Schwannomas are benign tumors that can develop in any part of a nerve containing Schwann cells. Skull base schwannomas are rare, representing approximately 4% of extracranial schwannomas. Among these, vidian nerve schwannomas are particularly uncommon, with only a few documented cases. In this report, we describe the case of a 58-year-old female patient who presented with an incidental finding of a skull base mass. The patient’s only symptoms were intermittent headaches and dry eyes. No mass was detected during the physical examination. Radiographic evaluation revealed a neoplasm within the vidian canal, and the lesion’s characteristics suggested a schwannoma. The patient underwent endoscopic resection, and subsequent histopathological analysis confirmed the diagnosis of schwannoma. Follow-up imaging and physical examination showed no evidence of recurrence. This case report highlights a schwannoma located in the vidian canal and extending into the foramen rotundum, which was successfully managed with endoscopic surgery.

Schwannomas are benign tumors that can develop in any part of a nerve containing Schwann cells. Skull base schwannomas are rare, representing approximately 4% of extracranial schwannomas. Among these, vidian nerve schwannomas are particularly uncommon, with only a few documented cases. In this report, we describe the case of a 58-year-old female patient who presented with an incidental finding of a skull base mass. The patient’s only symptoms were intermittent headaches and dry eyes. No mass was detected during the physical examination. Radiographic evaluation revealed a neoplasm within the vidian canal, and the lesion’s characteristics suggested a schwannoma. The patient underwent endoscopic resection, and subsequent histopathological analysis confirmed the diagnosis of schwannoma. Follow-up imaging and physical examination showed no evidence of recurrence. This case report highlights a schwannoma located in the vidian canal and extending into the foramen rotundum, which was successfully managed with endoscopic surgery.

Schwannomas are benign tumors that can develop in any part of a nerve containing Schwann cells. Skull base schwannomas are rare, representing approximately 4% of extracranial schwannomas. Among these, vidian nerve schwannomas are particularly uncommon, with only a few documented cases. In this report, we describe the case of a 58-year-old female patient who presented with an incidental finding of a skull base mass. The patient’s only symptoms were intermittent headaches and dry eyes. No mass was detected during the physical examination. Radiographic evaluation revealed a neoplasm within the vidian canal, and the lesion’s characteristics suggested a schwannoma. The patient underwent endoscopic resection, and subsequent histopathological analysis confirmed the diagnosis of schwannoma. Follow-up imaging and physical examination showed no evidence of recurrence. This case report highlights a schwannoma located in the vidian canal and extending into the foramen rotundum, which was successfully managed with endoscopic surgery.

Objectives: . Nasal valve surgery for internal nasal valve (INV) compromise has become increasingly popular. However, this rise in popularity has sparked debates regarding its indications and disputes over insurance coverage, primarily due to the lack of a gold-standard evaluation method. Therefore, we aimed to identify objective parameters for the INV compromise. Methods: . We analyzed 186 INVs in 93 patients who underwent nasal valve surgery. The data comprised facial computed tomography (CT) images, acoustic rhinometry, the modified Cottle test, and symptom scores. Patients were categorized based on their symptoms and the results of the modified Cottle test. We measured the INV angle, area, volume, lateral wall thickness, septal angle, and nasal bone area using CT. Results: . The compromised INV group, characterized by nasal obstruction with a positive modified Cottle test, exhibited smaller INV areas in both coronal and axial views, reduced INV volume in the axial view, and a thinner lateral wall in the coronal view (all P<0.05). Acoustic rhinometry indicated a smaller minimal cross-sectional area and volume in the compromised INV group (both P<0.001). Regression analysis demonstrated significant associations between a compromised INV and reduced INV area on the axial view, as well as the minimal cross-sectional area measured by acoustic rhinometry. Conclusion . Relying solely on the INV angle in CT scans has limitations in assessing compromised INV. Alternatively, the INV area on axial CT scans and the minimal cross-sectional area measured by acoustic rhinometry may serve as objective parameters for evaluating INV compromise.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

Background and Objectives: Fibrin sealant (FS) is widely used to reduce postoperative bleeding. This analysis aimed to assess the efficacy of FS to reduce complications after rhinoplasty.Materials and Method We searched PubMed, Scopus, Embase, the Cochrane Library, and the Web of Science database for articles on FS and rhinoplasty from the inception of publication to December 29, 2021. Post-rhinoplasty complications, such as edema and ecchymosis, were recorded. The final meta-analysis was performed using three studies. Results: Two subgroups were created based on the FS usage after rhinoplasty. The FS effect on edema reduction was favorable on the postoperative day-1 (standardized mean difference [SMD]=-1.07 [-1.70; -0.45]). In addition, the FS effect on ecchymosis reduction was favorable on the postoperative day-1 postoperative (SMD=-1.33 [-2.15; -0.50]). Conclusion Our study shows that FS reduces the early complications of rhinoplasty.

