Reconstruction after Resection of Lower Lip Squamous Cell Carcinoma / 대한이비인후과학회지

Lip cancer is the most common malignancy of the oral cavity and is the second most common cancer in the head and neck. Because lip cancer can be detected early, it is readily curable compared with other head and neck malignancies. In the treatment, surgery is recommended for most patients. After resection, reconstruction is important both aesthetically and functionally, because of it's prominent location of face and essential functions of sphincter to assist in mastication, swallowing, phonation, and expressing emotion. Recently, we performed the reconstruction of lower lip defects after resection of cancer using various methods and achieved good results. So we present the cases with a review of literatures.

A Case of Malignant Peripheral Nerve Sheath Tumor in Nasal Cavity / 대한이비인후과학회지

The malignant peripheral nerve sheath tumor (MPNST) is an extremely rare soft tissue sarcoma of ectomesenchyme. It is a highly malignant sarcoma, which is locally invasive, frequently leading to multiple recurrences and eventual metastatic spread. The peak incidence of this disease is known to arise in the seventh decades. In human body, trunk and extremities are the most commonly involved site, and only 8-14% of all lesions appears in head and neck region. Because of its non-specific clinical and histopathological presentation, the diagnosis of MPNST has been described as one of the most difficult diagnosis. But this difficulty of diagnosis was solved by the use of immunohistochemistry. The authors report a case of malignant peripheral nerve sheath tumor in nasal cavity with a review of the literature.

The Usefullness of Ultrasonography in the Treatment of Zygomatic Arch Fractures / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The zygomatic arch of midface is related to facial contour between skull base and zygomatic bone. The inadequate reduction of zygomatic arch fractures induces cosmetic problems like facial asymmetry and functional problems like limitation of mouth opening. Therefore, the correct diagnosis and adequate treatment of zygomatic arch fractures are needed in early stage and the correct evaluation of repositioned fragment during operation is important for the recovery of cosmetic and functional problem. The aim of this study is to estimate the value of ultrasonography as an intraoperative repositioning monitor in the reduction of zygomatic arch fractures. SUBJECTS AND METHOD: In the period from March of 2005 to October of 2006, 11 patients who had underwent ultrasonography guided reduction for zygomatic arch fractures were selected for clinical analysis. We repositioned depressed bony fragments via Gillies approach and evaluated continuously the repositioned state of bony fragments during operation using ultrasonography with 7.5 MHz linear transducer. RESULTS: There were 10 men and one woman, ranging in age from 19 to 74 years. All patients had chief complaints for trismus and pain of affected site and on physical examination, facial swelling, tenderness and depression of affected site were observed. In postoperative photographs and computed tomography scans, which were checked after postoperative 3 months, all patients showed good facial contour, well stabilized bony fragments and good alignment of zygomatic arch. CONCLUSION: The authors suggest that ultrasonography is a very useful tool for the treatment of an intraoperative repositioning monitory of zygomatic arch fractures.

A Case of Nasopharyngeal Amyloidosis / 대한이비인후과학회지

Amyloidosis is characterized by the deposition of extracellular fibrillar proteins in various tissues. Amyloidosis in the head and neck is a rare and benign condition that usually takes the form of localized amyloidosis. Among primary sites of head and neck area, nasopharyngeal amyloidosis has proven to be rare and there are only about ten cases that have been reported in the literature worldwide until today. We report a case of localized nasopharyngeal amyloidosis. Histopathologic examination of the mass revealed findings consistent with amyloidosis, which were stained with Congo Red. The postoperative recovery was uneventful. At the present time, the patient has no evidence of disease or recurrence and complication.

