경구강 레이저 및 로봇 수술

노종렬,유창환,Roh, Jong-Lyel,Ryu, Chang Hwan 대한기관식도과학회 2011 大韓氣管食道科學會誌 Vol.17 No.1

Traditionally, the main strategy of treatment of the head and neck cancer was en bloc resection including adjacent normal tissues through wide incision. However, the procedures may leave severe functional deficit such as swallowing difficulty, aspiration, and wide neck scar. Therefore, many attempts have been made up to minimize these morbidities. Of them, the minimal invasive approach such as transoral laser microsurgery (TLM) and transoral robot surgery (TORS) have been spolighted as a sensible strategy for organ preservation of the head and neck cancer patients. Results of TLM are equivalent to those obtained by conventional surgery, with considerably less morbidity, less hospital time and better postoperative function. Oncologic results of TLM are equivalent to conventional surgery. TORS are safe, feasible, and promising but oncologic safety is not yet verified. This article covers to current application of TLM and TORS, their advantages and limitations, and future direction.

성문협착과 마비의 치료

노종렬,Roh, Jong-Lyel 대한기관식도과학회 2006 大韓氣管食道科學會誌 Vol.12 No.2

성대돌기 육아종의 수술적 치료

유명상,송형민,노종렬,최승호,김상윤,남순열,Yu, Myeong-Sang,Song, Hyung-Min,Roh, Jong-Lyel,Choi, Seung-Ho,Kim, Sang-Yoon,Nam, Soon-Yuhl 대한후두음성언어의학회 2006 대한후두음성언어의학회지 Vol.17 No.1

Background and Objectives: Vocal cord granuloma is a exophytic inflammatory mass and caused by gastroesophageal reflux, voice abuse, endotracheal intubation. There has been a controversy in the treatment of vocal cord granuloma. Our aim of study is to know the clinical characteristics and the results of surgical management for vocal cord granuloma. Materials and Methods: We have reviewed and analyzed medical records of 55 patients who were diagnosed and surgically treated as vocal cord granuloma in Asan medical center from 1997 to 2005 retrospectively. Results: 25 cases were intubation granuloma and 30 cases were contact granuloma. In intubation granuloma, the clinical manifestation was hoarseness(70%), foreign body sensation(44%), chronic cough(21%). In contact granuloma, the clinical manifestation was hoarseness(67%), foreign body sensation(60%), throat clearing(21%). The recurrence rate after surgery was 8% in intubation granuloma and 33% in contact granuloma. Mean recurrence time was 4.1months in intubation granuloma and 3.2months in contact granuloma. Conclusion: Although there is no significant difference, recurrence rate after surgery was high in contact granuloma compared to intubation granuloma(p=0.125). Although this study is retrospective, surgical management must be considered in resolving diagnostic doubt, treating airway obstruction, and failure in conservative treatments.

영아 기관절개술의 임상적 고찰

한주희,최승호,노종렬,남순열,김상윤,Han, Ju-Hee,Choi, Seung-Ho,Roh, Jong-Lyel,Nam, Soon-Yuhl,Kim, Sang-Yoon 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.1

Background and Objectives: Improvements in the fields of neonatology and surgical subspecialities make tracheotomy possible to the younger population. But complication rates for infantile tracheotomy are significantly higher than that for the other pediatric tracheotomy. This study was designed to present our 9-year experiences of infantile tracheotomy and to evaluate the effect of several factors of complications. Materials and Methods: From 1996 through 2004, 60 tracheotomies were performed. Charts were reviewed with respect to indications for tracheotomy, underlying diseases, success rate in decannulation and length of support time until decannulation, complication and mortality rate. Results: There were 41 male patients and 19 female patients. Ventilatory support for neurological impairment(38.3%) was the leading indication for tracheotomy, followed by subglottic stenosis(36.7%), laryngomalacia(13.3%). Decannulation was accomplished in 60.0% of infants with an average of 56.5momths with tracheotomy. Complications occurred in 43.3%. There was one tracheotomy-related mortality in case of tracheal atresia. Most common complication was subglottic stenosis. Conclusion: Infantile tracheotomy had significant morbidities and its outcomes are thought to be usually related to the underlying disease and age. To prevent complication, early decannulation is advisable, and for long-term tracheotomy patients, regulation of reflux and infection may be necessary.

