• 제목/요약/키워드: Head resection

검색결과 313건 처리시간 0.027초

가성대에 발생한 신경초종의 경구강 레이저 절제술 치험 2례 (Two Cases of False Cord Schwannoma Treated with Transoral Laser Resection)

  • 김영록;김성원;홍종철;이봉주;이강대
    • 대한두경부종양학회지
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    • 제23권1호
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    • pp.58-62
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    • 2007
  • Schwannoma is a benign well-encapsulated tumors arising from the sheath of Schwann cell of the peripheral motors, sensory, and cranial nerves, but not from the optic and olfactory nerves. Since it is relatively common in the head and neck region, it should be included in the differential diagnosis of head and neck tumor. However, reports of laryngeal involvement have rarely appeared in the literature. We have experienced a 50-year old woman and 39-year old woman with history of progressive voice change. We recognized a benign mass at the false cord area with the telelaryngoscope and CT. The tumors were successfully removed by transoral CO2 laser resection without tracheotomy.

측경부에 발생한 다형성 지방육종 1예 (A Case of Pleomorphic Liposarcoma of the Lateral Neck)

  • 손정협;김현정
    • 임상이비인후과
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    • 제29권2호
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    • pp.295-300
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    • 2018
  • Pleomorphic liposarcoma is extremely rare in the head and neck region. It can be diagnosed by identifying multivacuolated lipoblast with pleomorphism. Most studies have reported that pleomorphic liposarcoma shows an aggressive behavior with poor prognosis. The treatment of choice is wide resection to ensure negative margin. The authors report a case of pleomorphic liposarcoma in a 67-year-old female, who was treated with primary resection of tumor and postoperative radiation therapy. The patient is well without any recurrence or metastasis after 1 year of follow-up.

수차례 재발한 다발성 부신경절종 1예 (A Case of Multiple Paraganglioma Presenting as Recurrent Tumor Nermerous Times)

  • 이석희;선민진;최미숙;이동욱
    • 대한두경부종양학회지
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    • 제27권1호
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    • pp.80-83
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    • 2011
  • Paraganglioma is a relatively rare, generally benign and slow growing tumor arising from widely distributed paraganglionic tissue thought to originate from the neural crest. In the head and neck region, paraganglionic tissue is distributed in the superior and inferior paraganglia such as the carotid body, the vagal body, and the jugulotympanic region. Approximately 10% of patients with paraganglioma have a family history of such tumors. Multiple lesions can be found in 26% of patients with family history. It is important to distinguish between paraganglioma and atypical carcinoid tumor and medullary thyroid cancer. This can be done with histopathologic evaluation and immunohistochemical markers. Complete excision is recommended for the treatment of this tumor. Paraganglioma is particularly aggressive and rapid recurrence of paraganglioma is common after local resection. We present a case of malignant paraganglioma in the neck which recurred 2 months after local resection. We suppose that radiation therpay could be the last option for the treatment in this clinical setting.

비부비동 미분화암의 두개안면절제술 후 전완부자유피판을 이용한 뇌 척수액 유출 폐쇄 시행 1례 (A Case of Cerebrospinal Fluid Leakage Repair with Forearm Free Flap after Craniofacial Resection of Sinonasal Undifferentiated Carcinoma)

  • 송기재;조진모;정운용;김훈;홍현준
    • 대한두경부종양학회지
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    • 제32권2호
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    • pp.91-94
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    • 2016
  • A 37 year-old male presented with sudden right proptosis and bilateral nasal obstruction. A huge tumor was noted in bilateral nasal cavities, ethmoid sinuses and central frontal sinus on magnetic resonance imaging. Right posterior frontal sinus wall and bilateral medial orbital wall was destructed by the tumor. Complete resection of the tumor was performed via minimal invasive craniofacial resection. Histopaghologic examination revealed sinonasal undifferentiated carcinoma (SNUC). Cerebrospinal fluid leakage was developed after 2 days of the surgery. On the 5th day, anterior skull base was reconstructed with forearm free flap (FFF). The patient got 6000cGy of radiotherapy and survived in 27 months of follow up.

기관절제 및 단단문합술에 의한 소아 기관협착증의 치료 (Tracheal Resection and End to End Anastomosis for Tracheal Stenosis in Children)

  • 최종욱;정근;김용환;김혜정;박찬;최건
    • 대한기관식도과학회지
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    • 제3권1호
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    • pp.94-100
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    • 1997
  • Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

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전종격동 기관절개술 이후에 발생한 무명동맥 파열 1예 (Rupture of Innominate Artery After the Anterior Mediastinal Tracheotomy : A Case Report)

  • 김승우;김춘동;김정민;사대진
    • 대한두경부종양학회지
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    • 제27권1호
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    • pp.92-95
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    • 2011
  • The anterior mediastinal tracheotomy(AMT) facilitates resection of stomal recurrence after total laryngectomy and tumors involving the cervicothoracic trachea and esophagus. An 81-year-old-man came to our clinic due to the progressive dyspnea during three months. He received the total laryngectomy five years ago. We diagnosed as Sisson type I stomal recurrence and then performed the wide excision, both selective neck dissection, sternal manubrium resection and AMT. Before surgery, we planned the pectoralis major myocutaneous flap. Unluckily we could not fulfill this procedure because of patient's medical status during anesthesia. The tracheocutaneous fistula was observed in the second postoperative day. He expired due to the huge bleeding from the wound. When AMT is performed, exact manipulation of major vessels and adequate flap are mandatory these elevate the feasibility of AMT.

구강암의 수술적 접근과 재건 (Surgical Excision and Reconstruction in Oral Cavity Cancer)

  • 안순현
    • 대한두경부종양학회지
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    • 제39권1호
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    • pp.11-14
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    • 2023
  • The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.

악성 섬유성 조직구종에서 광배근피판을 이용한 견관절 재건술 (Reconstruction of the Shoulder using Rotational Latissimus Dorsi Flap in the Malignant Fibrous Histiocytoma)

  • 한정수;정덕환;이영호;임양진
    • Archives of Reconstructive Microsurgery
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    • 제10권2호
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    • pp.111-117
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    • 2001
  • Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

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기도를 침범한 분화성 갑상선암종 (Laryngotracheal invasion by well-differentiated thyroid carcinoma)

  • 최종욱;김용환;박찬;고태옥;최건
    • 대한기관식도과학회지
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    • 제3권2호
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    • pp.287-292
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    • 1997
  • We report 22 cases of well -differentiated thyroid carcinoma infiltrating the upper airway tract. This retrospective study was undertaken to evaluate the prognosis md to determine optimal therapy for thyroid carcinoma adhering to or invading the trachea or larynx from 1984.3 to 1996.12. The treatment was individualized depending on the extent of the cancer. There were 12 cases dissected free by an laryngotracheal shaving, 7 cases removed by an tracheal resection with end to end anastomosis, 3 cases removed by an total laryngectomy. In all of these cases, we performed a total thyroidectomy with an accompanying neck dissection. There were no major complications during the operation. Over the 5-years observation period, 11 patients are alive without a sign of recurrence, 4 Patients are alive with recurrence, 7 died of thyroid carcinoma; 2 of 12 in an laryngotracheal shaving cases, 2 of 7 in an tracheal resection with end to end anastomosis case, 3 of 3 in an total laryngectomy case. The result showed an radical operation for thyroid carcinoma invading the laryngotrachea improves the survival rate, but limits improving the cure rate, and the invasion of the thrchea or larynx must be treated whenever possible by an total resection followed by radioiodine and external beam radiation.

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