• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.63-70
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• 2006

Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.470-476
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• 2018

Facial motor evoked potential (FMEP) by multi-pulse transcranial electrical stimulation (mpTES) can complement free-running electromyography (EMG) and direct facial nerve stimulation to predict the functional integrity of the facial nerve during cerebello-pontine angle (CPA) tumor surgery. The purpose of this paper is to examine the standardized test methods and the usefulness of FMEP as a predictor of facial nerve function and to minimize the incidence of facial paralysis as an aftereffect of surgery. TES was delivered through electrode Mz (cathode) - M3/M4 (anode), and extracranially direct distal facial muscle excitation was excluded by the absence of single pulse response (SPR) and by longer onset latency (more than 10 ms). FMEP from the orbicularis oris (o.oris) and the mentalis muscle simultaneously can improve the accuracy and success rate compared with FMEP from the o.oris alone. Using the methods described, we can effectively predict facial nerve outcomes immediately after surgery with a reduction of more than 50% of FMEP amplitude as a warning criterion. In conclusion, along with free-running EMG and direct facial nerve stimulation, FMEP is a useful method to reduce the incidence of facial paralysis as a sequela during CPA tumor surgery.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.77-80
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• 2009

Orbital solitary fibrous tumor (SFT) is a rare tumor originating from the mesenchyme. We describe the clinical presentations, radiological and operative findings, and pathological features of a patient with orbital SFT. The patient was a 46-year-old female who presented with progressive proptosis advanced for 20 months. On ophthalmological examination, no visual impairment was detected, but left eye was found to be obviously protruded on exophthalmometry. Orbital magnetic resonance imaging showed a 2.5 ${\times}$ 2 ${\times}$ 2 cm, intensely enhanced mass in the left orbit, which compressed the eyeball forward and the optic nerve downward. The patient underwent frontal craniotomy with superior orbitotomy and gross total resection was performed for the tumor. The histopathological diagnosis including immunohistochemistry was a SFT. After the surgery, proptosis was markedly relieved without visual impairment. Although orbital SFT is extremely rare, it should be considered in the differential diagnosis of orbital tumors. Clinical presentations such as painless proptosis and CD34 immunoreactivity play a significant role in differentiating orbital SFT from other spindle-cell neoplasms of the orbit.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.219-222
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• 2002

Malignant glomus tumor is a very rare disease originating from the paraganglia system through the body. Glomus tumor, also known as paraganglioma, usually are considered benign, and arises in a variety of head and neck locations, most of which include the carotid body, the vagus nerve, and the jugulotympanic area. The most widely accepted management of benign glomus tumor is surgical extiration. Here, we report a case of recurrent laryngeal glomus tumor which is proven malignant and metastatic to the brain and the lungs. We have treated the patient with combination chemotherapy and radiation to the brain, the result of which is partial response in terms of decreased size of metastatic lung lesions.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.173-176
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• 2010

In this report, we introduce an undetermined fibrous tumor with calcification occurring in the cerebellopontine angle (CPA). A 51-year-old woman was admitted with a short history of dizziness. Computed tomography and magnetic resonance images revealed a $2{\times}2{\times}2\;cm$ sized mass at the left CPA which was round and calcified. There was no dura or internal auditory canal involvement. At surgery, the tumor was located at the exit of 7th and 8th cranial nerve complex. It was very firm, bright yellow and well encapsulated. Histologic findings revealed that the tumor was predominantly composed of fibrous component, scant spindle cells and dystrophic calcification. Immunohistochemical staining demonstrated positive for vimentin and negative for epithelial membrane antigen (EMA), S-100 protein, CD34, factor XIIIa and smooth muscle actin. The diagnosis was not compatible with meningioma, schwannoma, metastatic brain tumors, and other fibrous tumors. Although the tumor was resected in total, long term follow-up monitoring is necessary due to the possibility of recurrence.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.494-496
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• 2014

The granular cell tumor (GCT) occurs extremely rarely in the mediastinum. Few mediastinal GCT cases have been reported in Japan or other countries. Here, we report a case of a 24-year-old man with superior mediastinal GCT. The mass was located just above the aortic arch. It was firm, oval in shape, and well encapsulated. The tumor was removed completely with video-assisted thoracoscopic surgery, but we had to resect the vagus nerve, which was already included in the tumor, along with the tumor. After the operation, the patient recovered without any specific complications except for a mild degree of hoarseness.

• The Korean Journal of Pain
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• v.24 no.4
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• pp.185-190
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• 2011

