급성호흡부전를 유발한 거대 흉골하 갑상선종 1예

신향애,홍성표,손인경,김철호 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.7

Substernal goiter is defined as a thyroid mass of which more than half is located below the thoracic inlet. As substernal goiter enlarges within the bony thoracic cavity, and vascular and visceral structures may slowly become compressed and compromised. Airway obstruction can occur due to the compression or the displacement of the trachea. Tracheal compression may rarely lead to severe respiratory compromise. Recently, we experienced a case of huge substernal goiter causing acute respiratory failure in a 63-year old female. We present this case with a review of the literature.

타액선에 발생한 다발성 MALT 림프종 1예

신향애,강희선,황은,김철호 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.12

Primary malignant lymphomas of the salivary glands are uncommon. The parotid gland was most frequently involved, followed by the submandibular gland, minor salivary glands and sublingual gland. The most common subtype is mucosa-associated lymphoid tissue (MALT) lymphoma. MALT lymphoma is a relatively indolent disease and tends to remain localized for prolonged period of time. But, we experienced a case of a multifocal salivary MALT lymphoma involving both parotid glands and right submandibular gland during its progression of disease. We report a case with a review of the literature. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:1166-9)

미만성 대세포성 B세포 림프종과 MALT 림프종이 혼재된 갑상선 림프종 1예

신향애 ( Hyang Ae Shin ),한재호 ( Jae Ho Han ),이종주 ( Jong Joo Lee ),김철호 ( Chul-ho Kim ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.1

Primary thyroid lymphoma is a rare thyroid tumor, representing approximately 2∼3% of all non-Hodgkin's lymphoma (NHL) and 2∼8% of all thyroid malignancies. Thyroid lymphomas typically occur in middle- to older-aged women. Pathologically, most thyroid lymphomas are non-Hodgkin's lymphomas of B-cell origin whereas Hodgkin's and T-cell thyroid lymphomas occur rarely. Diffuse large B-cell lymphoma (DLBCL) is the most common histologic type followed by mucosa-associated lymphoid tissue (MALT) lymphoma. MALT lymphomas classically arise in a background of longstanding autoimmune thyroiditis. We report a case of mixed diffuse large B-cell lymphoma and MALT lymphoma of the thyroid gland accompanied by Hashimoto's thyroiditis with a review of the literature.

윤상연골에 발생한 연골육종 1예

장재원,신향애,정하민,최은창 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.6

Laryngeal chondrosarcoma is a cartilaginous malignant tumor which is rarely encountered in the head and neck. They occur most often in the paranasal sinus, mandibule, and larynx. The cricoid cartilage is the most common site of the laryngeal chondrosarcoma. Complete surgical resection and postoperative radiotherapy are generally recommended. Almost all cases of the laryngeal chondrosarcoma are detected early because of the rapid development of symptoms such as dyspnea,dysphagia and hoarseness, which are caused by the anatomic location. Authors experienced a case of laryngeal chondrosarcoma that originated from the cricoid cartilage in a 67 yearold male without any symptoms. The mass was found on a routine esophagogastroduodenoscopy examination. Hemicricoidectomy with complete excision of tumor was performed via laryngofissure approach. The patient did not undergo radiotherapy, since all margins of the resected mass were tumor-free. There was no evidence of recurrence or metastasis 12 months after surgery. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:378-82

인후두 역류증에 대한 양성자 펌프 억제제 단기 치료가 음성에 미치는 영향

이자현,신향애,최현승,김창용,정세원,장정현 대한이비인후과학회 2014 대한이비인후과학회지 두경부외과학 Vol.57 No.10

Background and Objectives The aim of this study was to verify that voice analysis could be an alternate tool for the evaluation of proton pump inhibitor treatment of laryngopharyngeal reflux (LPR). Subjects and Method Twenty-two patients with LPR symptoms underwent laryngoscopy, stroboscopy and their reflux finding index (RFI) were evaluated. Subjective reflux symptom scores (RSS) and voice handicap index (VHI) were completed at the baseline. All patients underwent voice analysis. Thereafter, patients had short-term proton pump inhibitor therapy for 6 weeks. The RFI, RSS, VHI and voice analysis were repeated during the last week of the treatment. Results RFI was improved and both RSS and VHI were improved after the treatment. RSS and VHI were significantly correlated. In voice analysis, shimmer significantly improved and harmony to noise ratio (HNR) also improved. Conclusion Voice analysis can be indicators of treatment results of laryngopharyngeal reflux disease. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(10):703-6

