• 대한후두음성언어의학회지
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• 제32권1호
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• pp.43-47
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• 2021

Voice therapy is effective in many voice and speech disorders. However, patients have low accessibility to therapeutic facilities due to disease-unrelated reasons such as lack of time and pandemic of COVID-19. Contactless voice therapy could be an alternative and may helpful to all patients with voice and speech problems. We developed contactless voice and speech therapy program on the necessity of improving accessibility. Herein, we report the first case of voice therapy to 30 year-old female patient who complained voice change after total thyroidectomy using contactless voice and speech therapy service platform in Korea.

• 대한두경부종양학회지
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• 제39권1호
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• pp.37-40
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• 2023

Schwannoma is a slow growing benign tumor that can occur anywhere in our body. About 25~45% cases of schwannomas occur in the head and neck, but intra-thyroidal schwannomas are very rare, and mostly are diagnosed by post-thyroidectomy pathologic study. In this article, we present a case of intra-thyroidal schwannoma diagnosed preoperatively with core needle biopsy. The patient underwent enucleation of the thyroid tumor, and the pathology of the tumor was confirmed as schwannoma. Few cases of intra-thyroidal schwannomas have been reported in the literature, but none of them have been diagnosed through core needle biopsy preoperatively. Preoperative diagnosis of intra-thyroidal schwannoma can be helpful when determining appropriate surgical extent and avoid unnecessary thyroidectomy.

• 대한두경부종양학회지
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• 제39권2호
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• pp.27-30
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• 2023

A 65-year-old patient who underwent total thyroidectomy 10 years ago was suspected of having a parathyroid adenoma, and minimally invasive parathyroidectomy was planned. Preoperative ultrasonography(USG) and 99mTc MIBI scan indicated a left lower parathyroid lesion. In the first operation, intraoperative parathyroid hormone monitoring (IOPTH) was not possible due to hospital circumstances. Although no adenomatous lesion was found in the expected surgical field, surgery was completed after removing lesions around the left lower parathyroid gland. However, post-surgery, parathyroid hormone did not decrease at all, so a second operation was performed with IOPTH preparation. In the second operation, intraoperative ultrasonography was performed, and a suspected adenoma lesion was removed from the left upper lesion. He has been under follow-up for 3 years without complications. Surgeon-peformed intraoperative USG and preoperative scintigraphy had advantages in determining the localization of parathyroid lesion even withiout IOPTH.

• 대한두경부종양학회지
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• 제14권1호
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• pp.54-60
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• 1998

Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

• 대한두경부종양학회지
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• 제15권1호
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• pp.46-51
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• 1999

Background: Total thyroidectomy and postoperative radiodiodine ablation therapy in differentiated thyroid carcinomas enhance the reliability of serum thyroglobulin(Tg) levels and radioiodine scan in detecting recurrence or distant metastasis. There have been, however, some limitations in using these methods under certain conditions. Recently, several reports have indicated that thyroid peroxidase(TPO) could be used as an alternative tumor marker. We aimed to estimate the significance of serum TPO levels in differentiated thyroid carcinoma. Materials and Methods: Forty-eight patients who had undergone total thyroidectomy due to papillary thyroid carcinomas and who had been followed-up for at least 3 years were classified into two groups: 27 patients without any evidence of recurrence in group 1; and 20 patients with recurrence or distant metastasis in group 2. All patients were examined by radioiodine scans. Serum Tg, TSH, antithyroglobulin antibody, and TPO were measured and the relationships were statistically analyzed. The sensitivity and specificity of $^{131}I$ scan, serum Tg, and serum TPO were evaluated. Results: Serum Tg levels were $3.81{\pm}5.16ng/mL$ in group 1 and $147.02{\pm}193.75ng/mL$ in group 2. Only 2 patients in group 1 showed Tg levels exceeding 10ng/mL. In contrast, 4 patients in group 2 were under 10ng/mL. Serum antithyroglobulin antibody and TSH levels showed no statistical difference between the two groups. In group 1, 16 patients showed negative serum TPO results, and 4 patients in group 2 showed negative results. There was no correlation among serum Tg levels, antithyroglobulin antibody titers, and serum TPO levels in each group. In group 2, 4 patients with negative serum Tg levels showed positive TPO results and positive whole body scans. Two cases with false negative $^{131}I$ scans showed positive serum TPO and Tg results. In 4 cases showing false negative serum TPO levels, serum Tg levels and $^{131}I$ scans were positive. Conclusion: Serum Tg levels, radioiodine scans, and serum TPO levels can be clinically used as complementary methods in the diagnosis of recurrent or metastatic thyroid carcinomas. Serum TPO levels may be helpful when other methods fail to detect recurrences or distant metastasis in highly suspected patients.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.614-615
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• 2016

• International journal of thyroidology
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• 제10권2호
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• pp.127-132
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• 2017

Anaplastic transformation of differentiated thyroid cancer at distant metastatic sites is extremely rare and has a poor prognosis. It usually occurs in the thyroid gland or cervical lymph nodes. Here we report a case of anaplastic transformation arising at multiple distant metastatic sites including the lung, liver, adrenal gland, bone, and lymph nodes in a patient 3 years after total thyroidectomy for follicular thyroid cancer.

