ABSTRACT
Endochondral pseudocyst of the ear is a rare, benign, non-inflammatory cystic disease. It is known that there are a variety of treatment methods for pseudocyst, which is mainly common in the scaphoid or triangular fossa of the ear. Pseudocyst formation is prevalent in the residual cavity of the ear. So, to prevent a recurrence, a surgical approach is also required, but management through compression is necessary after surgery. Applying a cube magnet to the lesion to press provides patient convenience and facilitates continuous management.
ABSTRACT
Intramuscular hemangioma is a rare vascular benign proliferation that can occur within any muscle, particularly in the trunk and extremities. In the head and neck region, the masseter muscle is most commonly involved, followed by the periorbital and sternocleidomastoid muscles. Diagnosing intramuscular hemangioma is challenging because there are no characteristic symptoms; instead, magnetic resonance imaging is the best imaging modality to diagnose these lesions. Complete surgical resection is the treatment of choice, although the local recurrence rate is high. Herein, we report a rare case of intramuscular hemangioma located in the zygomaticus minor muscle, which is related to smiling and usually runs along the orbicularis oculi muscle. Distinguishing or separating these two muscles is challenging. However, based on the muscle vector of the midface and radiological findings, the two muscles were successfully separated. The zygomaticus minor was cut very slightly to approach to the lesion and the muscle fibers were split to excise it. A follow-up examination revealed no nerve damage or muscle dysfunction at 4 weeks postoperatively. This rare case may serve as a reference for managing intramuscular hemangioma in the head and neck region.
ABSTRACT
Intramuscular hemangioma is a rare vascular benign proliferation that can occur within any muscle, particularly in the trunk and extremities. In the head and neck region, the masseter muscle is most commonly involved, followed by the periorbital and sternocleidomastoid muscles. Diagnosing intramuscular hemangioma is challenging because there are no characteristic symptoms; instead, magnetic resonance imaging is the best imaging modality to diagnose these lesions. Complete surgical resection is the treatment of choice, although the local recurrence rate is high. Herein, we report a rare case of intramuscular hemangioma located in the zygomaticus minor muscle, which is related to smiling and usually runs along the orbicularis oculi muscle. Distinguishing or separating these two muscles is challenging. However, based on the muscle vector of the midface and radiological findings, the two muscles were successfully separated. The zygomaticus minor was cut very slightly to approach to the lesion and the muscle fibers were split to excise it. A follow-up examination revealed no nerve damage or muscle dysfunction at 4 weeks postoperatively. This rare case may serve as a reference for managing intramuscular hemangioma in the head and neck region.
ABSTRACT
Free flap surgery is commonly used for extensive facial burn. However, free flap surgery requires long operation time and difficult technique. Also, it requires further procedure to prepare the recipient vessels. Hence, applying pedicle flap surgery instead of free flap surgery is effective for patients with facial burn. Among a wide range of pedicle flaps, we performed lower trapezius myocutaneous pedicle flap to patients with third degree facial burn and got satisfactory results without complications. Lower trapezius myocutaneous pedicle flap has a wide arc of rotation so that it can cover middle and lower part of the face. Furthermore, it is thinner than other myocutaneous pedicle flap that can be used for facial reconstruction. Due to these advantages, lower trapezius myocutaneous pedicle can be an attractive option for the reconstruction of facial burn.
ABSTRACT
Purpose@#A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. @*Methods@#A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. @*Results@#Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. @*Conclusion@#Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.
ABSTRACT
Postburn scar contracture of sole can cause musculoskeletal deformity, restricted range of motion, and decreased quality of life. It is very important to exhibit similar characteristics of the sole when reconstructing the sole because it has to resist shearing force and weight bearing. In this case, we performed medialis pedis free flap for the postburn scar contracture of the sole and the flap survived without complication. The patient satisfied with functional and aesthetic outcomes. Medialis pedis free flap, which is harvested adjacent to the sole, can show similar characteristic of the sole and maintain adequate contour.Moreover, this flap can be harvested without sacrifice of major vessel or nerve. Due to these advantages, medialis pedis free flap can be an ideal option for the reconstruction of the sole.