알레르기성 비염 환자들의 음향음성학적 특성 및 음성장애지수

김성태,최승호,노종렬,이봉재,심미란,김상윤,남순열,Kim, Seong-Tae,Choi, Seung-Ho,Roh, Jong-Lyel,Lee, Bong-Jae,Shim, Mi-Ran,Kim, Sang-Yoon,Nam, Soon-Yuhl 대한후두음성언어의학회 2007 대한후두음성언어의학회지 Vol.18 No.1

Background and Objectives: There are few studies reported that specifically examine the phonetic characteristics and voice handicap index (VHI) in patients with Allergic Rhinitis. This study was designed to examine phonetic characteristics and VHI in adult patients with allergic rhinitis. Materials and Methods: Forty-two male patients diagnosed as allergic rhinitis were given skin-prick test and others, aged from 20 to 56 years, and were compared with a 16 male control group with no pathology and in the same age group. The VHI was used to measure the changes of patient's perception. Acoustic and aerodynamic analysis test were done, and a nasalance test performed to measure rabbit, baby, and mother passage. Acoustic rhionometry (AR) was performed to evaluate nasal volume and nasal crosssectional area. Statistical analysis was done using independent sample t-test. Results: VHI showed significantly different score in the studied group, higher than that of control group. AR graph showed that there was no significant differences of nasal volume and nasal cross-sectional area. The Shimmer and SFF value in the group of allergic patients were higher than in the control group. MPT value in the group of allergic patients was lower than in the control group. Nasalance in allergic patients showed hypernasality all passage. Conclusion: We suggest that patients with allergic rhinitis have considerable voice problems. Most of them have hypernasality, which may be a compensatory mechanism by nasal obstruction.

갑상설관낭종에서 발생한 유두상암종 4예

정재훈,한명월,노종렬,최승호,김상윤,남순열,Jung, Jae Hoon,Han, Myung Woul,Roh, Jong-Lyel,Choi, Seung-Ho,Kim, Sang Yoon,Nam, Soon Yuhl 대한기관식도과학회 2012 大韓氣管食道科學會誌 Vol.18 No.1

Carcinoma arising in a thyroglossal duct cyst is a not common disease. It is detected in approximately 1% of thyroglossal duct cyst, therefore the clinical manifestation of the patient with carcinoma is undistinguishable from the common cystic lesion. Clinically, it may be confounded with a benign lesion and diagnosed after operation. The mainstream of treatment is the Sistrunk operation, however, there is no definite agreement regarding further treatment in addition to an excision of the cyst. The role of total thyroidectomy and the radioactive iodine therapy have been discussed for adjuvant treatment. We have experienced four cases of papillary carcinoma arising in thyroglossal duct cyst. In the three of the cases, the patients underwent Sistrunk operation, while the other one had additional total thyroidectomy and postoperative radioactive iodine therapy. There was no complication in the perioperative period and no signs of recurrence or metastasis during follow-up period.

후두 전 절제술을 시행 받은 환자의 장기 추적 및 삶의 질

김인준,김지희,노종렬,최승호,김상윤,남순열,Kim, In-June,Kim, Ji-Heui,Roh, Jong-Lyel,Choi, Seung-Ho,Kim, Sang-Yoon,Nam, Soon-Yuhl 대한후두음성언어의학회 2007 대한후두음성언어의학회지 Vol.18 No.1

Objectives: There is a perception that a total laryngectomy has a devastating effect on patients and their families, but only a few studies have addressed long-term quality of life (QOL) after laryngectomy. Materials and Methods: A cross-sectional study of 32 patients more than 3 years since laryngectomy was performed. Patients were asked to complete the SF-36 questionnaire before surgery and within 3-5 years after surgery. Preoperative and postoperative SF-36 scores were compared with data on 46 age-matched healthy controls. Results: The most of SF-36 subscale scores showed significant deterioration after surgery. Preoperative scores had significantly poorer than the normal controls on 6 subscales, and also postoperative scores was lower than normal controls on 2 subscales. Conclusion: In the study, the quality of life of the patients who underwent total laryngectomy show poorer scores than pre operative status and normal controls.

