• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.137-147
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• 1997

The rarity of primary tumor of the trachea, which was recently estimated in a circumscribed population to be 2.7 new cases per million per year, explains the relatively limited experience that has been acquired even by major institutions. Although there may already by a high degree of airway obstruction, tracheal tumors are usually misdiagnosed as bronchial asthma or chronic bronchitis because of its nonspecific symptoms. Surgery is the treatment of choice. Recently, the authors experienced three cases of primary tracheal malignant tumors ; one case of mucoepidermoid carcinoma and two cases of adenoid cystic carcinoma. The authors report on these cases with a review of the literature for give help in differential diagnosis and treatment planing of tracheal tumor.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.504-509
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• 2005

Background : Endobronchial tumors cause life-threatening dyspnea and can lower the quality of life due to central airway obstruction. In those cases with an intraluminal tumor, various bronchoscopic techniques are available for tumor debulking. The therapeutic effect of bronchoscopic electrocautery for palliation in patients with a symptomatic tumor obstruction was studied. Method : Nineteen patients with bronchogenic carcinomas (n=15) and metastatic tumors affecting the bronchi (n=4), between March 2002 and March 2005, were enrolled in this study. Electrocautery was performed under local anesthesia using an electroprobe and diathermic snare. Using flexible bronchoscopy, a follow-up bronchoscopic examination was performed 3-4 days later. Symptom improvement was evaluated by $FEV_1$, FVC and dyspnea score (Modified Borg Category Scale (0~10)), both before and after the electrocautery. Results : The success rate of electrocautery on the follow up examination was 84%. Patients with endoluminal airway lesions had a mean overall decrease in the size of the obstruction to $47.8{\pm}15.7%$. The mean Improvement in the dyspnea score immediately after the endobronchial tumor debulking was $2.78{\pm}1.42$. The average improvements in the $FEV_1$ and FVC after electrocautery were $0.32{\pm}0.19L$ and $0.5{\pm}0.22L$, respectively. There were 2 cases of complications related with electrocautery (one each of pneumothorax and pneumonia). Conclusion : Electrocautery using an electroprobe and diathermic snare was an effective and safe palliative treatment for a symptomatic endoluminal airway obstruction in lung cancer.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.146-151
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• 2001

Background and Objectives： Primary benign masses in subglottis and trachea are rare. Symptoms of tracheal obstruction are similar to those of bronchial asthma, chronic bronchitis, as well as malignant lesions. Materials and Methods： Eight patients with benign tracheal masses from April 1992 through June 2001, at otolaryngology-head and neck surgery. department of Seoul national university hospital were studied by retrospective medical record review. Results : They were 3 females and 5 males aged from 0 to 57 years. The pathologies of the intratracheal masses were lipoma. tuberculosis, pleomorphic adenoma, hemangioma(two case), reparative giant cell granuloma, epithelial inclusion cyst and nonspecific lymphadenopathy, respectively. The most characteristic symptoms were dyspnea and stridor, both inspiratory and expiratory. Five of them had been treated as bronchial asthma. Conclusion： For the management of patients with the subglottis and tracheal masses, it is important to establish secure airway. regardless of pathology of the masses. The diagnosis should be considered in any patient with asthma-like manifestation, especially who fails to respond to medical treatment. It is necessary to examine the airway thoroughly, and chest and simple cervical X-ray may contribute to the diagnosis of possible intratracheal mass.

