ABSTRACT
BACKGROUND AND OBJECTIVES: Nowadays, temporalis fascia is the most commonly used graft material for closure of the tympanic membrane perforation, with the reported success rates of 90% or more. Fat graft myringoplasty has been used for closure of small tympanic membrane perforation and it appeared to be a safe, simple, efficient method. Several authors reported different success rates of fat graft myringoplasty from 70% to 97%. The aim of this study was to evaluate the outcomes of myringoplasty using autogenous fat graft performed in our department. MATERIALS AND METHODS: We reviewed the medical records of 54 patients who underwent fat graft myringoplasty from January 1999 to June 2000. RESULTS: Of 54 patients, 49 patients were successfully treated by fat graft myringoplasy, so the overall success rate was 90.7%. The success rate reduced with increasing size of perforation. Age, the location of perforation, experience of the surgeon, site of harvesting did not influence the success rate significantly. CONCLUSION: We estimated the success rate for fat graft myringoplasty as 90.7%, and this value is similar with that for temporalis fascia. So, fat graft myringoplasty must be considered in selected cases, particularly for small tympanic membrane perforation.
Subject(s)
Humans , Fascia , Medical Records , Myringoplasty , Transplants , Tympanic Membrane PerforationABSTRACT
BACKGROUND AND OBJECTIVES: Individual genetic susceptibilities to chemical carcinogens have been recognized as a major important host factors in human cancers. The cytochrome P450 family (CYPs) and glutathione-S-transferase (GST) have been reported to be associated with risks to the smoking-related human cancers. The purpose of this study is to determine the frequencies of the genotypes of CYP1A1 and GSTM1 genes in healthy control of Koreans and to identify the high-risk genotypes of these metabolic genes in head and neck cancer patients. MAERIALS AND METHODS: Ninety-six healthy controls and 93 head and neck squamous cell carcinoma patients are analysed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: The distributions of CYP1A1 and GSTM1 in healthy controls according to the MspI site and absence or presence of PCR products were as following: m1/m1:m1/m2:m2/m2=39.6%:47.9%:12.5%, GSTM1 (-):GSTM1 (+)=45%:55%. GSTM1 (-) type and CYP1A1 m2/m2 types were more frequent in cancer patients than healthy controls. Among the combined genotypes of CYP1A1 and GSTM1 genes, the relative risk of CYP1A1 m1/m2, GSTM1 (-) genotypes was 2.13 times of relative odds' ratio in head and neck cancer patients. According to the tumor location, CYP1A1 m2/m2, GSTM1 (-) genotypes of larynx and CYP1A1 m1/m2, GSTM1 (-) genotypes of oral and pharynx were the highest risk groups to cancers in their locations. CONCLUSION: These results suggest that the genetic polymorphisms of CYP1A1 and GSTM1 were an important major factor to determine the individual susceptibility to head and neck cancers in Korean. And these polymorphisms and cancers susceptibile genotypes of CYP1A1 and GSTM1 in Korean population are very unique in comparison with the other ethinics.
Subject(s)
Humans , Carcinogens , Carcinoma, Squamous Cell , Cytochrome P-450 CYP1A1 , Cytochrome P-450 Enzyme System , Cytochromes , Genetic Predisposition to Disease , Genotype , Glutathione Transferase , Glutathione , Head and Neck Neoplasms , Head , Larynx , Neck , Pharynx , Polymerase Chain Reaction , Polymorphism, GeneticABSTRACT
BACKGROUND AND OBJECTIVES: An individual difference in susceptibility to chemically induced carcinomas is in part ascribed to genetic differences of metabolic activity of environmental procarcinogens. The cytochrome P450 family (CYPs) and glutathione S-transferase (GST) have been reported to be associated with human cancers related with smoking. The purpose of this study was to determine the frequencies of the genotypes of CYP1A1 and GSTM1 genes in healthy control of Koreans and to identify the high-risk genotypes of these metabolic genes in head and neck cancer patients. MATERIALS AND METHOD: The genetic polymorphism of CYP1A1 exon 7 and GSTM1 genes were analysed in a group of 115 healthy Koreans and 107 head and neck squamous cell carcinoma patients using allelic-specific polymerase chain reaction. RESULTS: The genotypes of CYP1A1 exon 7 (Ile/Ile, Ile/Val and Val/Val) were 59.1%, 36.5% and 4.4%, respectively, in the healthy control group, and 57.0%, 31.8% and 11.2%, respectively, in the cancer patients . The distributions of GSTM1 [GSTM1 (-), GSTM1 (+)] in healthy control group were 46.1%, 53.9% respectively, and 53.3%, 46.7%, respectively, in the cancer patients. The relative risk (odds ratio) for combination of CYP1A1 Val/Val and GSTM1 (-) genotype was estimated to be 5.17, taking the risk of combined genotype Ile/Ile and GSTM1 (+) as a reference in cancer patients. CONCLUSION: These results suggest that the genetic polymorphisms of CYP1A1 exon 7 and GSTM1 were an important major factor in determining the individual susceptibility to head and neck squamous cell carcinoma in Koreans.
