• 대한기관식도과학회지
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• 제4권2호
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• pp.159-164
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• 1998

The developmental and subsequent addition of laser technology to existing surgical techniques offered new and exciting Possibilities for improving traditional endoscopic operations and expanding the scope of the specialty of otolaryngology-head and neck surgery. Lasers were found to be Precise, but potentially dangerous, surgical instruments whose use was associated with certain distinct and unprecedented advantages, but also with many unique and potentially serious, and sometimes catastrophic complications. The Purpose of this study was to evaluate the of elation technique of $CO_2$laser, kinds of anesthesia, equipments of operating room, and education of medical staff. Four hundreds 4 cases of $CO_2$laser laryngeal microsurgery were reviewed for the safety of $CO_2$laser in laryngeal microsurgery. Vocal polyp (46,3%) was the most common pathology in our cases. The others were vocal nodule, Reinke`s edema, epiglottic cyst, laryngeal granuloma, laryngeal papilloma, intracordal cysts, laryngeal tuberculosis, laryngeal web, laryngotracheal stenosis, and laryngeal cancer. Following complete equipment controls, treatment area controls, maintenance, service and procedural controls, personel protective equipment, and warning signs, no complications were found in our cases. In conclusion, laryngeal microsurgery with $CO_2$laser could be done safely without complication if complete preoperative preparation and education of medical staff preceded.

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.47-51
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• 2011

Background and Objectives: Vocal polyps arc one of the most frequent benign laryngeal diseases. They arc usually found at the midpoint of the vocal fold. They are mainly caused by vocal overuse. Vocal polyps arc usually removed surgically. Generally, age-related changes to speech are attributed to change in anatomy and physiology of the speech mechanism. These changes result in increased variability in the acoustic properties of speech with age. Still, not 'all studies of age-related changes in speech have taken differences between the young group and adult group after laryngeal microsurgery into account. The aim of this investigation was to compare improvement of acoustic analysis in young patients and elderly patients with vocal polyps, before and after the laryngeal microsurgery. Materials and Method: One hundred and twenty-eight patients who underwent laryngeal microsurgery for vocal polyps from 2008 through 2011 were reviewed retrospectively. 105 of the 128 patients under age 60 were classified as adult group (AG), and remaining 23 patients as elderly group (EG). The speech of AG and EG were evaluated before and after surgery for identification of differences for age group across measures of fundamental frequency (F0), Jitter, Shimmer and Maximum phonation time (MPT). Results: There were not significant differences between two groups for improvement of F0, Jitter, Shimmer, NHR, and MPT before and after surgery. The findings suggest that elderly group compares quite well with adult group in effectiveness of surgery. However, comparison between elderly group and young group (Age under 40) there was significant difference of improvement in Jitter and Shimmer. Conclusion: In general, the results of the present research showed significant improvement in vocal quality after phonosurgery of vocal polyp in both elderly and adult group. However, comparison of improvement between elderly group and young group, there were significant differences of improvement in jitter and shimmer. Therefore, in treatment planning of elderly group, we should consider age related changes of vocal cord.

• 대한기관식도과학회지
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• 제3권1호
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• pp.70-78
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• 1997

The development of preneoplastic and neoplastic squamous cell proliferations of body sites such as the skin, female lower genital tract, and larynx is strongly associated with specific types of human papillomaviruses (HPV). Antitumor $CD^{8+}$ cells recognize peptide antigens presented on the surface of tumor cells by major histocompatibility complex (MHC) class I molecules. The MHC class I molecule is a heterodimer composed of an integral membrane glycoprotein designated the alpha chain and a noncovalently associated, soluble protein called beta-2-microglobulin( $\beta$ -2-m). Loss of $\beta$-2-m generally eliminates antigen recognition by antitumor $CD^{8+}$ T cells. We evaluated the expression of $\beta$-2-m as a potential means of tumor escape from immune recognition and the presence of HPV DNA as a cause of laryngeal squamous cell carcinomas (SCCs). Laryngeal SCCs (n=39) were analyzed for MHC class I expression by immunohistochemistry and for presence of HPV by in situ hybridization technique. The results were as follows : 1) HPV DNA was detected in 10 (25.64%) out of 39 cases in laryngeal squamous cell carcinomas. 2) MHC class I down-regulation (heterogenous and negative expression) in HPV positive lesions was higher than HPV negative lesions. 3) The expression of MHC class I was related to cellular differentiation regardless of T-stage and nodal involvement. In conclusion, HPV was thought to be the etiological factor of SCC of larynx, and we found that the down-regulation of MHC class I was a common phenomenon In laryngeal SCC and may provide a way for tumor cells to escape from immune surveillance.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10697-10703
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• 2015

