• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.67-70
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• 2015

We propose an automatic vessel segmentation method of vertebral arteries in CT angiography using combined circular and cylindrical model fitting. First, to generate multi-segmented volumes, whole volume is automatically divided into four segments by anatomical properties of bone structures along z-axis of head and neck. To define an optimal volume circumscribing vertebral arteries, anterior-posterior bounding and side boundaries are defined as initial extracted vessel region. Second, the initial vessel candidates are tracked using circular model fitting. Since boundaries of the vertebral arteries are ambiguous in case the arteries pass through the transverse foramen in the cervical vertebra, the circle model is extended along z-axis to cylinder model for considering additional vessel information of neighboring slices. Finally, the boundaries of the vertebral arteries are detected using graph-cut optimization. From the experiments, the proposed method provides accurate results without bone artifacts and eroded vessels in the cervical vertebra.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.199-202
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• 2011

Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

• 대한두경부종양학회지
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• 제23권1호
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• pp.67-70
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• 2007

Myxoma is an uncertain mesenchymal cell origin, characterized by irregular round, stellate or spindle cells surrounded by the matrix containing abundant mucoid material and scant vascularity. Their occurrence in descending order of frequency is in the heart, subcutaneous tissue, bone and genitourinary tract. In the head and neck region, the most predilection sites are mandible and maxilla(more than 80%). Laryngeal myxoma is extremely rare：only 5 cases have been reported in the English literature. We report a rare case of laryngeal myxoma. A 60-year-old man with hoarseness visited the out-patient department. The mass was located between the vocal fold and the vocal ligament, filling with the left laryngeal ventricle. We planned the laryngo-microsurgery and successfully excised using $CO_2$ laser. The histopathologic finding revealed the myxoma. After 18 months of surgery, there is no evidence of recurrence and mucosal scarring in the vocal fold. This report is the first case of laryngeal myxoma involving the laryngeal ventricle and the true vocal cord together.

• 대한두경부종양학회지
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• 제18권2호
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• pp.223-226
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• 2002

The segmental mandibulectomy should be performed, if mandiblie invasion is suspected clinically and radiologically. And if tumor is located to mandible very closely or when microinvasion to mandible is suspected, marginal mandibulectomy is recommended. But in segmental mandibulectomy, reconstruction is difficult and cosmetic problem remains. In this case, we performed modified segmental resection of mandible, preserving the inferior margin of mandible, and maintains the continuity of the bone, in mucoepidermoid carcinoma of parapharynx, invading mandible. We reviewed the diagnosis, pathology, and treatment, and report the case with reviews of literature.

• 임상이비인후과
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• 제29권2호
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• pp.245-249
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• 2018

Neurilemmoma is a benign tumor that originates from the Schwann cell. It frequently occurs in head and neck regions, but neurilemmoma of external auditory canal is extremely rare. Here, we report a very rare case of 36-year-old male with a tumor located in the posterior wall of external auditory canal, preoperatively suspected as neurilemmoma originated from Arnold's nerve by temporal bone magnetic resonance imaging. The tumor mass was surgically excised and pathologically confirmed as a neurilemmoma.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권2호
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• pp.143-148
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• 1997

Cancer therapy for the head and neck malignoncy by surgery, radiotherapy, or combined modalities may cause substantial aesthetic and functional problems for the patient. The placement of osseointegrated implants into irradiated bone should only be performed when the predictability of achieving and maintaining osseointegration is high and the risk of developing of osteoradionecrosis is low. There are many benefits that irradiated patients may gain from the use of implants. A successful implant-retained prosthesis is dependent upon the implants attaining osseointegraton and then sustaining it during functional loads. The use of implants in irradiated patients requires high implant success rates that are acceptable to warrant their use. We report a case and review the literatures about implants in irradiated bone. In that case, the patient were undergone tumor resection and inner-table mandiblectomy due to squamous cell carcinoma of lower posterior gingiva. But 5 year later, the tumor were recurred, we resected the tumor and applied the radiation therapy. After then, we installed four IMZ implants after hyperbaric oxygenation, and made prosthesis using those implants. Until now they don't have any complications.

• Imaging Science in Dentistry
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• 제50권1호
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• pp.31-36
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• 2020

Purpose: The purpose of this study was to investigate the impact of radiotherapy on mandibular bone tissue in head and neck cancer patients through an analysis of pixel intensity and fractal dimension values on digital panoramic radiographs. Materials and Methods: Thirty patients with radiographic records from before and after 3-dimensional (3D) conformational radiotherapy were selected. A single examiner carried out digital analyses of pixel intensity values and fractal dimensions, with the areas of interest unilaterally located in the right angle medullary region of the mandible below the mandibular canal and posterior to the molar region. Results: Statistically significant decreases were observed in the mean pixel intensity (P=0.0368) and fractal dimension (P=0.0495) values after radiotherapy. Conclusion: The results suggest that 3D conformational radiotherapy for head and neck cancer negatively affected the trabecular microarchitecture and mandibular bone mass.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.381-384
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• 2005

Rhabdomyosarcoma is a rare malignancy of head and neck region. When rhabdomyosarcoma occurs in maxillary area, total maxillectomy is necessary. Total maxillectomy causes defects of orbital floor, palate, gingiva, and alveolar bone, causing severe facial deformity and functional impairment. Immediate maxillary reconstruction has to cover both bone and soft tissue to minimize cosmetic and functional problems. The fibular osteocutaneous free flap can provide paranasal, gingiva, oral mucosal lining and foundation for dental prosthesis, thus ensuring good cosmetic results and mastication, phonation function. We have experienced a reconstruction case of a 19-year-old man with rhabdomyosarcoma of the left maxillary sinus. The patient underwent total maxillectomy and neck dissection. We designed a fibular free flap that had a vascularized bone segment and a double skin paddle. Surgical outcomes were excellent in cosmetic and functional aspects.

• 대한치과보철학회:학술대회논문집
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• 대한치과보철학회 2005년도 추계학술대회
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• pp.109-109
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• 2005

• 대한핵의학회지
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• 제36권2호
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• pp.143-145
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• 2002

A 49-year-old male patient with a carcinoma of the right pyriform sinus had a whole-body bone scan and gamma camera based F-18 FDG-PET for staging. Tc-99m MDP bone scan depicted diffuse increased uptake in the left femur due to chronic osteomyelitis but no skeletal metastasis. F-18-FDG-PET revealed increased focal bone uptake and uptake in the draining sinus due to chronic osteomyelitis in addition to visualization of the right pyriform sinus carcinoma and right neck nodal uptake. Fluorine-18 fluorodeoxyglucose-positron emission tomography is significantly more accurate than the bone scan in pinpointing chronic osteomyelitis focus and draining soft tissue infection.