Subject(s)
Humans , Carcinoma, Squamous Cell , Cytochrome P-450 CYP1A1 , Cytochrome P-450 Enzyme System , Cytochromes , Exons , Genotype , Glutathione Transferase , Glutathione , Head and Neck Neoplasms , Head , Individuality , Neck , Polymerase Chain Reaction , Polymorphism, Genetic , Smoke , SmokingABSTRACT
BACKGROUND AND OBJECTIVES: Tinnitus is the perception of a sound produced involuntarily inside the body. Tinnitus can be divided into two major categories: (1) tinnitus generated by para-auditory structure, usually from vascular or myoclonic sources: and (2) tinnitus generated by the sensorineural auditory system. With the recent advent of magnetic resonance imaging and auditory brain stem response, it is now possible to diagnose objectively the lesion as causes of intractable tinnitus while they are still quite rare. So, we can consider the surgical treatment on objective causes of tinnitus. MATERIALS AND METHODS: The authors analysed forty patients with tinnitus, who had visited the OPD of our ENT dept. from 1998 April to 1998 September, through history taking, physical examination, many objective auditory tests including auditory brain stem response (ABR) and MRI scan. RESULTS: In ABR test, conduction pathway of BAEP (Brain stem auditory evoked potential) was abnormal in 31 (59.6%) patients. Average latency of I-III, III-V and I-V were 2.29 msec, 1.92 msec and 4.22 msec. The 22 of 31 patients who had abnormal conduction pathway of BAEP showed hearing disturbance. Two patients showing normal conduction pathway of BAEP had hearing disturbance. In MRI scan, abnormal findings were observed only in 13 (25%) patients. CONCLUSION: The use of ABR and MRI to diagnose intractable tinnitus might be valuable in routine tests.
Subject(s)
Humans , Evoked Potentials, Auditory, Brain Stem , Hearing , Magnetic Resonance Imaging , Physical Examination , TinnitusABSTRACT
BACKGROUND AND OBJECTIVES: Telomeres are specialized structures found at the ends of eukaryotic chromosomes. Telomeres stabilize the chromosome and protect DNA from illegitimate recombination. Telomerase is a ribonucleoprotein, a RNA dependent DNA polymerase, and acts as a reverse transcriptase-like enzyme, which maintains telomere length by adding telomeric repeat units of TTAGGG to the telomeric end. These telomeric repeat units have been found only in cells with unlimited replicative potential such as sperm cells, immortalized cell lines and cancer tissues, but not in normal somatic cells. Telomerase is believed to be characteristic of and may be the best indicator of cell immortality. This study was performed to indentify the role of telomerase activity in the multistep carcinogenesis of oral squamous cell carcinoma. MATERIALS AND METHODS:We performed a telomeric repeat amplification protocol assay in 10 oral leukoplakia, 5 tongue cancers and 10 normal oral mucosa tissues. RESULTS: All the five tongue cancer tissues showed telomerase activity. Although telomerase activity was detected in 9 of 10 oral leukoplakia tissues and in 9 of 10 normal oral mucosa tissues, the activity of telomerase was low compared to that of cancer tissues by semiquantitative analysis. CONCLUSION: These findings suggest that telomerase maybe play a key role in multistep carcinogenesis of oral malignancy. Telomerase activity was detectable in normal oral mucosa with renewal activity suggested that this enzyme might be an indicator of cell proliferation.