The laryngeal squamous cell carcinoma (LSCC) is one of the most common malignant tumors occurring in the head and neck. Tumor necrosis factor related apoptosis induce ligand (TRAIL) and TRAIL-receptors (DR4, DR5, DcR1, DcR2) are known as important members of TRAIL-mediated biochemical signaling pathway. Associations between polymorphisms in these genes and clinicopathological characteristics of human laryngeal carcinoma are not well defined. This study therefore aimed to investigate a possible relationship among the TRAIL and TRAIL-DR4 polymorphisms and sTRAIL levels in the risk or progression of LSCC. A total of 99 patients with laryngeal cancer and 120 healthy subjects were enrolled in the study. DR4 C626G and TRAIL 1595 C/T genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis and sTRAIL levels were measured by ELISA. There were significant differences in the distribution of DR4 C626G genotypes and frequencies of the alleles between laryngeal cancer patients and controls (p<0.001) but not in TRAIL 1595 C/T. We found the increased frequency of the DR4 C626G homozygote CC genotype in patients than in controls (p<0.001). Haplotype analysis revealed that there was also a statistically significant relationship between TRAIL and TRAIL-DR4 polymorphisms and laryngeal cancer. Serum sTRAIL levels in the laryngeal patients with CC genotype who had advanced tumour stage were lower than those of patients with early tumor stage (p=0.014). Our findings suggest that DR4 C626G genotypes and sTRAIL levels might be associated with progression of laryngeal cancer in the Turkish population.

• 대한기관식도과학회지
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• 제13권2호
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• pp.45-49
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• 2007

Background and Objective : Laryngeal Papillomatosis (LP) is the most common benign neoplasm of the larynx, but it tend to recur and it makes eradicating difficult. Meticulous $CO_2$ laser excision has been the most effective treatment to date. This article analyzes the clinical feature and therapeutic results of 42 LP patients who were undergone $CO_2$ laser excision. Methods : Forty two patients with recurrent LP were treated with $CO_2$ laser. And their medical records were reviewed retrospectively. Demographics, chief complaints at onset, initial distribution of papillomas, number of operations performed on each patient, and current results were evaluated. Results : Male in their twenties and forties are dominant in number in patient number. Most common site was anterior one thirds (69%) of glottis area (86%). LP recurred in 17 cases (40%), and in 4 cases, the lesion extended over the original margin. Patients were undergone surgery $1.62{\pm}0.87$ times, $2.53{\pm}0.72$ in recurred cases. Mean relapsing time was 6 momths (from 1momth to 8years). Ant. laryngeal web occurred in 2 cases (4.8%) and 1 case was combined with squamous cell carcinoma. Conclusion : Meticulously performed $CO_2$ laser excision can achieve significant voice and airway improvement and clinical cures. The $CO_2$ laser through microdirect laryngoscopy allows more precise and bloodless removal of papillomas.

• 대한두경부종양학회지
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• 제18권2호
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• pp.135-141
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• 2002

Backgrounds and Objectives: Metastasis is a complex multistep process that requires sequential interactions between the invasive cell and the extra-cellular matrix. Transforming growth factor-${\beta}1$ ($TGF-{\beta}1$) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by $TGF-{\beta}1$ plays important roles in neoplastic progression. The aim of this study was to investigate the role of $TGF-{\beta}1$ in the neoplastic invasion and metastasis through matrix metalloproteinase (MMP) of laryngeal cancer cell lines. Material and Methods: Two laryngeal cancer cell lines, SNU-899 and SNU-1076 were treated with recombinant $TGF-{\beta}1$, and the expression of MMP-2 and MMP-9 was immunohistochemically evaluated and gelatinase activity was studied by gelatin zymogram. Results: The cell growth inhibition was evident on 4th days after 1ng/ml and 10ng/ml $TGF-{\beta}1$ treatment. The expressions of MMP-2 and MMP-9, and their gelatinase activities were increased in dose-dependent manner. Conclusion: $TGF-{\beta}1$ treatment in laryngeal cancer cell lines induces the expression of MMP-2 and MMP-9, thus playing a role in the digestion of extracellular matrix gelatin.

• 대한후두음성언어의학회지
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• 제13권1호
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• pp.18-22
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• 2002

Background and Objectives : It has been pointed out that alcohol intake in human beings induces changes in voice register and maximum phonation time. These changes supposedly result from injection of the vibratory vocal folds. The purpose of this study was to clarify the voice changes associated with alcohol intake and the changes of laryngeal mucosa. Materials and Methods : The subjects included 29 volunteers, including 20 men and 9 women ranging in age from 22 to 31 years. Alcohol intake was accomplished by oral administration of 23% soju 1 bottle (255cc). Serum alcohol concentration levels were evaluated hourly for 3 h after ingestion of alcohol. Seven measurements were performed at pre-alcohol intake and post-alcohol intake hourly : fundamental frequency, jitter, shimmer, noise to harmonic ratio as the acoustic analysis, maximal phonation time, mean flow rate, and subglottal pressure as the aerodynamic analysis. The changes of laryngeal mucosa were evaluated by flexible laryngoscope at each measurement. Results : By comparing the acoustic and aerodynamic data and laryngeal mucosa before and after alcohol intake, there were not remarkable changes (p>0.05). Conclusion : The voice and laryngeal mucosa have not remarkably changed according to alcohol concentration in this study. Furthermore studies on the voice change induced by multiple alcohol concentrations are required.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.61-65
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• 2020

Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 2009년도 추계학술대회 논문집
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• pp.194-194
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• 2009

• Journal of Chest Surgery
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• 제26권5호
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• pp.409-412
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• 1993

We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.