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A Review of Minor Salivary Gland Tumor (소타액선 종양의 고찰)

  • Tae Kyung;Ji Yong-Bae;Jin Bong-Jun;Lee Seung-Hwan;Lee Hyung-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.115-120
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    • 2005
  • Background and Objectives: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of minor salivary gland tumor. Materials and Methods: A retrospective analysis of the patients with 52 cases of minor salivary gland tumor who were treated at the Hanyang University Hospital from 1996 to 2003 was performed. We analyzed demography, symptoms, histopathology, treatment and outcomes by the review of medical records. Results: Among 52 cases of minor salivary gland tumor, 46% were classified as benign and 54% were classified as malignant tumors. The most common benign tumor was pleomorphic adenoma. Adenoid cystic carcinoma(15/28) was the most common in malignant tumors. Eight patients were males and sixteen patients were females in benign tumors and 10 patients were males and 18 patients were females in malignant tumors. The most common site of benign tumor was the palate(17/22), whereas malignant tumors were most common in the nasal cavity and paranasal sinus(9/28). Asymptomatic mass was the most common symptom. According to the criteria given by the AJCC on staging, stage III and IV(21/28) were more common than stage I and 11(7/28). All benign tumors were treated with simple excision and had no recurrence. In malignant tumors, 25 patients underwent radical excisional operation and 13 patients of them had postoperative radiation therapy. Three of them were treated with additional chemotherapy. In whom treated with radical operation, 9 patients had recurrence. Three were recurred at the primary site with neck node metastasis, 3 were recurred at the primary site with lung metastasis, 1 was recurred at the primary site with neck node and lung metastasis, 1 was recurred only at neck node. Conclusion: In minor salivary gland tumor, malignant was more common than benign. Malignant tumor originated from minor salivary gland were more frequently diagnosed at advanced stage with high recurrence rate and distant metastasis. Early detection of the disease is needed to improve the prognosis of the patients with malignant tumors of the minor salivary glands.

Reconstruction with Radial Forearm Free Flap after Ablative Surgery for Oral Cavity and Oropharyngeal Cancers (구강암과 구인두암의 절제술 후 전완유리피판술을 이용한 재건술)

  • Cho Kwang-Jae;Chun Byung-Jun;Sun Dong-Il;Cho Seung-Ho;Kim Mn-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.41-46
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    • 2003
  • Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

The effect of conservative neck dissection in the patients with oral cancer (구강암 환자에서 보존적 경부청소술의 효과)

  • Kim, Bang-Sin;Hur, Daniel;Kim, Kyung-Rak;Yang, Ji-Woong;Jeoung, Youn-Wook;Kook, Min-Suk;Oh, Hee-Kyun;Ryu, Sun-Youl;Park, Hong-Ju
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.490-496
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    • 2010
  • Introduction: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. Materials and Methods: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). Results: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. Conclusion: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.

THE USE OF DISTRACTION OSTEOGENESIS TO TREAT HEMIFACIAL MICROSOMIA: A CASE REPORT (반안면 왜소증 환자에서의 골신장술: 증례보고)

  • Baik, Sung-Mun;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.559-566
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    • 2007
  • Distraction osteogenesis(DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia(Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy(IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.

Evaluation of Taste in The Patients with Oral Mucosal Disease by Electrogustomter (전기미각측정기를 이용한 구강점막질환 환자의 미각평가)

  • Lee, Yong-Han;Tae, Il-Ho;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.133-145
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    • 2008
  • The purpose of this study was to investigate the taste sensitivity in patients with oral mucosal diseases(Oral lichen planus(OLP), Recurrent apthous ulcer(RAU)) using electrogustometer. One hundred and seventy three subjects were included for the study and they were categorized into 2 groups(control 100, patient 73) and patient group was investigated in the Department of Oral Medicine, Pusan National University Hospital from April, 2005 until January, 2007. Control group was investigated in the clinics at Inchen Metroplitan city and Cheongju city from February to August, 2006. The electrical taste thresholds were measured by using an electrogustometer for the 4 different sites(tongue tip, tongue lateral, circumvallate papilla and soft palate) in oral cavity. The results were as follows ; 1. The electrical taste threshold in patient group was significantly decreased than that in the control group(p<0.001). 2. The electrical taste threshold, in terms of the chronicity and lesion multiplicity, was not significantly changed in patient group. 3. The electrical taste threshold was not significantly changed in Dexan only and Dexan+Prs combination treated group. 4. The electrical taste threshold, in terms of treatment progress(no response vs half response vs complete response), was not significantly changed. However subjective index which was determined by NAS(Numerical Analogy Scale) was significantly increased in no response group but significantly decreased in complete response group(p<0.001)

