• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.10 no.2
• /
• pp.140-148
• /
• 1999

The use of obturator is the prosthetic rehabilitation approach for restoration of the defected maxillary shape and function for the patients with palatal defect. The obturator can change the shape of vocal tract and nasality, but few reports on the effects of the change were presented. So, the authors performed the experimental study to compare the difference between the sizes of vowel triangles produced by maxillectomized patients before and after obturator-wearing and to consider how much improvement in speech intelligibility can be expected by obturator wearing. The 8 patients who were totally maxillectomized due to palatal cancer were participated as subjects. They produced 5 vowels(/a/, /i/, /u/, /e/, /o/) before and after obturator-wearing. The formants of the vowels were analyzed by the spectrogram of CSL, and their speech intelligibility were judged by normal 8 listeners. As results, the frequency of the first and the second formant showed no significant difference between the articulation before and after wearing, but the comparison of the sizes of vowel triangles, related with the speech intelligibility, showed significant difference. The vowel triangle of the articulation after wearing was larger than that of the articulation before wearing. /i/ showed the lowest speech intelligibility score among the vowel articulation before wearing. After wearing obturators, their scores increased on the whole, especially, in /a/, but the intelligibility of /u/ decreased after wearing.

• Korean Journal of Head & Neck Oncology
• /
• v.10 no.2
• /
• pp.171-177
• /
• 1994

We reviewed retrospectively 152 patients' records with salivary gland tumors confirmed histologically at Hanyang University Hospital from Jan. 1984 to Dec. 1993. The results obtained were as follows: 1) Sites of tumors were parotid gland in 102 cases(67%), submandibular gland in 29 cases(19%) and minor salivary glands in 21 cases (14%). 2) 113 cases(74%) were benign. and 39 cases(26%) were malignant. 3) The incidence of benign and malignant tumors were 81% & 19%, 69% & 31% and 48% & 52% in the parotid gland, the submandibular gland and the minor salivary glands respectively. 4) The most frequent histologic types of benign and malignant tumors were pleomorphic adenoma (64%) and mucoepidermoid carcinoma (11%) respectively. 5) The surgical procedures include superficial parotidectomy. total parotidectomy. extended total parotidectomy & neck dissection in the parotid gland. wide excision & neck dissection in the submandibular gland and wide excision, partial maxillectomy & neck dissection in the minor salivary glands. 6) The postoperative recurrence rate were 4.4% in benign tumors and 27% in malignant tumors.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.2
• /
• pp.152-156
• /
• 1994

Rhinocerebral mucormycosis is an acute fulminant opportunistic fungal infection in debilitated patients with underlying pathologic conditions, which are diabetic ketoacidosis, immunosuppressed disease. We experienced a case of rhinocerebral mucormycosis. The patient was 41 year-old female, who had diabetes for five years and suffered from left facial swelling and pain, left ophthalmoplegia and facial skin necrosis. Total maxillectomy was done combined with systemic Amphotericin B therapy, Biopsy proved mucormycosis but she expired.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.40
• /
• pp.31.1-31.8
• /
• 2018

Background: Verrucous carcinoma (VC) accounts for 1-10% of cases of squamous cell carcinoma (SCC) in the oral cavity, and 75% of VC occur in the oral cavity. Only 3% of primary intraosseous squamous cell carcinomas (PIOSCC), which means SCC occurring primarily in the bone, are VC. Verrucous carcinoma arising from odontogenic cysts (OC) is very rare, with only seven cases reported to date. Case presentation: This study reported a case of a patient who underwent partial maxillectomy and neck dissection for VC that occurred in the right anterior maxilla. The patient was admitted to the emergency department at our institution 8 years ago and showed cystic lesions in the anterior maxilla on facial computed tomography (CT) images. Treatment through other departments including assessment of laceration in the mental region and only suture was performed. This report highlights a very rare case of VC in the right anterior maxilla arising from a previous cystic lesion. Conclusions: Since PIOSCC can arise from OC, appropriate treatment of intraosseous cysts and regular radiologic evaluation are necesssary. Surgical exicision of the primary lesion without neck dissection can lead to good prognosis for patients with primary intraosseous verrucous carcinoma.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.1
• /
• pp.89-93
• /
• 2017

Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.

• Imaging Science in Dentistry
• /
• v.51 no.2
• /
• pp.203-208
• /
• 2021

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm characterized by the presence of ghost cells. It is considered to originate from either a calcifying odontogenic cyst(COC) or a dentinogenic ghost cell tumor(DGCT). Its clinical and radiographic characteristics are non-specific, including slow growth, locally aggressive behavior, and eventual metastasis. This case report describes a 43-year-old Thai man with plain radiographs and cone-beam computed tomographic images revealing a unilocular radiolucency with non-corticated borders surrounding an impacted left canine associated with radiopaque foci around the cusp tip. Based on the microscopic findings, the lesion was diagnosed as GCOC. Partial maxillectomy of the right maxilla was performed, and radiotherapy was administered. An obturator was made to support masticatory functions Three years later, the lesion showed complete bone remodeling and no signs of recurrence, and long-term follow-up was done regularly.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.2
• /
• pp.183-188
• /
• 2010

