• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.98-104
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• 2000

Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

• Korean Journal of Head & Neck Oncology
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• v.21 no.1
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• pp.10-14
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• 2005

Objectives: Various techniques of endoscopic thyroidectomy have been developed in thyroid resection since 1998 in the aspect of excellent cosmetic viewpoint. Of them, we evaluated our experiences and advantages of gasless axillary approach technique for resection of dominant thyroid nodules. Material and Methods: Twenty-nine cases of thyroid nodules were operated by the technique of gasless axillary approach during one year from December 2003 to December 2004. Twenty four patients underwent total lobectomy and five patients were partial lobectomy. Results: The operation time of first case took 300 minutes, however it became gradually shortened with case experiences down to 100-120 minutes. Pathologically, nodular hyperplasia was twenty cases, follicular adenoma five cases, papillary carcinoma three patients, and Hashimoto's thyroiditis one patient. There was no case of conversion to open thyroidectomy. Three cases of postoperative hoarseness were recovered spontaneously in 3 months. Hospital stay was four days for most patients. The cosmetic result was excellent without visible scar in anterior neck and chest. Conclusion: Endoscopic thyroidectomy via gasless axillary approach shows excellent result in cosmetic view point with hidden incision scar at axilla, and shorter hospitalization. However a question of longer operation time for dissection of the long plane over pectoral muscle is still remained.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.57-61
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• 2021

Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

• Archives of Plastic Surgery
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• v.48 no.2
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• pp.213-216
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• 2021

Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.164-169
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• 2003

Background and Objectives: The reconstruction is very important in Head and neck cancer surgery to repair the defect created by resection of tumors, to enable successful wound healing, to restore function and to provide acceptable cosmesis. The radial forearm free flap has been the most useful reconstructive flap because it provides a moderate amount of thin, pliable, relatively hairless skin and comparatively simple to do with minimal morbidity. The aims of this study is to estimate the outcome of the reconstruction with radial forearm free flap with the several factors in 140 head and neck cancer cases in our hospital for last 10 years. Materials and Methods: Retrospective review of the records of 140 patients underwent resection of the head and neck tumors and reconstruction with a radial forearm free flap from 1993 to 2003. The age, sex of the patients, Primary site, the complication of donor and recipient site, flap survival rate, median time to start diet, patient subjective symtoms about swallowing and articulating and the fact of revision reconstructive surgery were analyzed. Results: In primary pathologic site, 56 cases were oral cavity cancers, 44 cases, oropharyngeal cancers and 22 cases, hypopharyngeal cancers. Flap survival rate was 93.6% (13 leases). On donor site, wound dehiscence, hematoma, sensory change and infection were noted and on recipient site, most common complication were fistula and wound dehiscence. The complication rate of recipient's site was 19.1 % and donor site, 3.5%. In 118 cases (84.3%), the patients could take all kinds of food. Swallowing difficulty were noted in 22 cases 05.7%). In 5 cases, there was articulation difficulty but most of patients except patients having total laryngectomy (18 cases) couldn't have any difficulty in articulation and speaking. Conclusion: We conclude that the radial forearm free flap is the most appropriate reconstructive material for treating the defect in head and neck reconstruction.

• 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 Head & Neck Oncology
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• v.33 no.2
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• pp.67-70
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• 2017

We present a metastatic carcinoma from the breast to the neck soft tissue around common carotid artery, with a rare finding of voice change. A 60 year-old female patient presented with voice change for 7 months. Neck ultrasound revealed a soft tissue mass between internal jugular vein and common carotid artery. Result of fine needle aspiration biopsy was a metastatic carcinoma. Computed tomography and magnetic resonance image revealed $2.5{\times}3.0cm$ sized irregular marginated soft tissue mass in right lower neck encasing common carotid artery and internal jugular vein. Surgical resection was performed and pathologic result with immunohistochemical analysis confirmed the diagnosis of a metastatic invasive ductal carcinoma originated from breast.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.29-33
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• 2017

Verrucous carcinoma was first described by Ackerman who reported a case of verrucous carcinoma of the oral cavity. While it is primarily occurred in oral cavity, larynx is the second most affected site, accounting for nearly 35% of cases. It is a rare variant of well-differentiated squamous cell carcinoma and comprises 1% to 4% of all laryngeal carcinomas. It is characterized by locally invasive, slow growth and the surface shows papillary fronds with prominent hyperkeratosis. Because of the benign appearance and difficulty of the tissue diagnosis, it is often undiagnosed or misdiagnosed. The primary treatment modality is surgery and the extent of surgical resection may be guided by T stage. We experienced a case of verrucous carcinoma of larynx in a patient with hoarseness lasted for about 2 years and had difficult to diagnosis and treatment. Therefore we report this case with a brief review of literature.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.85-89
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• 2017

A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

• Korean Journal of Head & Neck Oncology
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• v.7 no.1
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• pp.17-23
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• 1991

The purpose of conservation surgery is complete eradication of the lesion with maximal maintenance of the proper function of the larynx. But the re are various methods of conservation surgery for the laryngeal cancer because of the unique embriological and anatomical characteristics of the larynx, which is the narrowest portion of the upper airway. The authors experienced 24 cases of conservation surgery for laryngeal cancer(7 in supraglottie cancer, 13 in glottic cancer, 4 in transglottic cancer) during recent 5 years and performed retrospective analysis of the cases. The result shows 91.6% of overall 3 years survival rate(87.5% of disease free 3 year survival rate). The authors concluded that conservation surgery for the laryngeal cancer preserve the function of larynx as possible and high cure rates were achieved by postoperative radiation therapy for the incomplete resection margin.