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Background and Objectives The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords.Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed.Results Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3–6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification.Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

Introduction: Pulmonary metastatic head and neck cancer has a poor prognosis. Pulmonary metastasectomy has been performed but only in carefully selected patients. The aim of this study was to examine the clinical characteristics and oncological follow-up of patients who underwent pulmonary metastasectomy. Methods: Data of 54 patients with squamous-cell carcinoma (SCC) or adenoid cystic carcinoma (ACC) who underwent metastasectomy between 2003 and 2019 at two tertiary referral centers were retrospectively reviewed. Results: The 3-year and 5-year disease-free survival rates after metastasectomy were 49.9% and 39.9% for SCC and 38.9% and 32.4% for ACC, respectively. Univariate analysis revealed that a disease-free interval (DFI) less than 14 months and R1 resection (hazard ratio [HR] [95% confidence interval]: 2.95 [0.77–5.62], 4.64 [0.99–21.65], respectively) were risk factors for recurrence in SCC and that a high T stage (HR: 5.24 [1.22–22.58]) was a risk factor in ACC. In SCC, a DFI less than 14 months and R1 resection (hazard ratio: 6.35 [1.36–29.54], 12.79 [1.53–106.95], respectively) were risk factors in a multivariate analysis. Conclusion: Pulmonary metastasectomy had a fair effect on head and neck SCC and ACC, and the prognosis was better in SCC patients with a DFI greater than 14 months.

BACKGROUND We evaluated the outcome of esophageal reconstructions using tissue-engineered scaffolds. METHOD Partial esophageal defects were reconstructed with the following scaffolds; animals were grouped (n = 7 per group) as follows: (a) normal rats; (b) rats implanted with three-dimensional printing (3DP) polycaprolactone (PCL) scaffolds; (c) with human adipose-derived mesenchymal stem cell (ADSC)-seeded 3DP PCL scaffolds; (d) with polyurethane (PU)-nanofiber(Nf) scaffolds; and (e) with ADSC-seeded PU-Nf scaffolds. RESULTS The esophageal defects were successfully repaired; however, muscle regeneration was greater in the 3DP PCL + ADSC groups than in the PU-Nf + ADSC groups (P

Unexpected parotid cancers are often encountered due to inaccuracies in the preoperative evaluation. This study aimed to examine the clinical characteristics and oncological outcomes of these cancers and to propose the appropriate management strategy. This is a multicenter case series study in which a total of 302 patients were diagnosed postoperatively with parotid cancers between 2003 and 2017. Of these, 85 cases without evidence of malignancy prior to surgery but identified as malignant on postoperative pathology were included. Of 85 patients, 76 and 9 underwent superficial and total parotidectomy, respectively. A positive resection margin was present in 24.7% of the cases. Postoperative radiotherapy was administered to 43.6% of patients; 4.2% had a local recurrence, and no patients died of the disease. The 5-year overall and relapse-free survival rates were 100.0% and 95.2%, respectively. Patients who underwent piecemeal resection had significantly poorer oncologic outcomes. Age, sex, histologic grade, T stage, extracapsular extension, resection margin status, and postoperative radiotherapy did not affect recurrence and survival. Preoperatively unexpected parotid cancers had excellent local control and overall survival despite positive or close resection margin, with or without postoperative radiotherapy. Therefore, patients with unexpected parotid malignancies may benefit from less aggressive postoperative management option.

