• Radiation Oncology Journal
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• v.28 no.1
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• pp.9-15
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• 2010

Purpose: This study was performed to examine the neck failure patterns after a complete response (CR) to definitive radiotherapy for advanced head and neck cancer patients, as well as evaluate the clinical significance of the results of this study. Materials and Methods: Between 1987 and 2008, the clinical data of patients who had been treated with radical radiotherapy for primary squamous cell carcinomas and enlarged cervical lymph nodes was analyzed retrospectively. Ultimately, the cases that showed CR of the cervical lymph node lesions to full-dose radiotherapy were included in this study. The recurrent rate and sites in the cervical lymphatic area were evaluated periodically by radiologic imaging studies, along with some factors which might have affected the rate of recurrence. Results: A total of 73 patients who achieved CR in neck area after radiotherapy were included in this study. The rate of subsequent neck failure among those patients was 19.2%. There was only a 5.5% failure rate in the 55 patients who underwent radiotherapy in their primary site. Eighty percent of the recurrent cases were found within 3 years (median follow-up, 68 months). The majority of neck recurrent cases (47%) were accompanied with the failure of the primary lesions. The initial response of the primary site and the method of radiotherapy simulation were significant prognostic factors associated with the nodal recurrence rate. Conclusion: The recurrence rate of cervical nodes in patients with CR to radiotherapy in the primary site and neck area was about 5%. These patients could be followed up with close observation without a planned neck dissection.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.280-285
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• 2016

Mandible defects could be caused by congenital malformations, trauma, osteomyelitis, tumor resection. If large areas are included for reconstruction, those are primarily due to tumor resection defects. The large jaw defect results in a problem about mastication, swallowing, occlusion and phonetics, and poor esthetics causes a lot of inconvenience in daily life. It is almost impossible to be a part underwent mandibular resection completely reproduced, should be rebuilt artificially. This case is of a patient who was diagnosed with squamous cell carcinoma pT1N0M0, stage I in February 2004 and received surgery (combined mandibulectomy and neck dissection operation (COMMANDO) in oromaxillofacial surgery) in March 2004, by implant assisted removable partial denture. We could obtain good retention and stability through sufficient coverage and implant holding. Follow up period was about four years. Mandibular left third molar regions have been observed to have resorption of surrounding bone, and periodic check-ups are necessary conditions.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.57-62
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• 2006

Giant cell tumors are potentially malignant tumors in vertebrae, affecting frequently difficult to diagnose and are often inoperable. So it will be treated using radiation because of their high recurrence rate and the mechanical compression of spinal cord, but many surgeons described tumors of the vertebra, and the affected vertebral body can be treated using radical or near to total excision, with anteroposterior vertebral fusion or instrumentation of the spine. we report a case of giant cell tumor affecting the third cervical vertebra which caused neck pain and destroyed the vertebra body had treated using radical excison with fusion of posterior arch using instrumentation of the spine together with a literature review.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.212-216
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• 2003

A Common peroneal nerve palsy caused by ganglionic cyst is very rare condition but well recognised entities. There have been three previous reports describing the magnetic resonance image (MRI) findings of peroneal nerve entrapment due to a ganglionic cyst. Ultrasonography, MRI, and electromyography (EMG), nerve conduction velocity (NCV), and microscopic examination were taken for diagnosis. A tubular structure near the fibular neck extending longitudinally over several slices with an inferior extension towards the superior tibiofibular joint with high T2 signal intensity was characteristic. The peroneal nerve was exposed and the ganglionic cyst was excised. The nerve was paralysed immediately after operation, but at 4 month after operation, started recovery of the function gradually and has recovered completely at 7 month. MRI is helpful to detect the extent, location, and origin of the cyst. Meticulous surgical excision can provide favorable result.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.512-518
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• 2021

Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5^th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.279-285
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• 1998

Exessive sweating of the palms and soles, is a psychologically and occupationally distressing and sometimes disabling condition. Hyperhidrosis is one of the common abnormalities in autonomic nervous system. There were no specific treatment on hyperhidrosis, so invasive thoracic sympathectomy via axillary thoracotomy or cervical approach had been used. Video-assisted thoracic surgery(VATS) is now mostly performed for treating of the palmar and axillary hyperhidrosis. From March 1996 to March 1997, 15 patients with bilateral palmar hyperhidrosis had been treated by the bilateral thoracic sympathectomy(T2, T3, T4) with thoracoscopic resection. The patient were evaluated preoperative and postoperative Digital Infrared Thermographic Imaging (DITI) at Kyung-Hee University Hospital. There were no case of the thoracotomy conversion. There were 3 complications ; pulmonary edema in 1 case, Horner's syndrome in 1 case, and gustatory hyperhidrosis in 1 case. More than half of the patients also had compensatory sweating in the lower abdomen, the buttocks, the back and the thighs. In conclusion, most of the patients were satisfied with the postoperative results of the thoracoscopic sympathectomy, including no more palmar and axillary sweating, less pain, better cosmetic appearances, decreased sweating of the face and soles. In addition, intraoperative temperature monitoring of the hands could estimate the successful thoracoscopic sympathectomy and the preoperative and postoperative Digital infrared thermographic imaging(DITI) could especially be the technique for the objective manifestation of the successful results of the thoracoscopic sympathectomy.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.920-926
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• 2006

Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.985-990
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• 2003

Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, corvical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an on-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.

• Korean Journal of Bronchoesophagology
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• v.17 no.2
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• pp.83-88
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• 2011

Robotic thyroidectomy has been developed to minimize neck scarring, and several authors have described its feasibility and safety, and have reported surgical outcomes comparable with conventional open thyroidectomy. The da Vinci surgical system robot provides a three-dimensional $10-12{\times}$magnified view of the surgical area. It also provides hand-tremor filtration, fine motion scaling, and precise and multi-articulated hand-like motions. Recently, robotic technology has also been applied to lateral compartment neck dissection in thyroid cancer. We have developed a new novel selective neck dissection procedure by a gasless unilateral axillo-breast (GUAB) approach with a da Vinci Surgical System for well-differentiated thyroid carcinoma to avoid a long visible neck scar. Based on our early experience, robotic selective neck dissection by GUAB approach is a safe, feasible and cosmetically excellent procedure. It can be an alternative to conventional open surgery in the highly selected patients with well-differentiated thyroid carcinoma. The oncologic safety of robotic selective neck dissection should be verified with long-term follow-up data.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.94-100
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• 1995

Despite improvement in respiratory care, including widespread use of low pressure and high volume cuffed tubes, tracheal stenosis remains a feared complication of prolonged intubation and tracheostomy. In such patients, other coexisting problems such as vocal cord paralysis, tracheoesophageal fistula, noncontiguous stenotic segments and laryngeal stenosis may occasionly be encountered. Therefore tracheal stenosis still presents a significant management problem, despite recent endoscopic advances and surgical techniques. Between 1991 and 1994, authors preformed tracheal resection with end-to-end anastomosis on 11 patients with tracheal stenosis. The total success rate (asymptomatic patients with patent airway) was 72.7% and there were no serious complication. This report reviews our experience about this procedure and surgical results. And it investigates associated factors for successful results.