The value of salvage operation for recurrent head and neck cancer after surgery alone or surgery with radiotherapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recurrent squamous carcinoma of head and neck carcinoma is not encountered infrequently. Surgical salvage is the most reasonable treatment for recurrence. The aim of the present review is to provide more information on the results and prognosis of surgical salvage after surgery alone or surgery with combined radiotherapy. MATERIALS AND METHODS: The operative salvage of recurrent head and neck carcinoma after surgery alone or surgery with combined radiotherapy was retrospectively studied in 18 patients treated between 1994 and 1999. Of the 18 patients in this retrospective review, there were 6 with local recurrence, 8 with regional recurrence, and 4 with stomal recurrence. RESULTS: The operative mortality was 16.6% and 72% of patients had one or more surgical complications. The 2-year crude survival rate in this series was 30% and the mean period of survival was 11.4 months. The 2-year survival rate were 33.3% for local recurrence and 50% for regional recurrence, and 0% for stomal recurrence. CONCLUSION: We concluded that surgical salvage had unsatisfactory results for patients with recurrent head and neck carcinoma after surgery alone or surgery with combined radiotherapy. Because of this low salvage rate, we should regard salvage surgery as palliative rather than therapeutic.

Two Cases of Double Free Flap Reconstruction for Oromandibular Defect / 대한이비인후과학회지

En bloc defects, which can also be defined as extensive composite defects, present as one of the most complex reconstructive challenges in the head and neck area. Although most head and neck defects can be reconstructed using a single free tissue transfer, the use of two free flap is indicated for massive tissue defects or for composite tissue requirement that cannot be met with a single free flap. In this paper, we report two patients with composite defects. They underwent single-stage, double free flap reconstruction utilizing a fibular osteoseptocutaneous flap to reconstruct the mandible and floor of the mouth, as well as an innervated radial forearm fasciocutaneous composite flap with the palmaris longus tendon and the latissimus dorsi free flap for the total tongue reconstruction. Both patients had acceptable functional and aesthetic outcomes.

The Effects of Steroid and Steroid Receptor Blocker in Initial Polyp Formation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The epithelial rupture theory for the polyp formation has been well approved. According to Norlander et al., the polyp formation initiated by multifactorial pathophysiological events (infection/inflammation) appears to be a series of the consecutive events involving the rupture of epithelium, prolapse of lamina propria, epithelial ingrowth, microcavity formation, and finally the polyp formation. The purpose of this study is to determine the effects of steroid and steroid receptor blocker at the early stage of the polyp formation in a rabbit model. MATERIALS AND METHODS: In 20 New Zealand white rabbits, polyps were induced by epithelial damage with ostial occlusion. The mometasone and RU 486, given by the biodegradable film (polylactic acid), were used to investigate the possible effects of steroid and steroid receptor blockers. After one and three weeks, macroscopic polyps were counted postmortem and on histological slides after serial sectioning. RESULT: The polyp formation was significantly increased in the RU 486-treated group, whereas it was reduced in the mometasone-treated group. According to the alpha-actin immunohistochemistry, neovascularization at the margin of the initial polyp in the RU 486-treated group markedly increased compared with the mometasone-treated group. CONCLUSION: Steroid is thought to inhibit the initial polyp formation by reducing neovascularization particularly at the margin of initial polyp.

Lymphadenitis Secondary to Toxoplasmosis in Parotid Gland / 대한이비인후과학회지

Toxoplamosis is a common parasitic infection that is widely distributed throughout the world, including the United States. However, the incidence in Korea is unknown. This report concerns a case of toxoplasmosis that manifested as intraparotid lymphadenitis in a 37-year-old woman. The etiology, clinical, microscopic, and laboratory findings, and treatment are reviewed.