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1.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 30-36, 2022.
Article in Korean | WPRIM | ID: wpr-920276

ABSTRACT

Background and Objectives@#There have not been any studies that compared retroauricular hairline (RAH) and V-shaped incisions for parotidectomy. In this regard, we aimed to evaluate the results of RAH and V-shaped incisions.Subjects and Method Between 2016 and 2019, 81 patients who underwent parotidectomy using RAH (n=46) and V-shaped (n=35) incisions were included in this study. Patient characteristics, tumor profiles, surgical parameters, postoperative complications, and cosmetic results were assessed. Mann-Whitney U test and the chi-squared test were used to inspect differences in continuous and categorical variables between the groups, respectively. @*Results@#In the RAH and V-shaped groups, the patient age was 52.7 and 42.1 years, respectively (p=0.002), and the tumour size was 2.7 and 1.8 cm, respectively (p<0.001). All parotidectomies were successfully completed with no incision extension or major complications. There were no significant differences in surgical parameters and postoperative complications between the two groups. The subjective scar satisfaction scores assessed at 3 months postoperatively were 9.0 and 9.3 in the RAH and V-shaped groups, respectively (p=0.191). The scores of male patients were 8.9 and 9.5 in the RAH and V-shaped groups, respectively, (p=0.026), while those of the female patients were 9.2 and 9.2, respectively (p=0.906). @*Conclusion@#The RAH and V-shaped incisions yields comparable surgical and cosmetic outcomes, with high patient satisfaction. For male patients, the use of V-shaped incision, if indicated, would provide higher scar satisfaction than the use of RAH incision.

2.
Ultrasonography ; : 124-130, 2022.
Article in English | WPRIM | ID: wpr-919567

ABSTRACT

Purpose@#We aimed to evaluate the true prevalence and characteristics of vagus nerve (VN) variations using the carotid artery (CA) and the internal jugular vein (C-I axis). @*Methods@#We examined patients who underwent neck ultrasonography (US) conducted by a single operator. A VN variation was defined as a VN located anterior or medial to the C-I axis. The subtypes of VN variation were classified as anterolateral, anteromiddle, anteromedial, and medial based on the relative location of the VN to the CA. The primary outcome parameters were the prevalence of VN variations and differences according to side, age, and sex. @*Results@#Out of 536 patients, right and left VN variations were identified in 20 (3.7%) and 186 (34.7%), respectively (P<0.001). The anteromiddle type was the commonest type observed on both sides. Eight right (1.5%) and 50 left VNs (9.3%) were located <2 mm from the lateral border of the ipsilateral thyroid gland (P<0.001). The prevalence of VN variations in male and female patients was 42.1% and 32.7%, respectively (P=0.029), and that in patients aged <20, 20-39, 40-59, and ≥60 years was 23.8%, 22.5%, 34.4%, and 47.4%, respectively (P<0.001). @*Conclusion@#Variations in the VN position were relatively common on US. The variations primarily involved the left VN in the lower cervical region, and an increasing prevalence with age was observed.

3.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 414-418, 2022.
Article in Korean | WPRIM | ID: wpr-938730

ABSTRACT

Amyloidosis is a rare benign disease characterized by the extracellular deposition of nonsoluble fibrillar proteins (amyloids) within organs. Laryngeal amyloidosis (LA) accounts for only 9%-15% of all cases of amyloidosis. Since clinical manifestations and laryngoscopic findings often overlap with those of laryngeal cancer, it is challenging to differentiate LA from laryngeal cancer prior to surgical biopsy. We report a case of LA mimicking laryngeal cancer, in which the diagnosis was facilitated by preoperative ultrasonography (US) and US-guided core-needle biopsy (US-CNB) prior to surgical biopsy. The US findings of this case were distinguishable from those of laryngeal cancer, which enabled us to consider a diagnosis other than laryngeal cancer. Amyloidosis was diagnosed preoperatively using office-based percutaneous US-CNB, avoiding general anesthesia needed for suspension laryngoscopic examination. This case suggests that US and US-CNB could be used as supplementary diagnostic modalities to evaluate suspicious laryngeal masses mimicking laryngeal cancer.

