• 대한두경부종양학회지
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• 제12권2호
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• pp.147-152
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• 1996

For advanced head and neck cancers that originate in midline structures, bilateral neck dissection should be considered even if the lymph nodes were negative clinically. But, many complications and mortalities may occur in synchronous bilateral neck dissection at sacrifing of both internal jugular vein. Therefore several types of bilateral neck dissection have been proposed, but the effective and safe methods were not determined yet. So, we have prefered the method of synchronous bilateral neck dissection with preserving one internal jugular vein at least. We operated 21 patients who might be expected high incidences of bilateral neck metastases with above type of neck dissection. We analyzed the data of 21 cases(42 sides) retrospectively. The results were as follows: 1) The primary sites were transglottic(33%), supraglottic(29%), hypopharynx(29%) and tongue base(9%). 2) Types of neck dissection were RND(4 sides), MND(7 sides), FND(16 sides), and SND (15 sides). 3) Postoperative complications were minimal and did not influenced morbidity. 4) Mean interval time of neck recurrence was 21 months. Overall neck recurrent rate after bilateral neck dissecton was 19%. In 19%, neck recurrence from positive lymph nodes was 63% and from negative lymph nodes was 37%. As a results, synchronous bilateral neck dissection with preservation of one internal jugular vein minimally should be done in cases which were suspected high incidence of bilateral lymph node metastases for cure and prevention of neck recurrence.

• 대한기관식도과학회지
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• 제17권1호
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• pp.53-56
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• 2011

Vocal cord paralysis (VCP) is a common complication after thyroidectomy despite the continuity of the recurrent laryngeal nerve (RLN) is preserved. Much efforts have been made into preventing VCP, but few of them focuses on the treatment strategies and prognosis after VCP take place. In this case, patient visited the clinic for papillary thyroid cancer in Rt. thyroid gland without VCP. She underwent total thyroidectomy with central neck dissection. During dissection, Rt main mass was encircling Rt. RLN. To make matters worse, Lt. RLN was severed due to tight attachment with Berry's ligament. After that, intratumoural dissection of Rt. RLN and end to end anastomosis of Lt. RLN were performed with microscopy to preserve the functions of RLNs as much as possible, otherwise permanent bilateral VCPs were inevitable. We report this case, since both vocal cords recovered from VCPs with symmetric, synchronous movements at postoperative follow up.