The appropriate tongue reconstruction method is critical for better functional outcomes. The aim of this study was to determine the optimal reconstructive method for restoring postoperative function based on the extent of resection. We retrospectively reviewed 43 patients with lateral oral tongue cancer who underwent glossectomy between January 2010 and October 2014. Tongue mobility, articulation, verbal diadochokinesis, speech intelligibility and swallowing outcomes were assessed 2-3 years postoperative and were analyzed according to resected tongue volume and the method of reconstruction. In partial glossectomy cases, the secondary intention group had better function in tongue mobility, articulation, and speech intelligibility (p< 0.001 for all) than the free flap reconstruction group. In contrast, in hemi-glossectomy cases, the free flap reconstruction group had better tongue mobility, articulation, verbal diadochokinesis and speech intelligibility (p < 0.05 for all) than the secondary intention group. There was no significant difference in swallowing outcome between the secondary intention and flap reconstruction groups in both partial glossectomy and hemi-glossectomy cases. In conclusion, secondary intention appears to be the most appropriate option after partial glossectomy. However, flap reconstruction is necessary to restore tongue volume and function in patients who undergo a resection of more than half of the tongue volume.
Plasmacytoma refers to malignant plasma cell tumor, which consists of abnormal proliferation of plasma cells. It can be classified into several types, multiple myeloma, solitary medullary plasmacytoma and extramedullary plasmacytoma according to clinical and histological aspects of the tumor. Multiple myeloma is the most common plasmacytoma and its main feature is the infiltration of plasma cells into the bone marrow. Over 10% of plasma cell count among the nuclear cells in the bone marrow biopsy allows diagnosis of multiple myeloma. This involves multiple organs and extramedullary sites including the spleen, liver, lymph nodes and kidney; however, the involvement of nasal cavity and paranasal sinus is rare. Recently, we experienced a case of multiple myeloma, which was present in both nasal cavities and paranasal sinuses. The case was treated with chemotherapy and radiotherapy followed by autologous bone marrow transplantation. We report on it with literature review.
Background and ObjectivesZZNeonatal hyperbilirubinemia is one of the important causative factors of sensorineural hearing loss including auditory neuropathy. The auditory brain stem response (ABR) is widely used as a screening or diagnostic tool for newborn hearing loss. This study aimed to analyze serial ABR results of newborns with severe hyperbilirubinemia. Subjects and MethodZZThis study examined 120 full term infants treated for hyperbilirubinemia in the neonatal intensive care unit. The first ABR was performed within one month after birth. Follow-up tests were conducted in patients with abnormal results (25 cases). The control group was composed of 21 healthy newborns who passed the newborn hearing screening. ResultsZZThe mean ABR threshold was higher in the newborns with hyperbilirubinemia than in the control group (43.8 dB nHL versus 30.0 dB nHL, p<0.001). Of the 25 newborns who underwent follow-up ABR, 15 newborns demonstrated recovery of the hearing threshold up to 30 dB nHL. The hearing threshold did not improve below 50 dB nHL for five newborns, of whom one was diagnosed with auditory neuropathy spectrum disorder. There was no difference in the mean ABR interwave latency between newborns with hyperbilirubinemia and the control group. ConclusionZZNeonates with hyperbilirubimenia might suffer transient or permanent hearing loss. Serial ABR tests might be essential for the diagnosis of sensorineural hearing loss in patients with neonatal hyperbilirubinemia.
Cerebrospinal fluid (CSF) rhinorrhea can be caused by head trauma, brain or sinus surgery, or neoplastic sinonasal disease. There are many diverse techniques for repairing skull base defects, and recently there has been a shift from using external approaches to endoscopic approaches. The reported success rate after endoscopic repair is 97%, but CSF rhinorrhea may recur in some cases. Recently, we witnessed one case of recurrent CSF rhinorrhea from the posterior wall of the frontal sinus after a traffic accident. The patient was a 48-year-old male and had recurrent CSF rhinorrhea, severe pneumocephalus and mental change even after a CSF leakage repair operation was performed by the neurosurgeon using the periosteal flap. We successfully treated recurrent frontal CSF rhinorrhea with fat graft and mucosal graft, using the above and below approach with the guidance of a navigation system.
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