4.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 253-259, 2022.
Article in Korean | WPRIM | ID: wpr-926725

ABSTRACT

In the last few decades, the standard surgical treatment for primary hyperparathyroidism (PHPT) has shifted from bilateral neck exploration to focused/minimally invasive parathyroidectomy (FMIP). This shift was accelerated by the introduction of intraoperative parathyroid hormone (IOPTH) monitoring, which can provide intraoperative information regarding the localization and complete excision of the pathological parathyroid gland during FMIP. Since the first clinical application of the IOPTH assay in 1991, IOPTH monitoring has substantially improved to date to increase its performance and availability. In addition, the clinical applications of IOPTH changed with the needs of actual clinical practice, although the fundamental concept and technique remained unchanged. In this review, we discuss the role of IOPTH monitoring in the surgical management of PHPT based on the results of contemporary studies and summarized the major issues regarding IOPTH.

5.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 19-25, 2021.
Article in Korean | WPRIM | ID: wpr-920190

ABSTRACT

Background and Objectives@#The incidence of papillary thyroid microcarcinoma (PTMC) continues to increase worldwide. However, there is a lack of a comprehensive understanding of recurrence after hemithyroidectomy in patients with PTMC. We aimed to evaluate the characteristics and risk factors of recurrence after hemithyroidectomy in patients with PTMC.Subjects and Method We included 527 patients with PTMC who underwent hemithyroidectomy between 2009 and 2017. @*Results@#At a mean follow-up of 76.4 months after hemithyroidectomy, recurrence occurred in 4.2% (22/527) of the patients. The times of recurrence were 60 months after initial surgery in 1 (4.5%), 6 (27.3%), 5 (22.7%), 4 (18.2%), 4 (18.2%), and 2 (9.1%) patient(s), respectively. The most common recurrence site was the contralateral remaining thyroid lobe. In univariate analyses, only multifocality was demonstrated to be associated with an increased risk of recurrence [hazard ratio (HR), 2.834; confidence interval (CI), 1.044-7.693; p=0.041). In multivariate analyses, multifocality (HR, 2.982; CI, 1.091-8.155; p=0.033) and central lymph node metastasis (HR, 9.649; CI, 1.238-75.217; p=0.030) were demonstrated to be associated with an increased risk of recurrence. @*Conclusion@#The follow-up after hemithyroidectomy for PTMC should focus on the postoperative 1–5-year period with meticulous inspection of the remaining thyroid lobe, particularly in patients with multifocality or central lymph node metastasis.

6.
Korean Journal of Radiology ; : 596-603, 2021.
Article in English | WPRIM | ID: wpr-902406

ABSTRACT

Objective@#To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. @*Materials and Methods@#This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. @*Results@#Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. @*Conclusion@#US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

7.
Korean Journal of Radiology ; : 596-603, 2021.
Article in English | WPRIM | ID: wpr-894702

ABSTRACT

Objective@#To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. @*Materials and Methods@#This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. @*Results@#Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. @*Conclusion@#US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

8.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 43-48, 2019.
Article in Korean | WPRIM | ID: wpr-719323

ABSTRACT

BACKGROUND AND OBJECTIVES: The purpose of the present study was to compare the results of V-shaped and modified facelift incisions for parotidectomy. SUBJECTS AND METHOD: Ninety parotidectomy patients who underwent V-shaped and modified facelift incisions from 2014 to 2018 were enrolled in this study. Patient characteristics, tumor profiles, surgical outcomes, postoperative complications, and cosmetic results were assessed for the V-shaped (n=20) and modified facelift (n=70) incision groups. RESULTS: The tumor size was significantly larger in the modified facelift incision group than in the V-shaped incision group (2.6 cm vs. 1.9 cm, p < 0.001). There were no significant differences between the two groups regarding other baseline tumor characteristics, operating time, and postoperative complications. Although the results of Vancouver Scar Scale was similar in both groups, the V-shaped incision group showed higher subjective scar satisfaction scores than the modified facelift incision group (9.3 vs. 8.6, p=0.001). CONCLUSION: The results suggest that the V-shaped incision is feasible and can provide better subjective scar satisfaction in selected parotidectomy patients without increased complications.