Background: Spinal nerve ligation (SNL) injury in rats produces a pain syndrome that includes mechanical and thermal allodynia. Previous studies have indicated that proinflammatory cytokines such as tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) play an important role in peripheral mediation of neuropathic pain, and that altered dorsal root ganglion (DRG) function and degree of DRG neuronal apoptosis are associated with spinal nerve injury. The present study was conducted to evaluate the expression of TNF-${\alpha}$ and the extent of apoptosis in the dorsal root ganglion after SNL in rats. Methods: Sprague-Dawley rats were subjected to SNL of the left L5 and L6 spinal nerves distal to the DRG and proximal to the formation of the sciatic nerve. At postoperative day 8, TNF-${\alpha}$ protein levels in the L5.6 DRG were compared between SNL and naive groups using ELISA. In addition, we compared the percentage of neurons injured in the DRG using immunostaining for apoptosis and localization of activated caspase-3. Results: SNL injury produced significant mechanical and cold allodynia throughout the 7-day experimental period. TNF-${\alpha}$ protein levels were increased in the DRG in rats that had undergone SNL ($12.7{\pm}3.2$ pg/100 ${\mu}g$, P < 0.001) when compared with naive rats ($4.1{\pm}1.4$ pg/100 ${\mu}g$). The percentage of neurons or satellite cells co-localized with activated caspase-3 were also significantly higher in rats with SNL than in naive rats (P < 0.001, P < 0.05, respectively). Conclusions: SNL injury produces mechanical and cold allodynia, as well as TNF-${\alpha}$ elevation and apoptosis in the DRG.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.205-210
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• 1999

Objectives: Major salivary gland tumor mainly develops in the parotid gland and pleomorphic adenoma is a large percentage. The aim of this study is to get clinicopathologic characteristics of overall major salivary gland tumors and suggestions regarding surgical management through collective review of 315 cases. Materials and Methods: This is a clinicopathologic review of 315 cases of major salivary gland tumor who were treated surgically at Department of Surgery, Head and Neck Clinic, Pusan Paik Hospital, Inje University during the period of 18 years from 1980 to 1997. Analysis was performed regarding the incidence, classification, surgery and its complications, and survival rate of salivary gland cancer. Results : 1) Parotid gland was the most prevalent site of salivary gland tumor(78%) and submandibular gland(21%) was next in order. Benign tumors were 257cases(81%) and malignant tumors were 58 cases(19%). 2) Male to female sex ratio was 1:1.2, the most prevalent age group was 3rd decade and the second group was 4th decade. 3) Histopathologically, the most common benign salivary gland tumor was pleomorphic adenoma. Warthin's tumor was next common. Among the malignant tumors, mucoepidermoid carcinoma was most common, and the next were adenoid cystic carcinoma and acinic cell carcinoma. 4) In pleomorphic adenoma, superficial parotidectomy was performed in 129 cases, and extracapsular tumorectomy was performed in 3 cases. In non-pleomorphic benign tumor, tumorectomy was performed in 21 cases. In 40 cases of deep lobe tumor, total parotidectomy was performed in only 2 cases and deep parotidectomy was performed in 38 cases. 5) Surgical complications were facial nerve injury 19 cases, Frey syndrome 13 cases, and salivary fistula 3 cases. 6) Overall 5-year survival rate of salivary gland cancer was 63%. Conclusion: Postoperative recurrence rate is low in benign tumor, but high in cancer of salivary gland tumor. Surgical procedure should not be aggressive in benign tumor, especially in parotid tumor, but should be aggressive in malignant salivary gland tumors.

• The Journal of the Korean dental association
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• v.58 no.9
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• pp.556-562
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• 2020

Neurofibroma is a benign, heterogenous peripheral nerve sheath tumor arising from the connective tissue of peripheral nerve sheaths, especially the endoneurium. Its intraoral occurrence is uncommon and its occurrence within mandible is extremely rare. A case of solitary intraosseous neurofibroma of the mandible involving masticator space in a 8-year-old male is reported. He was referred from a private local clinic with a chief complaint of limitation in opening of the mouth. Panoramic and cone-beam computed tomographic images showed unilocular radiolucent lesion with scalloped border at the right mandibular ramus, connected posteriorly to the enlarged mandibular foramen and anteriorly to the mandibular canal. T1-weighted magnetic resonance images showed soft tissue mass of isointensity compared with muscles. Contrast-enhanced T1-weighted images showed peripheral enhancement and T2-weighted images showed the heterogeneous hyperintense mass with extension between lateral and medial pterygoid muscles. The tumor was surgically removed under general anesthesia and diagnosed to be neurofibroma at the biopsy.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.37-41
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• 2000

Background and Objectives: The most commonly used incision for parotidectomy is modified Blair incision, but it has unsatisfactory cosmetic result due to long exposed scar in the neck. Therefore, we introduce an alternative approach with more acceptable scar named modified facelift incision. We report it's techniques, indications and disadvantages with our experiences. Materials and Methods: During the 1999, 15 patients were underwent parotidectomies using modified facelift incision. We studied the postoperative complications and the cosmetic results respectively. Results: There were 11 benign tumors, 3 malignant tumors, and 1 chronic inflammation. Total parotidectomy was performed in 2 malignant tumors and chronic parotitis patients. The others has superficial parotidectomy. In terms of operation field, there was no difference between classical incision and facelift incision. Partial facial nerve palsy was noted in 2 cases, who required sacrifice of branches of facial nerve because of malignant tumor invasion. There were no specific complications associated with this type of approach. Postoperative cosmetic results were satisfactory in all cases. Conclusion: Modified facelift incision provides better cosmetic result than conventional incision without narrowing of operation field. We believe that it is a safe alternative approach to all parotidectomy cases especially to women and patient with keloid skin. The only limitation of this incision is poor adaptability for combining neck dissection.