• Title/Summary/Keyword: 후두개

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Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results (후두암의 방사선치료 Patterns of Care Study를 위한 프로그램 항목 개발: 예비 결과)

  • Chung Woong-Ki;Kim I1-Han;Ahn Sung-Ja;Nam Taek-Keun;Oh Yoon-Kyeong;Song Ju-Young;Nah Byung-Sik;Chung Gyung-Ai;Kwon Hyoung-Cheol;Kim Jung-Soo;Kim Soo-Kon;Kang Jeong-Ku
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.299-305
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    • 2003
  • Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

요전완유리피판을 이용한 연구개 결손부 재건후 기능평가

  • 박해섭;김민식;선동일;유우정;김형태;박영학;조승호
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.188-188
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    • 1998
  • 구강후부암은 흔히 연구개, 설근부 등을 침범하여 연구개의 절제가 동반되고 이에 따른 발성, 연하 등에 장애를 남기게 된다. 이의 재건을 위해 다양한 피판술이 고안되고 있으며 그 중 요전완유리피판은 피판이 얇고 유연하여 입체적 형태의 재건이 용이하며 감각신경을 포함하여 재건할 수 있고 장장근인대를 포함시킬 경우 연구개의 역동적인 기능까지 재건할 수 있는 등의 장점으로 최근 많이 이용되고 있다. (중략)

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The indication of neck dissection in treatment of the supraglottic carcinoma (성문상부암 치료에 있어 경부곽청술의 적응)

  • 이병주;백무진;왕수건;전경명
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.106-106
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    • 1993
  • Cancer of the larynx is the most common malignant neoplasm of head and neck and has a generally favorable prognosis. But its incidences of lymph node metastasis and recurrence depend on the primary site of lesion. Especially, supraglottic carcinoma tends to involve the cervical lymph node with easy. We have analyzed retrospectively 49 cases of supraglottic carcinoma treated surgically with or without radiotherapy from March 1986 to February 1992 at the department of otolaryngology, Pusan National University Hospital to find out the incidence of ipsilateral and contralateral lymph node metastasis and to establish the indication of neck dissection followed by T stage. The incidence to the ispilateral and contralateral cervical lymph node metastasis in patients with lateral (aryepiglottic fold) lesions is higher than that in those with midline (epiglottis) lesion. And average incidence of isplateral lymph node metastasis was 51.0% regardless of T stage. Therefore routine neck dissection should be considered in surgical treatment of supraglottic carcinoma, especially, over T2 stage.

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The evaluation of risk for aspiration using lipid-laden macrophage index in infants with bronchiolitis (지질함유 대식세포 지표(lipid-laden macrophage index)를 이용한 세기관지염 환아에서 흡인의 위험성 평가)

  • Koh, Ji Yeon;Kang, Hee;Chung, Ju Young;Han, Tae Hee;Kim, Chang Keun
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.763-768
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    • 2006
  • Purpose : We investigated the risk of aspiration using the lipid-laden macrophage index(LLMI) from laryngeal lavages in infants with bronchiolitis. Methods : Laryngeal lavages from 22 infants with acute bronchiolitis caused by respiratory syncytial virus(RSV) were evaluated during the acute stage. Repeat studies were performed at 3 to 4 weeks after the initial study(remission stage). Lavage cell counts and differentials were determined. The amount of lipid per single macrophage was evaluated and the LLMI was determined by evaluating 100 cells. Comparisons between acute stage and remission stage were made. Twenty-four hour pH monitoring(pHm) was performed in 12 patients. Results : The total cell number was significantly higher in the acute stage compared with the remission stage(P<0.05). The LLMIs in the acute stage were significantly higher than those in the remission stage(P<0.05). The neutrophils percentage of laryngeal lavage correlated with the LLMI(r=0.69, P<0.001). Four children had positive pHm recordings(pH-positive infants) and eight had negative pHm recordings(pH-negative infants). The pH-positive infants had higher LLMI and higher neutrophils percentage than those of the pH-negative infants(P<0.05). Conclusion : These findings suggest that there is a transient increased risk of aspiration during bronchiolitis. The LLMI from laryngeal lavage may be a useful marker for pulmonary aspiration in infants with bronchiolitis.