A Clinical Study on the Taste Threshold of the Patients with Xerostomia (구강건조증환자의 미각역치에 관한 연구)

  • Ko, Myung-Yun;Kwon, Kyung-Min;Heo, Jun-Young;Tae, Il-Ho;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.67-73
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    • 2008
  • To investigate the change of taste sensitivity which follows after treatment for xerostomia, from September, 2006 to July, 2007, we categorized the patients, who were diagnosed as xerostomia in Oral Medicine, College of Dentistry, Busan National University, as subject group and from September, 2007 to December. The patients who were not diagnosed as systemic disease were categorized as control group. The results were as follows ; 1. Taste threshold comparison showed the differences at tongue lateral, tongue tip, circumvallate papilla between subject and control. 2. Taste threshold comparison showed no difference in male between subject and control. 3. Taste threshold comparison showed decrease in whole tongue except soft palate in female. 4. Taste threshold comparison showed no difference between first and second visit, but there was a tendency to change in circumvallate papilla.

HISTOLOGICAL AND CLINICAL STUDY OF ARTIFICIAL DERMIS IMPLANTATION FOR RESTORATION OF SOFT TISSUE DEFECTS (연조직 결손부 회복을 위한 인공진피 이식의 조직학적 및 임상적 연구)

  • Ryu, Sun-Youl;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.410-417
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    • 2006
  • The present study was aimed to compare the resorption rate and the histological change of the autogenous dermis and the artificial dermis (Terudermis$^{(R)}$) after the transplantation, and to report the clinical results of the use of Terudermis$^{(R)}$ in order to restore the soft tissue defect. Twenty mature rabbits, weighing about 2 kg, were used for the experimental study. The autogenous dermis and the Terudermis$^{(R)}$ size 1${\times}$1 cm were transplanted to the space between the external abdominal oblique muscle and the external abdominal oblique fascia of the each rabbits. They were divided into 4 groups (n=5 each) and gathered at 1, 2, 4, and 8 weeks after the transplantation. The resorption rate was calculated, and H-E stain was preformed to observe the histological changes. The chart review of the 17 patients who received Terudermis$^{(R)}$ graft to the facial soft tissue defects was conducted for the clinical study. The resorption rate at 8 weeks after the transplantation was 21.5% for the autogenous dermis, and 36.4% Terudermis$^{(R)}$. In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. The neovascularization and the progressive growth of the new fibroblast were shown in the Terudermis$^{(R)}$ graft. In clinical data of 17 patients, the size of the grafted Terudermis$^{(R)}$ was from 1.5$cm^2$ to 7.5$cm^2$ (average 3.5$cm^2$). Follow-up ranged from 5 to 25 months. Fourteen patients with cleft palate demonstrated stability of the graft and unremarkable complications. But unstability of the graft and the partial relapse were observed in three patients received the vestibuloplasty. These results indicate that Terudermis$^{(R)}$ can be available substitute of autogenous dermis because of the stability about resorption, the histocompatibility, and the unremarkable clinical complications.

ACUTE AIRWAY OBSTRUCTION IN AN INFANT WITH TREACHER COLLINS SYNDROME: REPORT OF A CASE (Treacher Collins 증후군 환아에서 급성 기도 폐색)

  • Ryu, Sun-Youl;Seo, Il-Young;Hwang, Ung;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.422-427
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    • 2004
  • Treacher Collins syndrome is inherited as an autosomal dominant trait with variable penetrance. It shows a marked variability even in the same family. This syndrome is developmental defect affecting the branchial arches. It is not usually associated with acute respiratory distress, but has symptoms of microtia, hypoplastic zygomatic bones, hypoplastic mandibular rami, and bilateral coloboma. It usually requires an emergency operation immediately after the birth. We experienced an infant with Treacher Collins syndrome who showed retrognathia, glossoptosis, microtia, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty associated with airway obstruction, and swallowing difficulty were also observed. To relieve severe upper airway obstruction caused by retrognathia and glossoptosis, we simultaneously performed tongue-lip adhesion and subperiosteal release of the floor of the mouth. The respiratory and swallowing difficulties were relieved and the tongue repositioned anteriorly. We report the present case with a review of the literature.

A CLINICAL STUDY OF PLEOMORPHIC ADENOMA IN SALIVARY GLANDS (타액선 다형성선종 환자의 임상적 연구)

  • Kim, Jong-Ryoul;Park, Bong-Wook;Byun, June-Ho;Kim, Yong-Deok;Shin, Sang-Hoon;Kim, Uk-Kyu;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.170-177
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    • 2005
  • The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.