A Case of Horizontal Partial Laryngectomy for Laryngeal Trauma

Laryngeal trauma is rare compared to other head and neck traumas, but it occurs, it can be life threatening. As for treatment, a laryngeal fracture that involves displacement of cartilage or extensive injury requires appropriate surgical treatments. For severe laryngeal fractures, conservative management is usually preferred with placing a stent to prevent laryngeal stenosis. But the downside of placing stents in the larynx includes the risk of granulation and infection. In this report, the authors describe a 35-year-old patient, who was diagnosed with blunt laryngeal trauma and treated by Horizontal partial laryngectomy. The patient's post-operative breathing and voice were fair, and airway stenosis did not occur afterwards.ope

A Case of Sebaceous Trichofolliculoma on the Right Cheek

Sebaceous trichofolliculoma is a rare benign tumor and represents a variant of trichofolliculoma. Up to now, only 5 cases of sebaceous trichofolliculoma were reported in Korea. It generally presents as a centrally depressed solitary tumor and occurs in areas rich in sebaceous lobules. Microscopically, it shows cystic cavities with or without keratin-filled portion and sebaceous lobules. The lobules are connected to the cystic wall. We report a case of infected sebaceous trichofolliculoma on the right cheek accompanied by a unilateral microtia in a 16- year-old man. The patient was treated with oral antibiotics and surgical excision. By summarizing 12 past cases, 6 Korean and 7 international, we have put together clinical features of Sebaceous trichofolliculoma.ope

A Case of Primary Squamous Cell Carcinoma of the Thyroid Gland

Primary squamous cell carcinoma of the thyroid gland is a very rare event, representing much less than 1% of all malignant tumors of the thyroid gland. The cancer is characterized by rapidly progressive clinical course in spite of its differentiated morphologic features. In most cases, a squamous epithelium is believed to be a result of metaplasia of a follicular epithelium, although in rare exceptions, it can originate from a remnant of the thyroglossal duct or ultimobranchial body. Squamous cell carcinoma of the thyroid gland can occur in a pure form or mixed with adenocarcinoma. Because their clinical behavior is more aggressive than that of other malignant neoplasm of thyroid gland, the tumor should be treated more vigorously at its initial stage. Recently, authors experienced one case of primary squamous cell carcinoma of the thyroid gland. We report our case with a brief review of literatureope

Open and Closed Reduction of Temporomandibular Joint Dislocation due to Tongue Cancer Operation

Temporomandibular Joint (TMJ) dislocation due to tongue cancer operation has a potential risk factor in that it may become a chronic anterior dislocation. In this regard, the treatment methods of TMJ dislocation are more complicated than that of the usual manual reduction therapy. To prevent the reduction procedure from becoming more complicated, clinicians should check the TMJ status afterward the head and neck operations. But, even with caution, chronic dislocation can happen. To restore normal jaw relation in these patients, one can be treated by manual reduction, open surgery under general anesthesia, and by fastening of additional intermaxillary fixations. Here we report two successfully treated cases of TMJ dislocations due to tongue cancer operation, one treated by the conservative method, and the other by the open surgery method.ope

Schwannoma of Tongue : A Case Report and Review

Schwannoma is a relatively uncommon, slow-growing benign tumor that is derived apparently from the Schwann cell. Tongue originated schwannomas are exceedingly rare within 1% and therefore often are not immediately included in the differential diagnosis and oral cavity tumors. In the current study, authors report a case of a schwannoma located at the tongue of a 49 years old patient treated by complete surgical excision. The patient is under clinical control, with no signs of recurrence even after 6 months.ope

