RESUMEN
Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic or lymphatic duct, is an uncommon complication of head and neck surgeries, which include neck dissection or thyroidectomy. A small amount of chyle leakage can be treated with conservative approaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of the wound and thoracic duct ligation via the chest or transabdominal thoracic duct embolization can be applied. Here, we report a case of intractable massive chyle leakage in a 78-year-old male after a left neck level V lymph node biopsy, which was not controlled after conservative management and explorative surgery. Various treatment approaches were attempted and successful management of chyle leakage was ultimately achieved by thoracic duct embolization.
RESUMEN
A calcified structure blocking the flow of saliva into the mouth is a major cause of salivary dysfunction. If a stone is detected, the goal of treatment would be to remove it. Furthermore, the fundamental treatment for preventing recurrence, although depending on the location and size of the stone, is salivary gland resection. The submandibular gland duct and hilum stone is usually removed by transoral approach. If there are multiple stones in the submandibular gland and the duct, it would be necessary to carry out resection of submandibular gland, using the intra-oral approach. We recently experienced a case of multiple stone in the submandibular gland and the duct in a 73-year-old man, who presented with the right submandibular area swelling after meals. We removed the submandibular gland and duct stone without intra-oral approach and present this case with a review of the literature.
RESUMEN
Epidural anesthesia has significantly advanced in neuraxial anesthesia and analgesia. It is used for surgical anaesthesia and treatment of chronic pain. Hearing loss during or after epidural anesthesia is rare, and it is known to occur by the change of the intracranial pressure. Cerebrospinal fluid is connected with perilymph in the cochlear and vestibule that is important to hearing and balance. If the intracranial pressure is abruptly transferred to the inner ear, perilymph can be leak, that called perilymphatic fistula, dizziness, and hearing loss can occur suddenly. We report a 65-year-old woman who presented with acute onset dizziness and hearing loss during the epidural nerve block for back pain, wherein we speculated a possibility of perilymphatic fistula as the mechanism of hearing loss and dizziness. The mechanism of dizziness and hearing loss was suspected with perilymphatic fistula.
Asunto(s)
Anciano , Femenino , Humanos , Anestesia y Analgesia , Anestesia Epidural , Dolor de Espalda , Líquido Cefalorraquídeo , Dolor Crónico , Mareo , Oído Interno , Fístula , Audición , Pérdida Auditiva , Pérdida Auditiva Sensorineural , Pérdida Auditiva Súbita , Presión Intracraneal , Bloqueo Nervioso , Perilinfa , Neumocéfalo , VértigoRESUMEN
OBJECTIVES: Ménière disease is a clinical syndrome characterized by the four major symptoms of episodic vertigo, sensorineural hearing loss, tinnitus, and aural fullness. Sensorineural hearing loss, especially low frequency, is the characteristic type of audiogram in Ménière's disease. However, it is difficult to distinguish idiopathic sudden sensorineural hearing loss (ISSNHL) with vertigo from the first attack of Ménière disease. The purpose of this study was to investigate the incidence of progression into Ménière Disease from low frequency ISSNHL. METHODS: Two hundred eighty-three patients were included in this study. We classified the patients with ISSNHL according to the hearing loss in audiogram and analyzed how many of them actually progressed to Ménière disease based on diagnosis criteria. RESULTS: Among the 240 patients, 37.1% (89 patients) were confirmed low frequency ISSNHL and 14.6% (13 patients) of them were diagnosed with Meniere disease. CONCLUSIONS: This study showed that the progression from low frequency ISSNHL to Ménière disease was higher than other frequency ISSNHL, as in other studies.
Asunto(s)
Humanos , Diagnóstico , Estudios de Seguimiento , Pérdida Auditiva , Pérdida Auditiva Sensorineural , Pérdida Auditiva Súbita , Incidencia , Enfermedad de Meniere , Acúfeno , VértigoRESUMEN
Asunto(s)
Adulto , Animales , Femenino , Humanos , Ratas , Regeneración Ósea , Fosfatos de Calcio , Fibrina , Fibroínas , Reacción a Cuerpo Extraño , Inflamación , Membranas , Seda , Cráneo , Ingeniería de Tejidos , TrasplantesRESUMEN
Asunto(s)
Niño , Femenino , Humanos , Diente Premolar , Quiste Dentígero , Boca , Extrusión Ortodóncica , Diente , Diente Primario , Diente ImpactadoRESUMEN
For the approach to the supraorbital rim and frontozygomatic suture line, surgeons have used the bicoronal incision or lateral eyebrow incision. However it may leave the scar or alopecia. For the successful surgical repair of the frontal sinus fracture and frontozygomaticomaxillary complex fracture, we reviewed the use of the supratarsal fold incision, and selected cases of the open reduction and fixation of frontal sinus fracture and frontozygomatic suture line fractures. We investigated six cases, two were frontal sinus anterior wall fracture and four were frontozygomaticomaxillary complex fracture. The patients underwent bony reduction via supratarsal fold incision to expose the frontal sinus and frontozygomatic suture line. In all six cases, the supratarsal fold incision provided very satisfactory exposure of lateral orbital wall, frontozygomatic suture line, frontal sinus and supraorbital rim. No patients had post-operative alopecia, scar, ptosis, lagophthalmus and hematoma. The supratarsal fold incision provides excellent approaches to the frontozygomatic suture line and frontal sinus and there was not any post-operative complicaitons. So it may be the option for the approach to the superolateral orbital rim or supraorbital rim for frontal sinus simple fracture and non-comminuted fractures at frontozygomatic suture area.
Asunto(s)
Humanos , Alopecia , Cicatriz , Cejas , Fracturas Óseas , Seno Frontal , Hematoma , Órbita , SuturasRESUMEN
The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Asunto(s)
Humanos , Arterias , Colgajos Tisulares Libres , Músculos , Necrosis , Colgajo Perforante , Tejido Subcutáneo , Colgajos Quirúrgicos , Muslo , Donantes de Tejidos , UltrasonografíaRESUMEN
Zygomatic arch fracture is one of the most commonly seen facial bone fractures and there have been many methods of reduction designed so far. However, for a simple fracture, the Gillies temporal approach is most commonly used because of the easy reducibility, and also because the depressed fracture can be approached without a facial incision. The Gillies temporal approach starts in the temporal area, between the temporalis muscle and deep temporal fascia. We have developed a new route which starts in the postauricular hair margin area and then reaches to the periosteum of the temporal bone. An elevator is then inserted to penetrate the periosteum and subperiosteal dissection is performed toward the zygomatic process of the temporal bone. At the origin of the zygomatic process, the route of dissection changes to the posterior aspect of the zygomatic arch using a curved palate elevator or the authors' modified Langenbeck elevator. This method of approach has been used in 6 cases of zygomatic arch fracture with good results and we report this method along with written reports.