• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.279-284
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• 2006

A multiple primary malignant tumor is a disease mainly encountered in the of the older age groups. Attempts should be made to rule out a second primary malignant neoplasm in the elderly patients with unusual signs and symptoms. We encountered a case of a 67-year-old male with triple primary malignant tumors of the stomach, larynx, and lung. The patient had been treated with a subtotal gastrectomy for early gastric cancer in 1991 and a Laser laryngectomy for the laryngeal squamous cell carcinoma in 2003. In 2005, lung cancer was found with the biopsy revealing an adenosquamous carcinoma. Systemic chemotherapy was performed.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.19-23
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• 2004

Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

• Korean Journal of Head & Neck Oncology
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• v.28 no.2
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• pp.118-121
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• 2012

Backgrounds : To evaluated the use of FDG PET/CT for the identification of extracapsular spread(ECS) with histologic correlation in laryngeal cancer. Methods : We reviewed 79 medical records of patients who underwent of FDG PET/CT for laryngeal cancer before surgery. Results : ECS was present in 41.9%(18/43) dissected necks and in 34.5%(20/58) dissected cervical levels. There was a significant difference in the SUVmax between cervical lymph nodes with ECS and without ECS($6.39{\pm}4.53$ vs. $1.19{\pm}1.64$, p<0.001). The cut-off value for the SUVmax for differentiating with ECS from without ECS was 2.8 with the sensitivity of 85.7% and the specificity of 85.6%. Conclusion : The median SUVmax cut-off values of FDG PET/CT higher than 2.8 was associated with greater risk cervical lymph node metastasis with ECS in patients with laryngeal cancer.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.201-205
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• 1996

Early detection of glottic cancer, facilitated by rigid telescopes or flexible fiberoptic laryngoscope in addition to sparse true vocal cord lymphatics, makes this a highly curable tumor in its early stage. Early glottic cancer has a high cure rate with only radiotherapy or conservative surgery. However complications such as mucositis with radiotherapy and voice complications with conservative surgery has raised recent interest in endolaryngeal laser cordectomy. Laser cordectomy can preserve phonatory function and avoid the complications such as mucositis of radiotherapy. To determine the effectiveness of laser cordectomy, the authors made a two year retrospective study of 23 early glottic cancer cases. Fourteen cases(60.9%) who underwent 1 to 3 endoscopic laser cordectomy with KTP-532 laser were cured with this procedure alone. Seven cases needed an additional radiotherapy and three cases needed therapy with salvage operation. We conclude that the endoscopic laser surgery is a good strategy for the properly selected glottic cancer.

• Korean Journal of Head & Neck Oncology
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• v.3 no.1
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• pp.65-70
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• 1987

