• 대한두경부종양학회지
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• 제12권2호
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• pp.201-205
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• 1996

이상의 성적에서 레이저 성대 절제술은 초기 성문암종에 대한 일차 치료법으로 유용하다고 생각되었으며, 일차 절제가 가장 중요하고 그후 성대를 포함한 전체 후두점막에 대하여 주기적으로 현수후두경하에 수술현미경을 이용한 추적관찰과 원격전이 및 이차암의 발생 유무에 대하여 적극적인 추적검사가 필요할 것으로 사료된다.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.7-10
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• 2008

The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.11-15
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• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• 대한기관식도과학회지
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• 제16권1호
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• pp.20-26
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• 2010

Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

• 대한기관식도과학회지
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• 제4권1호
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• pp.91-95
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• 1998

Background： Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods： Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II：37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II：18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.