Purpose: Cannulation of the major papilla is the most challenging part of endoscopic retrograde cholangiopancreatography (ERCP) for which physician-controlled wire-guided cannulation (PCWGC) and assistant-controlled wire-guided cannulation (ACWGC) are used as the cannulation techniques. PCWGC can reportedly save up to about 30% of the labor cost by reducing the number of assistants. This study aims to compare the safety and efficacy of PCWGC and ACWGC. Materials and Methods: Of the 2151 patients aged >20 years (4193 cases) who underwent ERCP at Yonsei University Medical Center between January 2015 and December 2016, 989 were included in this study. Results: Among efficacy outcomes, cannulation success rate, rate of precut sphincterotomy (PCWGC vs. ACWGC: 21.3% vs.25.9%), bile duct cannulation time (PCWGC vs. ACWGC: median 3.0 minutes vs. 3.6 minutes), and total procedure time (PCWGC vs. ACWGC: median 13.6 minutes vs. 13.1 minutes) were not significantly different. Among safety outcomes, lower rates of postERCP pancreatitis were observed with PCWGC than with ACWGC (PCWGC vs. ACWGC: 5.8% vs. 8.8%, p=0.128). Among other post-ERCP adverse events (bleeding, perforation, and cholangitis), the difference was not significant between the groups. Radiation exposure (total dose area product, PCWGC vs. ACWGC: median 1979.9 µGym2 vs. 2062.0 µGym2 , p=0.194) and ERCP cost excluding labor cost (PCWGC vs. ACWGC: $1576 vs. $1547, p=0.606) were not significantly different. Conclusion Requiring less assistants, PCWGC showed comparable efficacy and safety to ACWGC. PCWGC can be considered as an alternative option, especially in facilities lacking manpower and resources.

Schwannoma is benign tumor that can occur in any part of the nerve that contains a Schwann cell. It is rare in the head and neck region and is characterized by common postoperative neurologic symptoms. We experienced a cervical schwannoma in a 22-year-old young man. Except for a foreign body sensation in the neck and a mass in the anterior region, there were no other complaints. A retropharyngeal schwannoma was most suspected considering neck computed tomography, magnetic resonance imaging, laryngoscopy and fine needle aspiration. Surgical treatment was performed, and the origin of the schwannoma was diagnosed as the tonsillar branch of the glossopharyngeal nerve. Histopathological examination confirmed the presence of a schwannoma with typical characteristics. After surgery, the patient recovered without any side effects. We report this case with a review of the literature.

Background/Aims: Controversy regarding the effectiveness of neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma (PDAC) still exists. Here, we aimed to identify the potential benefits of neoadjuvant therapy followed by surgery for resectable PDAC. Methods: We reviewed radiologically resectable PDAC patients who received resection with curative intent at a tertiary hospital in South Korea between January 2012 and August 2019. A total of 202 patients underwent curative resection for resectable PDAC: 167 underwent surgical resection first during this period, and 35 received neoadjuvant chemotherapy/chemoradiation therapy followed by surgery. Resectable PDAC patients were subdivided, and 1:3 propensity score matching (PSM) was performed to reduce selection bias. Results: Compared with the group that received surgery first, the group that received neoadjuvant treatment followed by surgery had significantly smaller tumors (22.0 mm vs 27.0 mm, p=0.004), a smaller proportion of patients with postoperative pathologic T stage (p=0.026), a smaller proportion of patients with lymphovascular invasion (20.0% vs 40.7%, p=0.022), and a larger proportion of patients with negative resection margins (74.3% vs 51.5%, p=0.049). After PSM, the group that received neoadjuvant therapy had a significantly longer progression-free survival than those in the group that underwent surgery first (29.6 months vs 15.1 months, p=0.002). Overall survival was not significantly different between the two groups after PSM analysis. Conclusions We observed significantly better surgical outcomes and progression-free survival with the addition of neoadjuvant therapy to the management of resectable PDAC. However, despite PSM, there was still selection bias due to the use of different regimens between the groups receiving surgery first and neoadjuvant therapy. Large homogeneous samples are needed in the future prospective studies.

Objective: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.