ABSTRACT
Trichoepithelioma is a benign hair follicle tumor that can undergo malignant transformation into basal cell carcinoma in rare cases. Due to the similar clinical and histological features of trichoepithelioma and basal cell carcinoma, distinguishing between these types of tumors can be a diagnostic challenge. Punch biopsy obtains only a small sample of the entire lesion, and thus inherently involves a risk of misdiagnosis between histologically similar diseases. Therefore, if the possibility of misdiagnosis can reasonably be suspected, clinicians should conduct an excisional biopsy or immunohistochemical staining (e.g., CD10 and Bcl-2) to ensure an exact diagnosis. Although trichoepithelioma is benign, the surgical excision of solitary trichoepithelioma should be considered in order to avoid the possibility of malignant transformation, which has occasionally been documented for multiple familial trichoepitheliomas. Herein, we report a case that was initially misdiagnosed as trichoepithelioma before ultimately being diagnosed as basal cell carcinoma through excision and immunohistochemical staining.
ABSTRACT
The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.
ABSTRACT
Parotid gland plays the most critical role in saliva secretion in the oral cavity. Parotid gland injuries due to facial trauma can cause various complications such as formation of a fistula or sialocele. Thus, such saliva-related complications can interfere with wound healing and increase the risk of infection. Several previous studies have discussed the treatment of fistula or sialocele. Nonetheless, prevention of such complications is of utmost importance. We present a case of parotid gland injury due to trauma to the cheeks that was surgically treated, with early postoperative management involving oral administration of nortriptyline and closed drainage, without complications.
ABSTRACT
Skin cancer, which often occurs as a result of skin exposure to ultraviolet light radiation, usuallypresents with characteristic abnormal features, such as ulcerative lesions, irregular morphology,bleeding, and excessive growth. Therefore, skin cancer rarely resembles a benign tumor on visualinspection. Nonetheless, squamous cell carcinoma and basal cell carcinoma with nodular or polypoidfeatures can have a similar appearance to that of benign tumors, meaning that they aresometimes misdiagnosed as benign. As benign and malignant tumors have some overlappingfeatures, clinicians sometimes use additional imaging techniques such as ultrasonography to improvethe accuracy of the diagnosis because even a malignant tumor that externally resembles abenign tumor generally has internal morphological features characteristic of malignancy, such asinvasion and irregular borders. However, these imaging tools also have limitations, and punch orexcisional biopsy can be needed if malignancy cannot be completely ruled out. Herein, we reporta case of skin malignancy initially misdiagnosed as a benign epidermal cyst based on external visualinspection and ultrasonography.
ABSTRACT
Congenital cystic lymphatic malformations on the extremities are very rare. The patient described in this case study presented with a cutaneous and pedicled macrocystic lymphatic malformation that was eliminated by electrocauterization. A 4-day-old female infant with a congenital cutaneous mass on the dorsal area of her left first metacarpophalangeal joint presented to an outpatient clinic. An electrocautery device was used to cut the pedicle gently with minimal bleeding to avoid mass rupture and to minimize morbidity. A simple wet dressing was applied for 1 week, and the wound subsequently healed completely. Cutaneous macrocystic lymphatic malformations are very rare, especially on the extremities, and no consensus exists on their treatment, which has not been previously described. This report presents this rare case, along with a review of the literature.
Subject(s)
Female , Humans , Infant , Ambulatory Care Facilities , Bandages , Consensus , Electrocoagulation , Extremities , Hemorrhage , Lymphatic Abnormalities , Lymphocele , Metacarpophalangeal Joint , Rupture , Skin Neoplasms , Upper Extremity , Wounds and InjuriesABSTRACT
BACKGROUND: Some parts of a maxillary fracture—for example, the medial and posterior walls—may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls.METHODS: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated.RESULTS: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002).CONCLUSION: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.
Subject(s)
Humans , Facial Bones , Fracture Healing , Fractures, Bone , Maxilla , Maxillary Fractures , Maxillary Sinus , Periosteum , Retrospective Studies , Surgeons , Tomography, X-Ray ComputedABSTRACT
Angiomyolipomas are hamartomatous lesions consisting of smooth muscle bundles, thick-walled blood vessels, and mature adipocytes. They are usually found in the kidneys of tuberous sclerosis patients and more rarely in other organs, such as the liver, the oral cavity, the sinonasal tract, the heart, the large intestines, the lungs, and the skin. Cutaneous angiomyolipoma has shown to be very rare and generally occurs at the ends of the digits, the elbows, the ears, and the nose. Herein, we report the first documented case of angiomyolipoma of the glabellar region.
