacological flap delay, following experimental study was performed. Forty male Sprague-Dawley rats were divided into 4 groups and caudally based 2x8 cmsized flap was elevated on dorsal surface. In group 1, normal saline (0.25 ml/kg) was injected intraperitoneally as control, in group 2, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for preoperative seven days, in group 3, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for seven preoperative days, and in group 4, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for seven days preoperatively and for seven postoperative days. On the seventh postoperative day, the animals were sacrificed and the flap survival area was measured. The following results were obtained. 1. On the seventh postoperative day, the flap survival rates of group 2, 3, 4 were higher than that of group 1 with a statistical significance. 2. On the seventh postoperative day, the flap survival rate of group 3 was higher than group 2, but there was no statistical significance. 3. On the seventh postoperative day, the flap survival rate of group 4 was higher than that of group 2 and 3 with a statistical significance.In conclusion, preoperative administrations of prostaglandin E1 increase flap survival equally as when it is administrated postoperatively, and the improvement in flap survival can be enhanced by continuous administration of prostaglandin E1 in preoperative and postoperative period. So it is expected that surgical flap delay procedure is replaced by pharmacological flap delay by the use of prostaglandin E1 preoperatively.
Subject(s)
Animals , Humans , Male , Rats , Alprostadil , Dilatation , Endothelial Cells , Eosinophils , Erythrocytes , Erythropoietin , Kidney , Muscle, Smooth , Postoperative Period , Rats, Sprague-Dawley , Skin , Surgery, Plastic , Surgical Flaps , Survival RateABSTRACT
An aneurysm occurs in association with trauma, atherosclerosis, infection and congenital diseases. Among these, the traumatic arterial aneurysms developed from blunt trauma, crushing injury, perforation, and lacerations of vessels. Generally, most traumatic arterial aneurysms are false type, so called pseudoaneurysm. A pseudoaneurysm occurs by incomplete laceration of the vessel wall or partial division of the vessel. The vascular injury will make hematoma and fibrosis of neighboring tissues. After two to eight weeks post-trauma, the organized hematoma is liquefied and the fibrous tissue acts as an aneurysmal sac. We have experienced a case of dorsalis pedis artery pseudoaneurysm associated with arterial cannulation. So, we report a case of traumatic pseudoaneurysm with a review of literature.
