• Korean Journal of Head & Neck Oncology
• /
• v.16 no.2
• /
• pp.182-186
• /
• 2000

The reduction of the postoperative wound pain has been a concern in recent surgery, especially in various types of minimally-invasive surgeries. This study was performed to evaluate the postoperative analgesic effect of the preincisional local anesthesia with the mixture of ketorolac(Tarasyn) and bupivacaine to the surgical site in minimally-invasive thyroid surgeries. Of 491 patients who were scheduled for minimally-invasive thyroid surgeries between October 1999 and July 2000, 244 were randomly assigned to receive a mixture of ketorolac tromethamine 15mg(0.5ml) and 0.25% bupivacaine 3ml via surgical site infiltration 3 minutes prior to the skin incision. The outcomes of these patients were compared to those of the 247 controls. Total number of patients in need of post-operative analgesic requirements(n=39, 16.0%), total dose of postoperative analgesics used($19.6{\pm}8.4mg$ of ketorolac) and Visual Analogue Pain Score(VAS, $2.6{\pm}1.2$) of the preincisional local anesthesia group were significantly lower than those of the control group(p<0.05). The mean postoperative hospital stay was $1.6{\pm}0.4$ days for the preincisional local anesthesia group versus $1.9{\pm}0.7$ days for the control group. The preincisional local infiltration of ketorolac and bupivacaine in the minimally invasive thyroidectomies reduces postoperative wound pain thus would be more beneficial to the patients.

• The Korean Journal of Pain
• /
• v.8 no.1
• /
• pp.60-64
• /
• 1995

Stellate ganglion block is a selective sympathetic blockade affecting the head and neck, and the upper extemity. It is an important method which has been used most frequently in neuro-pain clinic due to its wide range of indications. The authors attermpted to define the minimal volume of local anesthetic which need for successful stellate ganglion block by using 1% mepivacaine HCl mixed with dye. In 40 heathy volunteers, two different volumes, 3 ml in the group 1 (n=20) and 4 ml in the group 2 (n=20), were injected by an anterior paratracheal technique at the sixth cervical vertebral level. We compared the degree in sympathetic blockade by clinical sings and symptoms and also checked the spread range of dye by plain X-ray. With seven criteria for an effective block. mean score was 5.7 in group 2, while 3.4 in group 1. These results suggest that 4 ml of local anesthetic are adequate for a successful stellate ganglion block.

• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.1
• /
• pp.115-120
• /
• 2015

PURPOSE: Vertebrobasilar insufficiency (VBI) should be carefully assessed in patient for whom manipulation of the cervical spine is to be undertaken. The purpose of this study was to investigate the changes in posterior cerebral artery blood flow velocity following head and body positioning by transcranial doppler ultrasonography (TCD) in healthy subjects. METHODS: Twenty two healthy female (mean age $20.77{\pm}1.30yrs.$) participants volunteered to participate in the study. None of the participants had a history of neck pain or headache within the last 6 months. To evaluate the cerebral blood flow, we measured the mean flow velocity of the posterior cerebral artery unilaterally (right side). The blood flow velocity was measured under 3 different head positions (in a neutral head position, ipsilateral head rotation and contralateral head rotation position) and 2 different body conditions (supine position and sitting position). RESULTS: The mean blood flow velocity of posterior cerebral artery was decreased in body positioning from supine to sitting (p<.05), but the decreased rate of blood flow velocity in posterior cerebral artery did not change significantly between ipsilateral head rotation and contralateral head rotation (p>.05). CONCLUSION: These result of our study show that body positioning (sitting and supine) affect the blood flow velocity in posterior cerebral artery.

• Korean Journal of Applied Biomechanics
• /
• v.23 no.3
• /
• pp.279-284
• /
• 2013

The purpose of this study was to determine the effect of head posture and respiratory pattern on muscle activities of sternocleidomastoid (SCM) and scalene during maximal respiration. The seventeen subjects with upper-costal breathing pattern were participated in this study. Surface electromyography was used to measure the muscles activities of SCM and scalene. The volume and velocity of inspiration were monitored by using the spirometer in each subject. Each subject was performed the 3-cycle of respiration in each condition. The mean values of three peak muscle activity in each muscle were used in the data analysis. A2 (head posture: forward head posture: FHP vs. neutral posture) X 2 (breathing pattern: costal vs. diaphragmatic) repeated-measures analysis of variance (ANOVA) was used to compare the normalized muscle activities of the SCM and scalene. The results showed that the muscle activities of SCM and scalene in diaphragmatic breathing were significantly lower than those in costal breathing for each head posture (p<.0125). The muscle activities of SCM in neutral position were lower than those in forward head position during costal breathing (p<.0125). The diaphragmatic breathing in neutral position of head is recommended to decrease the tension of the accessory inspiratory muscles during respiration in neck-pain patients with FHP.

