• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.29-34
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• 1988

Radiation therapy is generally considered to be the treatment of choice in $T_1$ glottic cancer, maninly because of preservation of voice function and its local control rate is comparable to that of surgery. Failures from radiation therapy can be ultimately salvaged by surgery. A retrospective analysis of the treatment of 25 patients with $T_1$ glottic cancer seen at the Yonsei Cancer Center from 1980 to 1984 is presented. Radiation dose to the target volume varied from 6400 to 7000 cGy in 6-7 weeks. The local control rate is 84%. Four patients had primary failure and three of these patients had salvage surgery. Of the 3 patients who had salvage surgery, 2 were cured and aonther one was died with progression of the disease. 5-year acturial and disease free survival rate are 91.1%,78.0% respectively.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.27-30
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• 2020

Among lesions in the larynx, laryngeal contact granuloma due to persistent tissue irritation can typically be attributed to endotracheal intubation, vocal abuse, or gastro-esophageal reflux disease. Treatment typically includes voice therapy, lifestyle changes and use of anti-reflux medication. Microsurgical removal is only indicated in cases of severe dyspnea due to mass size. Foreign body granuloma is a response of to any foreign material in the tissue. Foreign body granulomas are sometimes misdiagnosed as soft tissue tumors when the causative foreign body is not initially found. Delayed treatment of these foreign bodies may cause complications. We present a case of larynx granuloma due to impacted foreign body, probably fish bone, in the larynx that mimicked contact granuloma. We initially used anti-reflux medication, but to no avail. The laryngeal mass, observed through laryngoscopy, showed no improvement and therefore necessitated a proper pathologic diagnosis. We were able to successfully treat it via trans-oral laser CO2 microsurgery before any complications developed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.35-38
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• 2020

Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.95-100
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• 2019

Background and Objectives For patients with polyps and cysts, glottal gaps resulting from their lesions have negative respiratory effects when they vocalize. Phonatory Aerodynamic System is clinically used, but is often limited in the measurement of vowels. So the researchers attempted to verify the usefulness of Phonatory Aerodynamic System by comparing differences in respiratory characteristics and patterns which can be measured by the level of connected speech. Materials and Method Among the subjects who were diagnosed through a stroboscopy, there were 33 patients with polyps and 23 patients with cysts. Then, 36 subjects who were found to have no specific findings through a stroboscopy and perceptual test were selected to the normal group. We compared respiratory characteristics and patterns. And compared vocal polyps and cysts before and after laryngeal micro surgery (LMS). Results First, difference in respiratory patterns between the normal group and the patients with polyps and cysts were examined to show that breath groups, breath group syllables, and expiratory·inspiratory volume were significantly higher in the polyp/cyst group than those in the normal group, indicating that precision was lowered during the conversation, due to reduction in speech intelligibility and interruption of communication. Second, there were significant differences in maximum phonation time, mean flow rate, and subglottal pressure among respiratory characteristics, breath groups, breath group syllables, and inspiratory volume before and after LMS, which appeared to be similar to the normal group. Conclusion The understanding of respiratory characteristics and patterns produced by patients in connected speech which is most similar to natural speech was found to be the objective and useful method for examining characteristics of the subjects.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.448-450
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• 2003

Lipoma is a circumscribed mesenchymal tumor originating from the adipose tissue. The lesion is usually small and asymptomatic. The most common location is in the neck region, however, lipoma can be found in the mediastinum in rare occasions. Although lipoma reach to the large proportions in the mediastinum, it rarely compresses the neurovascular structure. We present a case of a 58-year-old man, in which a hourglass-type cervicomediastinal lipoma produced Horner's syndrome with voice change. The man presented a swelling at the right side of his neck, ptosis and anhidrosis on the right side of his face, and right chest discomfort. After the removal of the mass, all the symptoms which had been provoked by compression, as well as Horner's syndrome and hoarseness, nearly disappeared.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.82-86
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• 2019

In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.182-190
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• 1999

OBJECTIVES : To determine the results of posterior cricoid split with costal cartilage graft in the treatment of moderate and severe subglottic stenosis in adults, and to assess the effect of T-tube as a stent in this surgery. PATIENTS AND METHODS : Four adults with moderate and severe subglottic stenosis who underwent posterior cricoid split with costal cartilage graft from 1994 to 1995. Three patients were male and one was female. All of the patients had acquired subglottic stenosis, 2 of whom had a bilateral vocal folds paralysis. The surgical procedure we used included a cricoid lamina split with costal cartilage grafting and T-tube stenting. Arytenoidectomy was a added in 2 patients with bilateral vocal folds paralysis. RESULTS : Three of the 4 patients underwent decannulation, and 1 is still undergoing treatment. 3 patients who underwent decannulation demonstrated marked improvement in their symptoms of airway obstruction and good postoperative voice quality. CONCLUSIONS : The posterior cricoidotomy lumen augmentation with costal cartilage grafting is a safe and effective technique for the treatment of moderate and severe subglottic stenosis in adults and T-tube is a good alternative stenting material for this procedure.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.38-43
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• 2000

The reconstruction for the pharynx and cervical esophagus after wide resection in essential procedures and the several methods have the reported. Each method has advantages and disadvantages relatively. Five cases of free jejunal graft were analyzed retrospectively for the reconstruction of pharynx and cervical esophagus at Chungbuk National University Hospital from May 1996 through December 1998. Primary sites were one oropharyngeal cancer, three hypopharyngeal cancers and one subglottic cancer involved the cervical esophagus. Two grafts had necrosis. Postoperative minor complications were dysphagia, fistula, stricture of anastomosis site, and pneumonia in the order. There were not possible voice rehabilitation in three success cases.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.407-412
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• 2006

Purpose: Various attempts of reconstruction for pharyngoesophageal defects after ablative surgery have been made to restore the function of the pharyngoesophagus. A fabricated tubed radial forearm free flap or free jejunal free flap was used when the width of remnant pharyngeal wall was less than 50% of the normal width. However there are many disadvantages such as stricture, saliva leakage and fistula formation on tubed radial forearm free flap. The jejunal free flap has the problem such as short pedicle, poor tolerance of ischemic time, wet voice and delayed transit of swallowed food due to the uncoordinated contraction. The authors studied the utility of patch-type radial forearm free flap using the remnant posterior pharyngeal wall of the hypopharynx. Methods: Retrospective reviews in Severance Hospital were made on 25 patients who underwent reconstruction surgery with patched radial forearm free flap because of the hypopharyngeal cancer between 1996 and 2005. The patients of Group I had the narrow posterior pharyngeal wall and its width was less than 3centimeters after the tumor was resected. Those of Group II had the partial pharyngectomy and the width of the remnant pharynx was larger than 3 centimeters. Results: Seven patients belonged to the group I and the flap of this group had 100% survival rate. One case of fistula and no swallowing discomfort due to stricture was reported. The Group II including 18 patients also had the 100% flap survival rate. Neither fistula nor stricture was seen but the lower diet grade was checked. Conclusion: The patch type radial forearm free flap using the remnant pharyngeal wall have the advantage of the radial forearm free flap, and furthermore this flap is the safe reconstructive method even if the width of the remnant pharyngeal wall is less than 30% of that of normal pharynx.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.15-20
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• 2007

Background and Objectives：Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods：Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results：Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions：Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.