• Tuberculosis and Respiratory Diseases
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• v.76 no.3
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• pp.141-145
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• 2014

Although endobronchial hamartoma is a rare benign tumor, most patients with endobronchial hamartoma have respiratory symptoms such as obstructive pneumonia, hemoptysis, cough, or dyspnea due to bronchial obstruction. It can cause irreversible post-obstructive pulmonary destruction, thus early diagnosis and treatment is very important. Recently, there have been cases of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and electrocautery procedures for bronchoscopic treatment of malignant or benign central airway obstruction with comparable therapeutic efficacy and few complications. Bronchoscopic cryotherapy is a newly developed technique for management of central airway obstruction. Moreover, it provides diagnostic methods with improving diagnostic yield and safety. We report two cases of endobronchial hamartoma, each diagnosed and definitively treated with bronchoscopic techniques. Endobronchial biopsy and removal was successfully performed by cryotherapy via flexible bronchoscopy without notable complications. Follow-up bronchoscopic examinations excluded residual or recurrent disease.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.799-803
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• 1998

Background: Tumors of the trachea are rare despite their histologic similarity to tumors of the main stem bronchus and lung. Materials and methods: Fourteen patients with tracheal tumor underwent surgical, radiational, or laser photocoagulation therapy from March 1981 to July 1996. Nine patients were malignant and five patients were benign. The most common malignant tumor was adenoid cystic carcinoma. Results: Age ranged from 10 to 65 years with mean age of 45.9 years. Most tumors were located middle and lower one-third of trachea. Surgery was done through collar incision, or collar incision with vertical partial sternal division, or left posterolateral thoracotomy, or sternal division with laryngeal release. Two patients died after operation, because of the disruption of anastomosis and airway obstruction,and laryngeal edema after suprahyoid release. Only one patient died after 8 month of diagnosis. The other patients were doing well during the follow-up period.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.457-462
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• 2008

Background: Emergency airway access is essential when a patient has dyspnea that's due to tracheal or bronchial obstruction. Such methods as laser therapy and PDT are now being used for the treatment of tracheal obstruction that's due to benign diseases or nonsurgical malignant diseases. Cryotherapy is a method that uses extreme hypothermia for freezing a tumor to cause necrosis. In this study, we have evaluated the clinical effectiveness of performing endobronchial cryoablation through a flexible bronchoscope. Material and Method: 10 patients with tracheal obstruction that was due to endotracheal tumors were evaluated between May 2005 and May 2007. Eight were male and the mean age of the 10 patients was $59.4{\pm}18.4$ years. Three cases of tracheal obstruction were due to benign tumors and 7 were due to malignant tumors. The obstruction sites were 3 at the trachea, 3 at the carina and 4 at the bronchus. A flexible bronchoscope was inserted and the tumor was eliminated using a flexible cryoprobe. Follow up bronchoscopy was performed at 1 week and 1 month after cryoablation, and then we evaluated the decrease of dyspnea, the improvement of the performance and the complications of the procedures. Result: Complete remission was achieved in 4 patients and partial remission was achieved in 6 patients. Complications such as hemoptysis (100%), and cough (50%) were noted. Hemoptysis was spontaneously resolved in 3 to 8 days (mean: 4.9 days). A decrease in dyspnea and improvement in the performance was noted in all patients. Conclusion: Endobronchial stenosis plays a detrimental role in the life quality of a terminal cancer patient. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryoablation is considered to be a safe method that is clinically applicable to a wide range of tumors, including the removal of large tumors. We concluded that endobronchial cryoablation through a flexible bronchoscope is a safe, effective method for treating tracheobroncheal obstructions.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.97-102
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• 1999

Multiple symmetric lipomatosis(Madelung's disease) seems to represent a relatively common disease in Europe but has not been described in the Korean literature. It is characterized by highly typical symmetric deposits of subcutaneous fat on the neck, arms, and upper part of the trunk. The localized increase of adipose tissue is hyperplastic in nature and probably results from a local defect in adrenergic stimulated lipolysis. Multiple symmetric lipomatosis is frequently, but inconstantly, associated with alcoholism, liver disease, glucose intolerance, and hyperuricemia, but their etiologic role remains to be established. Clinical importance is the apparent high incidence of malignant tumors of the upper airways requiring through ear, nose, and throat and internal examination of all patients. Another importance is possibility of airway obstruction due to mass effect. Dietary treatment and weight loss are of limited value. Surgical treatment gives only temporary relief and should be restricted to patients with functional impairment. We report a case of a 63-year-old man with multiple symetric lipomatosis and alcoholism.