Soft Palate Reconstruction in Oral Cavity and Oropharyngeal Cancers / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Various kinds of flaps are used for reconstruction of defected soft palate, and with these, physiologic functions can be preserved. We report the clinical results of our 44 consecutive soft palate reconstructions in oral and oropharyngeal cancers. SUBJECTS AND METHOD: We reviewed the medical records of patients who were offered soft palate reconstruction with various kinds of flaps after ablative surgery of oral and oropharyngeal cancer from July 1997 to July 2004 and analyzed primary site, resection area of soft palate, reconstruction methods and postoperative functions using Modified barium swallow (MBS), articulation and resonance test. RESULTS: Various kinds of flaps were used according to the resected area of soft palate. In cases of resection area less than 1/3 (63.6%), the reconstruction methods were local flap (7.1%), rectus abdominis myocutaneous flap (3.6%), lateral thigh free flap (LTFF)(3.6%), and radial forearm free flap (RFFF)(85.7%). In cases of resection area that is more than 1/3 of the total resection, all cases were reconstructed with RFFF, combining more complex techniques such as double folding, palmaris longus tendon, and superiorly-based pharyngeal flap. Velopharyngeal insufficiency (VPI) was examined in only 2 (11.8%) patients, and in residue after swallowing was examined in 10 (41.2%) patients. Postoperative pronunciation was 'good' in 15 (68.2%) patients. CONCLUSION: In oral and oropharyngeal cancer, reconstruction of resected soft palate using various kinds of flaps is very useful and effective in postoperative physiologic functions such as in swallowing and pronunciation.

Clinical Analysis of Hearing Loss after Mild Head Trauma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We evaluated the clinical characteristics of hearing impairment in patients who suffered a blunt head trauma without any organic problems, including temporal bone fracture or intracranial hemorrhage. SUBJECTS AND METHOD: This retrospective study examined 42 patients presenting with hearing impairment after blunt head trauma within five recent years. This study included only patients without temporal bone fracture or intracranial hemorrhage. RESULTS: Most patients (90.5%) complained of associated auditory symptoms including tinnitus, dizziness, earfullness and otalgia as well as headache. In 38 patients (90.5%), the symptom was developed on the injured day. Fifteen ears of 13 patients showed sensorineural hearing loss, 2 ears of 2 patients conductive hearing loss, and 10 ears of 8 patients mixed hearing loss. Twenty-four ears of 22 patients showed sensorineural hearing loss only above 4 kHz, 8 ears of 7 patients mild hearing loss, 10 ears of 8 patients moderate hearing loss, 3 ears of 3 patients had a moderately-severe hearing loss, and 6 ears of 6 patients had a profound hearing loss. All cases (24 ears of 22 patients) who had a normal four-tone average complained many otologic symptoms other than a hearing loss. CONCLUSION: Blunt head injury is one of the most common causes of the neurologic disorders. It is important to perform thorough assessment of auditory symptoms as soon as possible. Otologic consultation should be sought in all cases for appropriate management.