• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.3
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• pp.168-174
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• 2016

Purpose: The management and clinical course in pediatric patients who had ingested foreign body were investigated retrospectively to evaluate the frequency and factor associated with successful removal of fishbone foreign body. Methods: Based on the medical records of patients younger than 15 years old who visited emergency room because of foreign body ingestion from January 1999 to December 2012, the authors reviewed clinical characteristics including type of ingested foreign bodies, time to visits, managements and complications. Results: Fishbone (50.1%) was the most common ingested foreign body in children. Among 416 patients with ingested fishbone, 245 (58.9%) were identified and removed using laryngoscope, rigid or flexible endoscope from pharynx or upper esophagus by otolaryngologists and pediatric gastroenterologists. The kind of ingested fish bone in children was diverse. The mean age of identified and removed fishbone group was 7.39 years old, and higher than that of unidentified fishbone group (5.81 years old, p<0.001). Identified and removed fishbone group had shorter time until hospital visit than the unidentified fishbone group (2.03 vs. 6.47 hours, p<0.001). No complication due to ingested fishbone or procedure occurred. Conclusion: Older age and shorter time from accident to hospital visit were the different factors between success and failure on removal of ingested fish bone in children.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.201-205
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• 1996

Early detection of glottic cancer, facilitated by rigid telescopes or flexible fiberoptic laryngoscope in addition to sparse true vocal cord lymphatics, makes this a highly curable tumor in its early stage. Early glottic cancer has a high cure rate with only radiotherapy or conservative surgery. However complications such as mucositis with radiotherapy and voice complications with conservative surgery has raised recent interest in endolaryngeal laser cordectomy. Laser cordectomy can preserve phonatory function and avoid the complications such as mucositis of radiotherapy. To determine the effectiveness of laser cordectomy, the authors made a two year retrospective study of 23 early glottic cancer cases. Fourteen cases(60.9%) who underwent 1 to 3 endoscopic laser cordectomy with KTP-532 laser were cured with this procedure alone. Seven cases needed an additional radiotherapy and three cases needed therapy with salvage operation. We conclude that the endoscopic laser surgery is a good strategy for the properly selected glottic cancer.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.99-103
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• 2014

A laryngeal web is connective tissue covered with epithelium stretching between both sides of the true vocal cords. Laryngeal webs were first reported by Fleischmann in 1882, and they cause upper airway obstruction and abnormalities of phonation. Congenital webs result from an arrest of reabsorption of the epithelium of the larynx at the tenth week of the fetus. The most common site of webbing is the anterior commissural glottic area, followed by other glottic areas and rarely subglottic or supraglottic areas. We have experienced two cases of congenital laryngeal webs. The webs were operated in two different methods. The first was excised under magnified vision through a laryngoscope, with a silastic keel secured between the raw surfaces of the separated mucosa. In the second case, the deepithelialized surfaces were exposed for a certain time length to mitomycin C to prevent postoperative webbing. We, hereby, report our experience of the diagnosis and management of two cases of a rare entity known as the congenital laryngeal web, and discuss the results with relevant studies.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.44-50
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• 2007

Background and Objectives: The 585-nm pulsed dye laser (PDL) has recently been adopted by otolaryngologists because of its epithelial-sparing properties. Many authors have reported the use of PDL for treatment of various vocal cord lesions. This purpose of this study is to examine the effectiveness of 585-nm PDL in the treatment of vocal polyp. Materials and Methods: Eight patients with vocal polyp were treated with 585-nm PDL from Sep. 2006 to Nov. 2006 in Yong-dong Sevrance hospital. 5 of them went through local anesthesia and 3 of them went through general anesthesia. In order to control laser fiber, flexible digital transnasal laryngoscope was applied under local anesthesia and general anesthesia using LMA, and micromanipulator was used under general anesthesia using endotracheal tube. The evaluations of vocal function was done at pre-and postoperation. Results: All patients improved in the perceptual evaluation of voice after PDL surgery. The aerodynamic study revealed that 5 of 8 patients showed improvement in maximal phonation time, and 6 of 8 showed improvement in mean airflow rate during phonation. The acoustic analysis revealed that all patients showed improvement in Jitter and Shimmer, and 7 of 8 showed improvement in noise to harmony ratio. Conclusion: This study demonstrates promising results in the efficacy of 585-nm PDL for the treatment of vocal polyps, and it illustrates a new option for vocal polyp treatment as well as the advantage of PDL surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.297-305
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• 2017

Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation. If the general method of intubation was expected to be difficult, awake intubation was performed. The degree of nasal bleeding during intubation was also evaluated. Results: The mean age of the operators (11 men, 7 women) was 27.8 years. FNI was performed in a total of 716 patients. The success rate was 88.3% for the first attempt and 94.6% for the second attempt. The failure rate of intubation in anesthetized patients was 4.9%, and 13.6% in awake patients. When intubation was performed in anesthetized patients, the failure rate from the first to fifth trial was 9.6%, which decreased to 0.7% when the number of trials increased to > 30 times. In terms of awake intubation, there was no failed attempt when the resident had performed the FNI > 30 times. The number of FNIs performed and nasal bleeding were important factors influencing the failure rate. Conclusion: The success rate of FNI increased as the number of FNI performed by residents increased despite the nasal bleeding.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.111-116
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• 2023

We provided general anesthesia management to a patient with advanced atrioventricular block, which was discovered in the remote period after open-heart surgery. A 21-year-old man with Noonan syndrome was scheduled to undergo excision of a median intramandibular tumor. At 2 months of age, the patient underwent endocardial repair for congenital heart disease. During our preoperative examination, an atrioventricular block was detected, which had not been previously noted. Emergency drugs were administered, and a transcutaneous pacemaker was placed. During anesthesia induction, mask ventilation was easy, and intubation was performed smoothly using a video laryngoscope. The transcutaneous pacemaker was activated in demand mode at a pacing rate of 50 cycles/min approximately throughout the anesthesia time, and the hemodynamic status remained stable. The effect of intraoperatively administered atropine was brief, lasting only a few seconds. Although body movements due to thoracoabdominal muscle spasm were observed during pacemaker activation, they did not interfere with surgery. In postoperative patients with congenital heart disease, an atrioventricular block may be identified in the remote period, and preoperative evaluation should be based on this possibility. In addition, during anesthesia management, it is important to prepare multiple measures to maintain hemodynamic status.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.155-159
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• 2022

Cohen syndrome is a rare genetic disorder associated with mutations in the VPS13B gene. Individuals with this disorder present with diverse clinical manifestations, including muscle hypotonia, intellectual disabilities, and typical facial characteristics, such as prominent upper central incisors and micrognathia. General anesthesia was administered to a 23-year-old man with Cohen syndrome. Although we observed prominent upper central incisors, an overjet of 10 mm, micrognathia, and thyromental distance of 4 cm, hypotonia was not observed in the patient. Intubation was rendered difficult when performing a direct laryngoscopy. However, smooth intubation was achieved using a video laryngoscope. The patient's train of four (TOF) count remained zero close to 60 min after rocuronium administration, suggesting that the drug's muscle-relaxant effect may have been prolonged. A TOF ratio of 0.79 was confirmed 130 min after rocuronium administration, and a TOF ratio of 1.0 was confirmed after administration of 150 mg of sugammadex. The patient's respiration remained stable after extubation, and no recurarization of muscle relaxation was observed. As demonstrated in this case report, it is important to closely monitor recovery from muscle relaxation and prepare multiple techniques for airway management in general anesthesia management of patients with Cohen syndrome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.1
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• pp.60-72
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• 1995

Temporomandibular joint ankylosis is the movemental obstacle of mandible which depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset, duration, anesthesia and treatment method, symptom, change of mouth opening, complication through medical record, X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis. The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul National University Hospital. 1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period of illness was 13.33 years. 2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation. 3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40.9% and the cases of using tracheostomy occupied 18.2%. 4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy (Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 36.6%. 5. In change of mouth opening reformed after surgery, Group III showed the best result of average 23.5mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation. Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining anatomaical & functional form, and then the development of various surgical methods will be requested.