This study investigated the impact of postoperative radiotherapy (PORT) on dietary function in patients who underwent pharyngoesophageal defect reconstruction using a free jejunal flap. A retrospective chart review of 36 patients who underwent circumferential pharyngoesophageal defect reconstruction using a free jejunal flap was performed. The European Organization for the Research and Treatment of Cancer head and neck cancer module questionnaire was used. Five items related to dietary function were selected and analyzed for changes in scores before and after PORT. Both the PORT and non-PORT groups showed improved dietary function before surgery, and no significant changes were noted at 3 and 12 months postoperatively. Repeated measures ANOVA showed that PORT had no significant impact on dietary function. In univariate analysis, no variable was a significant predictor of the score at 12 months, postoperatively. Previous radiotherapy and neck dissection had a close statistically significant relation. The multivariate analysis showed that neoadjuvant chemotherapy, previous radiotherapy, and neck dissection were significant predictors of the score at 12 months, postoperatively. PORT did not show a significant effect on the 12 months postoperative score. Free jejunal flap is an effective pharyngoesophageal defect reconstruction method that does not cause any dietary function disruption after PORT.

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Purpose: Skin and soft tissue infections (SSTIs) caused by mycobacteria are rare and difficult to diagnose and treat. Furthermore, systematic treatment protocols for mycobacterial SSTIs have not been established. This study introduces a strategy with radical resection and resurfacing using thoracodorsal artery perforator (TDAP) free flaps.Methods: From December 2013 to February 2022, 13 patients with mycobacterial SSTIs underwent radical resection and reconstruction using TDAP free flaps. Exact mapping of the lesion extent was performed preoperatively with magnetic resonance imaging. When the extent was limited to soft tissue, resection and reconstruction were performed in a single stage. However, in cases with bone or joint involvement, two-stage reconstruction was applied with radical resection and negative-pressure wound therapy followed by resurfacing with a flap. Complex defects formed after resection were filled with a musculocutaneous or chimeric flap. All patients were administered antimycobacterial medications.Results: Mycobacterial infection recurred in one patient; therefore, a total of 14 cases of reconstruction were performed. Reconstruction was performed with a TDAP free flap alone in 10 cases, with a chimeric flap in three cases, and with a musculocutaneous flap in one case. The flaps ranged in size from 7×5 cm2 to 25×12 cm2 (mean, 97.2 cm2). The mycobacterial species identified were Mycobacterium tuberculosis (n=8) and nontuberculous mycobacteria (n=5).Conclusion: For mycobacterial SSTIs, radical resection followed by resurfacing and reconstruction using TDAP free flaps can be an effective surgical treatment strategy.

Hyaluronic acid soft-tissue fillers are the second most widely used injectable agents in cosmetic surgery. During the coronavirus disease 2019 (COVID-19) pandemic, a few cases of delayed hypersensitivity reactions to hyaluronic acid filler injections have been reported following COVID-19 infection or vaccination against the virus. A 61-year-old woman visited the emergency room with swelling and redness on the entire face that started on the nasolabial area. She had received hyaluronic acid filler injections in her nasolabial area 8 months previously and had completed the primary series of vaccinations and received a booster dose of the mRNA Pfizer-BioNTech COVID-19 vaccine 1 month before the swelling episode. A corticosteroid was added to the antibiotic regimen because of the nonsignificant effect of the antibiotics. The symptoms then resolved, and corticosteroid use was tapered over the course of 2 weeks. Four months later, swelling and redness recurred on both nasolabial folds and chin, but the symptoms were more localized than before. The renewed symptoms regressed with surgical drainage and corticosteroid and antibiotic treatment. This study discusses this extremely rare case of a recurrent delayed hypersensitivity reaction to a hyaluronic acid soft-tissue filler following COVID-19 vaccination.

Although an epidermal cyst is a common cutaneous lesion that can present anywhere on the body, it is not easily found on the penis. A 64-year-old man visited Hanyang University Guri Hospital with a soft, large, subcutaneous mass on the right ventral side of the penile shaft that caused distortion. He had augmentation penoplasty 20 years ago with a dermal fat graft, but had not experienced any asymmetry or infection of the penis during the postoperative period. Three years prior the patient had observed a lump on his penis that had since grown slowly, causing distortion of the penis and sexual dysfunction. The mass was excised and diagnosed by a pathologist as an epidermal cyst. The patient was satisfied with the aesthetic result, and his sexual function gradually returned. Here, we introduce an extremely rare case of a penile epidermal cyst causing penile distortion. We suggest that the cause for its formation was incomplete de-epithelization of the graft during dermal fat grafting.