Analysis of Body Sway and Nystagmus with Galvanic Stimulation in Normal Subjects

BACKGROUND AND OBJECTIVES : The purpose of this study is to evaluate the possibility of clinical application of 'vestibular function test by electrical stimulation' measuring nystagmus and body sway which are generated by electrical stimulation. MATERIALS AND METHODS : Twelve normal subjects for measurement of nystagmus and eight for body sway volunteered to participate as subjects of the experiment. We used continuous direct current from 1mA to 3mA, and its polarity could be switched through the surface electrode on the bilateral mastoid process. Videooculogram was used to measure the nystagmus. Lateral body sway was recorded by using Computerized Dynamic Posturography. RESULTS: When stimulating the positive electrode over the right mastoid, left nystagmus and body sway toward right are observed. When stimulating the negative electrode over the right mastoid, right nystagmus and body sway toward left are observed. The nystagmus occurred 42% at 1mA, 75% at 1.5mA, 92% at 2mA, and 100% at more than 2.5mA. The slow phase velocity of the nystagmus were increased from an average of 1.9 deg/sec at 1mA to an average of 3.6 deg/sec at 3mA. However, they were variable from minimum of 0.1 deg/sec to maximum of 4.8 deg/sec even stimulated with fixed amount of current. Also, the asymmetry of the nystagmus on the each direction was observed over 27% at the stimulation of 2.5mA and 3mA. The body sway was observed on the 7 subjects except one. Among them, body sway occurred on stimulation of 1mA in 5 subjects. CONCLUSIONS : Evaluation of nystagmus with galvanic stimulation revealed high right-left asymmetry in normal subjects and needed more electrical stimulation. Evaluation of body sway with galvanic stimulation is more feasible as a vestibular function test, because it has higher manifestation rate, less asymmetry, and it need less electrical amplitude which cause less discomfort to the subjects.

Intraluminal Invasion of Upper Aerodigestive Tract by Thyroid Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Thyroid carcinoma infrequently invades the upper aerodigestive tract. However, when invasion occurs, it is the source of significant morbidity and mortality. If the tumor extends into the lumen of the upper aerodigestive tract, more critical problems can happen. There have been much debates about surgical therapy of thyroid carcinoma invading the upper aerodigestive tract whether it should be radical or conservative. This study was designed to investigate the intraluminal extension of the upper aerodigestive tract by thyroid carcinoma and review the spectrum of radical resection. MATERIALS AND METHODS: From 1996 to 2000, six patients with thyroid carcinoma invading the upper aerodigestive tract (intraluminal involvement) were radically resected at Inha University Hospital. Clinical records were reviewed retrospectively. RESULTS: The radical resection consisted of a total thyroidectomy and a neck dissection, combined with radical excisions that included three laryngectomies, two laryngopharyngoesophargectomies, and a case of partial pharyngectomy. The histologic types consisted of 5 papillary carcinoma and 1 anaplastic carcinoma. There was one preoperative mortality. Five patients received radioactive iodine therapy postoperatively. One patient died of nodal recurrence at the 13th postoperative month, and 4 patients are still alive with a follow-up period of 19-52 months. CONCLUSION: Based on our results of these six patients who had intraluminal involvement of the upper aerodigestive tract, we suggest that radical resection might be a worthwhile procedure. But it should be considered that radical resection might cause loss of functions in the head and neck organs, and therefore possibilites of conservative resection should be considered throughly during the preoperative examination.

A Case of Malignant Proliferating Trichilemmal Tumor Occurring in Lower Lip / 대한이비인후과학회지

Proliferating trichilemmal tumor is one of rare benign tumors originating from the outer root of the hair follicle sheath. The tumor is clinically benign, although it can display nuclear atypia, dyskeratotic cells, and mitotic figures. These features can be misleading, and a false diagnosis of a squamous cell carcinoma is possible. An abrupt enlargement of size is suggestive of malignant changes of the tumor. We report a case of a malignant proliferating trichilemmal tumor which occurred not on the scalp but on the lower lip. A 75-year-old man presented a lower lip mass with a smooth surface, measuring 4.5X3 cm, and his right submandibular lymph node was also palpable. The tumor was widely excised with bilateral functional neck dissection, and the defect on the lip was reconstructed using radial forearm free flap including the palmaris longus tendon. No recurrence was observed during the follow-up period.

A Case of Multiple Intramuscular Lipoma of the Tongue / 대한이비인후과학회지

Although lipomas are among the most common benign tumors, their occurrences in the oral cavity has been reported infrequently, accounting for only 2.2% to 4.4% of all benign tumors in this site. Especially, lipomas of the tongue are rare tumors that are represented by less than 0.5% of all benign tumors in the oral cavity. There are two types of solitary lipomas, the cutaneous (superficial) type and the deep-seated (subfascial) type. The deep and soft tissue-infiltrating lipomas are classified into between-muscle groups (intermuscular lipoma) or within-muscle groups (intramuscular lipoma). Intramuscular lipoma is composed of mature adipose tissues that infiltrate into muscles in a diffuse manner, and the entrapped muscle fibers exhibited varying degrees of atrophic change. We experienced a case of bilateral multiple intramuscular lipomas of the tongue which was cured by surgery.