양측성 성대결절 환자의 발성시작시간(VOT)에 관한 연구

박선영,김성태,김상윤,최승호,노종렬,남순열,Park, Sun-Young,Kim, Seong-Tae,Kim, Sang-Yoon,Choi, Seung-Ho,Roh, Jong-Lyel,Nam, Soon-Yuhl 대한후두음성언어의학회 2006 대한후두음성언어의학회지 Vol.17 No.2

Background and Objeetives : There are few studies reported that specifically examined the voice onset time(VOT) in patients with bilateral vocal nodules. The purpose of this study was to study the characteristics of voice onset in patients with bilateral vocal nodules. Materials and Methods : 52 female patients with bilateral vocal nodules were examined, aged from 20 to 54 years, and were compared with 25 normal female control group. All subjects produced five repetitions of the voiceless stops $/p^h,\;t^h\;k^h/$ in vowel context /ai_a/. VOT was measured by the time between the release of the stops and the onset of voicing. Results : VOTs of the voiceless stops $/p^h/\;and\;/t^h/$ in patients with bilateral vocal nodules were significantly shorter than those of normal subjects. VOT of the $/k^h/$ in them was shorter than those of normals, but the difference was not significant. This results showed that VOTs of the voiceless stops in patients with bilateral vocal nodules were shorter than those of normal subjects. Conclusion : The rapid onset of voicing in patients with bilateral vocal nodules might be associated with increased laryngeal muscle tension by hard glottal attacks. We suggest that VOT can be a clinically useful acoustic parameter for evaluating voice in patients with bilateral vocal nodules.

갑상선암 수술 후 재발한 경부림프절의 위치 확인에 있어서 초음파 유도하 참숯 현탁액 표식의 유용성: 예비보고

이종철,한명월,이정현,노종렬,남순열,김상윤,최승호,Lee, Jong Cheol,Han, Myung Woul,Lee, Jeong Hyun,Roh, Jong-Lyel,Nam, Soon Yuhl,Kim, Sang Yoon,Choi, Seung-Ho 대한기관식도과학회 2011 大韓氣管食道科學會誌 Vol.17 No.1

Objectives The high sensitivity of ultrasound and thyroglobulin determination for follow-up of differentiated thyroid cancer allows early detection of nonpalpable recurrences. Intraoperative localization of these small foci in previously dissected necks is a surgical challenge. We assessed the safety and effectiveness of ultrasound-guided tattooing (US-tattoo) with a charcoal suspension for localizing nonpalpable cervical recurrences after thyroidectomy for thyroid cancer. Subjects and Methods Between March 2009 and December 2010, we retrospectively reviewed 19 patients who underwent US-tattoo with injection of a charcoal suspension for recurrent thyroid papillary cancer on central neck compartment after thyroidectomy. All patients underwent the surgical dissection after US-tattoo. The complications and effectiveness of US-tattoo were evaluated. Results The technical success rate of US-tattoo for suspicious lesions was 100%. There was no complication with regard to US-tattoo. During surgery, all but one tattooed lesions were detected by surgeons. On final pathologic reports, all recurrence lesions but two cases were successfully removed. Conclusion Preoperative US-tattoo is a safe and effective method for successful reoperation of central neck compartment recurrences after thyroidectomy.

정상 구강 점막 소견의 구강 통증 환자의 진단 및 치료

김태수,김상윤,남순열,노종렬,최승호,Kim, Tae-Su,Kim, Sang-Yoon,Nam, Soon-Yuhl,Roh, Jong-Lyel,Choi, Seung-Ho 대한기관식도과학회 2008 大韓氣管食道科學會誌 Vol.14 No.1

Objectives : Oral pain without identifiable oral mucosa lesion is probably multifactorial origin, which include burning mouth syndrome (BMS), oral candidiasis and so on. The aim of this study was to analyze the characteristics of oral pain without identifiable oral mucosa lesion and to evaluate treatment outcome of those patients. Materials and Methods : We reviewed 50 patients without identifiable oral mucosa lesion who were complaint of oral pain. The patients were analyzed according tothe sites, associated symptoms, laboratory tests and fungus culture. The questionnaire included questions on their current diseases, smoking and alcoholic history, psychological factors, and symptoms. Results : The average age of patients was 60 years old. The most frequently involved site was tongue (92%), followed by palate, lower lip, oropharynx, and gingiva. 60% of the patients has psychological disorder as self reported. Culture for Candida was positive in 36% of patients and serum zinc deficiency was present in 60% of patients. Serum iron, vitamin B12, hemoglobin, folic acid deficiency were present in 6-2% of patients. Seventeen patients (65%) with BMS and twelve patients (66%) with oral candidiasis were improved after treatment. Conclusion : We recommend oral candida culture to oral pain patients without oral mucosa lesion. Zinc supplementation of zinc depletion patients may be helpful whereas other laboratory tests have no diagnostic values.