Objective: : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods: : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results: : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.

Hungry bone syndrome can occur after parathyroidectomy which is performed due to primary hyperparathyroidism. Hungry bone syndrome is characterized by showing postoperative hypocalcemia which is caused by the remineralization of various minerals, including calcium inside the bone. This syndrome requires a long term supplementation of calcium. Identifying the preoperative predictors of hypocalcemia is essential and important for postoperative management. From here on in, we report two cases of patients with parathyroid adenoma who have undergone parathyroidectomy. We would like to report and discuss the management of hungry bone syndrome experienced from the two cases that have been mentioned above. We report these two cases with a review of the literature.
Calcium ; Humans ; Hyperparathyroidism, Primary ; Hypocalcemia ; Minerals ; Parathyroid Hormone ; Parathyroid Neoplasms ; Parathyroidectomy*

Large cell neuroendocrine carcinoma is a rare malignant tumor of the parotid gland and has poor prognosis due to its aggressive and rapid growth and easy metastasis. Large cell neuroendocrine carcinoma usually occurs in the lung and intestine. However, a few cases of large cell neuroendocrine carcinoma have been reported in other sites such as the uterine cervix, thymus, urinary bladder, ovary and the ampulla of vater. In large cell neuroendocrine carcinoma of the parotid gland, radical parotidectomy is the first therapeutic step and can be followed by local radiation therapy. We report one case of primary large cell neuroendocrine carcinoma occurring in the parotid gland, and discuss the literature.
Ampulla of Vater ; Carcinoma, Large Cell ; Carcinoma, Neuroendocrine ; Cervix Uteri ; Female ; Intestines ; Lung ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Ovary ; Parotid Gland ; Parotid Neoplasms ; Prognosis ; Thymus Gland ; Urinary Bladder

Superficial parotidectomy is the most widely accepted form of the treatment for benign parotid tumors. But the risk of postoperative complications for the treatment of a benign condition cannot be ignored. Recent studies suggest that conservative parotidectomy (partial superficial parotidectomy or extracapsular dissection) might be the reliable option for the resection of benign parotid tumors. Conservative parotidectomy showed similar recurrence rate and lesser post operative complications than superficial parotidectomy.
Parotid Neoplasms ; Postoperative Complications ; Recurrence

PURPOSE: Radiotherapy for head and neck cancer does not impair the voice quality as much as laser treatment or surgery, but it can induce muscle wasting and fibrosis and symptoms of dry mouth. We investigated the effect of irradiation on the myosin heavy chain (MyHC) expression in laryngeal muscles. MATERIALS AND METHODS: Rats were irradiated with one dose of 10, 15, 20, 25, 30, or 35 Gy and other rats were irradiated with 20 Gy. The thyroarytenoid (TA), posterior cricoarytenoid (PCA), and cricothyroid (CT) muscles were subjected to reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Two weeks after irradiation with 10, 15, or 20 Gy, all the MyHC type expressions had decreased in a dose-dependent manner in the TA, PCA, and CT muscles, and especially the expression of MyHC IIa decreased much more than the expressions of the other MyHC isoforms in all muscles. In the 20 Gy-irradiated rats, almost all the MyHC isoform expressions declined over 12 weeks in the TA, PCA, and CT muscles, except for the MyHC I expression in the PCA and CT muscle. The MyHC IIa expression was markedly decreased in all the muscles. CONCLUSION: The laryngeal muscles responded differently to radiation, but they showed a time-dependent and long-lasting decrease in the expressions of all the MyHC isoforms in the TA, PCA, and CT muscles. In particular, the expression of the MyHC IIa isoform in all the muscles may be more sensitive to irradiation than the expressions of the other MyHC isoforms.
Animals ; Body Weight/radiation effects ; Gene Expression/radiation effects ; Laryngeal Muscles/*metabolism/*radiation effects ; Myosin Heavy Chains/*metabolism ; Protein Isoforms/*metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

Penetrating neck injuries are potentially dangerous and require emergent management because of vital structures in the neck. A 35-year-old woman was transferred to the hospital with massive bleeding in her mouth and lacerations of her neck after the stab injuries. Contrast-enhanced computed tomography (CT) and angiography revealed a leakage at the pharyngeal portion of the right internal carotid artery. Emergent endovascular treatment was undertaken by using the stent technique. The leakage was completely occluded immediately after the procedure. There was no complication. The stent technique was safe and effective for the treatment of zone III carotid artery stab injuries.
Adult ; Angiography ; Carotid Arteries ; Carotid Artery Injuries ; Carotid Artery, Internal ; Female ; Hemorrhage ; Humans ; Lacerations ; Mouth ; Neck ; Neck Injuries ; Stents

A cutaneous angiosarcoma is a rare, aggressive malignancy with a poor prognosis, with only a few cases of it in head and neck have been reported. In the present case, we reported a primary angiosarcoma of the nasal dorsum in a 70-year-old man without prior irradiation of head and neck region. The authors reviewed the literature and discussed treatment and prognosis of cutaneous angiosarcoma in nasal dorsum.
Aged ; Head ; Hemangiosarcoma ; Humans ; Neck ; Prognosis ; Sarcoma

The lips are essential in maintaining oral competence and assist in mastication, deglutition, and articulation. The lips are also important aesthetically, contributing to appearance and facial expression. Defects of up to one third of the lower lip can be closed primarily, but larger defects require more complex techniques. Successful lip reconstruction require careful meticulous planning to achieve the optimum functional and cosmetic result. When planning a reconstruction of a large defect of the lower lip, the following points should be taken into consideration: 1) maintain the sphincter function, 2) retain the sensation, 3) acquire a large enough opening for the mouth, 4) strive for an acceptable cosmetic appearance. It is not possible to satisfy all these criteria in every instance, and careful preoperative evaluation is essential. We describe here a successful technique to reconstruct a large lower lip defect using a depressor anguli oris musculocutaneous flap and a mucosal flap for elderly patients.

Penetrating injuries of the neck are diagnostic and therapeutic challenges to emergency physicians or surgeons. The neck is unique in that it contains a dense concentration of vital structures in a small anatomic space. Two treatment strategies have emerged over time. First, exploration of all penetrating neck injuries, and second, selective approach based in clinical and diagnostic work-up. We present a previously unreported case in the Korean literature, a zone III neck injury caused by a metal stick penetrating through the neck.
Emergencies ; Neck Injuries* ; Neck*

Primary laryngeal aspergillosis is exceptionally rare, and only nineteen cases have been reported in the literature. It is more commonly seen as a part of a wider infection involving the respiratory system in an immunocompromised host. We present here one case of primary laryngeal aspergillosis without any other airway tract extension and without any generalized immune deficit in a 58-year-old man. Direct laryngoscopy and biopsy confirmed the diagnosis of aspergillosis.
Aspergillosis* ; Biopsy ; Diagnosis ; Humans ; Immunocompromised Host ; Laryngoscopy ; Larynx ; Middle Aged ; Respiratory System