• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.200-202
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• 2008

Schwannoma is a benign soft tissue tumor arising from the schwann cells of the nerve sheath. Although 25 to 45% of schwannomas arise in the head and neck region, larynx is one of the rarest sites of involvement. Recently, we experienced a case of a laryngeal schwannoma causing voice change in a 53-years-old woman. Laryngeal schwannoma is located right false vocal fold with bulging, which was completely removed by microlaryngeal surgical excision. We report a rare case with a review of literature.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.22-26
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• 2015

Small cell carcinoma of larynx has been reported as a rare disease occurring in 0.5% of larynx cancer. This tumor is known as one of the most lethal of all malignancies and associated with early recurrence and distant metastasis, leading into death. We experienced a case of a 70-year old male patient, who had admitted for sore throat and dysphagia and diagnosed as small cell carcinoma of larynx. We present small cell carcinoma of larynx with a brief review of literature.

• Proceedings of the KSLP Conference
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• 1997.11a
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• pp.258-258
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• 1997

전체 성대 마비 환자의 약 10%에서 발생하는 것으로 알려진 양측 성대 마비는 안정 혹은 경미한 운동시에도 호흡 장애를 초래하는 경우라면 이에 대한 치료가 요구되는 질환이다. 이에 대한 치료 방법으로는 성문 기도를 넓히면서 흡인이 되지 않고 음성장애를 일으키지 않는데 목적을 두고 피열연골 고정술, 피열연골 절제술, CO2, 레저 피열연골 절제술, 성대 측방 고정술, 후성대 절제술, 점막하 성대 절제술, 근-신경식술 등 다양한 방법이 사용되어져 왔다. (중략)

• International journal of thyroidology
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• v.11 no.2
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• pp.130-136
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• 2018

Background and Objectives: Intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery has been employed worldwide to identify and preserve the nerve as an adjunct to visual identification. The aims of this study was to evaluate the efficacy of IONM and difficulties in the learning curve. Materials and Methods: We studied 63 patients who underwent thyroidectomy with IONM during last 2 years. The standard IONM procedure was performed using NIM 3.0 or C2 Nerve Monitoring System. Patients were divided into two chronological groups based on the success rate of IONM (33 cases in the early period and 30 cases in the late period), and the outcomes were compared between the two groups. Results: Of 63 patients, 32 underwent total thyroidectomy and 31 thyroid lobectomy. Failure of IONM occurred in 9 cases: 8 cases in the early period and 1 case in the late period. Loss of signal occurred in 8 nerves of 82 nerves at risk. The positive predictive value increased from 16.7% in the early period to 50% in the late period. The mean amplitude of the late period was higher than that of the early period (p<0.001). Conclusion: IONM in thyroid surgery is effective to preserve the RLN and to predict postoperative nerve function. However, failure of IONM and high false positive rate can occur in the learning curve, and the learning curve was about 30 cases based on the results of this study.

• The Journal of the Society of Stroke on Korean Medicine
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• v.23 no.1
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• pp.65-72
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• 2022

■Background Overall prevalence of visual field loss after stroke was estimated at 31%, ranged from 5.5- 57%. Among them, homonymous hemianopia is the most common symptom of post-stroke visual field loss and leads to a decrease in the quality of life and therapeutic effect. However, standard treatment has not been established. ■Case report A 48-year-old male with right side homonymous hemianopia by a left occipital-parietal lobe hemorrhage was treated with Qu-Ji-Du-Huang-Wan, acupuncture and electroacupuncture for 20 days. We used confrontation visual field exam, automated perimetry and visual analog scale for evaluating symptoms. Following treatment, confrontation visual field exam and the subjective discomfort was improved. ■Conclusions The present case report suggests that combined Korean medicine treatment might be an effective treatment of post-stroke homonymous hemianopia. A number of follow up studies should be conducted to clarify the effectiveness of treatment.

• The Journal of the Society of Stroke on Korean Medicine
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• v.24 no.1
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• pp.25-40
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• 2023

Background: Although not clarified, the overall prevalence of visual field loss after stroke was estimated at 52% of stroke survivors and for visual acuity loss, at 70% of them. Among visual field loss patients after stroke, homonymous hemianopia is the most common symptom. Visual defect degrades the quality of life by disrupting independent life and affecting the survival of the patients, but highly-evidenced treatment has not been found until now. ■Case report A 51-year-old female with left-side homonymous hemianopia and central vision loss by a right occipital-temporal hemorrhage was treated with Hyeolbuchukeo-tang, Ikgibohyeol-tang, acupuncture, electroacupuncture, and moxibustion. We used a confrontation visual field exam, automated perimetry and visual analog scale, and visual acuity test to observe changes in the patient's symptoms and evaluate the efficacy of the treatment. After 61 days of such interventions, the patient's subjective discomfort lessened, followed by positive changes in the scales of tests mentioned above. ■Conclusion This case suggests that combined Korean medicine treatment might be an effective tool for treating post-stroke homonymous hemianopia and central vision loss. More studies should be conducted to support the effectiveness of the treatment.

