• Archives of Plastic Surgery
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• v.37 no.2
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• pp.182-186
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• 2010

Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

• Journal of Korean Neurosurgical Society
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• v.55 no.3
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• pp.178-180
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• 2014

Despite significant advances in the treatment of all forms of chronic otitis media (COM), complications still can and do occur, with intracranial complications representing the most life-threatening cases, often requiring immediate therapeutic intervention. Herein, we present a rare case of rapidly progressing facial paralysis with concomitant severe headache and ipsilateral hearing loss secondary to an otogenic brain abscess, treated with the transmastoid approach, drainage, and facial nerve decompression.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.31-34
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• 2017

First branchial cleft anomaly is a very rare disease and exhibits various clinical presentations. Therefore, the diagnosis of first branchial cleft anomaly may be difficult; the condition is often misdiagnosed and mismanaged. Accurate diagnosis is very important, because if not diagnosed correctly, patients with first branchial cleft anomaly would be treated with local incision and drainage repeatedly. We report two cases of first branchial cleft anomaly. The first patient visited for recurrent swell and discharge in the infra-auricular area with a history of previous incision and drainage. The other patient showed a cystic mass in the infra-auricular area and all of them were misdiagnosed initially by their treating specialists elsewhere. The objective of this study is to share our experiences of first branchial cleft anomaly, and emphasize its various clinical patterns and the significance of accurate diagnosis.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.27-31
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• 2023

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare immunological small vessel disease which usually affects respiratory tract and kidneys. However, salivary gland involvement in GPA is rare as a primary manifestation. We report a case of GPA with the primary presentation of submandibular gland involvement. A 48-year-old female patient presented submandibular swelling with a skin defect that lasted for 1 month. Although the biopsy result was chronic inflammation, the skin defect did not heal for a month. Further imaging study revealed multiple lung and renal masses. More clinical manifestations such as gingivitis, ischemic change of finger joint and nasal tip skin, and positive c-ANCA test was presented. Additional biopsy was made at the submandibular gland, lung, and finger skin. The patient was finally diagnosed with GPA and treated with steroid pulse therapy and cyclophosphamide. The patient showed improvement of prior clinical symptoms.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.29-32
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• 2004

Fibrous dysplasia of the mandible is an unusual manifestation of the disease that is usually benign, occurs in young individuals, and is managed by conservative curettage or debridement. We present a case of persistent fibrous dysplasia complicated by pain and abscess formation that was successfully managed by radical resection and reconstruction with a free fibular flap. Although mandibular fibrous dysplasia is preferentially managed conservatively, treatment of this disease has evolved to a point where total excision and immediate reconstruction may be the treatment of choice and offer the best outcome.

• Korean Journal of Bronchoesophagology
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• v.15 no.2
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• pp.64-70
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• 2009

Descending necrotizing mediastinitis(DNM) can occur as a complication of oropharyngeal and cervical infections that spread to the mediastinum via the cervical spaces. Delayed diagnosis and inadequate mediastinal drainage through a cervical or minor thoracic approach are the primary causes of a high mortality rate. Therefore, We emphasize that aggressive and emergent mediastinal drainage by surgical approach is most important method of DNM treatment. We studied 5cases diagnosed as DNM from 2005 through 2007. All patients underwent emergent surgical drainage of deep neck infection combined with mediastinal drainage through a thoracic approach. Primary oropharyngeal infection lead to DNM in four cases(80%) and odontogenic abscess in one case(20%). The outcomes were favorable 5patients. Overall mortality rate was 0%. The time interval from diagnosis based on manifestation of initial symptoms(oral or pharyngolaryngeal area) to surgical intervention was $7.4{\pm}4.2$days. One patient required reoperation due to remnant mediastinal abscess and pericardial effusion. Early diagnosis and emergent combined drainage with neck and chest incisions, together with broad spectrum intravenous antibiotics, should be considered standard care for this disease. And intensive postoperative care which it is continuous mediastinal irrigation and antibiotics use can significantly reduce the mortality rate.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.85-87
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• 2005

The pyriform sinus fistula can cause a recurrent abscess in the neck and the current treatment of choice involves complete excision of the sinus tract. But, because of excisional difficult, chemical cautery has been intermittently used as a successful substitute. Recently we experienced a case of pyriform sinus fistula of 9 year-old female who was successfully treated with chemocauterization with trichloroacetic acid(TCA) and ligation of the internal opening of the fistula tract on suspension laryngoscopy. So we report this rate case with review of literatures.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.133-136
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• 2016

Facial abscess is a suppurative condition that is caused by infection and that its infected materials built up within the loose connective tissues or a fascial space of the head and neck. Facial abscess should be treated with a caution since it can make threat to patient's life. When pus collects near masticatory muscles, it may lead to masticatory muscle disorder reducing the range of mouth opening and the mobility of jaw. The authors review an uncommon case of facial abscess which occurred in temporal muscle and induced mouth opening limitation.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.142-147
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• 1998

Retained wooden foreign bodies following penetrating trauma are a difficult diagnostic problem. However, penetrating wooden foreign bodies of head and neck have the potential for misinterpretation or failure to detect such foreign bodies on CT. Given the likelihood that such a miss will result in an abscess or neurovascular injury, we present the method with higher window settings, they had a higher attenuation with a unique striated internal architecture and different Hounsfield numbers readily differentiate air and non-air hypodense material such as fat, or possibly wood. Being aware of the potential appearance of wood, we may also find CT useful in excluding small retained fragments in postoperative patients with persistent symptoms. This article presents two cases in which wooden foreign bodies of head and neck were present with CT evaluation.

• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.53-58
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• 1988

We have experienced 3 cases of papillary carcinoma of the thyroid gland seen as lateral neck cyst, Usually cystic lesions of the neck have been considered as benign lesions from clinical viewpoint. The usual differential diagnosis includes branchial cleft cyst, cystic hygroma, dermoid cyst, cold abscess(tuberculous lymphadenitis) and cavitating squamous cell carcinoma. A lateral neck cyst as the sole presenting complaint of the papillary thyroid carcinoma is very rare. Preoperative diagnosis of lateral neck cyst is often diagnostic dilemma. Fine-needle aspiration cytology can be helpful in detecting the cancer cells and in demonstrating the nature of the fluid component of the lateral neck cyst. Presence of brown murky fluid from the aspirated fluid is highly suggestive of thyroid carcinoma. The thyroid scans and B-mode ultrasonography mayor may not be helpful to detect the primary focus of the thyroid gland. We suggest that a patient with a lateral neck cyst in adult age group should be considered to be a possibility of underlying thyroid carcinoma presanting as lateral neck cyst.