Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Oronasal fistula is a rare but significant complication that diminishes the quality of life for patients undergoing treatment for cleft palate and head and neck cancer. Various surgical reconstruction methods can be used based on the size and location of the oronasal fistula. The intranasal inferior turbinate rotational flap is a simple and safe method for reconstructing the defect of nasal cavity. In this case report, we experienced a small oronasal fistula of a 50-year-old female caused by osteoradionecrosis after treatment for her malignant melanoma. Successful reconstruction was achieved with inferior turbinate rotational flap alone. For small oronasal fistula in the hard palate, the inferior turbinate flap alone can be a useful option for reconstruction.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Objectives: . This study investigated age-related differences in nasal morphometry and the degree of changes within an individual over at least a 10-year period by pairing previous and recent three-dimensional reconstructed computed tomography (CT) images. Methods: . Forty-eight adult Korean patients who underwent at least two CT scans of the nasal region with an interval of at least 10 years were selected. Patients were categorized into six subgroups according to sex and age (20–39 years, 40–49 years, and ≥50 years) at the time of initial imaging. Eight nasal parameters were measured on the initial and recent images, and paired comparisons between the two images were performed based on the data. The differences in the degree of change by age were also analyzed. Results: . Over an average image interval of 12 years, men exhibited an increase in the nasofrontal angle (3.2°±5.4°, P=0.041), profile nasal length (1.7±1.7 mm, P=0.002), and nasal bridge height (1.2±1.6 mm, P=0.002). Conversely, they showed a decrease in the nasofacial angle (–2.3°±2.9°, P=0.010). Women also demonstrated an increase in the nasofrontal angle (2.5°±5.2°, P=0.010), profile nasal length (1.4±1.9 mm, P<0.001), and nasal bridge height (1.3±1.6 mm, P<0.001). However, they exhibited a decrease in the nasofacial angle (–2.0°±2.1°, P<0.001), glabella angle (–9.1°±9.8°, P<0.001), and pyriform angle (–8.5°±10.1°, P<0.001). With the exception of the nasal bridge height (P=0.036) and pyriform angle (P=0.022), the degree of changes in most parameters did not show significant differences across age groups. Conclusion . Our findings indicate that the aging nose exhibits a greater nasal length with inferior angulation of the nasal tip, with an increase in the nasofrontal angle, profile nasal length, and nasal bridge height, along with a decrease in the nasofacial angle. The degree of most nasal morphologic changes demonstrated no significant differences by specific age group.

Background: It has been known that the fear of contagion during the coronavirus disease 2019 (COVID-19) creates time delays with subsequent impact on mortality in patients with acute myocardial infarction (AMI). However, difference of time delay and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI between the COVID-19 pandemic and pre-pandemic era has not been fully investigated yet in Korea. The aim of this study was to investigate the impact of COVID-19 pandemic on time delays and clinical outcome in patients with STEMI or non-STEMI compared to the same period years prior. Methods: A total of 598 patients with STEMI (n = 195) or non-STEMI (n = 403) who underwent coronary angiography during the COVID-19 pandemic (February 1 to April 30, 2020) and prepandemic era (February 1 to April 30, 2017, 2018, and 2019) were analyzed in this study. Main outcomes were the incidence of time delay, cardiac arrest, and in-hospital death. Results: There was 13.5% reduction in the number of patients hospitalized with AMI during the pandemic compared to pre-pandemic era. In patients with STEMI, door to balloon time tended to be longer during the pandemic compared to pre-pandemic era (55.7 ± 12.6 minutes vs. 60.8 ± 13.0 minutes, P = 0.08). There were no significant differences in cardiac arrest (15.6% vs. 10.4%, P = 0.397) and in-hospital mortality (15.6% vs. 10.4%, P = 0.397) between pre-pandemic and the pandemic era. In patients with non-STEMI, symptom to door time was significantly longer (310.0 ± 346.2 minutes vs. 511.5 ± 635.7 minutes, P = 0.038) and the incidence of cardiac arrest (0.9% vs. 3.5%, P = 0.017) and in-hospital mortality (0.3% vs.2.3%, P = 0.045) was significantly greater during the pandemic compared to pre-pandemic era. Among medications, angiotensin converting enzyme inhibitors/angiotensin type 2 receptor blockers (ACE-I/ARBs) were underused in STEMI (64.6% vs. 45.8%, P = 0.021) and non-STEMI (67.8% vs. 57.0%, P = 0.061) during the pandemic. Conclusion During the COVID-19 pandemic, there has been a considerable reduction in hospital admissions for AMI, time delay, and underuse of ACE-I/ARBs for the management of AMI, and this might be closely associated with the excess death in Korea.

Methods: Patients scheduled for shoulder surgery from June 2017 to July 2019 were allocated to a surgery group (n=224) or a cancellation group (n=96). These groups were compared with respect to patient characteristics, types of surgery, distance from patient’s home to the hospital, traveling time to the hospital, and waiting period before surgery. Reasons for cancellation and responses were acquired using a telephone interview and were subsequently analyzed. Results: The cancellation group was older, had a less frequent history of trauma, and had a lower proportion of patients undergoing arthroscopic rotator cuff repair than the surgery group (p=0.009, p=0.014, and p=0.017, respectively). In addition, mean distance from the patients’ homes to the hospital and preoperative waiting time were both longer in the cancellation group (p=0.001 and p<0.01, respectively). The most common reason given for cancellation was another medical condition (28.1%). Conclusions Older age, need for arthroscopic rotator cuff repair surgery, longer distance from the patient’s home to the hospital, and longer waiting period significantly increased the chance of cancellation. The main reason for canceling surgery was a concurrent medical condition. Therefore, identification of other medical conditions in advance is an important consideration when surgeons recommend shoulder surgery to patients. Surgeons should also consider patient’s age, type of surgery, distance from the hospital, and waiting time when assessing the possibility of surgery cancellation.

Functional paraganglioma is a rare tumor that secretes the catecholamine which is able to cause secondary hypertension. Surgical resection is the only curative treatment modality for this tumor, which can correct the secondary hypertension. The pterygopalatine fossa is a small retromaxillary space which contains a neurovascular bundle that crosses the middle cranial fossa to the nasal cavity, nasal septum, and oral cavity. To our knowledge, two cases have been reported for functional paraganglioma involving the pterygopalatine fossa removed by surgery. We present a patient who had a catecholamine-secreting paraganglioma in the pterygopalatine fossa, which is the first case successfully resected with an endoscopic approach.