Subject(s)
Humans , Cicatrix , Methods , Parotid Neoplasms , Postoperative Complications , Rhytidoplasty
9.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 735-739, 2019.
Article in English | WPRIM | ID: wpr-920024

ABSTRACT

Here, we describe two cases of cervical bronchogenic cysts mimicking thyroid cancer on ultrasound (US), introducing some sources of diagnostic error with the aim of improving the understanding of cervical bronchogenic cysts. In these cases, US demonstrated ill-defined nonhomogeneous hypoechoic nodules at the inferior pole of the thyroid gland, exhibiting several echogenic foci that mimicked microcalcification of papillary thyroid carcinoma. Although cervical bronchogenic cysts can be presented as highly suspicious thyroid nodules on US, recognition of this disease entity and comprehensive understanding of its presentation can allow an appropriate diagnostic process without unnecessary diagnostic surgery.

10.
Radiation Oncology Journal ; : 82-90, 2019.
Article in English | WPRIM | ID: wpr-761003

ABSTRACT

PURPOSE: To evaluate the results of hypofractionated radiotherapy (HFX) for early glottic cancer. MATERIALS AND METHODS: Eighty-five patients with cT1-2N0M0 squamous cell carcinoma of the glottis who had undergone HFX, performed using intensity-modulated radiotherapy (IMRT, n = 66) and three-dimensional conformal radiotherapy (3D CRT, n = 19) were analyzed. For all patients, radiotherapy was administered at 60.75 Gy in 27 fractions. Forty-three patients received a simultaneous integrated boost (SIB) of 2.3–2.5 Gy per tumor fraction. RESULTS: The median follow-up duration was 29.9 months (range, 5.5 to 76.5 months). All patients achieved complete remission at a median of 50 days after the end of radiotherapy (range, 14 to 206 days). The 5-year rates for locoregional recurrence-free survival was 88.1%, and the 5-year overall survival rate was 86.2%. T2 stage was a prognostic factor for locoregional recurrence-free survival after radiotherapy (p = 0.002). SIB for the tumor did not affect disease control and survival (p = 0.191 and p = 0.387, respectively). No patients experienced acute or chronic toxicities of ≥grade 3. IMRT significantly decreased the dose administered to the carotid artery as opposed to 3D CRT (V₃₅, p < 0.001; V₅₀, p < 0.001). CONCLUSIONS: Patients treated with HFX achieved acceptable locoregional disease control rates and overall survival rates compared with previous HFX studies. A fraction size of 2.25 Gy provided good disease control regardless of SIB administration.


Subject(s)
Humans , Carcinoma, Squamous Cell , Carotid Arteries , Follow-Up Studies , Glottis , Radiotherapy , Radiotherapy, Conformal , Radiotherapy, Intensity-Modulated , Retrospective Studies , Survival Rate
11.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 42-46, 2018.
Article in Korean | WPRIM | ID: wpr-760066

ABSTRACT

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the feasibility and safety of a retroauricular hairline incision in partial superficial parotidectomy. SUBJECTS AND METHOD: Twenty-three patients who underwent partial superficial parotidectomy via retroauricular hairline incision from 2014 to 2016 were enrolled in the study. Patient's characteristics, surgical outcomes and postoperative complications were assessed. Subjective cosmetic satisfaction was assessed using a visual analog scale 3 months after surgery. RESULTS: In all 23 cases, parotid tumors were removed successfully via retroauricular hairline incision alone without any exposure failure. The mean operating time and the amount of postoperative drainage was 117.6 min (range, 75–163 min) and 51.5 mL (range, 25–91), respectively. Major complications such as permanent facial nerve paralysis and hematoma were not reported. The mean visual analogue scale score for subjective satisfaction with the incision scar was 9.0 (range, 6–10). CONCLUSION: We conclude that partial superficial parotidectomy via retroauricular hairline incision for the treatment of benign parotid tumor is technically feasible and it provides excellent cosmetic outcomes without an increase in complications.


