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Background and Objectives@#Vocal fold (VF) scar is known to be the most common cause of dysphonia after laryngeal microsurgery (LMS). Steroids reduce postoperative scar formation by inhibiting inflammation and collagen deposition. However, the clinical evidence of whether steroids are helpful in reducing VF scar formation after LMS is still lacking. The purpose of this study is to determine whether intralesional VF steroid injection after LMS helps to reduce postoperative scar formation and voice quality.Materials and Method This study was conducted on 80 patients who underwent LMS for VF polyp, Reinke’s edema, and leukoplakia. Among them, 40 patients who underwent VF steroid injection after LMS were set as the injection group, and patients who had similar sex, age, and lesion size and who underwent LMS alone were set as the control group. In each group, stroboscopy, multi-dimensional voice program, Aerophone II, and voice handicap index (VHI) were performed before and 1 month after surgery, and the results were statistically analyzed. @*Results@#There were no statistically significant differences in the distribution of sex, age, symptom duration, occupation and smoking status between each group. Both groups consisted of VF polyp (n=21), Reinke’s edema (n=11), and leukoplakia (n=9). On stroboscopy, the lesion disappeared after surgery, and the amplitude and mucosal wave were symmetrical on both sides of the VFs in all patients. Acoustic parameters and VHI significantly improved after surgery in all patients. However, there was no significant difference between the injection and control group in most of the results. @*Conclusion@#There was no significant difference in the results of stroboscopy, acoustic, aerodynamic, and subjective evaluation before and after surgery in the injection group and the control group.
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Myofibrosarcoma is a rare malignant tumor originating from myofibroblasts. It is classified into low-grade, intermediate-grade, and high-grade according to the histological characteristics. High-grade myofibrosarcoma is reported very rarely worldwide, and its recurrence and metastasis are known to be more common. Myofibrosarcoma is diagnosed by histopathologic examination, and its treatment is complete surgical excision. With a review of literature, we report a case of myofibrosarcoma originating from the right masseter muscle in a 73-year-old male patient who complained of a right chin mass for 4 months. The MRI findings revealed a 4.8 cm-sized heterogeneous contrast-enhancing mass in the right masseter muscle with direct invasion into the ipsilateral medial pterygoid muscle and the mandible body. The patient was treated with margin-free surgical excision, including marginal mandibulectomy, and a highgrade myofibrosarcoma was finally diagnosed as the pathologic finding. Adjuvant radiation therapy was performed as a subsequent treatment, and no recurrence has been observed during follow-up for 1 year.
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Nasolabial cyst is a rare, non-odontogenic cyst that occurs in the submucosa of the anterior nasal floor. Its most likely origin is known to be remnants of the nasolacrimal duct. The patient usually comes to the hospital for swelling or pain in the nasolabial area, and the diagnosis is made by combining clinical features, radiologic imaging, and histological test. The most commonly used treatment is surgical excision via sublabial approach. A 40-year-old male, who had undergone maxillary orthognathic surgery for malocclusion 11 years ago, visited our hospital for pain and swelling of the nasolabial folds that had persisted for a year. A large nasolabial cyst with a size of 4.8×3.3×3.1 cm was confirmed on paranasal sinus CT, and surgical excision was performed via sublabial approach. The pathologic finding was a cyst lining consisting of ciliated pseudostratified columnal epithelium and goblet cells, consistent with the characterization of a nasolabial cyst. No recurrence was observed during follow-up for 3 months.
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Myofibroblastic sarcoma (MS) is an extremely rare form of head and neck tumor that originates from mesenchymal cells. Myofibroblasts are mesenchymal spindle cells that share the features of fibroblasts and smooth muscle cells. Radiologic examinations such as CT and MRI are useful first-line diagnostic tools for differential diagnosis. Complete surgical excision is recommended for successful treatment. MS can be classified as low, intermediate or high grade considering its histological differentiation and time course. Intermediate and high grade MS are known to be related to local recurrence or distant metastasis. With a review of literature, we report a case of MS arising from the left buccal mucosa in a 56-year-old male who complained of a painless left buccal mass. The patient was successfully treated by margin-free excision and the pathologic findings concluded as intermediate grade without any complication. There was no recurrence observed for two years since the surgery.