Subject(s)
Carcinogenesis , Carcinoma, Squamous Cell , Cell Line , Cell Proliferation , DNA , Leukoplakia, Oral , Mouth Mucosa , Mouth Neoplasms , Recombination, Genetic , Ribonucleoproteins , RNA-Directed DNA Polymerase , Spermatozoa , Telomerase , Telomere , Tongue NeoplasmsABSTRACT
BACKGROUND AND OBJECTIVES: Free fascia flaps provide neovascularity without adding bulk and are particularly suited to serve in microvascular transfers to recipient beds carrying an epithelial lining. As such, free fascia flaps may be useful in providing a mucosal lining at the interior side of the reconstructed larynx. This study examines the reliability of a composite reconstruction method using a combined vascular flap for the laryngeal defects. MATERIALS AND METHODS: A vascularized fascial flap which was consistently present and easy to isolate was developed in dogs. Laryngeal defects were reconstructed with a combined vascular flap consisting of lateral thoracic fascia, which is also used as a transferable vascular be). A buccal mucosa graft was fixed on this bed to provide as an internal lining. An autogenous auricular cartilage graft, circumferentially wrapped in vascular connective tissue, was used as an external support. RESULTS: There were no respiratory distress, limitation of activity, and laryngeal stenosis after the laryngeal reconstruction. CONCLUSION: We have maintained the positive aspects as well as improved the negative aspects of the experiment and devised a new series of experiments which are now in progress. The lateral thoracic fascia is used as a transferable bed with an autogenous cartilage for support. They may be a useful tool for laryngotracheal reconstruction.
Subject(s)
Animals , Dogs , Cartilage , Connective Tissue , Ear Cartilage , Fascia , Laryngostenosis , Larynx , Mouth Mucosa , TransplantsABSTRACT
BACKGROUND AND OBJECTIVES: The Klippel-Feil syndrome is a congenital anomaly characterized by fusion of the cervical vertebrae. It is often associated with serious congenital anomalies of the nervous, cardivascular, respiratory, and urogenital systems. Another anomaly often associated is hearing loss. For those cases of the Klippel-Feil syndrome accompanying hearing loss, the middle and inner ear deformities were reported in some, whereas aural atresia was extremely rare. The purpose of this paper is to report the fact that Klippel-Feil syndrome can be combined with congenital aural atresia and deafness. MATERIAL & METHOD: Recently we experienced a case of Klippel-Feil syndrome in a 28 year old female. In this case, the second and third cervical vertebrae were fused. The patient also presented a short neck, cardiovascular anomaly, bilateral congenital deafness, and bilateral congenital aural atresia. Radiographical observation showed soft tissue density in the bilateral external uditory canals and stenosis of bilateral internal auditory canals, but no definite middle and inner ear anomalies in the temporal bone were found by computerized tomogram. RESULT: As operative procedures, canaloplasty and meatoplasty were performed after cholesteatoma removal from the external auditory canal. The external auditory canal has been well maintained following the surgery. CONCLUSION: For patients with the Klippel-Feil syndrome, we must do full evaluation of the whole body in order to treat first any life threatening problems. Evaluation of hearing should then be followed to implement appropriate treatment and early rehabilitation.
Subject(s)
Adult , Female , Humans , Cervical Vertebrae , Cholesteatoma , Congenital Abnormalities , Constriction, Pathologic , Deafness , Ear Canal , Ear, Inner , Hearing , Hearing Loss , Klippel-Feil Syndrome , Neck , Rehabilitation , Surgical Procedures, Operative , Temporal Bone , Urogenital SystemABSTRACT
BACKGROUND AND OBJECTIVES: Since Sir Charles Bell (1829) demonstrated that motor innervation of the muscles of facial expression is by cranial nerve VII, many more research have contributed to the diagnosis and treatment of facial nerve paralysis. We attempted to evaluate the causes, arrive at accurate diagnosis and determine the treatment for facial nerve paralysis. MATERIALS AND METHODS: The authors analyzed 65 cases of facial nerve paralysis diagnosed at the Department of Otolaryngology, Hanyang University Hospital from January 1993 to December 1995. RESULTS: 1) The most common age group was the twenties. 2) The most common cause was trauma (23 cases, 35.4%). 3) The degree of facial nerve paralysis that were most common on first visits was Grade IV, based on the House-Brackmann grading method. 4) 38 cases (58.5%) were treated with chemotherapy and 27 cases (41.5%) were treated with surgical therapy. 5) Surgical techniques used were facial nerve decompression in 11 cases (40.8%), end to end anastomosis in 4 cases (14.8%), myringotomy with v-tube insertion in 4 cases (14.8%), tumor resection in 3 cases (11.1%), nerve graft in 2 cases (7.4%), mastoidectomy only in 2 cases (7.4%), and muscle transposition in one case (3.7%). CONCLUSION: In our review, the the most common degree of facial nerve paralysis on patients' first visits was Grade IV according to the House-Brackmann grading method. Statistically, there was no sexual difference in the incidences of facial nerve pals. The causes of facial nerve palsy due to trauma are recently on the rise because of increased traffic accident. However, iatrogenic incidents are decreasing because of the advance in the technical and instrumental development.
