Reconstruction after Mandibular Resection in Head and Neck Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mandible resection for head and neck tumors causes disturbance of mastication, deglutition, articulation, and cosmesis. Therefore, proper mandibular reconstruction is very important for physiologic and esthetic restoration. The purpose of this study is to compare the various methods of mandibular reconstruction. MATERIALS AND METHOD: This study was comprised of 13 cases of mandibular reconstruction at Kangdong Sacred Heart Hospital, from March 1991 to December 1994. All cases were analyzed according to the causes, size and sites of mandibular resection, timing of mandibular reconstruction and the methods of mandibular reconstruction. RESULTS: The majority of patients (11 cases) in this series underwent primary reconstruction. Eight patients underwent free tissue transfer for reconstruction, with special 4 cases of iliac free flap and 3 cases of fibular free flap. CONCLUSION: Even though there are many methods of mandibular reconstruction, primary reconstruction with free flaps using fibular and iliac bone, in particular, are suited for oromandibular defect.

Prognostic Significance of Ki-67 Index and Expression of Cyclin D1 in Squamous Cell Carcinoma of the Larynx and Hypopharynx / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various host and tumor parameters, particularly by the tumor size and lymph node metastasis have been studied in an attempt to evaluate and decide the optimal treatment of the patients with head and neck squamous cell carcinoma. However, it has been necessary that the prognostic parameters can be useful to evaluate the biological behaviors of the malignancy. The Ki-67 is a proliferative marker of tumor cells and cyclin D1 is a cell cycle regulator essential for G1 phase progression. Loss of regulation of cyclin D1 is likely to contribute to tumor development. The author evaluated the prognostic significance of cyclin D1 and Ki-67 in the carcinoma of larynx and hypopharynx to determine the relationship with the various clinicopathological parameters. MATERIALS AND METHODS: Paraffin embedded tissue specimens from 40 cases of squamous cell carcinoma of the larynx and hypopharynx were studied by immunohistochemical method using the Ki-67 and cyclin D1 antibody. K1-67 index and expression of cyclin D1 were compared with the recurrence, survival rate, disease free time and other clinicopathological parameters such as, primary site, pathologic differentiation, tumor stage and lymph node metastasis. RESULTS: The higher Ki-67 index was significantly correlated with poorer pathologic differentiation, and shorter disease free time. But there was no significant correlation between over expression of cyclin D1 and any factor for the head and neck cancer. However, the expression of cyclin D1 had a significant positive relationship with Ki-67 index (p<0.05). CONCLUSION: Ki-67 index is a good prognostic factors and cyclin D1 may be important in tumorigenesis for squamous cell cancer of the larynx and hypopharynx.

A Case of Jugular Bulb Injury by the External Ear Foreign Body / 대한이비인후과학회지

Foreign bodies of the external ear have been frequently encountered in the otolaryngological field. Recently, we experienced an interesting case of jugular bulb injury penetrating through the external auditory canal by an ear foreign body (woodswab), which was removed via mastoidectomy and facial recess approach. Immediately after removal of the foreign body, massive bleeding was followed and was controlled by SurgicelR packing and compression. Reporting this case, we suggest that special attention should be paid if the ear foreign body is associated with massive bleeding.

A Case of Basal Cell Adenocarcinoma in the Parotid Gland / 대한이비인후과학회지

Basal cell adenoma of salivary gland is an established variant of monomorphic adenoma. Few cases of malignant basal cell neoplasms have appeared in the literature. Basal cell adenocarcinoma has not only morphologic characteristics of the basal cell adenoma but also infiltrative, perineural and intravascular growth features that indicate a malignant potential. Some cases of these tumors which metastasized to the lymph nodes and lung have been reported. The peak incidence of age is in the fifth decade of life, and there is no gender predilection. The parotid gland is a predominant site of involvement. The authors have experienced such case of basal cell adenocarcinoma, which was presented by a single parotid mass. The tumor was removed by total parotidectomy with preservation of the facial nerve.