• Title/Summary/Keyword: Neck trauma

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Multiple Ossicular Dislocation Including Stapediovestibular Dislocation Presenting with Conductive Hearing Loss

  • Lee, Geonho;Kim, Yoonjoong;Kim, Bong Jik
    • Journal of Audiology & Otology
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    • v.25 no.3
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    • pp.159-162
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    • 2021
  • Temporal bone trauma can cause hearing loss and in case of prolonged conductive hearing loss, traumatic ossicular injury should be considered. Separation of the incudostapedial joint is the most common lesion, and stapediovestibular dislocation is relatively rare but can easily cause perilymphatic fistula. Here, we report a very rare case of external stapediovestibular dislocation after trauma, ending up with successful surgical outcome. A 27-year-old man with non-progressive hearing loss on the right side since childhood visited the clinic. Audiogram showed a conductive hearing loss with air-bone gap of 55 dB on the right side. Temporal bone CT revealed the disruption of ossicular chain. An exploratory tympanotomy identified multiple ossicular disruptions including external stapediovestibular dislocation with shiny fibrous membrane sealing the oval window. Ossicular chain reconstruction was performed using the total ossicular replacement prosthesis of titanium. A postoperative audiogram showed a recovery of air-bone gap less than 10 dB. To the best of our knowledge, this is the first case of external long-standing stapediovestibular dislocation, with oval window completely sealed with fibrous membrane, ending up with successful hearing recovery by surgery. This case would help dealing with such condition which can be encountered in the clinic.

Multiple Ossicular Dislocation Including Stapediovestibular Dislocation Presenting with Conductive Hearing Loss

  • Lee, Geonho;Kim, Yoonjoong;Kim, Bong Jik
    • Korean Journal of Audiology
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    • v.25 no.3
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    • pp.159-162
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    • 2021
  • Temporal bone trauma can cause hearing loss and in case of prolonged conductive hearing loss, traumatic ossicular injury should be considered. Separation of the incudostapedial joint is the most common lesion, and stapediovestibular dislocation is relatively rare but can easily cause perilymphatic fistula. Here, we report a very rare case of external stapediovestibular dislocation after trauma, ending up with successful surgical outcome. A 27-year-old man with non-progressive hearing loss on the right side since childhood visited the clinic. Audiogram showed a conductive hearing loss with air-bone gap of 55 dB on the right side. Temporal bone CT revealed the disruption of ossicular chain. An exploratory tympanotomy identified multiple ossicular disruptions including external stapediovestibular dislocation with shiny fibrous membrane sealing the oval window. Ossicular chain reconstruction was performed using the total ossicular replacement prosthesis of titanium. A postoperative audiogram showed a recovery of air-bone gap less than 10 dB. To the best of our knowledge, this is the first case of external long-standing stapediovestibular dislocation, with oval window completely sealed with fibrous membrane, ending up with successful hearing recovery by surgery. This case would help dealing with such condition which can be encountered in the clinic.

Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case (전위를 동반한 갑상연골 골절의 자연 치유 치험 1례)

  • Ryu, Hyun-Ho;Lee, Byung-Kook;Jeung, Kyung-Woon
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

A Case of a Traumatic Pancreatic Neck Transection Treated with a Binding Pancreaticogastrostomy (외상성 췌장 경부 절단에서 시행된 Binding 췌위장문합술 1례)

  • Sul, Young Hoon;Lee, Sang Il;Cheon, Kwang Sik;Song, In Sang
    • Journal of Trauma and Injury
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    • v.26 no.1
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    • pp.18-21
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    • 2013
  • Pancreatic injury following blunt abdominal trauma is rare, but it has high morbidity and mortality. Various treatments have been attempted, but none has yet been clearly established. The pancreatic neck transection is usually managed by using a distal pancreatectomy with or without a splenectomy. However, pancreatic insufficiency and the risk of post-splenectomy infection remain significant problems. To avoid these problems in patients with a pancreatic neck transection, one may use a pancreaticoenteric anastomosis as a treatment option, but a pancreatic fistula from the pancreaticoenteric anastomosis remains a significant cause of morbidity and mortality. Recently, several reports proposed the binding pancreaticogastrostomy to minimize the possibility of a postoperative pancreatic fistula developing after pancreatic surgery. Thus, we report a case of a traumatic pancreatic neck transection successfully treated with a binding pancreaticogastrostomy.