The Stabilizing Method of Zygomatic Arch Fracture Using Aqua Splint Suture Technique / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The zygomatic arch is the bony arch on both sides of the face consisting of the zygomatic bone. The zygomatic fractures are common maxillofacial injuries second only to nasal fractures due to its anatomical location of its structures. Various techniques have been applied for the treatment of zygomatic arch fractures but there is no desirable modality not only for the reduction but also for supporting depressed bony fragments without esthetic problems. The authors suggest aqua splint suture method, which is a new modality for the treatment of zygomatic arch fractures. SUBJECTS AND METHOD: In the period from March of 2004 to March of 2005, nine patients who had been performed reduction for zygomatic arch fractures were selected for clinical analysis. We repositioned depressed bony fragments by Gillies approach and stabilized repositioned bony fragments by external & internal fixation using aqua splint suture method. RESULTS: There were eight men and one woman, ranging in age from 19 to 68 years. All patients had chief complaints for trismus and facial deformities. Postoperative photographs and computed tomography, checked after 3 postoperative months, showed that all patients had the good facial contour and well stabilized bony fragments. CONCLUSION: The authors suggest that aqua splint suture method is a very simple, quick & effective technique for stabilizing repositioned zygomatic arch fractures.

A Case of Bilateral Pneumoparotitis in the Children / 대한이비인후과학회지

There are multiple causes of acute parotid swelling, including tumors, viral and bacterial infections, enlargement accompanying connective tissue and obstruction to salivary flow. A rare but well-documented cause of parotid swelling is pneumoparotitis. This is a condition in which there is insufflation of air into the acini of the parotid gland via Stensen's duct. The air may rupture through the parotid capsule, spread into the subcutaneous tissues of the face and neck, and even cause pneumomediastinum. We present a case of pneumoparotitis caused by flute playing. The clinical presentation, proposed pathophysiology, diagnosis and management of this rare condition are presented and discussed.

A Case of Merkel Cell Carcinoma in the Auricle / 대한이비인후과학회지

Merkel cell carcinoma is an uncommon neuroendocrine neoplasm of the skin and arises in adults with a peak incidence in the sixth and seventh decades. Head and neck area and extremities are the most common location. Among primary sites of head and neck area, auricular Merkel cell carcinoma has proven to be rare and only twenty cases have been reported in the literature worldwide until today. The authors report a case of Merkel cell carcinoma in auricle for the first time in Korea with a review of literatures.

Combination Therapy of Earlobe Keloids / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : Keloids are proliferative growths of dermal collagen which extends beyond the original wound. Many modalities are available for treatment of keloids but there is no desirable modality to prevent the recurrence of keloids until now. The authors suggest that the combination therapy of surgical excision, steroid injection and compression therapy is an effective method for prevention of recurrence. MATERIALS AND METHOD : Eleven patients who underwent surgical excision for earlobe keloids in the period from June of 2003 to July of 2005 were selected for clinical analysis. We injected steroid at the surgical margin after excision and compressed it by aluminum splint after skin closure. RESULTS : There were four men and seven women, ranging in age from 13 to 60 years (mean age, 29.2 years). The causes of keloids were earring in seven cases, trauma in two cases and middle ear surgery in two case. The keloids appeared at 1 to 17 years (mean, 3.9 years) after earring, trauma or middle ear surgery, and follow-up period ranged from 3 to 28 months (mean, 9.3 month). The sizes of keloids varied from 0.6x0.3x0.2 cm to 3.4x2.3x1.3 cm. Only one out of the 11 cases recurred and the remaining 10 cases had good results without recurrence. CONCLUSION : We believe that the combination therapy of surgical excision, steroid injection and compression by aluminum splint is a very effective therapy for treatment of earlobe keloids.

A Case of Septal Perforation Repair with Middle Turbinate Flap

The nasal septal perforation is an inadvertent complication of septal surgery which is caused by traumatic, iatrogenic, caustic or inflammatory reasons. Repair of the perforation is indicated when complications such as whistling sound, marginal crusting, frequent nasal bleeding and low-grade perichondritis develop. There is no standard surgical method for repair of a septal perforation. The size, site and the causing factor of perforation determine closure methods. A septal perforation using the concha bullosa flap of middle turbinate was successfully repaired.

