No abstract available.
Evoked Potentials, Auditory, Brain Stem*

No abstract available.
Ear, Middle*

Medullary thyroid carcinoma(MTC) is a malignancy of the thyroid C-cells, and it compromises 5-10% of all thyroid cancers. MTC occurs in both sporadic and hereditary types, the latter making up 25% of all MTCs and being compromised of three distinct syndromesmultiple endocrine neoplasia type IIa(MEN IIa), multiple endocrine neoplasia type IIb(MEN IIb), and familial medullary thyroid carcinoma(FMTC). To date, screening for MTC subtype is important for proper diagnosis and treatment. Recently, the authors experienced a case of FMTC. So, we report this case with the review of the literatures.
Diagnosis ; Mass Screening ; Multiple Endocrine Neoplasia ; Thyroid Gland* ; Thyroid Neoplasms*

Intramuscular hemangiomas are benign vascular lesions of skeletal muscle and constitutes less than 1% of all hemangiomas. Of all intramuscular hemangiomas, 13-25% occur in the head and neck, presenting lesions of enlarging soft tissue mass associated with pain. Usually they do not exhibit cutaneous changes, such as bluish skin discoloration as seen in cutaneous and superficial subcutaneous lesions. Because of their infrequency, deep location and unfamiliar presentation, intramuscular hemangomas are seldom correctly diagnosed clinically. We encountered a case of intramasseteric hemangioma in a 14-year-old female. She presented intermittent painful swelling on the right preauricular area. Sialography showed a multiple calcified lesion of the soft tissue, while CT scan and MRI showed a tumor mass lying in the masseter muscle. Angiography showed blush lesion but no tumor feeding arteries. After 6 months of intra-lesional sclerosing therapy with alcohol, total regression of tumor was obtained. As we experienced in this case, percutaneous sclerotherapy with alcohol could be the first therapeutic alternative.
Adolescent ; Angiography ; Arteries ; Deception ; Female ; Head ; Hemangioma ; Humans ; Magnetic Resonance Imaging ; Masseter Muscle ; Muscle, Skeletal ; Neck ; Salivary Gland Calculi* ; Sclerotherapy ; Sialography ; Skin ; Tomography, X-Ray Computed

Angiofibroma is a benign tumor that predominantly affects male adolescent and the most common benign tumor of nasopharynx. These tumors are highly vascular and usually with extension to the nose, paranasal sinus, pterygomaxillary fossa, infratemporal fossa, cranium, and the neck. There are many therapeutic approaches to huge sized angiofibroma with intracranial extension. Recently we experienced two cases of nasopharyngeal angiofibroma invading cranial base that was resected by facial translocation approach after superselective embolization and direct intratumoral embolization with good results. So, we report these with the review of literature.
Adolescent ; Angiofibroma* ; Humans ; Nasopharynx ; Neck ; Nose ; Skull ; Skull Base

Cholesterol granuloma is not a clinically or pathologically independent entity. It may develop in any portion of the pneumatic system of the temporal bone and can be associated with a variety of middle ear disorders. Three factors are considered to play an important role in its development: 1) interference with drainage 2) hemorrhage and 3) obstruction of ventilation. We reviewed 20 cases of cholesterol granuloma in the temporal bone by analysing findings of myringoscopy, temporal bone CT and/or MRI and operation, and concluded that cholesterol granuloma appeared clinically in three forms ; 1) in association with chronic otitis media, especially cholesteatoma 2) idiopathic blue eardrum 3) localized lesion in the middle ear, mastoid antrum, external auditory canal and petrous apex.
Cholesteatoma ; Cholesterol* ; Drainage ; Ear Canal ; Ear, Middle ; Granuloma* ; Hemorrhage ; Magnetic Resonance Imaging ; Mastoid ; Otitis Media ; Temporal Bone* ; Tympanic Membrane ; Ventilation

PURPOSE: Voice change after thyroidectomy has generally been the result of damage to the recurrent or superior laryngeal nerve. But many patients complain voice alteration without laryngeal nerve injury after thyroidectomy. The purpose of this study is to investigate whether strap muscle division results in any subjective or objective functional sequelae in voice, through long-term follow-up prospectively. METHODS: Twenty-two female patients who had undergone thyroid surgery between July 1998 and December 1999, were studied. The patients who were planned for neck dissection, who had benign laryngeal disease or vocal cord paresis, and whose vocal cord paresis were developed after thyroid surgery, were excluded from this study. Twelve patients had undergone thyroidectomy via retraction of strap muscle and ten patients had undergone thyroidectomy via cutting of strap muscle. For evaluation of voice, questionnaires for changes of voice, acoustics (fundamental frequency, jitter, shimmer, signal to noise ratio, noise to harmonic ratio, voice range), and aerodynamic (maximal phonation time) analyses were done. RESULTS: The subjective voice symptoms after thyroidectomy were disturbances of high pitch, singing, loud voice, and easy fatigue at phonation. There were no significant differences in voice parameters on acoustic and aerodynamic analyses between the strap muscle retraction group and the cutting group through long-term follow-up. CONCLUSION: We conclude that strap muscle division does not result in any subjective or objective functional problems in voice. We suggest that surgical division and reconstruction of these muscles should be employed routinely when operating on large, toxic or neoplastic glands.
Acoustics ; Fatigue ; Female ; Follow-Up Studies ; Humans ; Laryngeal Diseases ; Laryngeal Nerve Injuries ; Laryngeal Nerves ; Muscles ; Neck Dissection ; Noise ; Phonation ; Prospective Studies ; Signal-To-Noise Ratio ; Singing ; Thyroid Gland ; Thyroidectomy* ; Vocal Cord Paralysis ; Voice*

