후두에 발생하는 원발성 비호치킨 림프종

한명월,최승호,김상윤,남순열 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.9

Non-Hodgkin’s lymphoma rarely involves the larynx. We retrospectively reviewed six patients with the diagnosis of lymphoma involving the larynx from January 1997 to December 2007. Fiberoptic examination showed diverse features involving the supraglottis. On histologic examination of the biopsy specimen, there were mucosa-associated lymphoid tissue lymphoma (MALT) in 2 cases, Mantle cell lymphoma in 2 cases, and NK/T cell lymphoma in 2 cases. In 4 cases, there was no systemic involvement by the lymphoma. These patients were treated with multiagent chemotherapy and radiotherapy and developed a complete response to therapy. But in one NK/T cell lymphoma patient, tumor recurrence was detected in nasopharynx after 3 years. In the other NK/T cell lymphoma patient, there was appendix involvement and he expired after 3 weeks in diagnosis. The early symptoms of laryngeal NHL are usually subtle and easily neglected. Early detection and aggressive therapy should be considered in laryngeal NHL.

한국인에서의 중추청각처리장애 진단을 위한 검사도구의 적용과 나이에 따른 정상 범위

한명월,안중호,정종우 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.8

Background and Objectives:To develop and apply a diagnostic test tool for central auditory processing disorder (CAPD) and to obtain normative data of Korean subjects with normal hearing. Subjects and Method:After obtaining the approvement of the Institution Review Board of Asan Medical Center for this clinical study, we conducted this study for 135 subjects with normal hearing. Frequency & duration pattern tests and dichotic test were administered to subjects with normal hearing were evaluated by pure tone audiometry. Patients were separated into the following age categories:up to and including 7-year-olds, 8- and 9- year-olds, 10- and 11-year-olds, 12- to 18-year-olds and adults over 18. Results:The frequency pattern test showed that the mean score was 14.4±7.1, 19.7±9.2, 23.8±8.6, 24.1±7.0 and 28.5±2.7, for each age category, respectively. The duration pattern test showed that the mean score was 13.8±6.2, 17.0±6.1, 21.6±5.4, 25.6±4.3 and 28.4±2.1, respectively. The dichotic test showed that the right mean scores were 26.5±3.2, 27.0±3.2, 27.8±3.2, 29.4±0.9, 27.9±1.5 and left the mean scores 26.4±3.7, 27.0±2.6, 28.6±1.4, 28.6±1.3, 27.9±1.6 for each age category, respectively. Conclusion:We obtained the normative data of Korean subjects for the diagnosis of CAPD. Additional diagnostic tools and treatment methods must be developed continuously. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:694-8)

연하장애의 수술적 치료

한명월,최승호 대한연하장애학회 2011 대한연하장애학회지 Vol.1 No.1

Dysphagia, or difficulty swallowing, occurs commonly, especially in elderly and debilitated patients. Dysphagia encompasses a wide range of etiologies. Its proper evaluation and treatment uses tools and expertise from a variety of specialties working toward the common goals of safety and satisfactory quality of life. The head and neck surgeon can be an important member of the dysphagia rehabilitation team. Most causes of dysphagia do not require surgical intervention to accomplish these goals; however, several entities warrant surgery to treat a specific problem or to augment medical/therapeutic management. The role of surgery in the management of dysphagia is clear in some areas and controversial in others. Evaluation for the causes of dysphagia elucidates conditions that have been shown to benefit from surgery for safety, for improved quality of life, or both. Surgical therapy, when indicated, is safe and effective for many causes of dysphagia.

천식환자에서의 음성의 질

한명월,김성태,최승호,김상윤,남순열,Han, Myung-Woul,Kim, Seong-Tae,Choi, Seung-Ho,Kim, Sang-Yoon,Nam, Soon-Yuhl 대한후두음성언어의학회 2009 대한후두음성언어의학회지 Vol.20 No.1

