• 제목/요약/키워드: Complete excision

검색결과 338건 처리시간 0.019초

이상와루(Pyriform Sinus Fistula)에 대한 내시경적 경화요법의 3예 (Endoscopic Chemocauterization for Pyriform Sinus Fistula)

  • 박윤아;서진학;조상현;정웅윤;최은창;박정수
    • 대한두경부종양학회지
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    • 제17권2호
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    • pp.234-237
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    • 2001
  • Pyriform sinus fistula is a rare anomaly arising from 3rd or 4th branchial apparatus and has been recognized as one cause of acute suppurative thyroiditis or acute deep neck infection. Pyriform sinus fistula must be considered when a clinician is encountered recurrent left lower neck abscess and a history of repeated incision and drainage. The confirmation of the diagnosis is made when the fistula tract is identified on a barium swallow study and when the internal orifice of the fistula is found at the apex of pyriform sinus on laryngoscopic examination. A complete excision of the fistula tract has been proposed as a treatment of choice. However, in some cases it is very difficult to resect the tract completely because of severe inflammation and repeated drainage procedure. We present three cases of pyriform sinus fistula which are successfully treated by laryngomicroscopic chemocauterization using synthetic fibrin and $AgNO_3$.

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후두에 원발한 악성 흑색종 1례 (Primary Laryngeal Malignant Melanoma: Report of a Case with Review of Literatures)

  • 김은서;이용희;심정연;유영석
    • 대한두경부종양학회지
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    • 제16권2호
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    • pp.220-223
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    • 2000
  • Mucosal melanoma of the head and neck is a rare and usually lethal disease. Primary laryngeal malignant melanoma(LMM) are exceedingly rare tumors that morphologically are readily confused with more common types of laryngeal cancer. Treatment of choice for LMM is complete surgical excision and elective lymph node dissection is usually not recommended. The use of radiation or chemotherapy is generally thought to have no effect on local or distant disease and currently used as adjuvant therapy. The prognosis is extremely poor. We have experienced a 61 year old male patient with symptoms of foreign body and lump sense in throat. A dark pigmented polypoid mass was found on the right aryepiglottic folds with normal mobility of vocal cord. Total laryngectomy was performed under the diagnosis of malignant melanoma. Bone scan revealed multiple bony metastasis on ribs and lumbar vertebrae after 5 months of operation. There have been no evidence of recurrence at primary area. The patient died after 8 months of operation.

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Malignant Peripheral Nerve Sheath Tumor of Non-Neurofibromatosis Type I Metastasized to the Cerebrospinal Axis

  • Park, Man-Kyu;Sung, Joo-Kyung;Nam, Kyung-Hun;Kim, Kyoung-Tae
    • Journal of Korean Neurosurgical Society
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    • 제53권3호
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    • pp.190-193
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    • 2013
  • A malignant peripheral nerve sheath tumor (MPNST) is a type of sarcoma that arises from peripheral nerves or cells of the associated nerve sheath. This tumor most commonly metastasizes to the lung and metastases to the spinal cord and brain are very rare. We describe a case of young patient with spinal cord and brain metastases resulting from MPNST. An 18-year-old man presented with a 6-month history of low back pain and radiating pain to his anterior thigh. Magnetic resonance imaging showed a paraspinal mass that extended from the central space of L2 to right psoas muscle through the right L2-3 foraminal space. The patient underwent surgery and the result of the histopathologic study was diagnostic for MPNST. Six months after surgery, follow-up images revealed multiple spinal cord and brain metastases. The patient was managed with chemotherapy, but died several months later. Despite complete surgical excision, the MPNST progressed rapidly and aggressively. Thus, patients with MPNST should be followed carefully to identify local recurrence or metastasis as early as possible.

Microsurgical Fenestration of Middle Cranial Fossa Arachnoid Cyst

  • Kim, In-Soo;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
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    • 제40권2호
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    • pp.69-73
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    • 2006
  • Objective : The optimal surgical treatment for symptomatic middle cranial fossa arachnoid cysts is controversial. Therapeutic options include endoscopic fenestration, excision, cyst shunting, and craniotomy for fenestration of basal cistern. We reviewed the results of surgically treated middle cranial fossa arachnoid cysts. Methods : We performed a retrospective study in 18 cases of middle cranial fossa arachnoid cysts who had been treated with microsurgical fenestration between 1995 to 2003. The analysis was based on the results of the patients' age, sex distribution, developed area, clinical symptoms, treatment method, and complications. Results : Eighteen surgical treated middle cranial fossa arachnoid cysts patients were evaluated. The age range of cyst development was between 2 years and 44 years with the average of 16.4 years. The follow-up periods averaged 31.48 months. There were 15 male and 3 female patients, with significantly more cyst development in males than females. The most common clinical symptom was headache, followed by seizure. In the entire series, 77.8% of patients demonstrated a decrease in cyst size In serial imaging studies. Of them, 67.3% demonstrated a complete cyst effacement. Overall, 100% of patients with Grade I cysts, 81.8% of patients with Grade II cysts, 60% of patients with Grade III cysts exhibited evidence of decrease in cyst size during long-term monitoring. Complications included headache, meningitis, and hydrocephalus. Conclusion : Patients who were treated with microsurgical fenestration showed good outcome with acceptable complications. We concluded that microsurgical fenestration is a safe and effective surgical method for middle cranial fossa arachnoid cysts.

