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주영훈 대한연하장애학회 2014 대한연하장애학회지 Vol.4 No.2
Glottal closure occurs during the normal swallow was part of the mechanism that prevents aspiration of the bolus of foods. It also protects the airway from aspiration of respiratory secretions produced by the salivary glands of the upper aerodigestive tract. Glottal insufficiency disrupts glottal closure and herefore puts patients at risk of aspiration. Surgical treatment of glottal insufficiency includes injection laryngoplasty, medicalization thyroplasty with or without arytenoid adduction, cricopharynx muscle dilation, and cricopharynx myotomy. These treatment modalities should be included in the otolaryngologist’s armamentarium for managing dysphagia in patients with unilateral vocal fold paralysis.
주영훈,박준욱,조광재,김민식 대한이비인후과학회 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.3
Objectives. The aim of this study was to determine the role of preepiglottic space (PES) invasion in lymph node metastasis and prognosis in patients undergoing supracricoid partial laryngectomy (SCPL) with cricohyoidopexy (CHP). Methods. A retrospective review of 42 previously untreated patients with squamous cell carcinoma of the larynx that un- derwent surgery was performed. The mean age of the subjects was 61.3 years, and the male-to-female ratio was 38:4. Regarding their pathological stages, there were 3, 8, 22, and 9 cases of stage T1 to T4, respectively. Concerning the disease stage of the cervical lymph nodes, there were 30, 5, 6, and 1 cases with N0 to N3, respectively. Results. The PES invasion rate was 23.8% (10/42). Significant correlations were found between PES invasion and cervical lymph node metastasis (P=0.002). Seven of the 10 patients (70.0%) with PES invasion had cervical lymph node me- tastasis, whereas only 5 of the 32 patients (15.6%) without any evidence of PES invasion had lymph node metasta- sis. There was also a significant correlation of PES invasion with age (P=0.002) and T stage (P=0.030). However, there was no significant relationship between gender, primary tumor site, anterior commissure invasion, subglottic extension, paraglottic space invasion and PES invasion. There was a 5-year disease-specific survival of 70%. PES in- vasion served as a statistically significant prognostic factor for disease-specific survival (P=0.004). Cervical nodal me- tastasis (P=0.003) and subglottic extension (P=0.01) were also statistically significant prognostic factors associated with disease-specific survival. Conclusion. The PES invasion was significantly related to the cervical lymph node metastasis and prognosis in patients un- dergoing SCPL with CHP.
주영훈,황세환,선동일,조광재,박준욱,김민식 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.4
Objectives. Although T stage is an important prognostic tool for oral tongue cancer, it fails to define the depth of invasion and true three-dimensional volume of primary tumors. The purpose of this paper is to determine the relations between tumor volume and lymph node metastasis and survival in early oral tongue cancer. Methods. Forty-seven patients with T1-2 tongue cancer were included. Tumor volumes were measured by the computerized segmentation of T2-weighted magnetic resonance imaging. Results. The overall average tumor volume was 27.7 cm3 (range, 1.4 to 60.1 cm3). A significant positive correlation was found between tumor volume and pathological T stage, depth of invasion, and cervical lymph node metastasis (P<0.001, P<0.001, and P=0.002, respectively). When the tumor volume exceeded 20 cm3, the cervical metastasis rate increased to 69.2%. The overall 5-year disease specific survival rate was 80%. There was a statistically significant association between large tumor volume (≥20 cm3) and the 5-year disease-specific survival (P=0.046). Conclusion. Tumor volume larger than 20 cm3 was associated with greater risk cervical lymph node metastasis and poor 5-year disease-specific survival rate in early oral tongue cancer patients.
주영훈,조재근,구본석,권민수,권성근,권순영,김민수,김정규,김희진,남인철,노종렬,박영민,박일석,박정제,신성찬,안순현,원성준,류창환,윤태미,이길준,이도영,이명철,이준규,이진춘,임재열,장재원,장전엽,정만기,정유석,조재구,최윤석,최정석,이국행,정필상 대한이비인후과학회 2019 Clinical and Experimental Otorhinolaryngology Vol.12 No.2
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient’s treatment goals.
Morphologic Assessment of Polycaprolactone Scaffolds for Tracheal Transplantation in a Rabbit Model
주영훈,박정훈,조동우,선동일 한국조직공학과 재생의학회 2013 조직공학과 재생의학 Vol.10 No.2
The purpose of this study was to clarify whether a polycaprolactone (PCL)-framed porous tracheal scaffold could be used for the replacement of the trachea in rabbits and produce better results in terms of luminal epithelialization. The tracheal scaffold consists of a PCL-framework and a collagen layer. After a longitudinal cervical skin incision,the trachea was exposed and a rectangular defect (1×0.5 cm) was created on the cervical trachea by a scalpel on eight rabbits. PCL-scaffold was trimmed and fixed to defect boundaries with Tisseel. Postoperatively, the site was evaluated endoscopically and histologically. Bronchoscopic examinations at 1 week revealed that implant exposure was recognized in the entire length of the prosthesis. The luminal surface of the implanted scaffold was partially covered at 2 weeks and completely covered at 4 weeks. Histologic data showed that the epithelial lining was nearly completed 1 week after surgery and some inflammatory cells were seen in the submucosa. At 2 weeks, the epithelium was already covered and the migration of inflammatory cells was not observed. However the concentration of cilia was not observed at this week. At 8 weeks there was also a neovascularization with luminal epithelialization. These findings suggest that a PCL-framed porous tracheal scaffold used in our experiment is an effective way to regenerate the epithelium on the surface of an artificial trachea.