Background: Immunoediting theory, which explains the balance between the host immunity and cancer cells, could suggest a new way to reduce the recurrence of cancer. This study aimed to compare changes in immune cells in tumor-free lymph node and peripheral blood according to their malignancy, disease status, and prognosis. Methods: From October 2016 to August 2017, 26 malignant and 14 benign cases were enrolled, and the tumor-free lymph node and peripheral blood were harvested during the surgery. The proportions of cluster of differentiation 4 (CD4), CD8, CD19, CD33, CD40, and CD40 ligand (CD40L) expression and cytokine levels in the serum were compared between the malignant and benign patients. Furthermore, among the malignant group, the changes occurring due to the disease progression or recurrence were evaluated. Results: In the malignant patients, a significantly decreased proportion of cells expressing CD8 and CD40 in the peripheral blood was observed compared to benign patients. In the advanced stage (stage III or IV) and in patients with extracapsular spread, significant decrease in CD33 cells in tumor-free lymph nodes could be observed. On performing a survival analysis based on the recurrence, patients with interferon-γ (IFNγ) level greater than 16 pg/mL exhibited significantly higher recurrence rate, and this higher level of IFNγ was associated with distant metastasis. Conclusions: Immune markers exhibiting clinical significance differ from each other based on the comparison between benign and malignant groups, between advanced and early cancer, and between recurrence and nonrecurrence. And this result suggests that research in the immune system is likely to have an important effect on future treatment.

Nasal deformities due to trauma are more challenging to correct with rhinoplasty than nasal deformities of nontraumatic causes. Nasal osteotomy is an essential procedure for bone deviations. Preoperative planning is vital in these cases, but it is challenging to comprehend 3-dimensional (3D) structures of the nasal bone on 2-dimensional facial photographs and computed tomography images. We used a 3D-printing technique to fabricate real-size facial bone models with similar physical properties and texture as the actual bone. Furthermore, we established a precise surgical plan using simulated osteotomy on the 3D-printed model. Fused deposition modeling-type desktop 3D printer with polylactic acid filaments was used. A surgical plan was established using simulated osteotomy in 11 cases, and the actual surgery was performed as planned in 10 cases (90.9%). The 3D-printed model and stimulated osteotomy were useful for precise planning of osteotomy to correct nasal deformities due to trauma.

Unexpected parotid cancers are often encountered due to inaccuracies in the preoperative evaluation. This study aimed to examine the clinical characteristics and oncological outcomes of these cancers and to propose the appropriate management strategy.This is a multicenter case series study in which a total of 302 patients were diagnosed postoperatively with parotid cancers between 2003 and 2017. Of these, 85 cases without evidence of malignancy prior to surgery but identified as malignant on postoperative pathology were included.Of 85 patients, 76 and 9 underwent superficial and total parotidectomy, respectively. A positive resection margin was present in 24.7% of the cases. Postoperative radiotherapy was administered to 43.6% of patients; 4.2% had a local recurrence, and no patients died of the disease. The 5-year overall and relapse-free survival rates were 100.0% and 95.2%, respectively. Patients who underwent piecemeal resection had significantly poorer oncologic outcomes. Age, sex, histologic grade, T stage, extracapsular extension, resection margin status, and postoperative radiotherapy did not affect recurrence and survival.Preoperatively unexpected parotid cancers had excellent local control and overall survival despite positive or close resection margin, with or without postoperative radiotherapy. Therefore, patients with unexpected parotid malignancies may benefit from less aggressive postoperative management option.

AIMS: The purpose of this study is to compare the test-retest reliability of cervical vestibular evoked myogenic potential (cVEMP) parameters between monaural sequential (mSEQ) cVEMP and binaural simultaneous (bSIM) cVEMP recordings. MATERIALS AND METHODS: Twenty two volunteers aged 22 from 38 years were enrolled. Two different methods of cVEMP measurement were performed in the subjects. The two methods were (1) monaural sequential (mSEQ) measurement and (2) binaural simultaneous (bSIM) measurement. After a mean test-retest interval of 7.1 ± 2.8 days, the second run of the cVEMP measurement was performed in a random order. To compare the test-retest reliability of mSEQ and bSIM cVEMP responses, Intraclass correlation coefficient (ICC) and Spearman correlation were applied. RESULTS: Both p13 and n23 latencies did not show a statistically significant difference between the two cVEMP recording methods. Also, there were no significant differences in the inter-peak amplitude (IPA) and interaural amplitude difference (IAD) ratio between the two methods. The test-retest reliability of inter-peak amplitude (IPA) demonstrated a positive correlation for both mSEQ and bSIM cVEMP methods. The IAD ratio of bSIM cVEMP response demonstrated a statistically significant testretest reliability (ICC = 0.691, p = 0.015). However, the IAD ratio of mSEQ cVEMP response did not demonstrate a statistically significant test-retest correlation. CONCLUSION: Results implicate that bSIM cVEMP not only saves time, but it also has an advantage of a more reliable test-retest outcome.

