• Proceedings of the KOR-BRONCHOESO Conference
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• 2005.04a
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• pp.22.2-23
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• 2005

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.36-41
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• 2009

Background and Objectives: Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic. Methods: We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated. Results: Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III. Conclusion : Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.59-62
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• 2002

We present a case of nasopharyngeal stenosis which developed after adenotonsillectomy. A 11-year-old boy underwent adenotonsillectomy because of snoring at a local clinic using a $CO_2$ LASER. After the operation, he cannot breathe via nose due to severe cicatrical nasopharyngeal stenosis. Nasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with adenotonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix. Presenting symptoms range from mild hyponasal speech to severe airway obstruction. We treated the patient with velopharyngoplasty using two separate rotational mucosal flaps.

• Proceedings of the KSLP Conference
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• 1993.12a
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• pp.21-21
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• 1993

발성장애와 호흡곤란을 주소로 하는 성대 전연부 격막은 후두병변의 부적절한 치료, 만성염증 또는 외상 등의 후천적인 원인으로 발생하는 경우가 많다. 성문중 가장 협소한 부위인 전연부에 발생한 격막에 대하여는 여러 가지 다양한 치료방법이 보고되고 있지만, 재협착의 가능성이 높고, 치료후 반흔 조직에 의하여 음성의 질을 높이는데 한계점이 있다. (중략)

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.27-27
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• 1991

저자들은 후두전적출술을 시행한 환자의 음성재활을 위해 식도의 근육과 점막을 이용한 shunt를 만들고 이상적인 shunt의 기능을 위해 shunt의 길이, 직경, 적절한 괄약효과 보강, 음성훈련 요령등에 대해 개 5마리를 이용한 동물실험 및 5례의 임상 적용을 통해 다음과 같은 지식을 얻었기에 문헌 고찰과 아울러 보고하는 바이다. 1. shunt의 협착에 대한 문제는 없었다. 2. 식도측의 입구를 좁혀 줌으로서 기관으로의 흡인을 방지할 수 있었다. 3. Nelaton catheter는 72시간 삽입이 적당했다. 4. 음성훈련은 3주부터 시작함이 적당했다. 5. shunt의 길이는 3 cm가 적당했다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.122-125
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• 2016

Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1995.04a
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• pp.90.1-90
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• 1995

저자들은 최근 4년간 11례에서 기관절제 및 단단문합술을 사용하였기에 그 치료 결과를 살펴보고 치료적용의 범위를 넓혀보고자 한다. 대상은 후두-기관협착증 2례, 기관협착증 8례, 갑상선암 1례로 총 11례였으며 이중 3례에서 기관-식도누공이 동반되어 있었다. 술후 발거가 가능했던 경우는 8례였으며 발거가 불가능했던 경우는 술전에 이미 양측성대마비가 있던 경우 l례, 문합부위 아래에 새로운 협착 부위가 생겼던 1례, 기관 연골의 과도한 결손이 있었던 경우가 1례 있었다. 합병증으로 창상감염 1례, 육아조직 3례의 경우는 치료되었으며 양측성대마비가 있던 경우는 편측성대절제를 하여 관찰 중이다. 이상의 결과를 볼 때 기관절제 및 단단문합술이 실패한 경우는 2례로 술전 동반질환의 정확한 검사 및 절제부위의 국소화, 수술시 문합부위의 장력을 최소화하여 시행한다면 합병증은 비교적 받아들일만 하며 비교적 성공율도 기대할 만한 술식으로 여겨졌다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.2-14
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• 1983

Complications and sequelae of the laryngeal trauma are respiratory difficulties, edema or swelling, cellulitis or abscess, fistula, perichondrium and chondritis, chronic laryngeal stenosis, vocal cord paralysis, decannulation difficulty, and impaired voice production etc. Generally, the treatment of laryngeal injuries consists of initial tracheostomy for adequate airway and later surgical intervention for its complications and sequelae. Recently, authors experienced a case of closed laryngeal injury with thyroid cartilage fracture, left vocal cord paralysis, swallowing difficulty and right clavicular fracture owing to automobile accident. With reconstructive surgery for thyroid cartilage fracture, we established an adequate airway, improved swallowing function and better voice production.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2007.05a
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• pp.55-55
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• 2007

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.9.2-9
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• 1981

Now we are encountering with a growing number of severe head and neck injuries owing to automobile accidents, violence, and industrial injuries etc. In these circumstances, emergency tracheostomy and neurosurgical treatment are frequently necessary. When cervical trauma was ignored at initial stage, significant complications and sequelae may follow. So it deserves attention that meticulous and thoughtful treatments should be given to the cervical injuries as well as head injuries. We have recently experienced a case of laryngeal stenosis resulted from head and neck trauma. The patient was a 20-year-old male who underwent craniectomy and tracheostomy at another hospital about one and a half years prior to admission. With multistaged operations, we were able to re-establish an adequate natural air way.