• Title/Summary/Keyword: Ear tissue

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Internal Mammary Artery Perforator Flap for Immediate Volume Replacement Following Wide Local Excision of Breast Cancer

  • van Huizum, Martine A.;Hage, J. Joris;Oldenburg, Hester A.;Hoornweg, Marije J.
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.502-508
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    • 2017
  • Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

Complication and Morbidity of Donor Site after Free TRAM Flap (횡복직근 유리 피판술후 공여부 합병증과 이환율)

  • Ahn, Hee Chang;Sung, Kun Yong;Jo, Dong In;Choi, Seung Suk
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.68-73
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    • 2004
  • Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.

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Pedicled Anterolateral Thigh Flaps for Reconstruction of Recurrent Trochanteric Pressure Ulcer

  • Bahk, Sujin;Rhee, Seung Chul;Cho, Sang Hun;Eo, Su Rak
    • Archives of Reconstructive Microsurgery
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    • v.24 no.1
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    • pp.32-36
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    • 2015
  • The reconstruction of recurrent pressure sores is challenging due to a limited set of treatment options and a high risk of flap loss. Successful treatment requires scrupulous surgical planning and a multidisciplinary approach. Although the tensor fascia lata flap is regarded as the standard treatment of choice-it provides sufficient tissue bulk for a deep trochanteric sore defect-plastic surgeons must always consider the potential of recurrence and accordingly save the second-best tissues. With the various applications of anterolateral thigh (ALT) flaps in the reconstructive field, we report two cases wherein an alternative technique was applied, whereby pedicled ALT fasciocutaneous island flaps were used to cover recurrent trochanteric pressure sores. The postoperative course was uneventful without any complications. The flap provided a sound aesthetic result without causing a dog-ear formation or damaging the lower-leg contour. This flap was used as an alternative to myocutaneous flaps, as it can cover a large trochanteric defect, recurrence is minimized, and the local musculature and lower-leg contour are preserved.

Contents Analysis on the Dwellers' Medical Reports in High-Rise Mixed-Use Apartment (주상복합아파트 거주자의 질병자료에 관한 내용 분석)

  • Choi, Byung-Sook;Kang, In-Ho
    • Proceeding of Spring/Autumn Annual Conference of KHA
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    • 2008.04a
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    • pp.187-192
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    • 2008
  • This purpose of this study is to figure out the inter-relationship between the residence stories in high-rise mixed-use apartments and their residents' disease patterns throughout the dweller's medical reports in high-rise mixed-use apartments. Research basic data are obtained from medical fee request of National Health Insurance Corportion. Data are limited a housing complex to 'A' high-rise mixed-use apartment and a medical treatment time to 3 years(2004-2006). Analysis data of total 346,286 medical records, 43,159 disease records, and 8,999 persons are collected. By analyzing those data, findings are as follows: 1) Women is more medical treatments than men, 40-50 age group is more treated, and the residents of 6-25 stories are more received medical treatments. Diseases of the respiratory system and diseases of the eye and adnexa are relatively treated higher than other diseases. 2) The diseases of the respiratory system, the eye and adnexa, the skin and subcutaneous tissue, the ear and mastoid process), and the asthma have not relation to the high-storied residence through the data of disease records and personal records. But the analysis on the data of children, 7 ages and less, is showed a significant relation. And to conclude, there is no relationship between the residence of high-stories in that apartment and dwellers' disease patterns, but there is a little probable to the relationship in the pre-school child.

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AN EXPERIMENTAL STUDY OF THE EFFECTS OF BONE WAX ON THE MOUSE FEMORAL BONE DEFECTS (백서 대퇴골 결손부에 매식된 밀랍지혈제의 조직반응에 관한 실험적 연구)

  • kim, Jang-Yun;Han, Kyung-Su;Um, In-Woong;Chung, Ho-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.3
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    • pp.228-236
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    • 1992
  • This study was to designed to evaluate the reactions of mouse femoral bone to bone wax. In sixteen mice with a strain of I. C. R. mouse weighed approximately 300 to 850g 2.0~2.0mm sized bone defects were created by drilling. Half of mice were inserted by bone wax and the remainder serving as control without bone wax application. The mice were sacrificed 1, 2, 6, 8 weeks after operation and block specimens were prepared for light microscopy examination. The results obtained were as follows. 1. Histologic features of tissue reaction to bone wax were the presence of inflammatory cell infiltration and multinucleated giant cell. 2. Bone ear healing from the created margin were markedly impaired by the application of bone wax 3. New bone formation was markedly decreased in bone wax application.

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A CASE REPORT OF TOTAL AVULSED SCALP WITH RIGHT TOTAL EAR (우측이부를 포함한 전두피박이환자의 재이식 치험예)

  • Lee, Yeoul-Hi;Byun, Gi-Jung;Kim, Shin-Ho
    • The Journal of the Korean dental association
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    • v.15 no.2
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    • pp.115-120
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    • 1977
  • Extensive avulsion of the scalp, or stripping of a large area of soft tissue from the skull, is a serious accidnet. The avulsed scalp is often injured otherwise, such as by crushing, tearing, or from multiple laceration. The surrounding skin may be devitalized. Replacement of the scalp is usually followed by necrosis and sloughing within a short time. In such instances, the outer table of the cranium may become sucessively exposed. dry, dead, and affected by osteomyelitis. Hence the securing of early healing to prevent these is of the utmost importance. The successful case of reimplantation of the completely avulsed scalp, which is exposured to air for about 14 hours, is reported, in which there was partial growth of hair afterwards. The avulsed scalp caused by her long hair being caught in a grain belt was contaminated with hairs & dust. Authors treated this 19-year old female patient by split thickness skin graft, intermediate skin graft, full thickness skin graft from her own avulsed scalp.