False Vocal Fold Hypertrophy Caused by Thyroid Cartilage Inward Bowing

False vocal fold hypertrophy caused by diverse pathologic lesion, such as laryngeal amyloidosis, laryngeal lipidosis, laryngocele, saccular cyst and sulcus vocalis. False vocal fold hypertrophy, however, is also caused laryngeal structure deformity, irrespective of pathologic lesions. In this article, we report some cases of false vocal fold hypertrophy caused by inward bowing of thyroid cartilage. At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 male complained of hoarseness as subjects, and comfirmed of false vocal fold hypertrophy using the stroboscopy and larynx CT we checked vocal fold and laryngeal structure. Three patients with apparent hypertrophy of false vocal fold were investigated with computerized tomography (CT). In all patients, marked concavity of thyroid cartilage was revealed in CT scan at the level of the false vocal fold, and this deformity of the thyroid cartilage seemed to cause a protrusion of false vocal fold which taken as hypertrophy in stroboscopy. Careful palpation of the larynx and a CT scan taken at the level of the false vocal fold should be useful in determining whether hypertrophy of the false vocal fold is pathologic. For the next articles, It is necessary to discuss for the cause, diagnosis, treatment and prevention of inward bowing of thyroid cartilage.ope

An Yellowish Flat Intracordal Cyst : Open Cyst

Background and Objectives : Based on histological findings, intracordal cysts are divided in two subtypes : retention cysts and epidermoid cysts. They are typically located in the superficial layer of the lamina propria and appeared as opaque ovoid buldging masses underlying the epithelium. They are characterized by unilateral diminished mucosal wave on stroboscopy. In this article, we report some cases of patients with an oval shaped-yellowish flat cyst. Materials and Method : At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 female complained of hoarseness as subjects, using the stroboscopy we checked preoperative and postoperative vocal cord and operative findings. Surgery was performed under general anesthesia by the senior authors. All patients noted subjectively that their performing voice was improved. Results : During surgery, an oval shaped-yellowish flat cystic lesion was distinguished from normal epithelium. On palpation of this area with microforceps and cottons, the yellowish discharge was noted to move out from the opening of the cyst. In one case, the cyst was ruptured but remove the capsule completely. In other cases, sulcus was noted at the oppsite site. Conclusion : Because of the opening, the cyst was not easy to dissect and remove completely. After the debris was move out, fibrosis around the opening and invaginated epithelium extending into the deeper layers to the fold. The cyst was must removed carefully and completely for improvement of voice quality before evolving into a sulcus vocalisope

Guideline for the Surgical Management of Locally Invasive Differentiated Thyroid Cancer From the Korean Society of Head and Neck Surgery

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery.The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommenda-tions. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an inter-vention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC. © 2023 by Korean Society of Otorhinolaryngology-Head and Neck Surgery.ope

Usefulness of Nuclear Protein in Testis (NUT) Immunohistochemistry in the Cytodiagnosis of NUT Imdline Carcinoma: A Brief Case Report

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Gasless transaxillary robot-assisted neck dissection: a preclinical feasibility study in four cadavers

PURPOSE: We hypothesized that comprehensive neck dissection could be achieved via a gasless transaxillary approach using a robotic system. We intended to evaluate the accessibility of level I, IIB and VA nodes with transaxillary robot-assisted neck dissection of four cadavers. MATERIALS AND METHODS: Transaxillary robotic neck dissection was performed in four cadavers through a 7-cm longitudinal incision at the anterior axilla and a 0.8-cm-sized incision in the chest wall. RESULTS: We successfully performed neck dissection from level II to V in all four cadavers. However, dissection of levels IIB and VA, which lie on the cephalic portion of the spinal accessory nerve, was difficult. Vital structures, including the internal jugular vein, carotid artery, vagus nerve, phrenic nerve, superior thyroid artery and hypoglossal nerve, were successfully identified and preserved. CONCLUSION: Our results demonstrate the feasibility of robot-assisted neck dissection using a transaxillary approach. We suggest that gasless, transaxillary robotic neck dissection is a promising technique for treating nodal metastasis in thyroid cancers or in selected squamous cell carcinomas of the head and neck. However, some modification of the approach might be needed when performing comprehensive neck dissections of all levels of the neck.ope