• 대한후두음성언어의학회지
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• 제30권1호
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• pp.53-56
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• 2019

The optimal treatments of carcinoma in situ of glottis include radiotherapy, laser surgery and vertical partial laryngectomy. Conventional surgical treatments need general anesthesia and radiotherapy has several complications. Recently, the effectiveness of 532 nm potassium titanyl phosphate (KTP) laser has been proven and widely used in vocal fold diseases even some cases of vocal fold dysplasia. A patient with difficult laryngeal exposure underwent fiberoptic laryngeal laser surgery using KTP laser under local anesthesia, showed improved voice outcome and the glottic lesion was removed successfully without local recurrence and regional metastasis 18 months after surgery.

• 대한후두음성언어의학회지
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• 제32권1호
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• pp.35-38
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• 2021

Laryngeal lymphoepithelial carcinoma (LEC) is a rare tumor with only 34 cases in the published literature. Epidemiologically, laryngeal LEC is extremely rare in Asian. Originally, LEC is a common type of carcinoma in nasopharynx. Laryngeal LEC resembles nasopharyngeal LEC, except that most cases of laryngeal LEC are not associated with Epstein-Barr virus. We present a case of laryngeal LEC which developed at the left false cord extending to true vocal cord, para-glottic space and pre-epiglottic space. Total laryngectomy with bilateral neck dissection was performed. LEC was reported as biopsy confirmation result. The patient underwent postoperative radiotherapy and showed no evidence of recurrence during follow-up period of 42 months. In consideration that LEC in larynx have not been reported in South Korea yet, we introduce the clinical features and treatment outcomes of laryngeal LEC with literature review.

• 대한후두음성언어의학회지
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• 제32권2호
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• pp.104-108
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• 2021

The etiology of laryngeal hemangioma is unclear, and it is classified into infant and adult types. The former is capillary hemangioma and relatively common, the latter is cavernous type and very rare. The adult laryngeal hemangioma mainly occurs in supraglottis and glottis. A 75-year-old man came to our clinic with a voice change that started four months ago. The laryngoscopic finding showed that the surface of oval-shaped mass is covered with turbid exudates. We performed the laryngeal microsurgery with CO₂ laser. The mass was pathologically proven as cavernous hemangioma. We report a very rare and didactic case with review of relevant literature.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.39-42
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• 2022

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권1호
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• pp.1-17
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• 2024

The video laryngoscope is a novel instrument for intubation that enables indirect visualization of the upper airway. It is recognized for its ability to enhance Cormack-Lehane grades in the management of difficult airways. Notably, video laryngoscopy is associated with equal or higher rates of intubation success within a shorter time frame than direct laryngoscopy. Video laryngoscopy facilitates faster and easier visualization of the glottis and reduces the need for Magill forceps, thereby shortening the intubation time. Despite the advanced glottic visualization afforded by video laryngoscopy, nasotracheal tube insertion and advancement occasionally fail. This is particularly evident during nasotracheal intubation, where oropharyngeal blood or secretions may obstruct the visual field on the monitor, thereby complicating video laryngoscopy. Moreover, the use of Magill forceps is markedly challenging or nearly unfeasible in this context, especially in pediatric cases. Furthermore, the substantial blade size of video laryngoscopes may restrict their applicability in individuals with limited oral apertures. This study aimed to review the literature on video laryngoscopy, discuss its clinical role in nasotracheal intubation, and address the challenges that anesthesiologists may encounter during the intubation process.

• 대한방사선치료학회지
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• 제8권1호
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• pp.75-81
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• 1996

When high energy photon beam is incident upon an air cavity interface the effect of ionization build-up observed . This phenomenon is resulting from the surface layers of the lesions are significant deficiency of electrons reaching the layers because of the replacement, of solid scattering material by the air cavity, that is lack of electronic equilibrium. Measurement have been made in an acrylic phantom with a parallel plate chamber and high energy photon beams, CO-60, 4MV, 6MV and 10MV X-rays have been investigated. The result of our study show that a significant effect was measured and was determined to be very dependent on field size, air cavity dimension and photon energy. The reductions were much larger for 10MV beam, underdosage at the interface was 12, 12.2, 16.9 and $20.6\%$ for the CO-60, 4MV, 6MV and 10MV, respectively. It was found that this non-equilibrium effect at the interface is more severe for the higher energy beams than that of lower energy beams and the larger cavity dimensions the larger beam reductions occur. This problem is of clinical concern when lesions such as carcinoma beyond air cavities are irradiated, such as larynx, glottic and the patients with maxillectomy and ethmoidectomy and so forth.

• 대한기관식도과학회지
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• 제5권2호
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• pp.153-158
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• 1999

Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.

• 음성과학
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• 제10권2호
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• pp.111-128
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• 2003

Aerodynamic study is valuable information about the vocal efficiency in translating airflow to acoustic signal. The purpose of this study was to investigate the differences between trained singers and untrained controls under different two pitch by simultaneous using the airway interruption method and electroglottography (EGG). Under singing a Korean lied 'Gene', 20 (Male 10, Female 10) trained singers were studied on two one-octave different tone. Mean flow rate (MFR) , subglottic pressure (Psub) and intensity were measured with aerodynamic test using the Phonatory function analyzer (Nagashima Ltd. Model PS 77H, Tokyo, Japan). Closed quotients (Qx), jitter and shimmer were also investigated by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). These data were compared with those of normal controls. MFR and Psub were increased on high pitch tone in all subject groups. Statistically significant increasing of Qx and intensity were observed in male trained singers on high pitch tone (Qx;p = .025, intensity;p < .001). Beacasue of increasing of Qx and intensity, vocal efficiency was also significantly increased in male singers (p < .001). The trained singers' phonation was more efficient than untrained singers. The result means that the trained singers can increase the loudness with little changing of mean flow rate, subglottic pressure but more increasing of glottic closed quotients.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.134-137
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• 2007

Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.12-12
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• 1982

기관절개술은 1649년 Fienus가 처음으로 호흡곤란 환자에게 시술하고 Tracheotomy라 명명한 이래 기도확보, 기관 및 기관지로 부터 분비물 제거 및 산소공급을 목적으로 이용되어 많은 생명을 구하고 있다. 그러나 기관절개술후 성문하부의 협착, 기관연화, 기관절개공주위의 육아조직, 기관점막의 부종, 정신적인 의존 및 제 1기관륜 상부의 절개등으로 인한기관 Cannula 발거곤란증이 수반되기도 한다. 저자들은 1980년 4월 산업재해로 인한 두개내혈종 및 다발성늑골골절등으로 진단되어 타종합병원에서 개두술과 기관절개술을 받은 21세 남자환자에서 기관 Cannula 발거곤란증을 경험하였기에 중간보고하는 바이다. 1981년 11월 본원 이비인후과에 전원시 간접후두경 검사상 성대 및 가성대에 심한 부종이 있었으며 성대는 부정중위로 고정되어 있었고 기관지경검사상 성문하부에 협착이 인지되어 Jackson 식도 Bougie를 이용하여 3차에 걸쳐 Bougination으로 기관확장을 시도하였으나 효과가 없었다. 1981년 2월 협착부위의 기관륜과 윤상연골에 수직절개를 한 후 직경 1. 2cm의 Teflon tube를 협착부위에 삽입하고 9개월간 유치시킨 후 제거하고 Corking을 하여 현재 양호한 경과를 취하고 있다.