• Korean Journal of Head & Neck Oncology
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• v.22 no.1
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• pp.3-7
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• 2006

Purpose: The nonrecurrent laryngeal nerve(NRLN) is a rare anomaly that is associated with the developmentally aberrant subclavian artery. Although rare on the right side and exceptional on the left, an aberrant nonrecurrent pathway for RLN represents a major surgical risk. Three course variations of right NRLN can be distinguished: descending(type I) , horizontal(type II), ascending(type III). This study is performed to characterize the variations of NRLN, associated vascular anomaly, and proper surgical methods for preventing nerve damage. Materials and Methods: Between January 1998 and March 2006 3,381 thyroidectomy were performed at our institution, and during these operations a nonrecurrent laryngeal nerve was observed in 13 cases (0.38%). There were 1 men and 12 women with a median age of 48 years(range 28-57). All of them are identified on the right side. Results: In all cases, there were no clinical symptoms observed preoperatively. The nerve anomaly was diagnosed preoperatively in only one case. There were type I variations of right RLN in 2 cases and type II variations in 11 cases. The retroesophageal aberrant right subcalvian artery; no innominate(brachiocephalic) artery was found and the right common carotic artery was arising directly from the aortic arch, was seen in 12 cases. A vocal cord palaysis caused by NRLN damage during operation was observed in one patient(7.6%) , where the nerve was close to the superior thyroid artery. No other complications were noted. Conclusion: It can be possible to predict NRLN from signs associated with the vascular anomaly; clinical symptoms or imaging studies. When an vascular anomaly is not detected preoperatively, overlooking possibility of NRLN may lead to severe operative morbidity. Hence, It is most important to identify all the thyroid structures carefully during thyroid surgery and to be aware of the possibility of anatomic variations of RLN.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.9-14
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• 2020

Visual identification of recurrent laryngeal nerve (RLN) is considered as a gold standard of RLN preservation during thyroid surgery. Intraoperative neuromonitoring (IONM) is classified into the intermittent type and continuous type and helps surgeons identify the functional integrity of RLN and predict the postoperative vocal cord function. RLN injury during thyroid surgery is associated with tumor factors and surgeon factors. Tumor factors mean such as direct tumor invasion, adhesion of RLN to the tumor, and compression by a large thyroid tumor. Surgeon factors include nerve transection, stretching, thermal injury, and ligation injury. A recent meta-analysis reported that the IONM could reduce the RLN injury. Considering various nerve injury mechanism, we suggest that using both I-ONM and C-IONM together is more effective method in preventing nerve damage than using I-IONM alone.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.236-243
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• 1998

Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with $Gortex^{\circledR}$ tube reconstruction for carotid artery invasion, and so on. Conclusions: These data and review of literature suggest that the surgical method should be perfomed on the basis of individual condition and complete removal of all gross tumor with preservation of vital structures whenever possible will offer a good result.

• Korean Journal of Ichthyology
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• v.10 no.2
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• pp.231-240
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• 1998

The characteristics of cranium, vertebral column and fin supports of Acanthorhodeus gracilis were examined. The fish did not have a fontanell in cranium nor process of supraethmoid. It had double orbitosphenoids and a basioccipital process developed from anterior portion of basioccipital. It had a high and triangular dorsal process on supraoccipital. In the urohyal, hypohyal attachment was bifurcated and horizontal and vertical plate were in an elongated rhombus shape with posterior edge pointed. It had teeth of 1-rowed, 5/5 and 4 free teeth. The fish did not have a coracoid foramen on shoulder girdle. It does not have a uroneural on ural centrum. It had a long and slender posterior process of pelvic bone. It had a large and flat supraneural. The fish had 14 or 15 interneural spines, of which the 1st, 2nd, 3rd and 4th had single basiosts and the rest had double basiosts. It had 11 or 12 interhemal spines, of which the 1st, 2nd, 3rd and 4th had single basiosts and the rest had double basiosts.