BACKGROUND: Laparoscopic gastrectomy requires a reverse-Trendelenburg position and prolonged pneumoperitoneum and it could cause significant changes in cerebral homeostasis and lead to cognitive dysfunction. We compared changes in regional cerebral oxygen saturation (rSO2), early postoperative cognitive function and hemodynamic variables in patients undergoing laparoscopic gastrectomy with those patients that underwent conventional open gastrectomy. METHODS: Sixty patients were enrolled in this study and the patients were distributed to receive either laparoscopic gastrectomy (laparoscopy group, n = 30) or open conventional gastrectomy (open group, n = 30). rSO2, end-tidal carbon dioxide tension, hemodynamic variables and arterial blood gas analysis were monitored during the operation. The enrolled patients underwent the mini-mental state examination 1 day before and 5 days after surgery for evaluation of early postoperative cognitive function. RESULTS: Compared to baseline value, rSO2 and end-tidal carbon dioxide tension increased significantly in the laparoscopy group after pneumoperitoneum, whereas no change was observed in the open group. No patient experienced cerebral oxygen desaturation or postoperative cognitive dysfunction. Changes in mean arterial pressure over time were significantly different between the groups (P < 0.001). CONCLUSIONS: Both laparoscopic and open gastrectomy did not induce cerebral desaturation or early postoperative cognitive dysfunction in patients under desflurane anesthesia. However, rSO2 values during surgery favoured laparoscopic surgery, which was possibly related to increased cerebral blood flow due to increased carbon dioxide tension and the effect of a reverse Trendelenburg position.
Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Carbon Dioxide ; Gastrectomy* ; Head-Down Tilt ; Hemodynamics ; Homeostasis ; Humans ; Laparoscopy ; Oxygen* ; Pneumoperitoneum

Schwannomas are benign neoplasms arising from the sheath of myelinated nerve fibers and may occur in any part of the body. They mostly occur in the head and neck region, accounting for about 25% to 45% of all cases. The eighth cranial nerve is the most common site of origin. About 4% of all head and neck schwannomas originate in the nasal cavity and paranasal sinuses. The best treatment of schwannomas is surgical excision. Since it is an encapsulated tumor, difficultly is rarely encountered in its complete removal, and recurrence is unlikely. We present a unique and rare case of a 71-year-old man with a recurrent septal mass, finally diagnosed as a schwannoma, with a review of the literature.
Aged ; Head ; Humans ; Nasal Cavity ; Nasal Septum ; Neck ; Nerve Fibers, Myelinated ; Neurilemmoma* ; Paranasal Sinuses ; Recurrence ; Vestibulocochlear Nerve

In most cases, skull base osteomyelitis arises from infections of external auditory canal, middle ear or paranasal sinuses. On the other hand, atypical or central skull base osteomyelitis has no evidence of external otitis or other infection sources. It is often found located on clivus and involves lower cranial nerves and brainstem through the foramina of skull base. The overall rate of mortality reaches 10% and long-term neurologic sequelae are seen in additional 31% of cases regardless of aggressive treatment. We recently encountered a 68-year-old man with right facial pain and generalized headache, and we achieved good outcome with the recovery of vocal cord palsy and disappearance of headache by surgical debridement and long-term antibiotics. We report it with a review of literature.
Aged ; Anti-Bacterial Agents ; Brain Stem ; Cranial Fossa, Posterior ; Cranial Nerve Diseases* ; Cranial Nerves ; Debridement ; Ear Canal ; Ear, Middle ; Facial Pain ; Hand ; Headache ; Humans ; Mortality ; Osteomyelitis* ; Otitis Externa ; Paranasal Sinuses ; Skull Base* ; Vocal Cord Paralysis

The laryngeal granuloma (LG) is non-neoplastic lesion that mainly develops in the posterior vocal folds. It is welknown that mis- or overuse of voice, habitual coughing, and endotracheal intubation can become the cause of LG. The laryngopharyngeal reflux also comes into the spotlight as an etiologic factor. Although LG has a tendency to recur easily, it is not a premalignant lesion. The co-existence with granuloma and laryngeal cancer has not been reported earlier. Recently, we encountered a 72-year-old man with a posterior glottic mass, which was diagnosed as squamous cell carcinoma coexisting with granuloma. To our knowledge, this is a first report on two coexisting carcinomas in the glottis.
Aged ; Carcinoma, Squamous Cell* ; Cough ; Glottis* ; Granuloma* ; Granuloma, Laryngeal ; Humans ; Intubation, Intratracheal ; Laryngeal Neoplasms ; Laryngopharyngeal Reflux ; Neoplasms, Squamous Cell ; Vocal Cords ; Voice

Renal cell carcinoma (RCC) is known for its high propensity for early metastasis and one third of patients diagnosed with RCC present with metastatic disease at the time of diagnosis. RCC commonly metastasizes to the lung, bone, liver, brain, and skin by hematogenous spread, whereas metastasis to the head and neck region is rarer. In cases of head and neck metastasis, the thyroid accounts for a large percent. Parotid metastasis from renal cell carcinoma is an extremely rare finding. We recently encountered a 67-year-old man with left parotid mass and finally diagnosed as metastatic renal cell carcinoma. We report the rare case with a review of literature.
Aged ; Brain ; Carcinoma, Renal Cell* ; Diagnosis ; Head ; Humans ; Liver ; Lung ; Neck ; Neoplasm Metastasis ; Nephrectomy ; Parotid Gland* ; Skin ; Thyroid Gland

While ancient schwannoma (AS) from the cervical sympathetic chain is very rare. Preoperative Horner's syndrome resulting from cervical sympathetic chain schwannoma (CSCS) is extremely rare. A 58-year-old woman visited our clinic with a huge lateral neck mass that had been present for thirteen years. Ptosis and enophthalmos were observed on the left eye. After radiologic evaluation, we assessed the CSCS by performing surgical excision. Finally, pathologic examination revealed it to be AS. There has been no recurrence for 15 months after discharge, however Horner's syndrome has become more prominent. We report this unique case of ancient schwannoma with literature review.
Enophthalmos ; Eye ; Female ; Horner Syndrome ; Humans ; Middle Aged ; Neck ; Neurilemmoma ; Preoperative Period ; Recurrence ; Sympathetic Nervous System

Mucosa-associated lymphoid tissue (MALT) lymphoma, known as a distinctive type of non-Hodgkin's lymphoma, is an extranodal marginal zone B-cell lymphoma. It most frequently occurs in the stomach but has also been described in various non-gastrointestinal lesions, such as the salivary glands, conjunctiva, thyroid, orbit, lung, breast, kidney, liver, and prostate etc. It occurs very rarely in buccal mucosa. The MALT lymphoma tends to remain localized for long periods and respond to locally direct therapy. We recently encountered an 80-year-old male presenting with a foreign body sensation in the oral cavity; he was finally diagnosed as MALT lymphoma. We report this rare and unique case with a review of literature.
Aged, 80 and over ; Breast ; Conjunctiva ; Foreign Bodies ; Humans ; Kidney ; Liver ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Male ; Mouth ; Mouth Mucosa ; Orbit ; Prostate ; Salivary Glands ; Sensation ; Stomach ; Thyroid Gland