Subject(s)
Humans , Adipocytes , Angiomyolipoma , Blood Vessels , Ear , Elbow , Heart , Intestines , Kidney , Liver , Lung , Mouth , Muscle, Smooth , Nose , Perivascular Epithelioid Cell Neoplasms , Skin , Tuberous SclerosisABSTRACT
Asian eyes may have a narrow palpebral fissure and an upward Mongolian slant that is sometimes perceived as an angry or unfavorable expression. Among the various methods of oculoplastic surgery, lateral canthoplasty can alter the structure of the eyes such that they appear much bigger, thereby conveying a more favorable expression. We performed a lateral canthoplasty in which the lower eyelid tarsus was fixed to the periosteum while the lateral canthus was moved downward and backward. Here, we describe the surgical procedure we used to perform this technique.
Subject(s)
Humans , Ankle , Asian People , Blepharoplasty , Cosmetic Techniques , Eyelids , Lacrimal Apparatus , PeriosteumABSTRACT
Asian eyes may have a narrow palpebral fissure and an upward Mongolian slant that is sometimes perceived as an angry or unfavorable expression. Among the various methods of oculoplastic surgery, lateral canthoplasty can alter the structure of the eyes such that they appear much bigger, thereby conveying a more favorable expression. We performed a lateral canthoplasty in which the lower eyelid tarsus was fixed to the periosteum while the lateral canthus was moved downward and backward. Here, we describe the surgical procedure we used to perform this technique.
Subject(s)
Humans , Ankle , Asian People , Blepharoplasty , Cosmetic Techniques , Eyelids , Lacrimal Apparatus , PeriosteumABSTRACT
BACKGROUND: The incidence and etiology of facial bone fracture differ widely according to time and geographic setting. Because of this, prevention and management of facial bone fracture requires ongoing research. This study examines the relationship between socioeconomic status and the incidence of facial bone fractures in patients who had been admitted for facial bone fractures. METHODS: A retrospective study was performed for all patients admitted for facial bone fracture at the National Medical Center (Seoul, Korea) from 2010 to 2014. We sought correlations amongst age, gender, fracture type, injury mechanism, alcohol consumption, and type of medical insurance. RESULTS: Out of the 303 patients meeting inclusion criteria, 214 (70.6%) patients were enrolled in National Health Insurance (NHI), 46 (15.2%) patients had Medical Aid, and 43 (14.2%) patients were homeless. The main causes of facial bone fractures were accidental trauma (51.4%), physical altercation (23.1%), and traffic accident (14.2%). On Pearson's chi-square test, alcohol consumption was correlated significantly with accidental trauma (p<0.05). And, the ratio of alcohol consumption leading to facial bone fractures differed significantly in the homeless group compared to the NHI group and the Medical Aid group (p<0.05). CONCLUSION: We found a significant inverse correlation between economic status and the incidence of facial bone fractures caused by alcohol consumption. Our findings indicate that more elaborate guidelines and prevention programs are needed for socioeconomically marginalized populations.
Subject(s)
Humans , Accidents, Traffic , Alcohol Drinking , Facial Bones , Incidence , Insurance , National Health Programs , Retrospective Studies , Social ClassABSTRACT
BACKGROUND: In patients with medial orbital wall fracture, predicting the correlation between the degree of enophthalmos and the extent of fracture is essential for deciding on surgical treatment. We conducted this retrospective study to identify the correlation between the two parameters. METHODS: We quantitatively analyzed the correlation between the area of the bone defect and the degree of enophthalmos on computed tomography scans in 81 patients with medial orbital wall fracture who had been left untreated for more than six months. RESULTS: There was a significant linear positive correlation between the area of the medial orbital wall fracture and the degree of enophthalmos with a formula of E=0.705A+0.061 (E, the degree of enophthalmos; A, the area of bone defect) (Pearson's correlation coefficient, 0.812) (P<0.05). In addition, that there were no cases in which the degree of enophthalmos was greater than 2 mm when the area of the medial orbital wall fracture was smaller than 1.90 cm2. CONCLUSIONS: Our results indicate not only that 2 mm of enophthalmos corresponds to a bone defect area of approximately 2.75 cm2 in patients with medial orbital wall fracture but also that the degree of enophthalmos could be quantitatively predicted based on the area of the bone defect even more than six months after trauma.