• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.235-239
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• 2015

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.92-95
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• 2020

Tracheal granuloma, the most commonly reported sequela of pediatric tracheotomy. A variety of techniques are available for the management of tracheal granuloma. Potassium-titanyl-phosphate (KTP) laser has been previously established as an acceptable technique for removal of laryngeal surgery, which emits a green light with a wave length of 532 nm, which is well-absorbed by hemoglobin and can coagulate and vaporize tissue. The ability to deliver laser energy through a flexible glass fiber makes the technique convenient for use with a rigid bronchoscope, overcoming problems with intraluminal access encountered with earlier attempts at CO2 laser therapy for this problem. Another advantage of KTP laser is the avoidance of the risks and morbidity associated with an open procedure. We report our surgical technique KTP laser in the management of tracheal granuloma removal into the tracheostomy site. KTP laser is good tool for management of tracheal granuloma with low incidence of complications.

• 대한후두음성언어의학회지
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• 제32권1호
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• pp.48-50
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• 2021

More than half of patients presenting with hoarseness show benign vocal cord changes. However, in rare cases with benign mucosal lesions, it can be diagnosed as a malignant disease after histopathological examination. A 53-year-old man with a 30-pack-year smoking history was admitted for the evaluation of hoarseness, and using a laryngoscope, an enclosed, sac-like cystic lesion was detected on the midpoint of the right true vocal cord. The cystic lesion was deemed to be an intracordal cyst and treated with laryngeal microsurgery. However, pathological findings showed squamous cell carcinoma of the larynx arising in the intracordal cyst, which is exceptionally rare. Therefore, even if a benign lesion is initially suspected, a biopsy must be performed on a patient with smoking history to confirm the diagnosis. In conclusion, we report a case of squamous cell carcinoma of the larynx arising in the intracordal cyst.

• 대한두경부종양학회지
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• 제12권1호
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• pp.8-15
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• 1996

When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

• 대한기관식도과학회지
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• 제11권1호
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• pp.10-14
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• 2005

Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

• 대한두경부종양학회지
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• 제13권1호
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• pp.35-39
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• 1997

Background: Completion thyroidectomy is defined as the surgical removal of the remnant thyroid tissue following procedures less than total or near-total thyroidectomy. Although some authors advocate subtotal thyroidectomy with lower complication rates, total or completion thyroidectomy have been defended by others because of the improved survival and lower morbidity that is comparable with subtotal thyroidectomy. Objectives: The purpose of this paper is to review the necessity and safety of completion thyroidectomy for differentiated thyroid carcinoma(DTC). Materials & Methods: During the past 10 years(1986 to 1996) , authors have performed 211 total thyroidectomy. Ten of these patients were treated by completion thyroidectomy for DTC. Initial operation of 7 patients had been performed at St. Vincents Hospital and 3 patients at other hospital. The medical records of patients undergoing completion thyroidectomy were retrospectively reviewed. Results: The completion thyroidectomy specimen contained residual tumor cells in 8 of the 8 patients with papillary carcinoma and none of the two patients with follicular carcinoma. Complications of completion thyroidectomy were transient hypoparathyroidism in two patients and transient unilateral recurrent laryngeal nerve palsy in one patient. But permanent complications were not noticed. Conclusion: We recommend completion thyroidectomy as an efficient and safe method of surgical treatment with a low complication rate for DTC.

• 대한후두음성언어의학회지
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• 제22권2호
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• pp.133-136
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• 2011

Background and Objectives : Previous jet ventilation is not becoming more common because of high price, making loud noise, and causing a movement of the vocal cords due to the jet stream. So we designed a new type of manually controlled jet ventilation using previous laryngoscope and introduced it's clinical application. Materials and Method : A prospective study involved 20 patients all having undergone surgical intervention under new type of manually controlled jet ventilation from June 2009 to January 2011. The prospective study was to assess the vital sign and operative and postoperative complications. Results : The Manually Controlled Jet Ventilation were performed in 20 patients. 50% of the patients have Post-located laryngeal lesion, 20% with tracheal stenosis, 20% with glottic cancer biopsy and laser cordectomy, 10% with postglottic stenosis. Conclusion : Manually Controlled Jet Ventilation (Manujet) can be used for airway surgery.

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.112-116
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• 2015

Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.

• 대한기관식도과학회지
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• 제10권1호
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• pp.41-45
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• 2004

Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

• Radiation Oncology Journal
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• 제21권4호
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• pp.299-305
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• 2003

목적: 후두암 방사선치료의 표준화를 위하여 후두암에 관한 기본적인 임상 자료를 축적하고 필요한 조사 항목을 결정하여 전국적인 웹 기반 데이터 베이스 시스템을 개발하고자 하였다. 대상 및 방법: 1998년 1월부터 1999년 12월까지 호서호남 지역에서 후두암으로 진단되어 방사선치료를 받은 환자를 대상으로 임상적 분석을 시행하였다. 환자 선정 기준은 18세 이상이며 과거력상 타 장기의 암 진단 병력이 없고 후두에서 기원한 원발성 상피세포암으로 과거 후두에 대한 다른 질환으로 치료력이 없는 환자를 대상으로 하였다. 후두암에 관한 조사 항목 개발은 대한방사선종양학회 호서호남지회 소속 병원의 전문의들이 합의하여 일차적으로 선정한 항목에 대하여 각 병원에서 자체적으로 조사하였다. 통계처리는 SPSS v10.0을 이용하였다. 결과: 자료가 수집된 총 증례수는 45예이었다. 환자의 연령분포는 28$\~$88세(중앙값: 61)이었고 남녀비는 10 대 1로 대부분 남자에 발생하였다. 원발부위는 성문암이 28예(62$\%$), 성문상부암이 17예(38$\%$)이었다. 병리소견으로는 편평세포암이 대부분이었다(44/45, 98$\%$). AJCC (1997년도) 병기 I+II는, 성문암 28예 중 24예(86$\%$)에 비해 성문상부암의 경우는 16예 중 8예(50$\%$)이었다(p=0.002). 증상은 애성이 n예(89%$\%$로 가장 많았다. 진단은 간접후두경이 전체환자에서, 직접후두경검사는 43예(98$\%$)에서 각각 시행되었다. 치료로서 성문암 28예와 성문상부암 17예 중, 방사선 단독치료는 21예(75$\%$), 6예(35$\%$)에서 각각 시행되었다. 또한 수술요법과 방사선요법의 병용은 각각 5예(18$\%$), 8예(47$\%$)이었고, 항암화학요법과 방사선요법의 병용치료는 각각 2예(7$\%$), 3예(18$\%$)이었으나 두 원발 병소 간에 병용치료 빈도의 유의한 차이는 없었다(p=0.20). 방사선치료는 모두 선형가속기 6 MV X-ray를 이용하여 통상적 분할조사 법으로 시행되었다. 분할선량은 성문암 환자의 86$\%$에서 2.0 Gy를 사용한 반면 성문상부암은 59$\%$에서 1.8 Gy를 각각 사용하였다. 방사선단독치료를 완료한 환자에서 원발병소의 평균 총방사선량은 성문암에서 65.98 Gy, 성문상부암에서 70.15 Gy이었다. 수집된 자료를 기초로 후두암 방사선치료형태 연구에 필요한 총 12개의 모듈과 90개의 항목을 개 발하였다. 결론: 본 연구에서는 후두암 데이터베이스 시스템에 필요한 연구 항목을 개발하였다. 향후 웹 기반 데이터 베이스 시스템을 완성하고 전국의 방사선치료 자료를 축적하여 후두암에 대한 한국형 방사선치료의 표준화 및 적정화를 기하고자 한다.