Outfracture of the inferior turbinates during superior repositioning Le Fort I osteotomy with cone-beam computed tomographic analysis of the volume of the nasal cavity.

We have investigated the volumes of the nasal cavities of 35 patients treated with superior repositioning Le Fort I osteotomy by analysing cone-beam computed tomography (CT) data with a 3-dimensional reconstruction program to correlate changes in the volume of the nasal cavity that were associated with the maxillary superior repositioning and the role of outfracture of the inferior turbinates. The patients were treated at the Pusan National Dental Hospital during the 14-month period January 2011-March 2012.. The patients were divided into two groups, the first of which consisted of 20 patients who had superior repositioning of 4mm or more with a mean superior movement of 5.2mm and outfracture of the inferior turbinates (outfracture group). The second group consisted of 15 patients who also had more than 4mm impaction with a mean superior movement of 5.0mm and for whom outfracture was not done (no outfracture group). Nasal symptoms were investigated preoperatively and 6 months postoperatively using the Nasal Obstruction Symptom Evaluation (NOSE) scale, and 3-dimensional volumetric analysis was made using cone-beam CT data to assess changes in nasal volume. There were significant differences between the groups in volumetric changes (V1-V2) (p=0.001) but no significant differences between the sexes. The volume of the nasal cavity in the outfracture group decreased by 20% after superior repositioning, but that in the no outfracture group decreased by 33%. Among the 20 patients in the outfracture group not one complained of nasal symptoms postoperatively. We conclude that outfracture of the inferior turbinates should be considered when the amount of superior movement of maxilla is more than 4mm.

Facial Bone Fracture Patients Visiting Pusan National University Hospital in Busan and Yangsan: Trends and Risks.

PURPOSE: This study examined patients with facial bone fracture visiting Pusan National University Dental Hospital to understand the trends, and to enhance appropriate care and treatment for patients with facial bone fracture. METHODS: We investigated 531 patients presenting with facial bone fracture in Yangsan and 802 patients in Busan from January 2010 to December 2013. We divided the patients by year, month, gender, age, site, and cause to compare with historic data and other studies. RESULTS: The gender ratio was 3.58:1 in Yangsan and 4.31:1 in Busan. Patients aged in their 20s had the highest number of facial bone fractures in both Yangsan and Busan. The most frequent fracture site was the mandible, and the most frequent cause was slip down in both Yangsan and Busan. CONCLUSION: The investigation and comparison of patients with facial bone fracture who visited Pusan National University Hospital located at Yangsan and Busan from 2010 to 2013 found a difference in the total number of patients at each hospital, but the trends were not significantly different.

The impact factors on 5-year survival rate in patients operated with oral cancer.

OBJECTIVES: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. MATERIALS AND METHODS: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. RESULTS: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. CONCLUSION: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.