No abstract available.
Ear, Middle*

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

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

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*

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*

In the management of advanced maxillary sinus cancer, sometimes it requires an extensive ablation and orbital exenteration that results in large and full defects of the cheek and orbital regions. Reconstruction of large orbital-maxillary defects can be accomplished in one stage by microsurgical free transfer of rectus abdominis myocutaneous flap. The muscle component is suitable to fill the orbital and maxillary cavities, and the skin components are used for cheek, palate and lateral nasal cavity wall reconstruction as a three-dimentional folded free flap. Major problems with this flap are the bulkiness, the possibility of abdominal hernia and muscle weakness following the removal of the rectus abdominis muscle. Free deep inferior epigastric artery skin flap without rectus abdominis muscle is available in the reconstruction of large orbital-maxillary defect without the problems of the rectus abdominis myocutaneous free flap. We experienced one case of rectus abdominis myocutaneous free flap, and one other case of inferior rectus abdominis free flap for the reconstruction of huge surgical defects due to radical maxillectomy with orbital excenteration. Both of the patients were satisfied and there have been no severe complication associated with these technique.
Cheek ; Epigastric Arteries ; Free Tissue Flaps* ; Hernia, Abdominal ; Humans ; Maxillary Sinus Neoplasms* ; Maxillary Sinus* ; Muscle Weakness ; Myocutaneous Flap ; Nasal Cavity ; Orbit ; Palate ; Rectus Abdominis* ; Skin

BACKGROUND AND OBJECTIVES: Total laryngectomy is usually used for patients with advanced laryngeal cancer, and causes injuries to hypopharyngeal mucosa, cricopharyngeal muscle, pharyngeal constrictor muscle. These damages induce postoperative swallowing difficulties, although accurate and objective data have not been reported. The purpose of this study is to evaluate the changes and functional difficulties of swallowing mechanism in patients with total laryngectomy by manometric analysis. MATERIALS AND METHODS: We used station pull-through technique in two groups. The study group consisted of 11 total laryngectomized patients, and the control group consisted of 10 cases. We measured resting pressure, length, pressure after relaxation of UES (upper esophageal sphincter), and pharyngeal pressure. And 5 parameters were analyzed for coordination of hypopharynx and UES during swallowing. RESULTS: In the study group, the resting pressure, the maximal pressure after relaxation, and the length of UES was 36.3+/-10.5 mmHg, 149.8+/-14.6 mmHg, and 3.4+/-0.8 cm respectively. In the control group, the results was 34.9+/-9.6 mmHg, 85.5+/-12.3 mmHg, 2.2+/-0.6 cm respectively. The pharyngeal pressure was 81.8+/-10.1 mmHg in the study group, and 67.1+/-12.3 mmHg in the control group. The interval of pharyngeal constriction was 3.0+/-0.23 sec in the study group and 0.49+/-0.04 sec in the control group. The interval of UES relaxation was 2.43+/-0.14 sec in the study group and 0.99+/-0.03 sec in the control group. CONCLUSION: Manometric analysis showed higher pressure of the pharynx and UES in the total laryngectomized patients than in the normal adults. And there was a failure in the coordination between pharyngeal constriction and UES relaxation.
Adult ; Constriction ; Deglutition ; Esophageal Sphincter, Upper* ; Humans ; Hypopharynx ; Laryngeal Neoplasms ; Laryngectomy ; Mucous Membrane ; Pharyngeal Muscles ; Pharynx* ; Relaxation

BACKGROUND AND OBJECTIVES: The type of neck dissection performed for head and neck cancers depends on the experience of the surgeon and the status of the neck metastasis. The purpose of this study was to quantify the extent of lymphadenectomy achieved according to the various modifications of neck dissection based on microscopic pathologic analysis and to analyze the difference in the number of lymph nodes between the types of neck dissection. MATERIALS AND METHODS: Charts and pathologic finding of patients who underwent neck dissection from June 1994 to October 1999 were reviewed. Patients who received selective neck dissection or preoperative radiotherapy to the neck were excluded. The samples were 65 necks and were divided into four groups based on Medina's classification: radical neck dissection (group 1), Type I modified radical neck dissection (group 2), Type II modified radical neck dissection (group 3), and Type III modified neck dissection (group 4). The number of lymph nodes was counted by a pathologic microscopic examination for each region of specimens. The intergroup difference was analyzed by a one-way between-group analysis of variance (ANOVA). RESULTS: The mean number of dissected lymph nodes per specimen was 43.6 in group 1, 38.8 in both groups of 2 and 3, and 30.3 in group 4. Group 4 was significantly different from group 1 (p<0.05). Especially, the number of dissected lymph nodes from level II, III, IV of group 4 was significantly different from those of group 1 (p<0.05). There was no significant difference between other groups. CONCLUSIONS: The number of dissected lymph nodes decreases as the number of preserved non-lymphatic tissue structures increases. Level II, III, IV are less completely operated regions in functional neck dissection.
Classification ; Head ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Radiotherapy