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*

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: An accurate, preoperative assessment of tumor extent and lymph node involvement is necessary to plan and tailor therapy for patients with head and neck cancer. Metabolic imaging with tluorine-18-fluorodeoxyglucose (FDG) is a good method to detect primary cancers in the head and neck and to assess the involvement of lymph nodes, but it is not widely available because of high cost of positron emission tomography (PET). Recently, an alternative method for using FDG was developed: the coincidence detection PET (CoDe PET) using a gamma camera. The aim of this study was to evaluate the clinical utility of FDG CoDe PET using a gamma camera in patients with head and neck cancer. MATERIALS AND METHODS: Thirty FDG CoDe PET studies were performed in 7 patients before therapy and 19 patients after therapy with various head and neck cancers (Age : 25- 79 years, mean age : 50+/-13 years, 18 men, 8 women). All patients had fasted for 6 to 12 hours and were injected 1 1 l to 370 MRq of F-18-FDG 1 hour before imaging. With the exception of the physiological FDG uptake, all visually detectable focal FDC uptake in the primary cancer site or in the neck was considered positive. FDG CoDe PET studies were correlated with CT/MRI. The standard procedure for detecting the presence of disease was the combinations of repeated MRIs, 3 months of follow-up clinical evaluation and the result of a needle aspiration cytology or biopsy. RESULTS: FDG CoDe PET had a detcction rate that was comparable to that of CT/MRI in the pre-therapy group. However, in the post-therapy group, FDG CoDe PET could differentiate residual/recurrence of tumor from radiation change more accurately than could MRI. But, it had a less accurate detection rate for cervical metastases because of asymmetric neck muscle uptake. CONCLUSION: FDG CoDe PET is a sensitive and cost-effective method to detect primary tumor and lymph node involvement in primary head and neck cancers. It is also useful in differentiating residual tumor or tumor recurrence from post-therapy changes in patients with head and neck cancers.
Biopsy ; Electrons* ; Follow-Up Studies ; Gamma Cameras ; Head and Neck Neoplasms* ; Head* ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Male ; Neck ; Neck Muscles ; Needles ; Neoplasm Metastasis ; Neoplasm, Residual ; Positron-Emission Tomography* ; Recurrence

Ewing's sarcoma is an uncommon malignancy that usually occurs in children. It is composed of monotonous population of small cells with large nuclei and little cytoplasm. These cells fall into the category of the "small, round, blue cell tumors of children". Based on cytogenetic studies, Ewing's sarcoma appears to be of neuroectodermal origin and shares the same reciprocal 11:22 translocation as primitive neuroectodermal tumor. Long bones and pelvis are the preferential sites. The incidence of Ewing's sarcoma in all primary malignant bone tumors is four-seven percent. Only seven percent of Ewing's sarcoma occurs in the mandible either as primary or metastatic disease. The rarity is due to the paucity of hematopoietic marrow of the mandible. Soft tissue swelling and pain are the most common presenting symptoms. Differential diagnosis of Ewing's sarcoma of the mandible includes other mass lesions of the jaw such as osteosarcoma, Burkitt's lymphoma, retinoblastoma and neuroblastoma. Treatment for mandibular Ewing's sarcoma consists of various single and combination modalities including radiation, chemotherapy, and surgery. We report a case of a 24-year-old male with mandibular Ewing's sarcoma who was treated with chemotherapy (vincristine, adriamycin, cyclophosphamide and ifosfamide, etoposide) and concurrent radiation therapy (6MV, 180-200 cGy/d, 32 fractination, total dose: 5900 cGy).
Bone Marrow ; Burkitt Lymphoma ; Child ; Cyclophosphamide ; Cytogenetics ; Cytoplasm ; Diagnosis, Differential ; Doxorubicin ; Drug Therapy ; Humans ; Ifosfamide ; Incidence ; Jaw ; Male ; Mandible* ; Neural Plate ; Neuroblastoma ; Neuroectodermal Tumors, Primitive ; Osteosarcoma ; Pelvis ; Retinoblastoma ; Sarcoma, Ewing* ; Young Adult