• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.51-55
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• 2019

Pharyngocutaneous fistula is a relatively common, but serious complication after pharyngeal or laryngeal cancer surgery. It can cause wound infection, longer hospitalization period and sometimes carotid artery rupture which can be fatal. Recently, we experienced a 63-year-old larynx cancer patient who had dementia and alcoholic liver cirrhosis for underlying diseases. He underwent total laryngectomy and both neck dissection, and pharyngocutaneous fistula occurred during postoperative radiotherapy. Pharyngocutaneous fistula during postoperative radiotherapy has not yet reported in the literature, and there are few reports about pre and postoperative management of dementia patient after head and neck cancer surgery. Therefore, we report this case with a brief review of literature.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.702-704
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• 2018

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.46-52
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• 1994

This review is based on the 52 cases of salivary gland tumors treated at the department of surgerym Hallym University Kangdong Sacred Heart hospital during the period from March 1987 to May 1992. There were 43 benign and 9 malignant tumors. Twenty eight(54%) of these cases were located in the parotid gland, 14(27%) in the submandibular gland, the rest of 10 cases(19%) in the minor salivary glands. Female outnumbered male by the ratio 1.6:1. Pleomorphic adenoma was the most common tumor followed by carcinoma and adenolymphoma(Warthin's tumor). The most common presenting symptom in both benign and malignant tumors was palpable mass. However, some patients with malignancy presented symptoms such as pain, facial palsy and dysphagia. Among 9 cases with malignancies 3 cases were found to have metastasis in the regional lymphnodes and two cases had distant metastasis. In majority of benign parotid tumors, superficial parotidectomy was carried out. In three cases of carcinoma of parotid gland with lymphnode metastasis, total parotidectomy with radical neck dissection was done. One case out of two cases of carcinoma of submandibular gland was treated with total excision of the gland with radical neck dissection. There were no postoperative mortalies. Two cases each of facial palsies and wound infections were observed as complication.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.214-219
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• 1998

Objectives: To assess the effectiveness of the low-dose(30mCi) I-131 ablation therapy for remnant thyroid tissue following total thyroidectomy for differentiated thyroid cancer. Methods: Between March 1995 and December 1997, forty-eight patients were given ablative doses(30mCi) of I-131 after total thyroidectomy for differentiated thyroid cancer in the presence of I-131 uptake in remnant thyroid tissue. Effective ablation of remnant thyroid tissue was determined by following I-131 whole body scan. if remnant thyroid tissue remained, we repeated the same management at 6 months interval. Results: Thirty-eight(79.1%) patients had papillary, 8(16.7%) follicular, 1(2.1%) medullary and 1(2.1%) Hurthle cell type cancer. Forty-eight patients underwent total thyroidectomy, among those central neck dissection was performed in 35 cases, and modified radical neck dissection in 14 cases. Postoperative complication developed in 8 cases, which included 4 cases of transient hypoparathyroidism, 1 case of permanent hypoparathyroidism, 2 cases of transient recurrent laryngeal nerve palsy, and 1 case of wound hematoma. There were significant remnant thyroid tissue in 46 cases(95.8%) of patients after total thyroidectomy, which could be ablated by low dose(30mCi) I-131. There were no statistical difference between operative procedures and number of treatment of I-131. Conclusions: These results suggested that repeated low-dose(30mCi) I-131 therapy would be needed, therefore, high -dose I-131 therapy could be considered as ablation therapy for the remnant thyroid tissue after total thyroidectomy for differentiated thyroid cancer.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.183-192
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• 2021

Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results. Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied. Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1-2 months. Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than the initial lesion and less distortion of the body structures around the wound in the completely healed defect. If the operator can predict the process of healing and immediate radiating folds, PSS could be a favorable option for round skin defects in the head and neck.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.158-166
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• 1995

Planning of the skin incision is one of the most important point for safe removal of the head and neck cancer. The fact that so many types of incisions exist is strong testimony that there is hardly one incision that fits all situation. Factors that influence the choice are adequate exposure, changeability to other types of neck dissection, optimal exposure of the primary site and/or opposite side of the neck, and safety of the neck flap and cosmesis. Laryngeal and hypopharyngeal carcinomas are the most common tumor of the head and neck, even though there are so many diverse situation exist, there must be an optimal approach to each case. From 1992 to 1994 surgical approaches used for laryngeal and hypopharyngeal carcinoma at the Severance Hospital were reviewed. Types of surgical approaches, its pitfall, advantage and disadvantages were reviewed.

• Korean Journal of Head & Neck Oncology
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• v.7 no.2
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• pp.92-98
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• 1991

Numerous mycoutaneous island flaps or free flaps have been used to reconstruct a defect which resulted from the wide resection of tumor mass in head and neck region. Since the curative resection of tumor usually include muscles and bones as well as skin and mucosa, the anatomical and functional restoration of the defect depend on which and what amount of tissues were provided to cover the defect; good aesthetic appearance subsequently follows the result. Furthermore, a simultaneous neck nodes dissection usually results in exposure of major neck vessels., which should be protected with sufficient padding. The ideal method to reconstruct a defect in the head and neck region requires a sufficient coverage by muscle layer with good vascularity, a wide arc of rotation, and minimization of donor site defect. The pectoralis major myocutaneous flap which was first decribed by Ariyan and lateral trapezius myocutaneous flap by Demergasso meet these criteria. We describe the use of these myocutaneous flaps in reconstruction of mandible and oral cavity.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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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.

• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.5-11
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• 1988

CT examination has been used in the preoperative examination of patients with head and neck cancer. The accuracy of CT in detecting nodal metastases has not been well established. We studied 35 patients (41 neck specimens) with head and neck cancer who underwent neck dissection. Surgical pathologic findings were compared with preoperative CT scan to establish the diagnostic accuracy for cervical lymph node metastases. The results of physical examination, CT scans of neck and histologic examinations were compared each other. The overall diagnostic accuracy of CT was 83.3%. Comparison with clinical accuracy shows the CT scan to be superior to the clinical examination in spite of careful physical examination, particularly in detecting occult metastases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.1
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• pp.34-36
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• 2018