Life-Threatening Necrotizing Fasciitis of the Posterior Neck

  • Choi, Ji-An;Kwak, Jung-Ha;Yoon, Chung-Min
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.260-263
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    • 2020
  • Necrotizing fasciitis is an infection of the subcutaneous tissue that results in destruction of the fascia and is disproportionately common in patients with chronic liver disease or diabetes. Necrotizing fasciitis of the head and neck is rare, but has a high fatality rate. A 50-year-old man with a past medical history of diabetes reported a chief complaint of a wound in the posterior neck due to trauma. The wound had grown and was accompanied by pus and redness, and the patient had a fever. When the patient was referred to department of plastic & reconstructive surgery, the sternocleidomastoid muscle, semispinalis capitis muscle, splenius capitis muscle, and trapezius muscles were exposed, and the size of the defect was about 25×20 cm. Dead tissue resection was performed before negative-pressure wound therapy, followed by a split-thickness skin graft (STSG). After a 2-week course of aseptic dressing post-STSG, the patient recovered completely. No postoperative complications were observed for 1 year. Necrotizing fasciitis is a life-threatening, rapidly spreading infection, requiring early diagnosis and active surgical treatment. In addition, broad-spectrum antibiotics are required due to the variety of types of causative bacteria. Broad necrotizing fasciitis of the posterior neck is rare, but can quickly progress into a life-threatening stage.

Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report

  • Yusuke Tabata;Shuhei Matsui;Masabumi Miyamoto;Koichiro Omori;Yoichiro Tabata;Tokifumi Majima
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.212-217
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    • 2023
  • We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

Clinical studies on neck pain 4 cases associated with kyphotic cervical curvature (Kyphotic cervical curvature로 인한 항통(項痛) 4례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Cho, Hyun-Yeul;Bae, Eun-Jeong;Lee, Kyung-Min;Lee, Jeong-Hoon;Soe, Jung-Chul;Han, Sang-Won
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.230-239
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    • 2002
  • Kyphotic cervical curvature, straghtening is commonly caused by trauma, muscle spasm without trauma and wrong posture, etc. Objective : This study is performed to evaluate the clinical effect of neck pain associated with Kyphotic cervical curvatre on cervical x-ray lateral view. Methods : One of the many causes, We examined the patients with neck pain & upper back pain who visited to Department of Acupuncture & Moxibustion, Gumi Oriental Hospital of Kyung-San University from 16th June 1999 to 22th June 2000. Pre and post treatment, We evaluated the cervical angle, Jochumsen's method, VAS(visual analogue scale) and effective score of treatment. Results & Conclusion : 1. Kyphotic cervical curvature is mainly caused by wrong posture during long term, sudden trauma, etc. therfore, postcervical muscles and tendon are injuryed by strong stress. So, muscle imbalance and pain is occured. 2. On these cases, The improvement index for pre/post treatment showed 28/42, 10/15, 9/30, 28/42 degree in cervical angle. Jochumsen's method showed -1/+2, -9/-3, -5/-2, -1/+2mm. Afer treatment VAS is 2, 1, 1, 1 and effective score of treatment is above good. The results suggest that treatments of Oriental Medicine(Acupuncture & Moxibustion, Chu-Na, Cupping and Physical therapy) are effective methods for neck pain with kyphotic cervical curvature on cervical x-ray lateral view.

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Stent Graft Repair of Penetrated Injury of the Common Carotid Artery

  • Kim, Soon Jin;Ryu, Sang Woo;Chekar, Jaykey;Kim, Yong Tae;Seo, Bo Ra
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.172-175
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    • 2016
  • Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

A Case of Protrusion of False Vocal Fold Resulting from the Deformed Thyroid Cartilage (변형된 갑상연골에서 기인한 가성대 돌출 1예)

  • Lim, Sung Hwan;Kim, Seung Woo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.47-50
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    • 2018
  • Trauma, congenital malformation and aging process can be a cause of the deviation of laryngeal prominence in the thyroid cartilage. Among these, the senility is the most common cause. Usually, ossification in the thyroid cartilage has occurred symmetrically, but the asymmetrical event leads to the shift of laryngeal prominence. Also, such deformity can provoke protrusion of false vocal fold. A 75-year-old man with hoarseness and globus sense in throat visited our clinic. Five years ago, he experienced a blunt trauma on left midline neck and had a concave deformity in the left thyroid cartilage lamina. Laryngoscopic findings revealed a marked protrusion in the left false vocal fold. We performed the laryngeal microsurgery to discriminate the tumorous condition. The pathology revealed non-pathologic mucosa. We report a unique and didactic case with a brief literature review.

Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers (권역외상 및 응급센터에서 성형외과의 참여방안)

  • Lim, Nam Kyu;Kang, Dong Hee
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.710-714
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    • 2018
  • A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.