We reported that the degree of conductive hearing loss resulting from a tympanic membrane (TM) perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid, not location of perforation. This result was conflicted with previous study that revealed the influence of location of TM perforation on the severity of hearing loss in 1970 [1].

In the article titled "Determinants of Conductive Hearing Loss in Tympanic Membrane Perforation," published in the June 2015 issue of Clinics in Experimental Otorhinolaryngology (2015;8:92-96; http://dx.doi.org/10.3342/ceo.2015.8.2.92), an error occurred in the byline. The sixth author's name should have been given as Myung-Whan Suh.

Received July 3, 2013 Revised September 12, 2013 Accepted September 13, 2013 Address for correspondence Seung-Ha Oh, MD, PhD Department of Otorhinolaryngology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea Tel +82-2-2072-3649 Fax +82-2-745-2387 E-mail shaoh@snu.ac.kr Background and ObjectivesZZEosinophilic otitis media (EOM) is characterized by the presence of a highly viscous effusion containing eosinophils. It mainly occurs in patients with bronchial asthma, nasal polyps and is resistant to conventional treatments for otitis media. In these patients, steroid is very effective in controlling the disease. However, the major complication is sensorineural hearing loss, especially at high frequencies, which may occur despite steroid therapy. Subjects and MethodZZHere we report 10 cases of EOM at Seoul National University Hospital. Clinical courses and characteristics of the patients were analyzed. We compared the hearing deterioration and other clinical variables between EOM patients and age-matched non-EOM chronic otitis media patients. ResultsZZAll cases had viscous effusion and 9 cases were associated with asthma and nasal polyps. All patients had a decreased hearing in high frequency range compared to the age matched controls. The average bone conduction threshold difference at 2 kHz, 4 kHz was 22.4 dB HL and 42.5 dB HL, respectively. Among the patients, one showed profound sensorineural hearing loss bilaterally after the onset of EOM and received cochlear implantation. The open set sentence score was 82% 6 months after cochlear implantation. Most of the cases were resistant to conventional treatments for otitis media, such as administration of antibiotic agents, ventilation tube insertion or mastoidectomy. However, cases that were given steroid treatment had improvement in ear symptoms. ConclusionZZSince EOM patients show deterioration of hearing, it is important to properly diagnose EOM, start adequate treatment and explain to patients that the disease may last for a long period and progressive hearing loss may occur. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:692-9

Background and ObjectivesZZThe objective of this study was to determine whether the serum levels of zinc, vitamin B12, folic acid, iron, and fungus were correlated with symptoms of burning mouth syndrome (BMS) and to analyze the relationship between treatment responses and the results from serum examination. Subjects and MethodZZWe analyzed data from 284 patients whose serum examination results recorded responses to treatment were available from June 2004 to November 2011. A total of 219 patients experienced burning sensation, while 65 patients experienced only globus symptoms or voice changes. ResultsZZOf the patients who experienced burning sensations, 5 (2.3%) had vitamin B12 defi ciency, 23 (10.5%) had iron deficiency, 40 (24%) had zinc deficiency, but no patients had folic acid concentrations below the reference range. A total of 44 patients (25%) were fungus-positive. The comparison of the experimental and control treatment groups revealed that iron-deficient patients and fungal-positive patients were more frequently found in the experimental group (p= 0.023 and p=0.010, respectively). Abnormalities in the serum or physical examinations were observed in 126 patients (57.5%). Symptomatic treatments were performed for both groups, which corrected abnormalities in serum examinations. ConclusionZZThe rates of fungus positivity and iron deficiency were higher in the BMS group. However, we did not identify a correlation between the response to treatment and serum examination of the analyzed elements or fungus examination. The total secondary oral burning rate was found to affect treatment modality. � Korean J Otorhinolaryngol-Head Neck Surg 2013;56:23-7 Key WordsZZBurning mouth syndrome ㆍFungus ㆍSerum concentration.