A Case of Augmentation Rhinoplasty with Abdominal Keloid Tissue

The nose is an important aesthetic projection affecting the profile of the face. In general, east and South East Asians have noses characterized by a wide flat dorsum, a bulbous thick nasal tip, thick subcutaneous tissues with alar flare and a short, retracted columella. Such anatomical characteristics have resulted in augmentation rhinoplasty to be the most popular procedure for Far East Asian noses. Various materials have been used for augmenting the nasal dorsum from the past. But several kinds of problems still exist after these augmentations and there are no desirable materials until now. A case of augmentation rhinoplasty with keloid tissue for the first time in Korea is being reported.

The Clinical and Radiological Evaluation of Results about Closed Reduction for Children with Nasal Bone Fractures / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has generally been accepted that closed reduction is the management of nasal fracture in children. But proper management is still confusing and clinical and radiological evaluation about long term results have yet to be determined. The purpose of this study is to determine which closed reduction method for nasal bone fractures in children is effective when considering clinical and radiological aspects. MATERIALS AND METHOD: We analysed the medical records of 35 children with nasal bone fractures up to the age of 15, who were operated by closed reduction between 2000 and 2002. We evaluated postoperative satisfaction of doctors and patients and postoperative CT scan score (Motomura et al 2001) of 14 children over more than at least 2 postoperative years. RESULTS: A peak incidence ages ranged from 13 to 15 years. The most frequent cause was sports injuries. The degree of postoperative satisfaction and postoperative CT scan score was favorable. CONCLUSION: In management of nasal fracture in children, closed reduction is effective and satisfactory when clinical and radiological aspects are considered.

Clinical Study of Open Nasal Bone Fracture

BACKGROUND AND OBJECTIVES: Little is known about the treatment of open nasal bone fracture (ONF). The operative technique, timing, and management of ONF is still confusing. This study presents our treatment policy of ONF to help otolaryngologists decide proper management plan. MATERIALS AND METHODS: Of 380 consecutive patients who required surgical intervention, 57 patients underwent open nasal reduction. Of 57 patients, 15 had one-stage operation, and 42 had two- stage operation. Postoperative patients' satisfaction was evaluated using a visual analogue scale and the reasons of dissatisfaction were analyzed. RESULTS: ONF had poorer outcome than closed nasal bone fracture. Unsatisfactory cosmetic results such as scan of the external nose and change of the skin color were the most common problems associated with open nasal reduction. CONCLUSION: Operation timing and technique should be selectively applied to different types of nasal bone fracture and wound state. Meticulous wound care as well as accurate nasal bone reduction is mandatory for ONF.

Renal Effects of Extracorporeal Shockwave on Rats with Genetic Predisposition to Hypertension / 대한비뇨기과학회지

PURPOSE: Although shockwave induced injury to the normal kidney is regarded as negligible, it may be more prominent, and harmful, in case of uncontrolled hypertension. The purpose of our study was to investigate the effects of a repetitive focused shockwave on the renal morphology and blood pressure of spontaneous hypertensive rats (SHR), and to compare the results with normotensive controls. MATERIALS AND METHODS: At 14 weeks of age, 10 SHRs received four separate shockwave treatments (1,000 shocks per treatment at 17.2kV) at one week intervals, with 10 normotensive controls receiving the same treatment. At 20 weeks of age, their subsequent changes in blood pressure and renal morphology were compared. RESULTS: In the SHR group, the renal shockwave treatment retarded their somatic growth, whereas in the control group, which received same treatment, there was no significant growth delay. Renal morphologic damages, such as interstitial hemorrhages, were more prominent in the hypertensive group than in the normotensive controls. CONCLUSIONS: Our results clearly showed that spontaneous hypertensive rats were more prone to shockwave induced renal injury. Careful noting of a family history of hypertension, and the proper antihypertensive treatment, are necessary steps to prevent or reduce possible complications.