Subject(s)
Humans , Accidents, Traffic , Decompression , Diagnosis , Drug Therapy , Facial Expression , Facial Nerve , Incidence , Muscles , Otolaryngology , Paralysis , TransplantsABSTRACT
BACKGROUND: It is very difficult to evaluate the anatomy of several tiny structures of paranasal sinus(PNS), especially frontal recess area. Until now, plain X-ray, coronal and axial computed tomogram(CT) and MRI have been used as the radiologic study of PNS. However, there is a lack of full understanding with these 2 dimensional images. Routine coronal and axial CT helps us understand the structure of PNS approximately. But they have limitations in understanding the A-P directional anatomy and difficulties especially in establishing the 3 dimensional concept with frontal recess, which has the various structure as the degree of developing of agger nasi and surrounding structure of frontal recess. OBJECTIVES: We studied to resolve these difficulties and limitations in understanding the A-P directional anatomy and 3 dimensional concept of complicated structures of PNS. MATERIALS AND METHODS: We checked PNS CT in 20 patients who have been suspected to have paranasal problems, and we reconstructed each CT scan into axial and sagittal images from the thin cutted axial PNS CT by using 3 dimensional reconstruction software, SIENET magic view 1,000. RESULTS: With comparing each reconstructed images this problem, we got clear understanding of the structures of A-P direction of nasal cavity and PNS, especially frontal recess area. CONCLUSION: Three dimensional reconstructed views provides clear images in complicated anatomy of nose and paranasal sinus, so it is considered to helpful in planning of surgery.
Subject(s)
Humans , Magic , Magnetic Resonance Imaging , Nasal Cavity , Nose , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: The workup of thyroid nodule is complex, and there are many and varied indications for thyroid imaging. Ultrasonography is first-line structural investigative modality in thyroid nodular disease. It can effectively differentiate a solid from a cystic lesion. Ultrasonography is also the best study available to measure nodule size. Computed tomography provides useful information about the extension of thyroid nodules and regional lymph node involvement or local recurrence. OBJECTIVES: We analysed Ultrasonographic(US) and Computed Tomographic(CT) findings of thyroid nodule to determine the difference between a benign and a malignant mass and to evaluate the differential findings, if any. MATERIALS AND METHODS: The subjects were 80 cases with a pathologically proven thyroid nodule(US in 47 cases, CT in 33 cases) at the Hanyang University Medical Center, from July 1995 to July 1996. US and CT findings were retrospectively analysed about size, multiplicity, solid and cystic change, margin, calcification, and invasion of adjacent structures. Statistical analysis was performed using the chi-square and Fisher's exact test. RESULTS: 1) Invasion of adjacent structures was observed in 4 cases(25%) in CT, and it was proved statistically significant finding of malignacy. 2) Thyroid nodule with cervical lymphadenopathy was observed in 4 cases(25%) in CT, and it was proved as significant finding of malignancy. 3) The solid pattern of thyroid nodules was observed in 13 cases(81.3%) in CT, and it was proven statistically significant finding of malignancy. 4) The other findings of CT and US which were examined, showed no statistically significant correlation between benignancy and malignancy. CONCLUSION: CT has a significant role of differentiation between benign and malignant tumor of thyroid gland by detection of invasion of adjacent structures, solid pattern, and cervical lymphadenopathy.
Subject(s)
Academic Medical Centers , Diagnosis , Lymph Nodes , Lymphatic Diseases , Recurrence , Retrospective Studies , Thyroid Gland , Thyroid Nodule , UltrasonographyABSTRACT
BACKGROUND: Amplification of the chromosome 11q13 region has been observed in a variety of human cancers, including head and neck squamous cell carcinoma and carcinomas of breast, esophagus, lung, bladder, and liver. The chromosome 11q13 region has various putative oncogenes, of which cyclin D1 is most consistently amplfied and overexpressed. OBJECTIVES: To estabilsh the frequency and clinicopathologic correlations of cyclin D1 amplification in head and neck squamous cell carcinomas. MATERIALS AND METHODS: Fresh tissue samples were obtained from 26 patients with head and neck cancers undergoing surgery or biopsy. Amplification of cyclin D1 was evaluated in 26 head and neck squamous cell carcinomas by Southern blotting. The presence or absence of amplification was correlated with anatomic site, tumor stage, and differentiation pattern. RESULTS: Five tumors of 26(19%) showed a twofold to 4-fold amplification of cyclin D1 compared with beta-actin control prove. Amplified and nonamplified groups revealed no differences in anatomic primary site, stage, N stage, and pathologic differentiation. CONCLUSION: We showed a significant incidence of cyclin D1 amplification in head and neck squamous cell carcinomas, but cannot demonstrate an association with clinical presentation and pathologic findings.