Leiomyosarcoma is a malignant neoplasm of smooth muscle origin and mostly originate from the wall of uterus and gastrointestinal tract, but primary leiomyosarcoma of the oral cavity is extremely rare. This tumor has a very poor prognosis due to high recurrence and metastasis rate, with 5 year survival rate of 32%. And regional lymph node metastasis is uncommon event. Complete wide surgical excision is the treatment of choice. A 64-year old man who had a painful ulcerative lesion on the labial & palatal gingiva of #11, 21 visited our department, and was diagnosed as leiomyosarcoma through a biopsy. Partial maxillectomy was carried out, with no following radiotherapy or chemotherapy. After months follow-up, there has been no evidence of recurrence or metastasis. But after months, we clinically find out two enlarged immobile palpable lymph node in right submandibular area of patient. So a biopsy was performed via an extraoral incision under local anesthesia. Histopathologic diagnosis diagnosis of the biopsy was lymph node metastasis of prior existed leiomyosarcoma. We report a case of a primary leiomyosarcoma occurred in a 64 year-old male patient involving the anterior maxillary region with regional lymph node metastasis with a review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.3
• /
• pp.231-239
• /
• 1999

In oral and maxillofacial surgery, there are many cases requiring the graft of epidermal tissues such as maxillectomy, and vestibuloplasty. There have been so many challenges for the culture of the epidermal tissue. Observing the ultrastructure of the cultured human oral kertinocytes, we could compare this findings with that of in vivo ones. With that, we could find the differencies and similarities between cultured cells and in vivo ones, and evaluate the clinical applications of cultured tissue. Human gingiva was obtained and the specimen was explanted on 24-well plate. Two types of culture media were used in this culture system. One was for the growth of the keratinocytes (Media I), and the other was for the stratification (Media II). Media I had special ingredients for the epidermal growth. Those were 0.5% dimethyl sulfoxide (DMSO), 30ng/ml of epidermal growth factor (EGF), 30ng/ml of cholera toxin, and $5{\mu}g/ml$ of transferrin. We cultured the oral keratinocytes for 3 weeks, and at that time the cultured keratinocytes were processed to prepare the specimen for the TEM study. The results were as follows.; 1. In the phase contrast micrograph, epidermal outgrowth firstly appeared on the 3rd day after explantation, and the growing keratinocytes were activley mitotic, and had polygonal shape and increased N/C ratio. 2. In the phase contrast micrograph, the outer most cells exhibited areas where broad cytoplasmic processes extended out onto the culture subtratum(fan-like appaearance). 3. In the TEM micrographs, the cultured keratinocytes showed stratification. The cells were in elongated form, and there were no morphologic differencies among the layers usually found in the in vivo gingiva. 4. Most of cellular organelles underwent lysis, and keratohyaline granules were seen. Tonofibrils were dispersed in the cytoplasm. 5. The cells were interconnected by desmosomes, and their frequency of distribution was considered to be lower than that of in vivo keratinocytes. 6. We could conclude the cultured oral keratinocytes exhibited signs of terminal differentiation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.2
• /
• pp.125-127
• /
• 2010

The coexistence of aspergillosis and squamous cell carcinoma (SCC) in the maxillary sinus was very rare. To our knowledge, this is the second report of coexistent SCC and aspergillosis in the maxillary sinus. A 58-year-old man underwent surgery for unilateral maxillary sinus infection with oroantral fistula. In the surgical specimen, SCC and aspergillosis were co-detected with routine and immunohistochemical stainings. Moreover, human papillomavirus 18 (HPV-18) was detected by polymerase chain reaction in the sinus specimen. The patient was re-operated with subtotal maxillectomy and has been followed up for two years without any evidence of recurrence or metastasis. Although it is not understood how aspergillosis could induce carcinoma formation, the chronic inflammation caused by prolonged fungal infection might be carcinogenic. Moreover, HPV-16 and -18 were another causative pathogens of SCC in the head and neck region. We recommend careful examination, including preoperative cytology, in patients with maxillary sinus fungal infections because of the potential for cancer development.

• The Journal of Korean Society for Radiation Therapy
• /
• v.8 no.1
• /
• pp.75-81
• /
• 1996

When high energy photon beam is incident upon an air cavity interface the effect of ionization build-up observed . This phenomenon is resulting from the surface layers of the lesions are significant deficiency of electrons reaching the layers because of the replacement, of solid scattering material by the air cavity, that is lack of electronic equilibrium. Measurement have been made in an acrylic phantom with a parallel plate chamber and high energy photon beams, CO-60, 4MV, 6MV and 10MV X-rays have been investigated. The result of our study show that a significant effect was measured and was determined to be very dependent on field size, air cavity dimension and photon energy. The reductions were much larger for 10MV beam, underdosage at the interface was 12, 12.2, 16.9 and $20.6\%$ for the CO-60, 4MV, 6MV and 10MV, respectively. It was found that this non-equilibrium effect at the interface is more severe for the higher energy beams than that of lower energy beams and the larger cavity dimensions the larger beam reductions occur. This problem is of clinical concern when lesions such as carcinoma beyond air cavities are irradiated, such as larynx, glottic and the patients with maxillectomy and ethmoidectomy and so forth.