• The Korean Journal of Pain
• /
• v.6 no.1
• /
• pp.100-104
• /
• 1993

Malignant tumors of the paranasal sinuses are quite rare entity, with maxillary neoplasms accounting for less than 1 percent of all head and neck malignancies. When considering the paranasal sinuses alone, 77 percent of cancers arise in the maxillary sinuses. There is no situation more frustrating than the management of the patients with chronic facial pain due to cancer. The initial step in managing patients with cancer pain is the use of oncologic therapy in the form of radiotherapy, surgery, chemotherapy, alone or combined, either to effect a cure or decrease the size of the tumor and thus decrease or eliminate the pain. When oncologic therapy is ineffective in providing relief, the pain must be treated by one or more of the followings: Systemic analgesics and adjuvant drugs, psychologic techniques of analgesia, neurostimulating techniques, neuroablative surgical procedures, regional analgesia with local anesthetics or neurolytic blocks. An 82-year old patient had severe pain of the orbital and infraorbital region due to squamous cell carcinoma of the maxillary sinus. We successfully treated this patient with the percutaneous retrogasserian ethanol gangliolysis by a H$\ddot{a}$rtel approach, and the analgesia lasts until the death of the patient.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.3
• /
• pp.1255-1258
• /
• 2015

Background: Locally advanced head and neck cancer is generally incurable and has a short survival rate. This study aimed to evaluate symptom relief, disease response, and acute toxicity after palliative hypo-fractionated radiotherapy and long-term survival in affected patients. Materials and Methods: Between January 2011 to December 2011, 80 patients who were histopathologically diagnosed as having stage III or stage IV head and neck squamous cell carcinoma based on Eastern Cooperative Oncology Group (ECOG) performance status 1-3, were offered palliative radiotherapy (20 Gy/5Fr/5 Days). Later these patients were evaluated on 30th day after completion of treatment for disease response based on World Health Organisation (WHO) criteria and palliation of symptoms using symptomatic response grading and acute toxicities by the Radiation Therapy Oncology Group (RTOG). Many patients were given post radiation therapy (RT) palliative chemotherapy for appropriate palliative care and a few patients were selected for further curative RT. The overall survival was also evaluated among this group of patients with last follow up date of 1st May, 2014. Results: The most common presenting complaint was pain followed by dysphagia. Most patients (60-70%) had appreciable relief in their presenting symptoms. A good response was observed in the majority following palliative RT; a few patients had progressive disease and some had stable and regressed disease. None of the patients experienced radiation toxicity that required hospital admission. Almost all showed grade one and two acute skin and mucosal toxicity one month after completion of treatment. The mean survival days for patients given only hypofractionated palliative RT was 307 days, those with post palliative RT and palliative chemotherapy was 390 days and patients who went on to receive further palliative RT and curative RT dose had significantly overall survival of 582 days. Conclusions: Advanced head and neck cancer should be identified for suitable palliative hypofractionated radiotherapy to achieve acceptable symptom relief in a great proportion of patients and should be followed by palliative chemotherapy or curative RT in suitable cases for long-term symptom-free survival.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.2
• /
• pp.146-148
• /
• 2014

Benign triton tumor (BTT) or neuromuscular hamartoma is an uncommon tumor composed of mature neural and well-differentiated striated muscular elements. Its development is exceptionally rare in the adult and head region. This report describes a case of adulthood BTT that occurred in the orbit. The patient was a 53-year-old woman who presented with right periorbital swelling and pain in eyeball over 2 months. Magnetic resonance imaging revealed a well-enhancing mass surrounding optic nerve and ocular muscles in the right retrobulbar area. The tumor was subtotally removed via transcranial approach. Its pathological diagnosis was confirmed to be a neuromuscular hamartoma. She developed diplopia postoperatively. Adulthood BTT should be considered in the differential diagnosis of head and neck tumors. It is also important to make adequate therapeutic strategy to avoid postoperative neural dysfunction.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.4
• /
• pp.264-266
• /
• 2007

Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.25 no.1
• /
• pp.77-81
• /
• 2019

Background: The Purpose of this study was investigated the effects of the Self Sling Suspension on the numbness, radiated pain, visual analogue scale (VAS), Cobb's angle, Jochumsen's depth, neck disabliity index (NDI). Methods: This study was carried out with a 4 forward head posture (FHP) & 4 herniated nucleus pulposus (HNP) survivors. Outcomes such as the Numbness, Radiated Pain, VAS, Cobb's angle, Jochumsen's depth and NDI were measured pre- and post-intervention for both groups. Results: 2 HNP decrease was found numbness & radiated pain. After the intervention, was decreased VAS, NDI and was increased Cobb's angle, Jochumsen's depth. Conclusions: Applying Self Sling Suspension treatment to FHP & HNP patients proved to have a positive effect.

• Journal of Oral Medicine and Pain
• /
• v.45 no.4
• /
• pp.115-119
• /
• 2020

Infectious myositis, an infection of the skeletal muscles, is a rare condition and potentially life-threatening if not detected and treated in the early stages. This clinical entity may arise from various pathogens, such as bacteria, fungi, parasites, and viruses. A propagation of contiguous infection, penetrating trauma, vascular insufficiency, or hematogenous spreading of microorganisms can cause infectious myositis. Though several cases have been reported in large muscle groups in the lower extremities, there are only a few reports on infectious myositis of the masticatory muscles. We report three cases of infectious myositis presenting jaw pain and trismus. Unlike a common head and neck infection caused by the spreading of odontogenic origin, the early diagnosis of infectious myositis was difficult because no specific lesion suspected to be the infection source was observed in the physical examination and the plain radiographs. Advanced imaging modalities such as computed tomography and magnetic resonance imaging, and laboratory evaluation is useful for the early detection of infectious myositis.