Subject(s)
Humans , Actins , Biopsy , Blotting, Southern , Breast , Carcinoma, Squamous Cell , Cyclin D1 , Cyclins , Esophagus , Head , Incidence , Liver , Lung , Neck , Oncogenes , Urinary BladderABSTRACT
BACKGROUND: Adequate exposure of skull base lesion and intraoral lesion occupying the posterior oral cavity, base of tongue, tonsil, superior hypopharynx, anterior skull base, and infratemporal space for wide-field primary surgical resection is critical to tumor ablation. The division of mandible for resection of tumor was first undertaken by Roux in 1836, and many studies renewed the interest of mandible sparing procedure for surgical treatment of oropharyngeal carcinoma. OBJECTIVES: Mandibular swing approach for gaining access to oral cavity, oropharynx, and skull base for excision of tumor, provides excellent exposure with low complication rate when there is intervening grossly normal tissue between the tumor and bone. We studied mandibular swing approach with our surgical experience, with special emphasis on its subtypes related to osteotomy sites and forms. MATERIALS AND METHOD: The records of 20 patients underwent mandibular swing approach at Hanyang University Hospital, were studied by chart review. The patients were retrospectively reviewed to assess age, sex, tumor site origin, stage of disease, types of neck dissection and methods of the reconstruction, types of the mandibular osteotomies, and difference of complication rates between symphyseal and parasymphyseal osteotomy. RESULTS: Post-operative complications occured in 6 patients(30%). But osteotomy related complication rate was 15%. Complications of osteotomy site occurred at a rate of 20% in the symphyseal osteotomy group, but no complications arose in parasymphyseal osteotomy group. CONCLUSIONS: We believe that, if the mandible is clinically and radiologically clear of malignant involvement, midline mandibulotomy is more feasible surgical approach method for treatment of oral cavity, oropharyngeal, skull base lesion.
Subject(s)
Humans , Hypopharynx , Mandible , Mandibular Osteotomy , Mouth , Neck Dissection , Oropharynx , Osteotomy , Palatine Tonsil , Retrospective Studies , Skull Base , Skull , TongueABSTRACT
This study was undertaken to investigate the histopathological change in the tracheal mucosa of rats by light microscope following acute exposure to ortho-chlorobenzylidene malononitrile(CS). 2.0g/m3 of CS was inhalated to experimental rats for 20 minutes per day during 3 days in a plastic chamber. The experimental animals were sacrificed at 12 hours, 24 hours, 3 days, and 5 days after CS gas exposure. Specimens were obtained from upper most part of tracheal mucosa of the rats. After H and E stain and PAS stain were performed, all specimens were observed by light microscope. The result were as follows: 1) At 12 hours after exposure , there were some cilia destruction, widening of lamina propria, and infiltration of inflammatory cells in subepithelial layer. Epithelial lining and goblet cells were well preserved. 2) At 24 hours after exposure, epithelial lining and basement membrane were destructed and goblet cells were decreased in number. Infiltration of inflammatory cells in subepithelial layer were as sustained and vascular congestion was observed. 3) At 3 days after exposure, regeneration of epithelial layer, goblet cells, and basement membrane were identified. In subepithelial layer, a few inflammatory cells were infiltrated. 4) At 5 days after exposure, intact epithelial layer and numerous normal goblet cells were appeared. Lamina propria was narrowed and no inflammatory cells were in subepithelial layer. The results suggested that the tracheal mucosa of the rats shows a siginificant degenerative change after acute exposure to ortho-chlorobenzylidene malononitirile. However, it was temporary and reversible change.
Subject(s)
Animals , Rats , Basement Membrane , Cilia , Estrogens, Conjugated (USP) , Goblet Cells , Inhalation , Mucous Membrane , Plastics , RegenerationABSTRACT
No abstract available.