Subject(s)
Humans , Cicatrix , Drainage , Facial Nerve , Hematoma , Methods , Paralysis , Parotid Gland , Postoperative Complications , Visual Analog Scale
12.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 605-610, 2018.
Article in Korean | WPRIM | ID: wpr-718226

ABSTRACT

BACKGROUND AND OBJECTIVES: The purpose of the present study was to evaluate the usefulness of a posterior-based buccinator myomucosal flap (the Bozola flap) for the reconstruction of oral cavity defects after tongue cancer resection. SUBJECTS AND METHOD: Fifteen patients who underwent from 2014 to 2016 reconstruction of the oral cavity with a Bozola flap after surgical management of tongue cancer were enrolled in the study. Patient characteristics, surgical outcomes, and complications associated with the Bozola flap were evaluated. RESULTS: The flap was successfully harvested and transferred in all patients. The mean flap harvesting time was 25.3 min. The donor site was closed primarily in 14 patients, and a buccal fat pad flap was used in one patient. Although partial necrosis of the flap occurred in two patients, no other major complications were noted. CONCLUSION: The results of this study demonstrate that the Bozola flap is a good option for reconstruction of moderate sized oral cavity defects in tongue cancer patients.


Subject(s)
Humans , Adipose Tissue , Methods , Mouth Mucosa , Mouth , Necrosis , Plastic Surgery Procedures , Tissue Donors , Tongue Neoplasms , Tongue
13.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 42-46, 2018.
Article in Korean | WPRIM | ID: wpr-920014

ABSTRACT

BACKGROUND AND OBJECTIVES@#The purpose of this study was to evaluate the feasibility and safety of a retroauricular hairline incision in partial superficial parotidectomy.SUBJECTS AND METHOD: Twenty-three patients who underwent partial superficial parotidectomy via retroauricular hairline incision from 2014 to 2016 were enrolled in the study. Patient's characteristics, surgical outcomes and postoperative complications were assessed. Subjective cosmetic satisfaction was assessed using a visual analog scale 3 months after surgery.@*RESULTS@#In all 23 cases, parotid tumors were removed successfully via retroauricular hairline incision alone without any exposure failure. The mean operating time and the amount of postoperative drainage was 117.6 min (range, 75–163 min) and 51.5 mL (range, 25–91), respectively. Major complications such as permanent facial nerve paralysis and hematoma were not reported. The mean visual analogue scale score for subjective satisfaction with the incision scar was 9.0 (range, 6–10).@*CONCLUSION@#We conclude that partial superficial parotidectomy via retroauricular hairline incision for the treatment of benign parotid tumor is technically feasible and it provides excellent cosmetic outcomes without an increase in complications.

14.
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics ; : 79-82, 2018.
Article in Korean | WPRIM | ID: wpr-758510

ABSTRACT

BACKGROUND AND OBJECTIVES: Laryngeal contact granuloma is benign inflammatory disease induced by excessive mechanical contact of larynx such as endotracheal intubation, voice abuse, laryngeal microsurgery as well as laryngopharygeal reflux. Because it is caused by various risk factors, multiple treatment modalities are required. The purpose of study is to evaluate treatment effect of topical steroid through nasal cavity in contact granuloma. MATERIALS AND METHOD: Fifty-two patients were enrolled in this study with exception of intubation granuloma. Patients were classified with four groups (Proton pump inhibitor (PPI), Nasal steroid spray (SPR), PPI+SPR, Observation) according to treatment modality. RESULTS: Patients who treated with PPI (Odds ratio 2.45, p=0.03) and combination of PPI and SPR (Odds ratio 2.88, p<0.01) had significantly better response than patients who not treated with medical therapy. CONCLUSION: Combination therapy of nasal steroid spray and PPI is effective for contact granuloma of larynx and considered as a treatment of choice rather than PPI only treatment.