Prevalence of Laryngo-pharyngeal Reflux(LPR) Related Symptoms at the Out Patient Department in Korea : One Week Survey (우리나라 이비인후과 외래환자의 인.후두 역류증상 발병빈도 조사(One Week Survey 결과))

  • Choi, Hong-Sik;Kim, Hyung-Tae;Seo, Jang-Soo;Wang, Soo-Gun;Cho, Jae-Sik;Choi, Gun;Hong, Ki-Hwan;Kim, Seok-Il;Lee, Won-Chul
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.87-97
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    • 2000
  • One week survey to investigate the prevalence rate and clinical characteristics of laryngopharyngeal reflux symptoms in Korea. The subject(n=7,704 patients) was newly enrolled patients at the out patient clinic in 90 ENT departments of resident training hospitals and 11 local clinics, which were voluntarily participated in the study 1) Twenty five percent of all enrolled patients has LPR-related symptoms or clinical findings from the examination by ENT specialists. 2) Among e name of LPR-related diagnosis, globus syndrome was e most common, and follows by reflux laryngitis, and chronic laryngitis. 3) Women was more prevalent than men, and it is common in 5th, 6th, and 7th decades, which seems to be related with aging process. 4) Most popular symtoms of LPR. were globus sensation, conic throat clearing, and hoarseness of unknown origin. 5) Aggravating factors of LPR-related symptoms were tiredness, mental stress, drink alcohol, cigarettes smoking, spicy food, and drinking coffee. 6) LPR-related symptoms were more common in professional voice users. 7) In past medical history, diseases of stomach and tonsillitis were most common.

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Laryngeal Transplantation in the Canine by End-to-end Anastomosis of the Recurrent Laryngeal Nerve Branches (반회신경분지의 단단문합에 의한 개의 후두이식)

  • 최홍식;김영호;조정일;김세헌;김상균;김광문;홍원표
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.9 no.1
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    • pp.59-65
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    • 1998
  • Instead of brilliant advancement of the organ transplantation in the medical fields, laryngeal transplantation still has couple of problems to be solved before trial on human. Among them functional restoration of the implanted larynx is the most important point. Recent advancement in animal model studies showed possibility of solving the main problem. Eighteen cases of canine laryngeal transplantation in mongrel dogs were done in this department. One cranial artery and two external jugular veins were connected. External and internal branches of the superior layngeal nerve and anterior and posterior branches of the recurrent laryngeal nerve were connected individually. Only two dogs have lived longer than 4 weeks(4weeks, and 10 1/2weeks) and they died unfortunately due to asphixia caused by obstruction of the cannula. Thirteen dogs only lived five days through 15 days. The main causes of the failure were obstruction of the connecting vein, pharyngocutaneous fistula and the wound infection. Although the result was not good enough to evaluate the functional restoration of the implanted larynx, the implanted larynges from the two dogs lived longer than minimum criteria of long term survival(4 weeks) were relatively good in shape at the time of autopsy. This program will be continued after renovation of the animal lab. facilities.

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Morphological and Functional Outcomes after Vertical Hemilaryngeal Transplantation in the Canine (개에서 후두수직절반 이식 후 형태 및 기능에 대한 연구)

  • 김영찬;최홍식;정유삼;양해동;김태만;강성석;정형진;조성우;이성민
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.2
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    • pp.102-118
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    • 1999
  • In this study, the author developed a new animal model to examine morphological changes and functional recoveries after vertical hemilaryngeal transplantation in the canine. Seven vertical hemilaryngeal transplantations were carried out in the canine. After preparing the host dog removing right sided hemilarynx, hemilarynx of the donor dog was transplanted by hooking up the arteries, veins, nerves and hypopharyngeal mucosa. Especially, recurrent laryngeal nerve was anastomosed at the branch level(anterior and posterior) respectively. After 7 days, for the first evaluation of the transplantation, four out of seven dogs were considered successful. Three dogs survived more than one month, which is the critical period to evaluate the functional recovery after transplantations. After EMG examination, two dogs(#3, #5 dog) showed some functional recoveries. The five-transplanted hemilarynges were sectioned at the arytenoid cartilage region to examine the morphological changes. The results showed that the transplanted hemilarynx appeared normal as control in #5 dog. In addition, #2 dog showed fairly good condition even though died from asphyxia after 9 days out of transplantation. The other. three dogs(#3, #6, #7) showed various levels of atrophy and disappearance of the muscles and cartilages in their larynges. It can be suggested that this model could contribute an advance to preparing human laryngeal transplantation in the future.

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Treatment of an Occipital Fracture by Esquillectomy (골편적출술을 적용한 후두골 골절 치료)

  • Park, Jin-Uk;Cho, Ki-Rae;Chang, Dong-Woo;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.450-452
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    • 2010
  • A 4-year-old male Yorkshire terrier was referred to us with signs of vomiting and unconsciousness due to a blunt head trauma. Gross examinations detected facial edema, subcutaneous hemorrhage and hypersalivation. A survey radiograph located an occipital fragment which was displaced caudally. A three-dimensional computed tomographic reconstruction demonstrated that the ventral portion of the fragment was attached incompletely. Because of the instability of the fragment, it was decided to perform an esquillectomy. After removing the fragment, the defect was reinforced with a muscular flap originating from the splenius muscle. The patient's condition gradually improved except for a slightly ataxic gait. At 20 months follow-up, there was no evidence of ataxia. The neurological status did not deteriorate before starting surgical intervention, although the patient sustained a skull fracture with severe intracranial hemorrhage. It is likely that the fragment being displaced outwardly played an important role in preventing an increase in intracranial pressure which could have led to neurological deterioration.