• 대한기관식도과학회지
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• 제2권1호
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• pp.57-62
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• 1996

Tracheal stenosis can be classified into intrinsic stenosis secondary to tracheal inflammatory lesion or mass effect and extrinsic stenosis secondary tumors of thyroid, esophagus and mediastinum. Extrinsic stenosis which is frequently encountered in clinical setting could be often overlooked due to mild symptom. Recently, even with the increasing interest in extrinsic tracheal stenosis there are limitation in it's diagnosis and treatment. The purpose of this study is to provide guidance in the diagnosis and treaonent of extrinsic tracheal stenosis. Here, we report the etiology, symptoms, radiologic findings, pulmonary fuction finding, treatment and its results in 26 cases of extrinsic tracheal stenosis. Causes of extrinsic tracheal stenosis included compression of aiway by thyroid benign tumor in 13 cases to be the most common, next by thyroid malignancy in 9 cases, metastatic mediastinal turner in 2 cases, 1 case each for esophageal cancer and parathyroid cancer. In 3 cases simple tracheal resection and end to end anastomosis were done, 1 cases underwent total laryngectomy, and 8 cases were treated by conservative management, where all cases failed in treatment. The remaining 14 cases were successfully treated by removing the causes and maintaining tracheal tube insertion for amount of time. Extrinsic tracheal stenosis due to benign conditions were treated satisfactorily by removing mass, however with the malignant causes there was considerable amount of difficulty in treatment.

• Journal of Chest Surgery
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• 제23권5호
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• pp.1021-1026
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• 1990

The patients with tracheal stenosis have become more increasing in recent due to the increased use of tracheostomy and assisted ventilation Anesthetic management during tracheal reconstruction is a concern to the anesthetist and the surgeon, who must share the airway as a operation field and at the same time provide good gas exchange. Multiple technique such as the tube ventilation system or C \ulcornerP bypass method have been recommended to achieve this goals. However, these methods have disadvantages of poor surgical exposure and hemorrhagic complication from using C \ulcornerP bypass The technique for HFJV was first described for bronchoscopy, and it involves positive-pressure breathing with high flow[40 \ulcorner60L/min] of oxygen This flow is directed to a semirigid catheter inserted in the endotracheal tube and the tracheal reconstruction can be done without interruption. From Dec. 1986 to July 1990 we have experienced 6 patients of tracheal stenosis necessitating circumferential resection and end to end anastomosis; 5 patients with tracheal stenosis following cuffed tracheostomy or intubation, a patient with tracheal stenosis due to invasive thyroid cancer. The specific advantages during tracheal reconstruction are unobstructed field during surgical reconstruction and good gas exchange through the procedure.

• 대한두경부종양학회지
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• 제37권1호
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• pp.63-66
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• 2021

Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial circumferential tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.

• Journal of Chest Surgery
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• 제28권4호
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• pp.416-418
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• 1995

The microwave tissue coagulation therapy was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases.We experienced one case of the restenosis after the tracheal reconstruction. The patient, who was 42 year-old male, had severe dyspnea due to the tracheal stenosis for 4 years. The resection of tracheal stenosis and tracheal reconstruction was done. But the restenosis occurred at the tracheal anastomosis site because of the protrusive granulation at one month after operation. The patient was successfully treated by the microwave tissue coagulation therapy.

• 대한두경부종양학회지
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• 제34권2호
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• pp.61-64
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• 2018

Malignant lesion of the trachea predominantly results from direct spread of adjacent tumors, whereas primary tracheal malignancies are rarely observed. Tracheal tumors are usually diagnosed late on account of delayed specific symptoms: dyspnea, stridor, coughing and hemoptysis. Primary tracheal tumors, although very rare, may extend into the thyroid gland and present as a thyroid mass. Surgery, followed by adjuvant radiotherapy, is the treatment of choice. A case of primary tracheal cancer with thyroid invasion is reported, and a review of the literature is presented.