Subject(s)
Humans , Granuloma , Granuloma, Laryngeal , Intubation , Intubation, Intratracheal , Larynx , Methods , Microsurgery , Nasal Cavity , Risk Factors , Voice
15.
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics ; : 94-97, 2018.
Article in Korean | WPRIM | ID: wpr-758507

ABSTRACT

BACKGROUND AND OBJECTIVES: Fourth branchial cleft cyst is a rare congenital anomaly which cause a recurrent cervical abscess. Complete excision of fourth branchial cleft cyst is difficult because of a complicated fistula tract. In addition to attempting chemocauterization with trichloroacetic acid (TCA) to avoid surgical complications, authors performed an electrocauterization to close internal opening of pyriform sinus. MATERIALS AND METHODS: We reviewed ten patients of fourth branchial cleft cyst underwent TCA chemocauterization and electrocauterization simultaneously. Clinical characteristics including patient informations, medical records, treatment results were analyzed retrospectively. RESULTS: Interval time until diagnosed with fourth branchial cleft cyst was variable from several days to decades. Five patients had a history of incision and drainage. Mean follow up period was 36.1 months and all patients were treated with no recurrence. CONCLUSION: TCA chemocauterization with electrocauterization can be a effective choice to reduce recurrence rate and ensure safety of patients of fourth branchial cleft cyst.


Subject(s)
Humans , Abscess , Branchial Region , Branchioma , Drainage , Fistula , Follow-Up Studies , Medical Records , Pyriform Sinus , Recurrence , Retrospective Studies , Trichloroacetic Acid
16.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 135-139, 2017.
Article in Korean | WPRIM | ID: wpr-648720

ABSTRACT

Ewing sarcoma (ES) is an uncommon type of malignancy that arises most frequently in the long bones of the extremities and the pelvis. Primary ES of the head and neck region is extremely rare, accounting for only 1-9% of all ES cases. Because ES typically affects children and young adults, it is of paramount importance to differentiate such tumors from benign lesions or congenital neck masses, particularly in cases where lesions arise primarily from the soft tissue rather than from the bone. We encountered a case of ES of the strap muscle in a 4-year-old boy that manifested as an isolated midline neck mass mimicking a thyroglossal duct anomaly. We report this case along with a brief literature review.


Subject(s)
Child , Child, Preschool , Humans , Male , Young Adult , Extremities , Head , Neck , Neck Muscles , Pelvis , Sarcoma, Ewing
17.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 120-124, 2017.
Article in Korean | WPRIM | ID: wpr-648687

ABSTRACT

BACKGROUND AND OBJECTIVES: Traditionally, the surgical approach for the excision of second branchial cleft cysts involves performing a transverse cervical incision on the skin overlying the mass. Recently, there has been a significant interest on the cosmetic outcomes of this surgery, and it has been found that the retroauricular approach produces better results. The purpose of this study was to evaluate the feasibility of a retroauricular approach for the excision of second branchial cleft cysts without the assistance of endoscopic or robotic system. SUBJECTS AND METHOD: From August 2013 to May 2016, a total of 12 patients with second branchial cleft cysts underwent surgery for the excision of the cyst via retroauricular approach, which involved an incision along the retroauricular sulcus and hairline. The surgical outcomes, complications, and subjective satisfaction with incision scars were assessed. RESULTS: In all 12 cases, the second branchial cleft cysts were removed successfully under direct vision and without the requirement of endoscopic assistance. The mean operation time was 80.3 min (range, 65-105 min). No significant complications were reported, such as skin flap necrosis, hematoma, seroma, or serious cranial nerve injury. The mean visual analogue scale score for subjective satisfaction with the incision scar was 8.8 (range, 7-10). CONCLUSION: The excision of second branchial cleft cysts via retroauricular approach without the assistance of endoscopic or robotic system is technically feasible and it provides a favorable cosmetic outcome.


Subject(s)
Humans , Branchial Region , Branchioma , Cicatrix , Cranial Nerve Injuries , Hematoma , Methods , Necrosis , Seroma , Skin
18.
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics ; : 144-147, 2017.
Article in Korean | WPRIM | ID: wpr-13292

ABSTRACT

Laryngeal neoplasm is the second most common malignancy of the upper aerodigestive tract. About 85% to 95% of laryngeal malignancies are squamous cell carcinoma that arises from the epithelial lining of the larynx. The exact cause of laryngeal neoplasm is unknown, but certain risk factors can affect the chances of developing it. Chronic inflammation is a mutagen factor confirmed in the carcinogenesis of various tumor. Inhalation injuries cause histopathologic damage to laryngeal mucosa and inflammation change. This long term inflammation may leads to the development of dysplasia and malignant transformation. Recently, we experienced a case of malignant transformation of laryngeal mucosa after inhalation injury patient 25 years ago. Herein, we reported this rare case and review the relevant literature.


