1.A large invasive chondroblastoma on the temporomandibular joint and external auditory canal: a case report and literature review
Heeyeon BAE ; Dong-mok RYU ; Hyung Kyung KIM ; Sung-ok HONG ; Hyen Woo LEE ; Youngjin SHIN ; Yu-jin JEE
Maxillofacial Plastic and Reconstructive Surgery 2021;43(1):26-
Background:
Chondroblastomas, which account for approximately 1% of all bone tumors, typically occur in long bones, such as the femur, humerus, and tibia. However, in extremely rare cases, they may also occur in the craniofacial region where the tumor is often found in the squamous portion of the temporomandibular joint (TMJ) and in the temporal bone.Case presentation: This case report describes a large chondroblastoma (diameter, approximately 37 mm) that occurred in the TMJ. The tumor was sufficiently aggressive to destroy the TMJ, mandibular condyle neck, external auditory canal (EAC), mandibular fossa of the temporal bone, and facial nerve. The tumor was completely excised using a pre-auricular approach. The EAC and surgical defect were successfully reconstructed using a temporoparietal fascia flap (TPFF) and an inguinal free fat graft. There was no local tumor recurrence at the 18-month follow-up visits. However, the patient developed sensory neural hearing loss, and his eyebrow paralysis worsened, eventually requiring plastic surgery.
Conclusion
Large, invasive chondroblastomas of the TMJ can be completely removed through a pre-auricular approach, and the resulting surgical defect can be reconstructed using TPFF and free fat grafts. However, preoperative evaluation of the facial nerve and auditory function is necessary. Therefore, a multidisciplinary approach is essential.
2.The use of a pedicled buccal fat pad for reconstruction of posterior mandibular defects
Hyen Woo LEE ; Sung ok HONG ; Heeyeon BAE ; Youngjin SHIN ; Yu-jin JEE
Maxillofacial Plastic and Reconstructive Surgery 2021;43(1):23-
Background:
The pedicled buccal fat pad has been used for a long time to reconstruct oral defects due to its ease of flap formation and few complications. Many cases related to reconstruction of defects in the maxilla, such as closing the oroantral fistula, have been reported, but cases related to the reconstruction of defects in the mandible are limited. Under adequate anterior traction, pedicled buccal fat pad can be a reliable and effective method for reconstruction of surgical defects in the posterior mandible.Case presentation: This study describes two cases of reconstruction of surgical oral defects in the posterior mandible, all of which were covered by a pedicled buccal fat pad. The size of the flap was sufficient to perfectly close the defect without any tension. Photographic and radiologic imaging showed successful closure of the defects and no problems were noted in the treated area.
Conclusion
In conclusion, the pedicled buccal fat pad graft is a convenient and reliable method for the reconstruction of surgical defects on the posterior mandible.
3.A Case of Bullous Pemphigoid in a Metastatic Melanoma Patient Treated with Pembrolizumab, Dabrafenib, and Trametinib
Donghwi JANG ; Jongeun LEE ; Jaihee BAE ; Yeonjoo JUNG ; Heeyeon KIM ; Se Jin OH ; Jong Hee LEE ; Dong-Youn LEE ; Ji-Hye PARK
Korean Journal of Dermatology 2023;61(1):62-65
Bullous pemphigoid (BP) is a chronic and recurrent bullous disorder that may be associated with the administration of certain drugs. Recently, bullous cutaneous adverse events after immunotherapy (IT) or targeted therapy have been increasingly reported. Here, we report a case of BP in a patient diagnosed with metastatic melanoma after treatment with pembrolizumab, dabrafenib, and trametinib. Histopathological examination showed a subepidermal blister with perivascular lymphocytic and eosinophilic infiltration; the accompanying findings of linear immunoglobulin G and C3 deposition by immunofluorescence microscopy were consistent with BP. Since IT agents may initiate immune dysregulation and pathologic autoantibody production, which are required for the pathogenesis of BP, the lesions were thought to be cutaneous adverse events caused by IT.