• 대한기관식도과학회지
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• 제9권1호
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• pp.101-104
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• 2003

One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

• 대한두경부종양학회지
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• 제20권1호
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• pp.58-61
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• 2004

Lymph node metastasis of thyroid cancer occurs to anterior compartment (level VI) and superior mediastinal lymph node (Level VII). In lateral neck, it occurs commonly in middle and lower jugular lymph node (level III, IV). And it can also metastasis to posterior neck lymph node (level V). Superior mediastinal lymph node metastasis of thyroid cancer requires superior mediastinal dissection with massive removal of peritracheal and periesophageal soft tissue. After superior mediastinal dissection, severe complication may occurs such as innominate artery rupture and tracheal necrosis. We describe a case of tracheal necrosis as a complication of superior mediastinal dissection and total thyroidectomy in thyroid cancer patient.

• 대한기관식도과학회지
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• 제8권1호
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• pp.57-60
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• 2002

Tracheoinnominate artery fistula is a rare but a catastrophic complication after tracheostomy or tracheal reconstruction. We experienced two cases of tracheoinnominate artery fistula after tracheal reconstruction and tracheostomy. The first patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and reconstruction of trachea. She died of bleeding 3 days after the reoperation. The second patient was a 68 year old man who underwent right upper lobectomy due to lung cancer. After operarion MRSA Pneumonia was developed and tracheostomy was performed 10 days after intubation. Twelve days after tracheostomy, massive bleeding occurred and emergency operation of ligation of innominate artery was performed. He died of sepsis 7 days after reoperation.

• Journal of Chest Surgery
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• 제31권8호
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• pp.792-798
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• 1998

배경: 기관의 폐쇄 질환은 기관 삽관과 기관 절개술에 의한 협착, 기관 종양, 갑상선 종양, 기관내 결핵등 다양한 질환이 원인이 될 수 있는데 최근 이런 기관 질환에 대해 병변 부위를 완전히 절제한 후 단단 문합 술을 시행하여 좋은 결과를 얻고 있다. 대상 및 방법: 이에 저자들은 1985년에서 1996년까지 38명의 기관 폐쇄 병변에 대해 실시한 기관 절제 및 재건술의 성적과 결과를 분석하였다. 기관 절제 길이는 2 cm이하에서 6 cm까지 다양하였으며, 수술 방법은 경부 횡절개 22례, 경부 및 부분 흉골 정중절개 12명, 우측 흉부절개 를 4례에서 시행하였으며, 기관 병변 주위를 완전 절제한후 32명의 환자에서 기관 단단 문합술을, 6명의 환자에게 윤상연골 절제가 동반된 후두 기관 문합술을 시행하였다. 이중 3명에서 봉합부 장력을 감소시키기 위해 후두 분리가 필요하였다. 결과: 합병증으로 창상 감염 4례, 문합 부위 육아종 증식 2례, 성대 마비 1례, 폐렴 2례, 전신성 캔디디아시스 1례가 발생하여 그중 수술전 의식이 명료하지 않아서 수술후 T-tnbe 삽입이 필요하였던 2명 환자가 폐렴에 의해, 외상에 의해 전신성 캔디디아시스가 발생한 1례가 사망하였다. 결론: 이상의 성적으로 6 cm 까지의 기관 병변에서 기관 절제가 재건술로 좋은 결과를 얻을 수 있었으나 의식 상태나 전신상태가 나쁜 환자에서의 기관절제와 재건술은 수술후 합병증 및 사망률이 높으므로 보존적 치료가 좋을 것으로 사료된다.

• 대한두경부종양학회지
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• 제27권1호
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• pp.77-79
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• 2011

Tracheal diverticulum is very rare, that is usually an incidental finding at routine chest computed tomography scan. Differential diagnosis of tracheal diverticulum includes pharyngocele, laryngocele, Zenker diverticulum, apical lung hernia, blebs and bulla, and pneumomediastinum. Treatment options can be devided into medical and surgical. The majority of patients is asymptomatic and requires no specific intervention. We experienced one case of tracheal diverticulum in patient with tongue cancer and report it with reviews of literature.