• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.51-55
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• 2019

Pharyngocutaneous fistula is a relatively common, but serious complication after pharyngeal or laryngeal cancer surgery. It can cause wound infection, longer hospitalization period and sometimes carotid artery rupture which can be fatal. Recently, we experienced a 63-year-old larynx cancer patient who had dementia and alcoholic liver cirrhosis for underlying diseases. He underwent total laryngectomy and both neck dissection, and pharyngocutaneous fistula occurred during postoperative radiotherapy. Pharyngocutaneous fistula during postoperative radiotherapy has not yet reported in the literature, and there are few reports about pre and postoperative management of dementia patient after head and neck cancer surgery. Therefore, we report this case with a brief review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.417-421
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• 2007

Post-intubation granuloma of the larynx is a rare complication of general inhalation anesthesia, which is associated with direct mechanical irritation of laryngeal mucosa from trauma, prolonged period of endotracheal intubation, multiple intubations and endotracheal movement. This study was performed retrospectively to evaluate symptoms, incidence, duration and site for prevention of the intubation granuloma. The authors investigated 16 patients of intubation granuloma among 719 patients during 1 year period from August, 2005 to July, 2006 at the Department of Oral & Maxillofacial Surgery, Pusan National University Hospital. The results were as follows. 1. The incidence was 16/719 cases(2.2%) 2. The female to male ratio was 7:1 3. Hoarseness was the main symptom 4. Most cases occurred after 2-jaw orthognathic surgery.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.15-20
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• 2007

Background and Objectives：Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods：Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results：Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions：Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.

• Radiation Oncology Journal
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• v.12 no.3
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• pp.323-329
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• 1994

Purpose: In supraglottic cancer, radiation therapy is used to preserve the laryngeal function but combined surgery and radiation therapy is required in advanced stage. The authors Present the results of radiation therapy alone and combined surgery Plus Postoperative radiation therapy for supraglottic cancer. Methods and Materials: A retrospective analysis was done for 43 patients with squamous cell carcinoma of the supraglottic larynx who were treated from Feburary 1982 to December 1991, in the Department of Radiation Oncology, Korea University Hospital. Patient distribution according to the AJCC staging system was as follows: I, 3($7.0\%$); II, 7($16.3\%$); III, 17($39.5\%$); IV, 16($37.2\%$). Patients' age ranged from 30 to 72 years(median 62). Follow up durations were from 21 to 137 months(median 27). Seventeen patients($39.5\%$) were treated by radiation therapy alone with radiation doses of 6840-7380 cGy and 26 patients($60.5\%$) were treated with surgery plus postoperative irradiation with doses of 5820-6660 cGy. Results: Overall five-year survival rate for all stage was $51.8\%$, with $100\%$ for Stage I and II, $47.3\%$ for Stage III, and $29.2\%$ for Stage III. The difference of the survival rate by stage was statistically significant(p=0.0152). Five-year survival rates were $100\%$ for locally confined tumor in the supraglottic larynx, $37.5\%$ for transglottic extension, $26.7\%$ for hypopharynx extension, and only two of 5 patients with both transglottic and hypopharynx extension were alive(p=0.0033). Five-year survival rates by neck node status were as follows: $55.0\%$ for NO, $64.3\%$ for N1, $50.0\%$ for N2, and all 2 of N3 were died of disease. Overall survival rate for radiation therapy alone group was $42.8\%$, and it was $56.7\%$ for surgery plus postoperative radiation therapy group with no statistically significant difference(p=0.5215). In Stage I and II, all Patients survived. In Stage III and IV, 5-year survival rate for radiation therapy alone group was $28.5\%$ and $43.4\%$ for surgery plus postoperative irradiation group(p=0.5103). Local control rate was $58.8\%$(10/17) for radiation therapy alone group and $73.1\%$ (19/26) for surgery plus postoperative irradiation group. Three patients from surgery plus postoperative radiation therapy group developed distant metastasis in lungs. Conclusion: Treatment results of radiation therapy alone was excellent in early stage supraglottic cancer. In advanced stage, even the difference was statistically not significant, the result of postoperative radiation therapy group was superior compared with radiation therapy alone group. Since 1992, concomitant chemoradiotherapy with hyperfractionated radiotherapy is being used to improve the result of the treatment and preserve the laryngeal function in advanced stage supraglottic cancer.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.47-51
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• 2009

Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.2
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• pp.88-95
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• 2013

In recent years, the application of injection laryngoplasty to a variety of laryngeal disorders has regained popularity. The technique of injection laryngoplasty has several appealing qualities including relative technical ease, low cost, and wide availability in many clinical settings. A growing number of injectable substances and injection methods have been developed. This review is intended to provide an updated discussion of indications, materials, and techniques for injection laryngoplasty.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2659-2664
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• 2015

