• Asian Spine Journal
• /
• v.12 no.6
• /
• pp.1117-1122
• /
• 2018

Study Design: Prospective study. Purpose: To assess the prevalence of periodontoid calcification and its associations with acute cervical pain. Overview of Literature: Calcium pyrophosphate dihydrate (CPPD) deposition disease is a common rheumatological disorder that occurs especially in elderly patients. Although CPPD crystals induce acute arthritis, these crystals are not usually symptomatic. Calcification surrounding the odontoid process (periodontoid calcification) has been reported to induce inflammation, resulting in acute neck pain. This disease is called crowned dens syndrome. Whether calcification induces inflammation or whether the crystals are symptomatic remains unclear. Methods: The prevalence of periodontoid calcification at the atlas transverse ligament was examined by computed tomography of the upper cervical spine in patients suspected of brain disease but no cervical pain (control group, n=296), patients with pseudogout of the peripheral joints but no cervical pain (arthritis group, n=41), and patients with acute neck pain (neck pain group, n=22). Next, the correlation between the prevalence of periodontoid calcification and symptoms was analyzed. Results: In the control group, 40 patients (13.5%) showed periodontoid calcification with no significant difference in the prevalence with gender. The prevalence of calcification increased significantly with age (p=0.002). In the arthritis group, 26 patients (63.4%) reported periodontoid calcification. In the neck pain group, 14 patients (63.6%) reported periodontoid calcification. Multiple logistic regression analysis by age and group revealed that higher age, inclusion in the arthritis group, and inclusion in the neck pain group significantly affected the prevalence of calcification. Conclusions: Our results cumulatively suggest that periodontoid calcification is an aging-related reaction and that calcification per se does not always cause neck pain. Periodontoid calcification was observed more frequently in patients with pseudogout of the peripheral joints and in those with acute neck pain than in asymptomatic control patients.

• Korean Journal of Head & Neck Oncology
• /
• v.38 no.2
• /
• pp.29-32
• /
• 2022

Lipoma is one of the most common benign soft tissue tumors. However, giant lipomas compressing and deforming the neurovascular structure rarely occur in the lateral neck. A 70-year-old man visited our outpatient clinic for treatment of a visible painless neck mass that had been identified 2 years prior. Neck magnetic resonance imaging revealed that a 10 × 9 × 4 cm fatty mass located between the sternocleidomastoid and sternohyoid muscles invaded the carotid sheath. Under general anesthesia, the mass was excised without damage to the adjacent neurovascular structures. Upon histopathological examination, the mass was identified as a lipoma. During the surgery, enlargement of the internal jugular vein was observed under the resected mass. However, on ultrasound examination, the function of the internal jugular vein was evaluated as good. No recurrence or neurological and vascular complications were reported during a 6-month follow-up after the surgery. As a giant lipoma located in the deep layer of the lateral neck can deform important cervical structures, its impact on the surrounding structures should be carefully assessed preoperatively to minimize the rate of possible complications.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.22 no.2
• /
• pp.115-118
• /
• 2011

Background and Objectives : The voice change occurs after tonsillectomy and adenoidectomy. This study was designed to examine the postoperative nasalance changes using Nasometer. Materials and Method : From April 2009 to February 2010, data of twenty-eight patients who underwent tonsillectomy, tonsillectomy & adenoidectomy were evaluated. 12 males and 16 females were chosen. Nasalance test was performed before, after 1 week, after 1 month from the surgery. Results : Postoperative mean nasalance results statistically significant increased in 1 weeks after surgery, and returned to the preoperative state in 1 month after surgery. Conclusion : Although the nasalance increased immediately after tonsillectomy and adenoidectomy temporally, it was recovered 1 month after surgery. Therefore, the voice change that come postoperatively could be considered as no concern, and surgeons need to aware of various facts, which can affect voice changes before the surgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.2
• /
• pp.142-145
• /
• 2008

Background and Object: The aim of this study is to evaluate the change of patient's subjective voice handicap index (VHI) and acoustic parameters before and after laryngeal microsurgery for benign vocal cord disease. Materials and Method: We analyzed 78 patients who received laryngeal microsurgery for benign vocal cord disease from January 2004 to February 2007 retrospectively. There were 28 vocal polyp, 40 vocal nodule, 5 intracordal cyst and 5 Reinke's edema. Jitter, shimmer, harmony to noise ratio (HNR) were analyzed before surgery and 2-3months after surgery using the Doctor's speech science program. The voice handicap index introduced by the Pittsburgh Voice Center was used to examine patient's subjective change of voice quality. Results: Acoustic parameters of jitter, shimmer and HNR were improved in patients with vocal polyp and vocal nodule after surgery. The acoustic parameters were not improved in patients with Reinke's edema, statistically. Only jitter was improved significantly in patients with intracordal cyst (p<0.05). The VHI was significantly improved after surgery. The change of jitter and shimmer was significantly correlated with the change of VHI after surgery. Conclusion: The acoustic parameters and VHI were significantly improved in patients with benign vocal disease after laryngeal microsurgery.