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Regulatory Effects of Gamisamul-tang on Atopic Dermatitis Induced in the NC/Nga Mice

  • Yang, Sun-Sim;NamGung, Uk;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.4
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    • pp.1036-1043
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    • 2006
  • The present study was conducted to investigate the effect of Gamisamul-tang (GSMT) on atopic dermatitis (AD). AD was induced in NC/Nga mutant mice by DNCB treatment. GSMT administration reduced levels of skin severity scores. Serum levels of IgE, IgG, IgM, and inflammatory cytokines including IL-4, IL-4 and 1L-13 were significantly decreased by GSMT treatment. Levels of mRNA's encoding IL-4, IL-6, IL-13, $TNF-{\alpha}$, and $interferon-{\gamma}$ in the dermal tissue and draining lymph node (DLN) by real time RT-PCR analysis showed decrease by GSMT testament. Moreover, the number of CD4+ and CD8+ cells was significantly decreased in the spleen and DLN tissues. Histological examination showed that infiltration levels of immune cells in ear, skin, and DLN of AD-induced NC/Nga mice were much improved by GSMT treatment. The present data suggest that GSMT may play an important role in recovering AD symptoms by regulating immune reactivity.

Utilizing Pedicled Muscle Flap for Defect Coverage after External Auditory Canal Cancer Resection (외이도에 발생한 악성종양에서 유경근육피판을 이용한 결손 재건)

  • Lee, Kangwoo Nathan;Kim, Eun Key
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.37-42
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    • 2011
  • Purpose: Cancer arising from the external auditory canal is a rare disease. A lesion that seems harmless in someway, can be lethal when inadequately excised, the tumor may infiltrate nerves, the parotid and auditory tissues before re-invading the skin. Wide resection of the lesion surrounding the structure and reconstruction with an adequate plan is crucial for the treatment of this disease. Methods: Two patients with external auditory canal cancer were treated with muscle flaps and skin grafts. Lateral temporal bone resection (LTBR) was performed for complete resection of the cancer. The defect cavity was obliterated with highly vascularized tissue using pedicled sternocleidomastoid muscle, and temporalis muscle individually, combined with full thickness skin graft for covering the skin defect of the ear. Results: Clear resection margin was obtained, and both patients showed disease free survival during the follow up. There was no complications of hematoma, infection, flap loss, or wound problem in both patients. Both patient received radiation therapy, there was no osteoradionecrosis or any other complication related to radiation therapy. Conclusion: Utilizing pedicled muscle flaps for managing defects after wide resection of the external auditory canal cancer is an effective method for managing this difficult disease.

A Case of Granulomatosis with Polyangiitis with IgG4-Related Disease Expressed by Facial Paralysis and Hearing Loss (안면 마비와 난청으로 진단된 면역글로불린 G4 연관질환 동반 육아종성 다발 혈관염 1예)

  • Kim, Hyung-sik;Doo, Jeon Gang;Yeo, Seung Geun;Kim, Sang Hoon
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.240-244
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    • 2018
  • Granulomatosis with polyangiitis (GPA) and Immunoglobulin (Ig) $G_4$-related disease ($IgG_4$-RD) are rare diseases and early diagnosis and proper management are imperative to prevent multi-organ damage. The authors present a case of a 60 years old woman who had facial paralysis and hearing loss. Lt intact canal wall tympanomastoidectomy, Lt facial nerve decompression and ossiculoplasty with partial ossicular replacement prosthesis (PORP) was done. During operation, middle ear tissue was biopsied and GPA with $IgG_4$-RD was diagnosed. After methyl prednisolone (MPD) pulse therapy and azathioprine therapy, the severity of paralysis was improved. We present this case because common otologic symptoms like facial palsy and hearing loss could be initial symptoms of rare systemic disease.

Audiogram in Response to Stimulation Delivered to Fluid Applied to the External Meatus

  • Geal-Dor, Miriam;Chordekar, Shai;Adelman, Cahtia;Kaufmann-Yehezkely, Michal;Sohmer, Haim
    • Journal of Audiology & Otology
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    • v.24 no.2
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    • pp.79-84
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    • 2020
  • Background and Objectives: Hearing can be elicited in response to vibratory stimuli delivered to fluid in the external auditory meatus. To obtain a complete audiogram in subjects with normal hearing in response to pure tone vibratory stimuli delivered to fluid applied to the external meatus. Subjects and Methods: Pure tone vibratory stimuli in the audiometric range from 0.25 to 6.0 kHz were delivered to fluid applied to the external meatus of eight participants with normal hearing (15 dB or better) using a rod attached to a standard clinical bone vibrator. The fluid thresholds obtained were compared to the air conduction (AC), bone conduction (BC; mastoid), and soft tissue conduction (STC; neck) thresholds in the same subjects. Results: Fluid stimulation thresholds were obtained at every frequency in each subject. The fluid and STC (neck) audiograms sloped down at higher frequencies, while the AC and BC audiograms were flat. It is likely that the fluid stimulation audiograms did not involve AC mechanisms or even, possibly, osseous BC mechanisms. Conclusions: The thresholds elicited in response to the fluid in the meatus likely reflect a form of STC and may result from excitation of the inner ear by the vibrations induced in the fluid. The sloping fluid audiograms may reflect transmission pathways that are less effective at higher frequencies.