• 대한두경부종양학회지
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• 제19권1호
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• pp.16-20
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• 2003

Objectives: Radiotherapy is an effective treatment in the initial management of T1 glottic carcinoma, but local recurrent or residual tumor growth is found in approximately 10% of the patients. Even in recurrence or residual tumor, in highly selected cases, conservation surgery with preservation of a portion of the larynx is feasible. So we investigated the efficacy of salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation. Material and Methods: Retrospectively we reviewed a consecutive series of 10 patients treated by conservative vertical partial laryngectomy of the larynx for radiation-failure, recurrent T1 glottic squamous cell carcinoma treated at Severance Hospital from 1994 to 2002. Results: Local recurrence developed in 4 patients (40%). Two patient was salvaged by further totallaryngectomy. Successful salvage was achieved finally in 8 (80%) of the 10 patients. There was no operative mortality. Postoperative perichondritis was developed in two patients. One was resolved by conservative treatment, but the other has underwent the total laryngectomy. Conclusion: A vertical partial laryngectomy in case of recurrent glottic carcinoma after a course of irridation should be the therapy of choice when stringent criteria are observed.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.134-137
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• 2007

Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.128-132
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• 2004

Objectives : The total laryngectomy for laryngeal cancer has made patients be afraid of voice loss. Early staged glottic or supraglottic cancer can be treated with conservative laryngeal surgery which preserve voice, though which was not normal voice comparing before. Voice analysis is used to evaluates objectively the quality of the voice in pre- and postoperation, 4 different types of conservative laryngeal surgery : laser cordectomy, supracticoid partial laryngectomy, vertical partial laryngectomy, and supralottic laryngectomy. Materials and Methods : The patients who received conservative laryngeal surgery(laser cordectomy : 23 cases, vertical partial laryngecotmy : 9cases, supracriocoid partial laryngectomy : 6cases, supraglottic laryngectomy : 8cases) from 1995 to 2001 in the Asan medical center. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum comfortable phonation time and subglottic pressure were used as parameters for voice analysis. Results : The patients who received laser cordectomy(shimmer : 5.26${\pm}$1.12%, jitter : 3.33${\pm}$0.42%, NHR : 0.47${\pm}$0.02, MPT : 9.32${\pm}$3.59sec) and supraglottic laryngectomy(shimmer : 4.39${\pm}$1.03%, jitter : 1.49${\pm}$0.14%, NHR : 0.51${\pm}$0.06, MPT : 8.9${\pm}$0.59sec) showed better results than other two procedures, but differed from normal value. Especially the patients who received supracricoid partial laryngectomy(shimmer : 9.23${\pm}$1.56%, jitter : 5.81${\pm}$1.23%, NHR : 5.89${\pm}$1.13, MPT : 6.3${\pm}$1.18sec, MFR : 632${\pm}$89ml/sec) had poorer quality of voice but presented fast functional recovery time, and the subjective symptom was improved as time goes by slowly. Conclusion : The appropriate conservative laryngeal surgery for each cancers and stage can preserve the acceptable voice for patients. Supracricoid partial laryngectomy for T1b glottic cancer can be used for acceptable voice despite its poor voice analysis.

• 대한기관식도과학회지
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• 제4권1호
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• pp.91-95
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• 1998

Background： Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods： Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II：37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II：18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.

• 대한후두음성언어의학회지
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• 제30권1호
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• pp.53-56
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• 2019

The optimal treatments of carcinoma in situ of glottis include radiotherapy, laser surgery and vertical partial laryngectomy. Conventional surgical treatments need general anesthesia and radiotherapy has several complications. Recently, the effectiveness of 532 nm potassium titanyl phosphate (KTP) laser has been proven and widely used in vocal fold diseases even some cases of vocal fold dysplasia. A patient with difficult laryngeal exposure underwent fiberoptic laryngeal laser surgery using KTP laser under local anesthesia, showed improved voice outcome and the glottic lesion was removed successfully without local recurrence and regional metastasis 18 months after surgery.