Acute mastoiditis continues to be a potentially dangerous infection in the antibiotic era. Despite use of antibiotics to treat suppurative acute otitis media in children, the incidence of subsequent development of acute mastoiditis and its complications, including periauricular subperiosteal abscess, facial paralysis, meningitis, and brain abscess has not plunged down below a certain level. Mastoidectomy has been the routine procedure for treating acute mastoiditis with subperiosteal abscess but recently many authors suggest that subperiosteal abscess complicating acute coalescent mastoiditis can be successfully treated by broad-spectrum antibiotics, myringotomy, and minor surgical procedures such as incision and drainage, not necessarily requiring simple mastoidectomy. Contrary to the recent trend shift from a surgical disease to a medical disease, we report two consecutive acute mastoiditis cases definitely mandating simple mastoidectomy to emphasize the role of surgical intervention even in the recent trend shift from a surgical to a medical disease.
Abscess ; Anti-Bacterial Agents ; Brain Abscess ; Child ; Drainage ; Facial Paralysis ; Humans ; Incidence ; Mastoid ; Mastoiditis ; Meningitis ; Otitis Media ; Surgical Procedures, Minor

Schwannoma is a relatively slow-growing, encapsulated benign tumor that is derived from the Schwann cell of the nerve sheath. We report here on a case of schwannoma of the mouth floor with a review of the literature. A 67-year-old woman presented with a right mouth floor mass, which was first detected 5 years ago. The preoperative diagnosis was ranula on the basis of the physical findings and the computerized tomographic findings. However, the mass was found to be a true neoplastic lesion rather than a cystic lesion in the course of surgical dissection. The permanent pathologic report of the mass was schwannoma. Postoperatively, although the patient had no problem with taste, the pain-sense, speech and swallowing, she had mild deviation of the tongue towards the same side of the mass, which means that the function of the hypoglossal nerve was somewhat impaired. Her tongue deviation was spontaneously resolved within 6 weeks postoperatively.
Aged ; Deglutition ; Female ; Humans ; Hypoglossal Nerve ; Lingual Nerve ; Mouth ; Mouth Floor ; Neurilemmoma ; Ranula ; Tongue

Reconstruction with free flaps has become the choice of reconstruction for most patients with head and neck defects. However, pedicled flaps, such as pectoralis major pedicled flap and latissimus dorsi pedicled flap (LDPF), can also be used instead in selected patients. We performed LDPFs in 6 patients from November 2007 to September 2009. Five of the patients were females with either vascular diseases or large skin defects, or they were highrisk old patients. One male patient received LDPF as a salvage after tongue reconstruction with a free flap failed. Various types of head and neck defects were effectively managed with LDPF without complications. LDPF can be one option for head and neck reconstruction especially in patients who may hve high risk in undergoing free flap reconstruction.
Female ; Free Tissue Flaps ; Head ; Humans ; Male ; Neck ; Skin ; Surgical Flaps ; Tongue ; Vascular Diseases

BACKGROUND AND OBJECTIVES: Koufman described a pseudocyst of the vocal folds for the first time in 2001. A pseudocyst in all parts of the body and that is related to secretory glands is already well known, but such a lesion of the vocal folds has only been mentioned a few times. It is unclear whether or not to define a pseudocyst of the vocal folds as a benign lesion of the vocal folds. The objective of this study was to introduce the demographic and clinical findings of pseudocyst and to discuss our diagnostic and therapeutic strategies. SUBJECTS AND METHOD: We carried out a retrospective review of all the medical records, the preoperative voice lab results and the operation records from 2006 to 2009. All the patients underwent laryngomicrosurgery due to benign vocal folds lesions. We select 11 cases that showed subepithelial lesion without a definite capsule. RESULTS: Seven patients had had the history of voice abuse. One patient has been a smoker, another was an ex-smoker and the others were non-smokers. According to aerodynamic assessment, the maximum phonation time was 14.6 seconds and the mean airflow was typically increased. On laryngoscopy, all were translucent and spherical or fusiform subepithelial lesions. The preoperative stroboscopic findings showed a uniform feature of damping on the vocal fold lesion. Both the unroofing technique and the microflap technique were used. CONCLUSION: A pseudocyst would be a subepithelial lesion without a definite epithelial lining that contains serous discharge. We suggest that a pseudocyst of the vocal fold is a new benign lesion.
Humans ; Laryngoscopy ; Medical Records ; Phonation ; Polyps ; Pyridines ; Retrospective Studies ; Thiazoles ; Vocal Cords ; Voice