• 대한두경부종양학회지
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• 제11권2호
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• pp.119-124
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• 1995

Traditionally, wound drainage after thyroid or parathyroid surgery has been widely used to prevent airway obstruction due to accumulation of hematoma or seroma within the paratracheal dead space. Recently, however, the routine use of drains after thyroid or parathyroid surgery has become a matter of controversy. To determine whether the rouine use of drains after thyroid or parathyroid surgery is warranted, a prospective study on the complications after various types of thyroid or parathyroid surgery without wound drains was conducted. Three hunded sixty-six consecutive patients underwent thyroid or parathyorid surgeries by one surgeon from January through December 1994 were included in this study. Of these, only 38 patients (10.4%) required the wound drains. Indications for drainage included the patients with a large dead space(n=9) or wet operative field at the conclusion of surgery(n=11), and patients with radical neck disection(n=18). In the remaining 328 patients(89.6%), the wounds were closed without drains after thyroid lobectomy and isthmusectomy(n=226), bilateral subtotal thyroidectomy(n=21), total or near-total thyroidectomy(n=62), isthmusectomy(n=9) and parathyroid surgery(n=l0). Histologic findings revealed benign tumors in 214(65.2%), carcinoma in 89(27.1%), Graves' disease in 15(4.7%), hyperparathyroidism in 7(2.1%) and parathyroid cyst in 3(0.9%). Among the 328 patients without drain used, wound related complications were seen in only 15 patients(4.6%); 12 patients with seroma and 3 patients with hematoma. All but one complications could be controlled by two or three aspirations, and the remaining one patient required re-exploration. There were no instances of laryngeal nerve palsy or wound infection. The mean length of hospital stay after surgery was 2.8 days with a range of 1 to 11 days. These results support the routine use of drains is not warranted in most thyroid or parathyroid surgeries.

• 대한두경부종양학회지
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• 제11권2호
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• pp.125-131
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• 1995

The authors present 15 cases in which the diagnosis of thyroid cancer was established pathologically among 300 cases of Graves' disease diagnosed clinically at Chosun University Hospital, from January 1982 to December 1994. These cases were analyzed in order to establish guidelines for prophylactic node dissection as part of the initial management of thyroid cancer in patients with Graves' disease. The analysis revealed the following: 1) The average age of the 15 patients was 34.5 years and the male: female ratio was 1 : 4.0. 2) In 8 of the 15 cases(53.5 %) the occult thyroid carcinoma measured less than 1.5cm. 3) The degree of invasivensess manifested in these fifteen cases may be summarized as follows: In Group 1(6 cases) there was absence of microscopic capsular invasion and of lymphnode metastasis. In Group 11(4 cases) threre was microscopic capsular invasion but absence of lymphnode metastasis: In Group III(4 cases) there was either extrathyrodal soft tissue invasion or regional lymph node metastasis: and in Group IV(1 case) there was lymphnode invasion and distant metastasis. 4) Thirteen patients underwent either subtotal or near total thyroidectomy, and 2 patients underwent total thyroidectomy. Seven patients underwent some type of neck dissection, as follows: anterior compartment dissection in one of the cases in Group I; functional neck dissection in two cases and jugular node dissection in one case in Group II; and anterior compartment dissection in one case and modified radical neck dissection in two cases in Group III. 5) The author propose the following guidelines for prophylactic initial node dissection when a unexpected coexisting thyroid carcinoma in encountered on the frozen section during the surgical management of Graves' disease; Group I cases do not require initial neck dissection in group II, anterior compartment dissection in sufficient. In Group III, either jugular node dissection or functional neck dissection should be performed, and followed by postoperative Ra$^{131}$I therapy, Group IV requires Ra$^{131}$I therapy with or without modified radical neck dissection depending in the patient's condition.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.120-126
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• 2018

Background: Minimizing scarring has long been a challenge in plastic surgery. Factors affecting scar formation are well known, but the effect of some patient-specific factors such as dermal thickness remains unverified. Management of factors predictive of scarring can improve postoperative patient satisfaction and scar treatment. Methods: For 3 years, we used ultrasonography to measure dermal thickness in female patients who had undergone thyroidectomy for cancer at our hospital. We confirmed the influence of dermal thickness on hypertrophic scar formation and the Patient and Observer Scar Assessment Scale scar score 6 months after surgery. Results: There was a positive correlation between dermal thickness and scar score (p<0.05), and dermal thickness appears to be a cause of hypertrophic scar formation (p<0.05). Conclusion: Thick dermis was found to cause poor scar formation and hypertrophic scarring. Prediction of factors that can influence scar formation can be used to educate patients before surgery and can help in scar management and improvement in patient satisfaction.