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흉쇄유돌근의 회전피판을 이용한 수술 중 발생한 유미루의 치료 1예
김서빈(Seo Bin Kim),이형신(Hyoung Shin Lee),이강대(Kang Dae Lee),김성원(Sung Won Kim) 대한두경부종양학회 2016 대한두경부 종양학회지 Vol.32 No.2
Chyle fistula is one of the complications of neck dissections. Although immediate surgical repair seems to be the best choice when chyle leakage is observed during the operation, some operators can be embarrassed when chyle leakage is heavy and not controlled during surgery. In this case, chyle leakage was occurred after extensive resection of lymph nodes in left level IV, and was not controlled in any way. The clavicular head of sternocleidomastoid muscle was dissected and inferior-based muscular flap was rotated to cover the suspected region of fistula orifice. Amount of drainage was checked less than 20 ml per day in the following days, and drain tube was taken out on the 3rd postoperative days. We present the technique using the inferior based sternocleidomastoid muscle flap for intraoperative management of chyle leakage not easily controlled.
설하선 절제술 후 수술 중 초음파를 이용한 몰입성 하마종의 경구강 배액술
김서빈(Seo Bin Kim),김영준(Yeong Joon Kim),이소연(So Yeon Lee),이형신(Hyoung Shin Lee) 대한두경부종양학회 2023 대한두경부 종양학회지 Vol.39 No.1
Sublingual resection is known as the most effective treatment of choice to prevent recurrence in patients with plunging ranula. In this case report, we present our experience with a 37 year-old man with prolonged upper neck mass diagnosed as plunging ranula. He had persisting mass lesion even after 4 times of sclerotherapy. Due to fibrotic change the pseudocyst could not be drained after removing the sublingual gland. To resolve the mass lesion, ultrasonography guided transoral drainage was performed. Intraoperative ultrasonography may be useful for transoral drainage of plunging ranula difficult to approach after sublingual resection.
갑상선 절제술 후 발생하는 주관적인 음성 기능 저하의 위험 요인에 대한 연구
이형신(Hyoung Shin Lee),김성원(Sung Won Kim),박찬우(Chan woo Park),김창회(Chang Hoi Kim),김서빈(Seo bin Kim),임수진(Su jin Lim),이강대(Kang Dae Lee) 대한두경부종양학회 2016 대한두경부 종양학회지 Vol.32 No.1
Background and Objectives: Quality of voice may be deteriorated after thyroidectomy without any injury to recurrent laryngeal nerve. While there have been several studies showing the change of acoustic parameters after thyroidectomy, factors related to deteriorated voice quality have been rarely studies. In this study, we sought to analyze the factors associated to deteriorated voice quality after thyroidectomy. Materials and Methods: We made a retrospective review of 35 patients who underwent thyroidectomy for papil-lary thyroid carcinoma. Voice analysis including acoustic analysis, voice handicap index 10 (VHI-10), and GRBAS score was conducted before and 3 months after surgery. Patients were grouped according to the amount of increase in VHI-10 after surgery ; group A (ΔVHI<7) and group B (ΔVHI≥7). Clinicopathologic factors associated to patients of group B were analyzed and changes of parameters from acoustic analysis in each group were evaluated. Results : Patients of group B were associated with age ≥ 45 years (p=0.025) and showed borderline association to total thyroidectomy (p=0.075) and tumor size ≥ 1cm (p=0.086). Multivariate analysis demonstrated that those with age ≥ 45 years were independently associated to deteriorated quality of voice (p=0.014, HR=18.38). Patients of group B were also associated to significant deterioration of high pitch (p<0.001) and Grade score with borderline significance (p=0.054). Conclusion: Patients older than 45 years may have higher risk of deterioration of quality of voice after thyroi-dectomy based on increase of VHI-10 score (ΔVHI≥7). Association with deterioration of high pitch should also be considered in these patients.
갑상선 후방 피막을 침범하는 갑상선미세유두암의 임상양상에 대한 고찰
장성욱(Seong Uk Jang),오정호(Jung Ho Oh),김서빈(Seo Bin Kim),김성원(Sung Won Kim),이형신(Hyoung Shin Lee),노웅재(Woong Jae Noh),이강대(Kang Dae Lee) 대한두경부종양학회 2015 대한두경부 종양학회지 Vol.31 No.2
Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.