• Title/Summary/Keyword: Neck surgery

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Nonrecurrent Laryngeal Nerve; Prevention of Neural Injury by Preoperative Neck CT (비회귀성 후두 신경; 수술 전 경부 CT를 통한 신경 손상의 예방)

  • Kim, Jin-Sung;So, Sang-Soo;Choi, Dong-Il;Yang, Yun-Su;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.1
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    • pp.67-70
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    • 2007
  • Background and Objectives: The nonrecurrent laryngeal nerve(NRLN) is exceedingly rare nerve anomaly that is associated with developmentally aberrant subclavian artery. The presence of NRLN is associated with an increased risk of vocal cord palsy in thyroid surgery. The purpose of this study is to investigate its prevalence, associated vascular anomaly and necessity of recognizing its possibility for prevention of intraoperative nerve damage. Materials and Methods: Between January 2004 and December 2006, 583 thyroidectomy were performed at our hospital. Of these cases, 529 cases(90.7%) were checked preoperative neck CT. Results: Patients with preopreative neck CT, 6 cases show the retroesophageal abberant right subclavian artery that arising directly form the aortic arch. 5 cases of these 6 cases(5/6, 83.3%) and of 583 patients(5/583, 0.8%) performed thyroid surgery were identified NRLN per-operatively. All of them are identified on the right side. There were 4 women and 1 man. In all cases, there were no clinical symptoms. I case was performed only left hemithyroidectomy, so we cannot identified NRLN. No vocal cord palsy was observed. Conclusion: It is possible to predict NRLN from preoperative neck CT. When NRLN is suspected, careful, complete dissection of the nerve is always advocated. These process can reduce the operative morbidity.

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A Case of Metastasizing Pleomorphic Adenoma Metastasized to Lymph Node (림프절 전이가 발생한 전이성 다형선종 1예)

  • Park, Sung Ho;Kim, Nam Young;Kim, Kyoung Hun;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung-Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.15-18
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    • 2016
  • Pleomorphic adenoma is the most common benign neoplasm of salivary glands. Pleomorphic adenoma can metastasis without malignant transformation. Metastasizing pleomorphic adenoma is equal to pleomorphic adenoma histologically yet metastasis to distant sites. Most Metastasizing pleomorphic adenoma are diagnosed many years following the initial treatment. 45-year-old man was found to have an asymptomatic right submandibular mass. A right submandibular gland excision and selective neck dissection was performed and pathology confirmed metastasizing pleomorphic adenoma. We report this case with a brief literature review.

Clinical Aspects of Surgically Treated Parathyroid Adenoma with Primary Hyperparathyroidism (수술적으로 치료한 원발성 부갑상선 기능항진증을 동반한 부갑상선종의 임상적 고찰)

  • Lyu, Sun-Ho;Lee, Kyung-Seok;Cho, Young-Ju;Kong, Il-Seong;Lee, Eun-Jung;Yang, Yun-Su;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.1
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    • pp.9-13
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    • 2010
  • Background and Objectives : Parathyroid adenoma is a rare disease in Korea, but the incidence of parathyroid adenoma has gradually increased due to generalized measurement of serum calcium and imaging study according to wide spread public health screening program. In previous researches, the analysis of clinical aspects were insufficient due to a few cases. The purpose of this study was to assess the clinical analysis of surgically treated parathyroid adenoma with hyperparathyroidism. Methods : We reviewed the medical records of nineteen cases of parathyroid adenoma with hyperparathyroidism. Initial symptom to visit hospital, hypercalcemia associated medical symptom, surgical outcome and complication were investigated. Serum total calcium, parathyroid hormone, phosphate, alkaline phosphatase were checked before and after surgery. Imaging study was performed with combination of radionuclide parathyroid scan, ultrasonography and neck CT scan. Results : The initial symptoms were no symptom(6/19), pelvic pain(5/19), muscular weakness (3/19), bone pain(3/19) and palpable neck mass(2/19) in order of frequency. Serum total calcium, parathyroid hormone decreased and phosphate increased after surgery than before surgery statistically significantly. Sensitivities of parathyroid scan, neck ultrasonography and neck CT as preoperative localization test were 88.2%, 72.7%, 73.3% each. The most common postoperative complication was transient hypocalcemia(9/19). Conclusion : Similar to previous study, parathyroid adenomas have numerous clinical features and surgical treatment via unilateral approach with preoperatively localized single parathyroid adenoma was successful. In our study, parathyroid adenoma was predominantly detected by elevated serum calcium level with no clinical symptom so we need to evaluate parathyroid adenoma, if serum calcium elevated.