동맥 흉곽 출구 증후군을 일으킨 쇄골하동맥 맥관 육종 -1례 보고- (Arterial Thoracic Outlet Syndrome due to Angiosarcoma of the Subclavian Artery a case report)

  • 이철범;함시영
    • Journal of Chest Surgery
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    • 제29권10호
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    • pp.1160-1165
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    • 1996
  • 저자들은 지금까지 발생보고 예가 없는 좌쇄골하동맥 맥관육종 1례 수술을 치험하였다. 제 1늑골의 기형이 있는 19세 여자 환자로, 1년 전부터 점진적으로 심해진 동맥 흉곽 출구 증후군의 증상을 나타냈다. 쇄골 중앙부를 절제한 후 폐쇄된 쇄골하 동맥 제 3부분과 상완 동맥 분절을 절제하고 대복재 정맥을 이용하여 우회로 조성술을 시행하였다. 쇄골하 동맥의 병리 조직 소견은 벽재성형 맥관 육종이었으며 혈액 응고 인자 WII과 관련되는 항원에 대한 조직 화학적 염색 소견도 양성이었다. 수술전 일상 생활을 할 수 없을 정도 심한 증상이 수술후 거의 소실되었으며, 수술후 4개월된 현재 직장 생활을 계속하고 있다.

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Flap reconstruction of soft tissue defect after resecting a huge hemangioma of the nose

  • Lim, Joonho;Oh, Jeongseok;Eun, Seokchan
    • 대한두개안면성형외과학회지
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    • 제21권1호
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    • pp.69-72
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    • 2020
  • Hemangioma is a benign vascular tumor that grows by endothelial cell hyperplasia. It occurs most frequently in the head and neck region. Nose reconstruction is tricky because of its unique three-dimensional structure and different tissue components. We report a case of successful reconstruction of near-total nose defect using the paramedian forehead flap combined with a nasolabial flap, immediately after excision of nasal hemangioma. A 49-year-old male patient was presented with a huge mass at the nose. Preoperative magnetic resonance imaging showed prominent vascular channels extending to the forehead and cheek. Complete resection of the mass was performed, which resulted in an eccentric defect. The right paramedian forehead flap and the left nasolabial flap were designed and transferred to the defect. Flap division was performed 1 month later. The patient is satisfied with the overall appearance and did not develop any functional deficit.

소아의 위장관 중복증 (Gastrointestinal Duplications in Childhood)

  • 김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제7권1호
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    • pp.26-30
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    • 2001
  • Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.

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후두에 발생한 점액종 1예 (A Case of Laryngeal Myxoma)

  • 김윤환;오장근;신향미;문태현;김정범;김영생
    • 대한기관식도과학회지
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    • 제15권2호
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    • pp.71-74
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    • 2009
  • Myxoma is a benign mesenchymal neoplasm that can occur in the head and neck. Laryngeal myxoma is extremely rare and easily confused with a laryngeal polyp. The common clinical presentation is hoarseness, dysphonia, dyspnea and dysphagia depending on their size and location. Treatment for laryngeal myxoma is complete surgical excision with surrounding normal tissue. To our knowledge, 11 laryngeal myxomas have been reported in the English literature, and all patients except only 1 case were male. We report the second female case of myxoma on a vocal cord with a review of literature.

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원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술 (Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius)

  • 송석환;이윤민
    • Archives of Reconstructive Microsurgery
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    • 제20권1호
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    • pp.82-88
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    • 2011
  • Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

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화학 소작술 및 결찰을 이용한 이상와 누공의 치험 1예 (Pyriform Sinus Fistula with Recurrent Deep Cervical Abseesses Successfully Treated with Trichloroacetic Acid Cauterization and Ligation)

  • 박영학;이정학;송기영;조승호
    • 대한후두음성언어의학회지
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    • 제16권1호
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    • pp.85-87
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    • 2005
  • The pyriform sinus fistula can cause a recurrent abscess in the neck and the current treatment of choice involves complete excision of the sinus tract. But, because of excisional difficult, chemical cautery has been intermittently used as a successful substitute. Recently we experienced a case of pyriform sinus fistula of 9 year-old female who was successfully treated with chemocauterization with trichloroacetic acid(TCA) and ligation of the internal opening of the fistula tract on suspension laryngoscopy. So we report this rate case with review of literatures.

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