• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.2
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• pp.83-87
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• 2013

The term "phonosurgery," coined in the early 1960s, refers to surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (endoscopic microsurgery of the vocal folds), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection of medications as well as synthetic and organic biologic substances), and reinnervation of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. The purpose of the surgery is usually to improve the vibratory characteristics of the layered microstructure of the vocal folds. Phonomicrosurgery has developed from convergence of microlaryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.3
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• pp.118-123
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• 2021

The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

• Clinical and Experimental Pediatrics
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• v.62 no.10
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• pp.395-399
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• 2019

Background: The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported. Purpose: The study aimed to evaluate the methodology, efficacy, and side effects of Mitomycin C in the treatment of esophageal strictures. Methods: This study included 30 children with resistant esophageal strictures. Upper GI endoscopy was performed up to the area of stricture, esophageal dilatation was done, endoscopy was repeated, and Mitomycin C was applied topically under direct endoscopic vision. The effect of the procedure was followed over a period of 3-5 years. Results: The response to Mitomycin C was excellent (clinically and endoscopically) in 28 patients (93.3%) and good (endoscopically only) in 2 patients (6.7%). No side effects of topical Mitomycin C in children with esophageal strictures were reported in this study. Conclusion: Esophageal dilatation followed by local Mitomycin C application may be a useful strategy for treating resistant esophageal strictures.

• Journal of radiological science and technology
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• v.22 no.1
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• pp.87-90
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• 1999

Treatment of human calculi by extracorporeal shock-wave lithotripsy(ESWL) was introduced for kidney stones in 1980. This technology was then applied to the treatment of bile duct stones and pancreatic stones. Some reports have also shown that disintegration of pancreatic stones by extracorporeal shock-wave lithotripsy is possible with successful subsequent endoscopic extraction of the fragments at home ana abroad. We tried removal of pancreatic calcification stones by endoscopic procedures, but could't be removed because the basket got entagled in the endoscopy. We report one case of this pancreatic calcification stones ; the stones were successfully fragmented and completely removal by extracorporeal shock-wave lithotripsy.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.699-702
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• 2003

Endoscopic removal is acceptable for the treatment of endotracheal/endobronchial mass, because it is less invasive in high-risk patients and a conservative procedure for benign tumors. Two benign tumors in the lumen of the trachea (pure lipoma) and in the intermediate bronchus (hamartoma) were completely eradicated by our procedures, which involved diathermic snaring and residual mass removal with biopsy forceps under the guidance of fiberoptic bronchoscopy. No tumor recurrence was evident after extended follow-up (6 years for endotracheal lipoma and 2.5 years for endobroncheal hamartoma). Our method is safe and less invasive for the patient and provides the surgeon with better view during procedure.

• Archives of Reconstructive Microsurgery
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• v.2 no.1
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• pp.62-69
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• 1993

Recently, conservative and bloodless operative procedures have been focused, so that endoscopic laser have been used. However application of endoscopic laser surgery for laryngeal lesion is capable for followings: (1)capability of delivery through an operating microscope, (2) vaporization of ultraspot. $CO_2$ laser which has been used, has limitations for voice improvement because of 700 micron beam spot. KTP-532 laser which is capable of delivery through an operating microscope vapore 200 micron ultraspot has developed and applied to microlaryngeal surgery. We have experienced 60 cases who were contracted with hoarseness(53 cases of benign lesions vocal nodule 13, vocal polyp 13, bilateral diffuse polyposis of vocal cords 11, intracordal cyst 8, vocal papilloma 5, laryngocele 1, laryngeal stenosis 2 and 7 cases of malignant lesions : laryngeal carcinoma stage I and II) since 1991. We operated them with KTP-532 Laserscope(3 Watt/0.05 sec., pulsed or continuous. San Jose, Calif, USA). Forty eigh cases(90.6%) of 53 bengin laryngeal lesions and 4 cases(57.1%) of malignant lesions were significantly improved in their voices. There were a few complications and technical problems, but laser surgery alone had a limitation to eradicate the disease.

• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.301-305
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• 2017

Multiloculated hydrocephalus (MLH) is a condition in which patients have multiple, separate abnormal cerebrospinal fluid collections with no communication between them. Despite technical advancements in pediatric neurosurgery, neurological outcomes are poor in these patients and the approach to this pathology remains problematic especially given individual anatomic complexity and cerebrospinal fluid (CSF) hydrodynamics. A uniform surgical strategy has not yet been developed. Current treatment options for MLH are microsurgical fenestration of separate compartments by open craniotomy or endoscopy, shunt surgery in which multiple catheters are placed in the compartments, and combinations of these modalities. Craniotomy for fenestration allows better visualization of the compartments and membranes, and it can offer easy fenestration or excision of membranes and wide communication of cystic compartments. Hemostasis is more easily achieved. However, because of profound loss of CSF during surgery, open craniotomy is associated with an increased chance of subdural hygroma and/or hematoma collection and shunt malfunction. Endoscopy has advantages such as minimal invasiveness, avoidance of brain retraction, less blood loss, faster operation time, and shorter hospital stay. Disadvantages are also similar to those of open craniotomy. Intraoperative bleeding can usually be easily managed by irrigation or coagulation. However, handling of significant intraoperative bleeding is not as easy. Currently, endoscopic fenestration tends to be performed more often as initial treatment and open craniotomy may be useful in patients requiring repeated endoscopic procedures.

• Journal of Rhinology
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• v.25 no.2
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• pp.63-68
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• 2018

Olfactory dysfunction is one of the most common complaints of patients with chronic rhinosinusitis. Patients who suffer from olfactory dysfunction report a negative effect on their overall quality of life. Chronic rhinosinusitis-related olfactory impairment is the most treatable form of olfactory disorder; however, outcomes after endoscopic sinus surgery (ESS) are challenging to predict. Previous studies have documented a wide range in overall improvement after ESS. The purpose of this study is to review the factors that predict changes in olfaction after ESS.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6733-6736
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• 2014

Background: Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Recently, natural orifice specimen extraction (NOSE) and intracorporeal anastomosis have been proposed to minimize abdominal wall trauma and improve the quality of laparoscopic colon resections Objective: To evaluate the feasibility and safety of a new approach combining intracorporeal delta-shaped anastomosis and transvaginal specimen extraction for totally laparoscopic sigmoid colectomy. Materials and Methods: Mobilization of bowel and dissection of lymph nodes were performed laparoscopically. After both proximal and distal incisal edges about 10.0 cm distance from sigmoid neoplasm were transected with an Endoscopic Linear Cutter-Straight, a small incision about 1.0 cm was created on the each colon wall of the contralateral side of the mesentery. Then anvils of an Endoscopic Linear Cutter-Straight were inserted into each colon through the small incisions, and incision and anastomosis between the walls of each colon were performed with a linear stapler. A V-shaped anastomosis was made on the wall and the remnant openings was reclosed with the Endoscopic Linear Cutter-Straight. The culdotomy was enlarged with laparoscopic ultrasound dissector. Transvaginal extraction of specimens was accomplished through a wound protector. Results: Surgery was performed for 11 patients with sigmoid cancer. No intraoperative complications or conversions occurred. The mean operating time was 132 min. All the patients were treated laparoscopically without any postoperative complications. Conclusions: The procedures of intracorporeal delta-shaped anastomosis and transvaginal specimen extraction are safe and oncologically acceptable for selected colon cancer cases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.34-40
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• 2017

Purpose: This study was performed to review the outcomes of gastrostomy insertion in children at our institute during 10 years. Methods: A retrospective chart review was performed on 236 patients who underwent gastrostomy insertion from October 2005 to March 2015. We used our algorithm to select the least invasive method for gastrostomy insertion for each patient. Long-term follow-up was performed to analyze complications related to the method of gastrostomy insertion. Results: Out of 236 patients, 120 underwent endoscopic gastrostomy, 79 had laparoscopic gastrostomy, and 37 had open gastrostomy procedures. The total major complication rates for endoscopic gastrostomy insertion, laparoscopic gastrostomy insertion, and open gastrostomy were 9.2%, 8.9%, and 8.1%, respectively. The most common major complication was gastroesophageal reflux requiring Nissen fundoplication (3.8%), and other complications included peritonitis (1.3%), hiatal hernia (1.3%), and bowel perforation (0.8%). Gastrostomy removal was successful in 8.6% and 5.0% of patients in the endoscopic and surgical gastrostomy groups, respectively. Gastrocutaneous fistula occurred in 60% of surgically inserted cases, requiring a second operation. Conclusion: This retrospective study was performed to review the outcome of gastrostomy insertion, as well as to introduce an algorithm that can be used for future cases. Further studies should be conducted to make a consensus on choosing the most appropriate method for gastrostomy insertion.