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박영학,박해섭,전범조,조승호 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.4
Cervical necrotizing fasciitis (CNF) is an uncommon infection of the subcutaneous soft tissue and fascia. If proper treatment is delayed, the infection may cause extensive necrosis of overlying skin, extend to deeper planes and produce severe systemic ;however, the onset is often insidious in the form of nonspecific regional neck swelling, erythema and fever, rendering clinical distinction from more benign inflamatory conditions of the neck, such as cellulitis, may be impossible at an early stage. We present a series of 3 patients with CNF, each of whom had diferent clinical courses. One patient, with significant cormobidity at the time of presentation, died of CNF. (Korean J Otolaryngol 2002;45:416-21)
편도암 절제술후 전완유리피판술을 이용한 연구개 결손부 재건의 기능적 결과
김민식,선동일,박해섭,조승호,제현순,Kim, Min-Sik,Sun, Dong-Il,Park, Hae-Sup,Cho, Seung-Ho,Jai, Hyeon-Soon 대한기관식도과학회 1999 大韓氣管食道科學會誌 Vol.5 No.2
Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.