Background: To examine the expression of cysteine-rich 61 (Cyr61/CCN1) protein in laryngeal squamouscell carcinoma (LSCC) tissues, and its relationship with the tumor epithelial-mesenchymal transition (EMT), invasion, metastasis, and prognosis. Materials and Methods: Immunohistochemistry was used to detect the expressions of Cyr61, Vimentin (Vim), and E-cadherin (E-cad) in 88 cases of LSCC tissues and 30 cases of tumor-adjacent normal tissues. Vim and E-cad were used as mesenchymal and epithelial markers, respectively, to determine the relationship between Cyr61 expression and the EMT of LSCC cells. In addition, clinical and histopathological data were combined to analyze the relationship between the positive-expression rates of Cyr61, Vim and E-cad and LSCC invasion, metastasis and prognosis. Results: In LSCC tissues, Vim expression rate was significantly higher than that of the tumor-adjacent tissues, whereas E-cad expression rate was significantly lower than that of the tumor-adjacent tissues. The Vim expression rate was significantly higher in stages T3 and T4 than in stages T1 and T2 LSCC tissues, whereas E-cad expression rate was significantly lower in stages T3 and T4 than in stages T1 and T2 LSCC tissues. Compared to the group without lymph node metastasis, the Vim expression rate was significantly higher and the E-cad expression rate was significantly lower in the group with lymph node metastasis. The expression rate of Cyr61 was significantly higher in LSCC tissues than in the tumor-adjacent normal tissues. In addition, the Cyr61 expression rate was higher in stages T3 and T4 than in stages T1 and T2 LSCC, and higher in the group with lymph node metastasis than in the group without lymph node metastasis. The Vim expression rate was significantly higher in the Cyr61 positive group than in the Cyr61 negative group, whereas the E-cad expression rate was significantly higher in the Cyr61 negative group than in the Cyr61 positive group. Survival analysis indicated that survival rates of Cyr61 positive, Vim positive and E-cad negative groups were significantly lower than that of Cyr61 negative, Vim negative and E-cad positive groups, respectively. Conclusions: Cyr61 expression is closely associated with LSCC invasion and lymph node metastasis. Overexpression of Cyr61 may induce EMT and therefore leads to LSCC invasion and metastasis and poor prognosis. Cyr61 may become a new maker for clinical prediction of LSCC invasion and metastasis and a new target for LSCC treatment.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.58-62
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• 2007

Schwannoma is a benign well-encapsulated tumors arising from the sheath of Schwann cell of the peripheral motors, sensory, and cranial nerves, but not from the optic and olfactory nerves. Since it is relatively common in the head and neck region, it should be included in the differential diagnosis of head and neck tumor. However, reports of laryngeal involvement have rarely appeared in the literature. We have experienced a 50-year old woman and 39-year old woman with history of progressive voice change. We recognized a benign mass at the false cord area with the telelaryngoscope and CT. The tumors were successfully removed by transoral CO2 laser resection without tracheotomy.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.29-33
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• 2017

Verrucous carcinoma was first described by Ackerman who reported a case of verrucous carcinoma of the oral cavity. While it is primarily occurred in oral cavity, larynx is the second most affected site, accounting for nearly 35% of cases. It is a rare variant of well-differentiated squamous cell carcinoma and comprises 1% to 4% of all laryngeal carcinomas. It is characterized by locally invasive, slow growth and the surface shows papillary fronds with prominent hyperkeratosis. Because of the benign appearance and difficulty of the tissue diagnosis, it is often undiagnosed or misdiagnosed. The primary treatment modality is surgery and the extent of surgical resection may be guided by T stage. We experienced a case of verrucous carcinoma of larynx in a patient with hoarseness lasted for about 2 years and had difficult to diagnosis and treatment. Therefore we report this case with a brief review of literature.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.619-623
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• 2018

Mucosal bridges of vocal fold have been described as a parallel band to vocal folds with the presence of sulcus vocalis. However, the type of mucosal bridge crossing each vocal fold has not been well documented in the literature. Herein, we present two cases of mucosal bridge found in the vocal fold connecting the mid-portions of true vocal folds. Two patients who had no history of laryngeal trauma, surgery or oro-tracheal intubation visited our clinic due to voice change. Laryngoscopic examination revealed that they had a mid-portion mucosal band without any other mucosal lesions. Two patients underwent laryngomicrosurgery with pulsed dye laser. After the surgery, they showed significant improvement of voice quality.