• Proceedings of the KOR-BRONCHOESO Conference
• /
• 2005.04a
• /
• pp.34.1-34.1
• /
• 2005

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 2005.04a
• /
• pp.37-42
• /
• 2005

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.1
• /
• pp.53-62
• /
• 1991

Tracheostomy may be used to assure airway protection in various clinical situation. It, as a known operation, has a history spanning 2000 years. The first clear account of a successful tracheostomy was recorded in 1546 by Brasavola. Until 1718 the term "bronchotomy" was used to describe the procedure. Heister then introduce the term "tracheotomy and this was later adopted and popularized by Trousseau about 1830. The term "tracheostomy" appeared in medical literature after 1820 and the two terms "tracheostomy" and "tracheotomy" are used interchangeably today. Indications include relief of upper airway obstruction, facilitation of pulmonary toilet, diminution of dead space and need for prolonged mechanical ventilation. The extent of indication of tracheostomy has a tendency to increase, thus oral and maxillofacial surgeons have some opportunities to face a situation that require tracheostomy. So, we reported retrospective study of 31 cases of tracheostomy patient in oral and maxillofacial surgery with reference review to reveal the significance of surgical skill and management capability of emergercy state maxillofacial surgery patients.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.25 no.3
• /
• pp.153-163
• /
• 2018

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

• Korean Journal of Bronchoesophagology
• /
• v.6 no.1
• /
• pp.80-86
• /
• 2000

Background : Stomal recurrence that occasionally follows total laryngectomy is associated with very poor prognosis regardless of treatment modality, so it is very important to identify high risk patients to prevent stomal recurrence. Objectives : We attempted to select an optimal management method to prevent stomal recurrence by analyzing risk factors in each patient who was found to have stomal recurrence following total laryngectomy. Materials and Methods : Risk factors in each of eleven patients who had stomal recurrence out of 159 patients who underwent total laryngectomy in the last ten years were analyzed retrospectively. Data were gathered on risk factors such as the presence of subglottic extension, extralaryngeal extension, thyroid gland invasion, lymph node metastasis, timing of tracheotomy, tumor stage, postoperative radiotherapy, and inclusion of the stoma in the radiotherapy field. Results : There were eight cases of subglottic extension, six cases of extralaryngeal invasion, one case of pharyngocutaneous fistula that occurred as a postoperative complication, and one case who was taken completion laryngectomy following conservation surgery. With the exception of one case who was taken tracheotomy prior to total laryngectomy, all tracheotomies were performed intra-operatively after endotracheal intubation. There was no evidence of paratracheal lymph node or prelaryngeal lymph node metastasis on preoperative neck CT scan. There were six cases of T4 tumors, four cases of T3 tumors, and one case of T2 tumor. Salvage surgery was performed following radiotherapy in three cases, and aside from one case who was not taken post-operative radiotherapy, postoperative radiotherapy including the stoma was performed in the remaining seven cases within one month after surgery. Conclusion : Total laryngectomy with wide paratracheal lymph node dissection, thyroidectomy, and tracheotomy should be performed for patients who have high risk factors such as subglottic extension and advanced stage. We believe that tracheotomy should be precede endotracheal intubation. Efforts should be made to prevent stomal recurrence by utilizing postoperative radiotherapy and by minimizing postoperative complications such as infection and fistula.

• Korean Journal of Head & Neck Oncology
• /
• v.25 no.1
• /
• pp.18-23
• /
• 2009

Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.6 no.1
• /
• pp.5-8
• /
• 1995

Bilateral vocal cord palsy is uncommon but is serious because of airway obstruction. Treatments of bilateral vocal cord palsy are initially tracheotomy, vocal cord lateralization and vocal cord reinnervation. Recently, we experienced nerve-muscle pedicle reinnervation in 3 cases of bilateral vocal cord palsy, so reported it with a review of literature.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1982.05a
• /
• pp.12-12
• /
• 1982

We have recently experienced a case of decannulation difficulty resulted from head and thoracic injury. The patient was 21-year-old male who undergone craniectomy and tracheotomy at other hospital about 7 months ago prior to admission On admission, there was swelling in glottic and subglottic region in indirect laryngoscopy and bronchoscopy with fixation of vocal cords in paramedian position. We tried to reestablish an adequate air way with bougination using Jackson esophageal bougie but there was no effect with it. So we performed vertical incision through cricoid cartilage and tracheal rings and insertion of Teflon tube in stenotic lesion for 9 months and removed it. At present time, the patient has been satisfactory corking training course.

• The Journal of the Korean dental association
• /
• v.52 no.10
• /
• pp.602-614
• /
• 2014

Obstructive sleep apnea syndrom(OSAS) is defined by total or partial collapse of the upper airway during sleep. In the presence of specific anatomic features, OSAS is potentially amenable to surgical treatment. Initially, the only treatment available for these patients was a tracheotomy that bypassed the obstruction and resulted in a 100% cure. However, this was not readily accepted by most patients, and surgical methods other than tracheotomy were developed to successfully maintain adequate upper airway patency during sleep by comparing to postoperative polysomnography(AHI,RDI etc). In this paper, I would like to provide an overview of some of the multilevel surgical techniques available for treating OSAS as well as the necessary preoperative considerations.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.2
• /
• pp.97-102
• /
• 2022

Background and Objectives Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist. Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period. Results Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients. Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.