• Archives of Plastic Surgery
• /
• v.48 no.1
• /
• pp.49-54
• /
• 2021

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer. Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients' age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated. Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups. Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

• Archives of Craniofacial Surgery
• /
• v.21 no.1
• /
• pp.27-34
• /
• 2020

Background: Free-flap reconstruction for recurrent head and neck cancer may be challenging depending on the previous treatments, those are, chemotherapy, radiotherapy, and surgery, including neck dissection or free tissue transfer. Specifically, the previous treatment could compromise the neck vessels, thereby making free-flap reconstruction more difficult. This study aimed to investigate the correlation between previous treatments and vascular compromise of the free flap. Methods: In this retrospective study, 124 free-flap reconstructions in 116 patients for recurrent head and neck cancer between 1993 and 2017 were investigated. The demographic characteristics, previous treatments, flap choices, infections, recipient vessels, and vascular crises were evaluated. Results: Of the 124 reconstruction cases, 10 had vascular crises. There were six revisions, totaling six flap failures. The success rate of free-flap reconstruction for recurrent cancer was 95.2%, which significantly differed from that for primary cancer (98.8%, p= 0.006). Moreover, in the recurrent cancer group, no correlation was found between previous treatments and vascular crises (p> 0.05). Increased rates of contralateral or uncommon anastomoses were found following neck dissection (p< 0.05). Conclusion: Previous neck dissection or radiotherapy could lead to scarring and tissue damage, which could in turn make microvascular reconstruction more challenging; however, the effect was not definite in this study. Approximately 60% of patients with previous neck dissection had compromised ipsilateral recipient vessels, which resulted in contralateral or uncommon anastomoses. In this study, free-flap reconstruction seems to be quite safe and preferable in patients with recurrent head and neck cancer based on the overall survival rate.

• Korean Journal of Head & Neck Oncology
• /
• v.20 no.1
• /
• pp.24-28
• /
• 2004

Background and Objectives: Salivary gland tumors are relatively rare and constitute 3% to 4% of all head and neck neoplasms. Their relative infrequency, inconsistent classification, and highly variable biologic behavior make some difficulty, but some general features can be drawn regarding the incidence, pathology, and pattern of behavior of the various benign and malignant tumors of salivary glands. The present study aims to provide a clinical characteristics of salivary gland tumors. Materials and Methods: We analyzed retrospectively clinical features of the 138 patients who were treated surgically at Chonbuk National University Hospital from 1992 through 2002. Results: We found 107 benign and 31 malignant tumors. Among the patients, 58 were males and 80 were females. The most common age group was the fifties. The most common site of both benign and malignant was parotid gland in major salivary glands and palatal region in minor salivary glands. The most common presenting symptom was palpable mass in both benign and malignant tumor. Histopathologically, the most common type was pleomorphic adenoma in benign tumor and mucoepidermoid carcinoma in malignant tumor. All cases were treated surgically and the most common postoperative complications was transient facial nerve weakness. Conclusion: 138 cases of salivary gland tumors were presented with respect to their clinical features.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.3
• /
• pp.885-890
• /
• 2012

Background: Head and neck cancers are prevalent in Thailand, in particular in the southern region of the country. However, survival with a large data set has not been reported. The purpose of the present study was to evaluate the survival figures and the prognostic factors in a cohort of patients treated in a university hospital located in the south of Thailand. Patients and Methods: Consecutive new cases of primary carcinoma of the oral cavity, oropharyx, hypopharynx and larynx, treated at Songklanagarind Hospital during 2002 to 2004, were analyzed. The 5-year overall survival rates were obtained by the Kaplan-Meier method. Prognostic factors were identified through multivariate Cox regression analysis. Results: A total 1,186 cases were analyzed. Two-thirds (66.6%) of the cases were at advanced stage (stage III & IV) at presentation. The five-year overall survivals for the whole cohort, oral cavity, oropharynx, hypopharynx and larynx were 24.1%, 25.91%, 19.2%, 13.4%, 38.0% respectively. Stage and treatment type were strong prognostic factors for all sites. An age ${\geq}$ 80 years was associated with poor survival in oral cavity and larynx cancer. Conclusions: The results revealed remarkably poor outcomes of the patients in the series, indicating a strong need to increase the proportion of early stage presentations and maximize the treatment efficacy to improving outcomes. Very old patients are of particular concern for treatment care of oral cavity and larynx cancer.

• Journal of Yeungnam Medical Science
• /
• v.40 no.2
• /
• pp.164-171
• /
• 2023

Background: The study aimed to evaluate the effect of prehydration solution on hearing thresholds after cisplatin chemotherapy. Methods: In this retrospective cohort study, we reviewed the data of patients who underwent ≥3 courses of cisplatin-based chemotherapy for locally advanced head and neck cancers at a tertiary referral center (n=64). The dextrose solution (DW) group (n=26) received 2 L of normal saline and 1 L of 5% dextrose. The Hartmann solution (HS) group (n=38) received 2 L of normal saline and 1 L of HS. Hearing data were measured 1 day before starting the first course of chemotherapy, and again 20 days after the first, second, and third courses of chemotherapy. The severity of hearing loss was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE). Results: Thresholds at all frequencies after chemotherapy were greater in the DW group than in the HS group. The increase in thresholds in 1 to 4 kHz after the third course of chemotherapy was greater in the DW group than in the HS group. CTCAE grades after the second and third courses of chemotherapy were greater in the DW group than in the HS group. Logistic regression showed that the odds ratio for CTCAE grade 3 or 4 after the third course of chemotherapy in the DW group was 4.84 on univariate analysis. Conclusion: Prehydration using a solution with salt was associated with a decrease in change in hearing thresholds after cisplatin chemotherapy in patients with head and neck cancers.

• Archives of Craniofacial Surgery
• /
• v.19 no.4
• /
• pp.243-247
• /
• 2018

Vascular anomalies are disorders of the endothelium and surrounding cells that can affect the vasculature and involve any anatomical structure. The most common problem associated with vascular anomalies is psychological distress related to disfigurement as well as functional defects, as many lesions affect the head and neck. This article provides an overview of the current clinical features that distinguish the major types of vascular anomalies that affect the head and neck.