하인두 내에 발생한 유경성 섬유지방종 1예

이태성,신향애,기정혜,김지훈 대한후두음성언어의학회 2022 대한후두음성언어의학회지 Vol.33 No.2

Fibrolipomas are a rare microscopic variant of lipomas, characterized by mature adipose tissue interspersed with dense fibrous connective tissue. These lesions are rarely observed in the head and neck region and represent <0.6% of all benign tumors of the larynx and hypopharynx. Their clinical presentation depends on the location and size of lesions. Patients present with variable symptoms; however, fibrolipomas of the larynx and hypopharynx are clinically important because these tumors can cause unpredictable airway obstruction, particularly during general anesthesia induction. We present a case of a hypopharyngeal fibrolipoma in a 61-year-old patient with frequent dyspnea, dysphagia, and muffled voice. Laryngoscopy revealed a well-demarcated pedunculated ovoid mass involving the larynx. We performed laryngomicrosurgery using a carbon dioxide laser for surgical excision and subsequent evaluation confirmed the diagnosis of fibrolipoma. We report a case of hypopharyngeal fibrolipoma, together with a literature review.

비·부비동 양성 종양의 임상적 고찰

김진국,신향애,임채형,장현종,심대보 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Background and Objectives: Benign tumors of the nose and paranasal sinues are rare in comparison with malignant growths. Authors aimed to investigate the incidence and characteristics of benign sino-nasal tumors. Materials and Methods: From 1994 through 2004, 25 cases of benign sino-nasal tumors (17 men and 8 women) were diagnosed and cared at the Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University. We reviewed medical records of patients to find out clinical features, radiologic findings, operative findings, therapeutic options, and outcomes. Postoperative observation was given for fifteen months on the average. Results: The most common symptom was nasal obstruction, followed by nasal mass, frequent nasal bleeding, headache, and rhinorrhea, and the mass mainly placed in the lateral nasal wall. There were 12 cases (48%) of inverted papilloma, 4 (16%) cases of squamous papilloma, 4 (16%) cases of hemangioma, 1 (4%) case of pleomorphic adenoma, 1 (4%) case of leiomyoma, 1 (4%) case of lipoma. All the tumors were surgically removed. For the treatment of inverted papilloma, medial maxillectomy had been performed before 1997(2 cases); however, most cases have been managed with endonasal endoscopic technique since 1997. Recurrence was observed in two patients with inverted papilloma and one patients with squamous papilloma. Conclusion: Inverted papilloma is the most common benign tumor in the nose and paranasal sinuses, followed by squamous papilloma and hemangioma. The optimal management of benign tumors is complete excision of tumor and endonasal endoscopic surgery is an effective treatment for an inverted papilloma.

Larynx-Preserving Partial Pharyngectomy via Lateral Pharyngotomy for the Treatment of Small (T1~2) Hypopharyngeal Squamous Cell Carcinoma

임영창,정하민,신향애,최은창 대한이비인후과학회 2011 Clinical and Experimental Otorhinolaryngology Vol.4 No.1

Objectives. To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). Methods. We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. Results. The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. Conclusion. LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.

후두에 발생한 유전성 혈관부종 1예

심대보,임영창,신향애,김진국 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.4

Hereditary angioneurotic edema (HAE) is an autosomal dominant disease that results from the deficiency of C1 esterase inhibitor (C1-INH) function. Urgent proper intervention of the upper airway is warranted to save the life of patients with the disease, which often causes acute airway obstruction. We present, with a review of literature, a case of 37-year old woman with HAE of larynx. (Korean J Otolaryngol 2006;49:464-7)

성문상부 편평세포암종 N0 경부의 예방적 외측 경부청소술에서Level Ⅳ 림프절의 절제가 반드시 필요한가?

임영창,김민범,신향애,권순호,이세영,이진석,구본석,최은창 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.9

Background and Objectives:To determine whether level IV lymph nodes can be saved in the elective lateral neck dissection (LND) as a treatment for patients with squamous cell carcinoma of the supraglottic larynx. Subjects and Methods:From January 1997 to May 2002, 42 patients with supraglottic squamous cell carcinoma and a clinically N0 neck who underwent an elective LND were studied prospectively. The incidence of pathological metastasis to the level IV lymph nodes and a regional recurrence after an elective LND were evaluated. Results:Of the 42 patients, 10 (24%) had lymph nodes positive for microscopic metastatic squamous cell carcinoma. Two (5%) of the 42 patients had involvement of the level IV lymph nodes, whose clinical T-stages were above cT3. None of the clinical T1 or T2 tumors showed level IV nodal metastasis. There were two cases (5%) of the ipsilateral neck recurrence:these patients developed recurrence in the level II and stomal area, respectively. Conclusion:The level IV lymph node metastasis was rare in this study, and nodal recurrence after LND in squamous cell carcinoma of the supraglottic larynx was infrequent. Therefore, this region may be preserved in elective LND for patients with early squamous cell carcinoma of the supraglottic larynx.