Brace Compression for Treatment of Pectus Carinatum

BACKGROUND: Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. MATERIALS AND METHODS: Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. RESULTS: Thirteen (72.2%) patients completed the treatment (mean time, 4.9+/-1.4 months). In patients who completed the treatment, the mean overall satisfaction score was 3.73+/-0.39. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. CONCLUSION: Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.

Dissecting Intramural Hematoma of the Esophagus: A case report / 대한흉부외과학회지

Dissection intramural hematoma of the esophagus (DIHO) is a rare, but well-documented condition that is part of the spectrum of acute esophageal injuries; these include the more common Mallory-Weiss tear and Boerhaave's syndrome. This disorder is predominantly seen in women during their sixth or seventh decade and the disease has various etiologies, but the pathogenesis has yet to be clarified. The triad of symptoms for this disorder includes retrosternal pain, hematemesis and odynophagia. It is important to differentiate esophageal submucosal dissection form other disorders that have a similar appearance, such as Mallory-Weiss syndrome and esophageal perforation because the prognosis of DIHO is excellent with conservative therapy and these other diseases require surgical treatment. We report here on a case of a dissecting intramural hematoma of the esophagus that was preoperatively misdiagnosed as the submucosal tumor of the esophagus preoperatively, and it was confirmed by Video-assisted thoracic surgery.

Surgical Treatment of Primary and Metastatic Malignant Tumors of the Accessory Parotid Gland / 대한이비인후과학회지

Abstract Tumor of the accessory parotid gland is frequently mistaken as a cheek subcutaneous tumor because of its location and rarity. Preoperative tissue diagnosis is imperative for proper treatment of this rare tumor. In technical point of view, the parotidectomy approach with wide facial nerve dissection and careful elevation of cheek flap is the key to safe resection of the tumor without complication of facial nerve injury. We report one case each of primary and metastatic cancer of accessory parotid gland with a brief review of literature.