Clinical Comparison of Transoral Removal with Sublingual Gland Preservation versus without Sublingual Gland Preservation versus Submandibular Gland Resection for Proximal Duct Stone of Submandibular Gland: Prospective Study / 대한이비인후과학회지

Background and Objectives@#Proximal submandibular stone is not a rare disease. The aim of this study is to evaluate the surgical outcomes of 3 different ways to treat proximal submandibular stone: intraoral removal of stone (IORS) with sublingual gland (SLG) resection, IORS without SLG resection and submandibular gland (SMG) resection. @*Subjects and Methods@#We prospectively reviewed the surgical outcomes of IORS with SLG resection group (22 patients), IORS without SLG resection group (35 patients) and SMG resection group (22 patients). To evaluate the surgical outcomes, we analyzed the location and size of stones, mean operation time, mean hospital stay, mean postoperative degree of pain based on a visual analog scale (0–10), and incidence of complications. @*Results@#There were no significant differences between the mean diameter of stones and lengthfrom the hilum to stones. The mean operation time was shorter in the IORS without SLG re-section group than that in IORS without SLG resection group, and was significantly shorter than that of the SMG resection group. The mean hospital stay of the IORS without SLG resection group was also shorter than that of IORS with SLG resection group, and was significantly short-er than the SMG resection group. IORS without SLG resection group felt less pain than IORS with SLG resection group and SMG resection group. Four patients who underwent IORS without SLG resection experienced transient and mild SMG swelling, and mild paresthesia was noted on the same side. All patients recovered within 3 months. Intraoral removal of proximal SMG stones exhibited several advantages over SMG resection in terms of hospital stay, mean operation, time and postoperative pain. @*Conclusion@#Based on our results, we suggest that IORS without SLG resection be selected as the primary procedure for the removal of proximal submandibular stones rather than SMG resection.

Effects of lesion size, shape, and resection amount on the final length of the scar in staged excision: An animal experiment in pigs

Background@#In staged excision procedures, it is difficult to estimate the number of excisions that will be required and the extent of scar lengthening. The purpose of this study was to investigate the effects of the size, shape, and resection amount of lesions on the outcomes of staged excision through an animal experiment. @*Methods@#In total, 20 ellipses with five different designs (n=4) were evaluated on pig skin. The experiment consisted of two groups: group 1 had excisions of the same length, but with different widths, while group 2 had excisions of the same size, but with different amounts of resection. The size of the lesions and the amount of resection were analyzed in terms of the ratio of length (long axis) and width (short axis) (S/L ratio). @*Results@#In the first group, initial ellipses measuring 5×4, 5×3, and 5×2 cm increased in size to 9.25±0.07 (185%), 8.55±0.07 (171%), and 8.10±0.14 cm (162%), respectively. In the second group, in which all ellipses measured 5×3 cm, those with a resection amount of 5×1.5, 5×2, and 5×2 cm with a fish fin grew to 8.75±0.15 (175%), 8.55±0.07 (171%), and 8.60±0.17 cm (172%), respectively. In group 1, the larger the S/L ratio, the longer the final length. In group 2, a greater resection amount was associated with a shorter final length. @*Conclusions@#We believe that the measurements of this study in terms of shape, size, and excision amount will be reasonable predictive references for staged excision procedures.

Isolated Right Ventricular Noncompaction Accompanied by Right Ventricular Failure / 대한내과학회지

Noncompaction of the ventricular myocardium is a rare congenital cardiomyopathy caused by arrest of normal endomyocardial embryogenesis. Isolated right ventricular noncompaction (IRNC) is an even rarer form of this disease. We report herein on a 68 year-old male diagnosed with IRNC who presented with right-sided heart failure, without involvement of the left ventricle. Diagnosis was achieved with the aid of echocardiography and ventriculography. Medical treatment including prescription of diuretics, a calcium channel blocker, and digitalis, improved both the symptoms and right ventricular function.

Coronary Artery Fistula Draining into Lung Parenchyma Causing Localized Pulmonary Edema: Transcatheter Closure with an Amplatzer Vascular Plug 4

Coronary artery fistula draining into lung parenchymal vasculature has not been reported. Herein, we describe a case of an 81-year-old woman who presented with a localized pulmonary edema on right upper lobe associated with coronary fistula emptied into vasculature in right upper lobe. She underwent transcatheter closure of the fistula with an Amplatzer Vascular Plug 4, which resulted in complete occlusion and improved localized pulmonary edema.