하인두암은 거의 대부분 이상동(Pyriform Sinus) 에서 발생하며 상당한 정도 진행 시까지 별다른 증상을 나타내지 않는다. 저자들은 1966년부터 1985년까지 만 20년간 하인두에서 발생된 암환자 63명을 중심으로 임상 관찰 및 문헌고찰과 함께 발표하는바이다. 원발병소로는 전체 중 58명에서 이상동, 하인두벽(hypopharyngeal wall) 3명, Postcricoid hypopharynx 와 pharyngopalatine fold 에서 각각 1명씩의 발생빈도를 보였다. 저자들은 설저(base of tongue)암, supraglottic Ca. 및 경부 식도(cervical esophagus)암 경우는 모두 제외시켰다. 임상증상으로서는 경부 종괴(lump)가 33 예로써 가장 현저했으며 또한 첫증상으로써 연하곤란(dysphagia) 또는 sore throat를 나타낸 경우는 32 예 이었다. 그 외에 hoarseness 가 20 예, bloody sputum 4 례 및 호흡곤란 2 예의 순이었다. 내원까지의 증상기간은 대부분 $4{\sim}6$ 개월 이었다. 흡연관계는 1일 1값 이상의 중등도 흡연 경우는 전체의 58% 이었으며 흡연 사실이 있었던 경우는 전체의 88% 이었다. 연령별 발생빈도는 50대$\sim$60대에서 48명으로서 현저히 높았다. 완치 목적의 수술적 치료는 24명에서 시행하였으며 치료 거절은 16명이었다. 치료 거절하였던 환자들 중 81% 가 임상적 제 4 병기였으며 보조적 치료 요법을 실시한 환자들의 78% 에서 제 4 병기였다. 또한 완치 목적의 치료 실시 경우의 67% 에서 제 4 병기였다. 수술요법은 일반적으로 "후두 인두 적출술 및 양측 경정맥 임파군 곽청술"(laryngopharyngectomy with bilateral jugular dissection) 또는 후두 인두 적출술 및 동측의 표준 광범위 경부 곽청술(standard radical neck dissection) 과 반대측의 경정맥 임파군 곽청술을 시행하였다. 3 년 이내와 3 년 이상무병 상태(free of disease) 경우가 각각 4명씩이었다. 마지막 예후 추적 조사시까지 무병 상태였던 환자를 포함하여 예후 추적 조사기간 중 추적 실패 경우는 7명이었다. 확정된 3 년 생존율(determinate 3-year survival rate) 은 31% 이었다. 수술 사망이 1명 있었으며 재발경우는 9 명이었다. 재발부위로는 원발병소 재발이 7명, 경부 재발 1명 및 원격전이가 1명 이었으며, 저자들은 이에 대한 실패 원인을 규명코져 하였다.

• Korean Journal of Head & Neck Oncology
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• v.30 no.2
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• pp.39-42
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• 2014

Background and Objectives : Pharyngocutaneous fistula is the most common complication after total laryngectomy. The objective of this study was to determine the incidence of pharyngocutaneous fistula after total laryngectomy in patients operated on in our department and to establish whether specific factors predispose to fistula formation. Materials and Methods : For 10 years(2003-2014), 49 cases of patients who were diagnosed with laryngeal cancer and underwent total laryngectomy in our department. Patients who underwent radiotherapy before the surgery was 24 cases(48.9%) of all total laryngectomy patients. And those who were needed flap reconstruction because of extensive tumor involvement to hypopharynx were also 24 cases(48.9%), whereas primary closure were performed in 25 cases(51%). Results : The postoperative pharyngocutaneous fistula was found in 12 of the 49 patients(24.5%). The radiotherapy before surgery was a statistically significant factor that increase the incidence of postoperative fistulas(p=0.037). Large extent of surgery including flap reconstruction was almost statistically significant factor of raising postoperative fistula rates(p=0.051). Conclusion : According to this study, the presence of postoperative fistula seems to be influenced by previous radiotherapy and the extent of surgery. These could be the risk factors of pharyngocutaneous fistula after total laryngectomy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.56-59
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• 2011

Inflammatory pseudotumor is characterized by the presence of a mass that may mimic malignancy and is composed of spindle cells mixed with variable amounts of extracellular collagen, lymphocytes, and plasma cells It is benign tumor commonly involves lung and orbit and rarely that occurs in the head and neck The cause and pathogenesis of inflammatory pseudotumor still remain controversial. Some bacterial infection or chronic irritation may have prompted some speculation that an initially reactive process can change into an overt neoplastic disease. It tends to affect children and young adults than old ages. We present a case of inflammatory pseudotumor involving the tongue base, in a 73-year-old patient with repeated oral bleeding that aggravated over a few days. Clinical examination showed angiomatous polyp like findings in oropharynx that easy bleeding tendency. CT images showed well defined soft tissue mass with focal enhancement. After surgery, tumor was finally diagnosed inflammatory pseudotumor by histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.16-20
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• 2003

