Excision of Second Branchial Cleft Cyst Via Retroauricular Approach without Assistance of Endoscopic or Robotic System / 대한이비인후과학회지

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.

Language Development in Profoundly Prelingually Deaf Children with Cochlear Implantation: Long-Term Outcomes / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is well established that cochlear implantation provides significant benefits for prelingually profound deaf children. However, there are few studies that examined the long-term outcome of cochlear implantation beyond 10 years in prelingually deaf children. The purpose of this study was to examine the long-term benefit of cochlear implantation for children with more than 10 years of experience of using cochlear implantation, regarding auditory performance and academic status. We then determined the age effect of cochlear implantation on auditory performance for prelingually deaf children. SUBJECTS AND METHOD: The longitudinal development of auditory performance of 119 deaf children was analyzed after cochlear implantation. Among the 119 children, 58 were included for analysis. RESULTS: The children who received cochlear implanst at younger age showed significantly better auditory performance. Age at which implantation had been performed had a significant effect on the development of auditory performance before 4 years of age. Many children continued to demonstrate improvements of auditory performance upto five years of implant use. Some showed development of auditory performance upto 10 years cochlear implantation. CONCLUSION: The present result indicates that speech perception and performance for children continue to improve over time from 5 upto 10 years while using cochlear implant. The use of earlier cochlear implantation was demonstrated to provide better auditory performance. The age at which implantation was performed was one of the important factors influencing the long-term outcome of cochlear implantation.

Clinical Characteristics and Treatment of Oroantral Fistula / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Oroantral fistula is an epithelialized communication between the oral cavity and the maxillary sinus. The aim of this study is to investigate the clinical characteristics and treatment of oroantral fistula. SUBJECTS AND METHOD: Patients who have undergone treatment for oroantral fistula between May 1995 and December 2015 were enrolled in this study. The demographic data of these patients and characteristics of oroantral fistula were analyzed. Patients with oroantral fistula were initially administered oral antibiotics for 3 weeks. If fistula persists in spite of the medication, surgery (soft tissue flap with or without bone graft) was performed. The surgical results according to the presence of bone graft were compared. RESULTS: Twenty-two patients were in accordance with the inclusion criteria. The male to female ratio of patients was 12:10, with the mean age of 47.9±13.4 years. The main complaint of patients was pus discharge from the fistula. Two patients were successfully treated with antibiotics whereas 20 patients underwent surgery. Recurrence occurred in 3 patients, who were treated with soft tissue flap, but no recurrence developed in the patients treated with soft tissue flap and bone graft. Although dehiscence of soft tissue flap occurred in one patient treated with bone graft, it was successfully treated by secondary intention without an additional surgery. CONCLUSION: Bone graft bears the negative pressure of the oral cavity and the weight of secretions including the blood. In addition, it induces secondary intention for the dehiscence of the flap. In this regard, bone graft seems to contribute to the surgical success of oroantral fistula.