Burn Injury Caused by Electrosurgical Unit during Adenotonsillectomy / 대한이비인후과학회지

Electrosurgical units are frequently employed during adenotonsillectomies to reduce both operation time and the amount of bleeding. Complications related to electrosurgical units have rarely been reported or taken into consideration by the majority of surgeons during operations. We report a case of an electrosurgical unit induced burn injury during an adenotonsillectomy. More specifically, the injury was a second-degree burn that occurred on the right oral commissure and the lip. The exact cause of the burn was not determined despite a close examination of the electrosurgical unit. An ointment was applied frequently to the lesion to prevent the wound from drying; the wound subsequently healed without any permanent scarring. Preventive methods, such as a thorough inspection of devices prior to surgery, the technique of using the third finger, and the use of a cheek retractor, may be necessary to avoid burn injuries caused by electrosurgical units.

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.

A Case of Kaposi's Sarcoma on Oropharynx and Hypopharynx in Human Immunodeficiency Virus-Negative Patient / 대한이비인후과학회지

The number of patients diagnosed with Kaposi's sarcoma has grown steadily since it was first discovered in 1972 by Moric Kaposi, a Hungarian dermatologist. Kaposi's sarcoma can be classified into four subtypes according to clinical form, epidemiology, and prognosis: idiopathic, endemic or African, immunosuppresion related, and acquired immunodeficiency syndrome related or epidemic Kaposi's sarcoma. A single idiopathic Kaposi's sarcoma in the head and neck area is very rarely found in an immunocompetent person. We experienced a case of Kaposi's sarcoma of the oropharynx and hypopharynx. The patient was healthy 70-year-old man and had no signs of being human immunodeficiency virus positive or immunocompromised. The patient was treated with inductive chemotherapy using capecitabine (Xeloda(R))/cisplatin followed by radiotherapy to a total 54 Gy.

A Case of Thyroid Hemiagenesis with Concurrent Papillary Thyroid Carcinoma / 대한이비인후과학회지

Thyroid hemiagenesis is an extremely rare congenital abnormality of the thyroid gland, characterized by the absence of one lobe. The true prevalence of this congenital abnormality is uncertain, because the absence of one thyroid lobe usually does not cause clinical symptoms by itself. However, several studies showed that the prevalence of this anomaly was estimated as 0.05-0.2%. Thyroid hemiagenesis is more frequently found in women, and in the left lobe. Commonly found in the remaining lobe are benign adenoma, a multinodular goiter, hyperthyroidism, chronic thyroiditis, and rarely carcinoma. We report a case of 53-year-old woman with an incidentally discovered thyroid nodule. Thyroid ultrasonography and computed tomography scan was performed in order to evaluate the nodule, and they showed the absence of the right thyroid lobe. The nodule was suspected as papillary thyroid cancer and subsequent surgery to remove it confirmed the absence of the right lobe.