Objectives: Radiotherapy is an effective treatment in the initial management of T1 glottic carcinoma, but local recurrent or residual tumor growth is found in approximately 10% of the patients. Even in recurrence or residual tumor, in highly selected cases, conservation surgery with preservation of a portion of the larynx is feasible. So we investigated the efficacy of salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation. Material and Methods: Retrospectively we reviewed a consecutive series of 10 patients treated by conservative vertical partial laryngectomy of the larynx for radiation-failure, recurrent T1 glottic squamous cell carcinoma treated at Severance Hospital from 1994 to 2002. Results: Local recurrence developed in 4 patients (40%). Two patient was salvaged by further totallaryngectomy. Successful salvage was achieved finally in 8 (80%) of the 10 patients. There was no operative mortality. Postoperative perichondritis was developed in two patients. One was resolved by conservative treatment, but the other has underwent the total laryngectomy. Conclusion: A vertical partial laryngectomy in case of recurrent glottic carcinoma after a course of irridation should be the therapy of choice when stringent criteria are observed.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.6.1-6
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• 1978

Dsysphagia or difficulty in swallowing is a symptom wich indicates the presence of disease or dysfunction. Because the cause & the original site are variable, it is significant to study the clinicostatistical analysis on 133 cases with complant of dysphagia during the last one year in the department of Otolaryngology, College of Medicine, Seoul National University. The results are as follows; 1) Among the total O.P.D. patients (6313 cases), patients complaining the dysphagia are 2.1%. 2) Male to female sex ratio is 1. 3 to 1, slightly predominent in male and average are 35.7 years. 3) The duration of chief complaint is about 251 days in average, but excluding the 8 cases with more than year of symptom, it is about 40 days. In detailed analysis of the duration; 67 cases (50.4%) occurred within 1 weak: 24 cases (18.0%), 1 week to 1 month: 34 cases (25.6%), 1 month to 1 year: 8 cases (6.0%), more than 1 year. 4) As to the site of origin, the oropharyngolaryngeal origin 106 cases (76.7%) are 4 times as many as the esophageal origin 27 cases (20.3%). 5) As to the etiological classification: inflammation 67 cases (50.4%), tumor 28 cases (21.0%), corrosive agent 14 cases (10.5%), foreign body 11 cases (8.3%) in order. 6) As to the disease entity: pharyngitis and tonsillitis 42 cases (31.6%), stomatitis 14 cases (10.5%), corrosive esophagitis 14 cases (10.5%), laryngeal tumor 12 cases (9.0%), peritonsillar abscess 9 cases (6.8%), esophageal foreign body 7 cases (5.2%), tongue tumor 7 cases (5.2%), tonsillar tumor 6 cases (4.5%), (pharyngeal foreign body 4 cases (3.0%)in order.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.5 no.1
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• pp.59-63
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• 1994

The authors observed the clinical status of 29 patients with vocal cord paralysis caused by tumor from April, 1983 to September, 1993 at Department of Otorhinolaryngology, Yongdong Severance hospital, Yonsei University College of Medicine. The results were as follows: 1) In the kinds of neoplasms, the most frequent were lung Ca. with 13 cases(44.8%), followed by 8 cases by thyroid Ca., 3 cases by neurogenic tumor, 2 cases by mediastinum tumor, cervical esophagus Ca., tracheal Ca., glomus jugulare were 1 case each. 2) In sex distribution, there were 18 cases of males and 11 cases of females with the male to female ratio being 1.8:1. In age distribution, most of the cases(10 cases ; 34.5%) were in the 7th decade. 3) In chief complaints, most of the cases(17 cases : 58.6%) had hoarseness only and aspiration, stridor, dyspnea, cough, dysphagia were present in some cases. 4) In site of the paralysed vocal cord, 21 cases were in the left cord. 5 cases in the right cord and 3 cases in the both cords. 5) In the position of paralysed vocal cord, most of the cases(23 cases : 79.3%) were in the parmedian position.