BACKGROUND AND OBJECTIVES: It is critical to distinguish benign from malignant thyroid nodule and to select a patient for surgery. Fine needle aspiration cytology(FNAC) and various radiologic techniques are used in the evaluation of thyroid nodule. The purpose of this study is to evaluate the diagnostic accuracy of preoperative FNAC, ultrasonography(US) and computed tomography(CT) in thyroid nodule, and to identify the reliable factors of radiologic imaging in the differential diagnosis of thyroid nodule. MATERIALS AND METHOD: Retrospectively, we reviewed 34 patients among 50 patients with thyroid nodule who were evaluated by FNAC, US and CT and operated on at our Department from June 1995 to December 1998. By comparing the preoperative FNAC results, US and CT findings with postoperative pathologic diagnosis, the results were as followed. RESULTS: Overall diagnostic accuracy of FNAC, US, and CT was 84.4%, 88.2%, 79.4%. Solid nature, ill defined margin, calcification, lymphadenopathy on US imaging indicated the possibility of malignancy. Solid nature, ill defined margin, lymphadenopathy on CT imaging indicated the possibility of malignancy. CONCLUSION: This study suggests that FNAC has a high sensitivity(75.0%) and specificity(93.8%) rate and it is therefore a valuable initial diagnostic procedure. US has higher diagnostic accuracy than computued tomography.
Biopsy, Fine-Needle ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lymphatic Diseases ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography*

The term "amyloidosis" is a disease characterized by deposition of altered proteins in the tissue. The amyloid deposit occurs always in the extracellular matrix and presents a fibrillary conformation. Primary localized tonsillar amyloidosis is a very rare disease of unknown cause that occurs in the absence of systemic involvement of amyloidosis or associated chronic inflammatory diseases. We present a case of primary localized amyloidosis in the left tonsil. Histopathologic examination of the mass revealed findings consistent with amyloidosis, which were stained with Congo Red and apple green birefringence under the polarized light fluorescence microscopy. An extensive workup for systemic involvement of amyloidosis was negative and the patient underwent tonsillectomy. The postoperative recovery was uneventful. At present, the patient has no evidence of disease or recurrence.
Amyloidosis* ; Birefringence ; Congo Red ; Extracellular Matrix ; Humans ; Microscopy, Fluorescence ; Palatine Tonsil* ; Plaque, Amyloid ; Rare Diseases ; Recurrence ; Tonsillectomy

BACKGROUND AND OBJECTIVES: There are many controversies about the extent of thyroidectomy and neck dissection in cases of thyroid cancer. Hypocalcemia is one of serious complications after total thyroidectomy. The on-set of hypocalcemia depends on many factors and different literature cites variable incidence. This study was performed to evaluate the incidence of postoperative hypocalcemia and the safety of total thyroidectomy with central neck dissection in thyroid cancer. MATERIALS AND METHODS: We conducted a retrospective chart review of 17 patients who underwent total thyroidectomy for thyroid malignancies from June 1995 to December 1998. Routine central neck dissection was performed and modified radical neck dissection was done in cases with positive neck node. We analyzed the onset-time of hypocalcemia, serum albumin level, hypocalcemic incidence according to the number of identified and autotransplanted parathyroid glands, lowest calcium level, clinical features and duration of calcium replacement in hypocalcemic patients. RESULTS: The incidence of postoperative hypocalcemia was 76.5% (13/17)and most cases (58.9%)occurred on the first postoperative day. The serum albumin level was lower on the first postoperative day than on the third postoperative day. The average number of identified parathyroid glands was three, and the more parathyroid glands there are, the less hypocalcemia we found. Parathyroid gland autotransplantation were performed in 12 cases. Symptomatic transient hypocalcemia occurred in 6 cases (35.2%). Asymptomatic transient hypocalcemia occurred in 6 cases (35.2%). Permanent hypocalcemia occurred in 1 case (5.9%). CONCLUSION: The incidence of postoperative hypocalcemia was relatively high but half of them were asymptomatic. There are no need for thyroid hormone replacement in asymptomatic transient hypocalcemic patients and that we found total thyroidectomy with central neck dissection is a safe procedure in most of thyroid malignancies.
Autografts ; Calcium ; Humans ; Hypocalcemia* ; Incidence ; Neck Dissection* ; Neck* ; Parathyroid Glands ; Retrospective Studies ; Serum Albumin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*