Subject(s)
Humans , Burns , Carcinogenesis , Carcinoma, Squamous Cell , Inflammation , Inhalation , Laryngeal Mucosa , Laryngeal Neoplasms , Larynx , Mucous Membrane , Risk Factors
19.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 293-299, 2016.
Article in Korean | WPRIM | ID: wpr-654469

ABSTRACT

BACKGROUND AND OBJECTIVES: To evaluate the diagnostic utility of ultrasound (US)-guided core-needle biopsy (CNB) (US-CNB) performed by a head and neck surgeon for mass lesions with inconclusive result in previous fine-needle aspiration cytology (FNAC). SUBJECTS AND METHOD: Forty six patients who had previously inconclusive results of non-diagnostic specimen, undetermined significance, and malignancy/suspicious malignancy with undetermined subtype were included in the study. They were divided into the repeating FNAC (rFNAC) group and CNB groups. Procedure time, success of targeting, and complications were evaluated in the CNB group. In addition, the diagnostic utility of CNB was compared with that of FNAC. RESULTS: US-CNB was successfully completed by a head and neck surgeon in all 23 cases without any major complications. The US-CNB group showed significantly lower rates of repeated non-diagnostic/undetermined results than in the rFNAC group (0% vs. 40.9%, p=0.001). In addition, CNB provided specific pathological diagnoses that permitted the surgeon to establish an appropriate treatment plan in 95.7% (22/23) of the CNB group, while rFNAC provided specific pathological diagnoses in 56.5% (13/23) of the rFNAC group (p=0.002). CONCLUSION: US-CNB can be performed safely by head and neck surgeons, providing better diagnostic results compared with those of rFNAC for mass lesions with inconclusive results in previous FNAC.


Subject(s)
Humans , Biopsy , Biopsy, Fine-Needle , Diagnosis , Head and Neck Neoplasms , Head , Neck , Ultrasonography
20.
Clinical and Experimental Otorhinolaryngology ; : 173-177, 2016.
Article in English | WPRIM | ID: wpr-32539

ABSTRACT

OBJECTIVES: Somatostatin inhibits lymph production and reduces lymph flow into the lymphatic duct. We hypothesized that octreotide, a long-acting somatostatin analog, would reduce drainage after neck dissection (ND) by reducing the overall lymphatic flow in the neck as well as thoracic duct flow. METHODS: From 2012 to 2014, total 123 patients who had undergone left-sided comprehensive ND, were divided into an octreotide group (49 patients) and a control group (74 patients). Seventeen patients from the octreotide group and 17 from the control group were individually matched by age (±10 years), sex, body mass index (±1 kg/m2), type of cancer, surgeon, and the extent of surgery. These 34 patients were finally included in the study. RESULTS: The total fluid drainage volume (540.9 mL vs. 707.9 mL) and drainage volume during the period of octreotide use (the first 5 postoperative days) (461.1 mL vs. 676.4 mL) were significantly lower in the octreotide group. The duration of drain placement (6.3 days vs. 9.4 days) was also shorter in the octreotide group. In the octreotide group, the mean triglyceride concentration in the drainage fluid was significantly lower than that in the control group (43.1 mg/dL vs. 88.8 mg/dL). There was no complication associated with the use of octreotide. CONCLUSION: Our study has shown that postoperative octreotide injections reduce postoperative drainage and the duration of drain placement. Further studies with larger patient populations are warranted to confirm these results and to evaluate the clinical benefits for patients.


Subject(s)
Humans , Body Mass Index , Case-Control Studies , Chyle , Drainage , Neck Dissection , Neck , Octreotide , Prospective Studies , Somatostatin , Thoracic Duct , Triglycerides
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