Background and Objectives: In patients with asthma, increased obstruction and resistance of airway result in impairment in the generation of voice. Allergy and nasal polyposis, which are frequently observed in patients with asthma, are other factors that affect the vocal performance. Bronchodilators and steroids are commonly used in the treatment of asthma, and these agents also have been reported to be associated with voice changes. The aim of this study is to evaluate the voice quality in patients with mild to-moderate asthma by subjective and objective methods. Materials and Methods: A total of 36 patients with asthma established in the Department of Respiratory Medicine were included in this study. 23 were women and 13 were men, with a mean age of 51.7 years. The average duration of asthma was 77.0 months. All patients had mild-to moderate asthma. Acoustic and aerodynamic analyses were performed and the movements of the vocal cords were examined by videolaryngostroboscopy (VLS). Voice Handicap Index (VHI) and GRABS scales were used for subjective evaluations. Results: 50% of patients suffered from dysphonia and FO was 119.3${\pm}$23.7 Hz in male and 198.2${\pm}$18.4 Hz in female patients. There were no significant differences in average shimmer and NHR between females (4.90${\pm}$2.95% ; 0.1O${\pm}$0.04 dB) and males (4.64${\pm}$2.45% ; 0.20${\pm}$0.15 dB). However, the value of jitter was greater for females (2.60${\pm}$1.92%) than for males (1.21${\pm}$0.84%). The VHI score was above the normal limit in 35%, and VLS findings were shown diverse abnormality in 89% asthmatics from mucosal change to hyperfunction of supragottis and contact granuloma. But duration of illness and steroid dose did not correlate with these findings. Conclusion: Subjective and objective abnormality was shown in more than 50% of asthmatic patients. We suggest that persons who suffer from asthma should be examined for possible voice disorders by laryngologist. Additionally, appropriate medical care and voice therapy should be provided for those who have voice disorders associated with asthma.

후두에 발생한 신경초종 1예

한명월,김인준,남순열 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.3

Neurogenic neoplasms involving the head and neck are uncommon. We report a case of supraglottic schwannoma. The tumor was located in the right false vocal cord level. It was removed by transoral CO2 laser surgery. (Korean J Otorhinolaryngol- Head Neck Surg 2008;51:289-91)

두경부암의 방사선 저항성 기전 및 극복방안 연구

한명월 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.5

Radiotherapy plays an important role in the treatment of most of solid tumors including headand neck squamous cell carcinoma (HNSCC). Radioresistance can lead to locoregional recur-rence and distant metastases. Despite significant progress in research of radioresistance, itsprediction and overcoming strategies remain challenging. This review describes the potentialbiomarkers correlated to the radioresistance and complex signal pathway in mechanism of ra-dioresistance focusing on the PI3K and EphA3 pathway.

두경부암의 기능보존수술

노종렬,한명월 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.1

Organ preservation strategy in treatment of the head and neck cancer (HNC) has led to an increase in the use of primary chemoradiation in both laryngeal and extralaryngeal sites for recent two decades. Primary non-surgical chemoradiotherpay has replaced the traditional gold standard of surgery followed by postoperative radiation with saving the organ and no compromising oncological outcomes. In accompany with wide clinical extension of primary chemoradiation, organ preservation surgery through open transcervical or transoral route has been increasingly used in the patients with HNC at both primary and salvage settings. Minimally invasive transoral approach using lasers or robots has been more spotlighted as a sensible strategy for organ preservation of the HNC patients. There is, however, a paucity of randomized controlled clinical trial data comparing primary organ-preserving chemoradiation to organ preservation surgery. Future direction leads to conduct well-designed clinical trials to establish the functional and oncological benefits of the organ preservation surgery. This article reviews the role of organ preservation surgery in head and neck cancer.

일측성 성대 마비의 치료 원칙

한주희,한명월,남순열,Han, Ju-Hee,Han, Myung-Woul,Nam, Soon-Yuhl 대한후두음성언어의학회 2009 대한후두음성언어의학회지 Vol.20 No.2

Vocal fold paralysis continues to be a dominant topic in laryngology. This review article discusses the management principle of patients suffering from unilateral vocal fold paralysis. There are currently some main methods ; voice therapy ; injection laryngoplasty ; laryngeal framework surgery ; reinnervation procedures.

재발성 호흡기 유두종증의 병변내 시도포비어 치료

송형용,한명월,최승호,김상윤,남순열,Song, Hyoung-Yong,Han, Myung-Woul,Choi, Seung-Ho,Kim, Sang-Yoon,Nam, Soon-Yuhl 대한후두음성언어의학회 2009 대한후두음성언어의학회지 Vol.20 No.2

Background and Objectives: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the aerodigestive tract. We aimed to estimate the effect of intralesional injections of cidofovir in patients with RRP. Materials and Method: Within the period from January 2003 to July 2007, 13 patients aged 2 to 61 years were treated with intralesional injections of cidofovir combined with surgical excision of RRP. Cidofovir was injected intralesionaly at a concentration of 5 mg/cc after complete removal of the papilloma with $CO_2$ laser or microdebrider. We evaluated the effect of intralesional cidofovir therapy by comparing pre-treatment mean interval of recurrence with post-treatment interval of recurrence. Results: Of 13 patients, two patients showed complete response during follow up period and four patients showed partial response. Seven patients did not respond to cidofovir at all. Mean pre-treatment mean interval of recurrence was 9 months and mean post-treatment interval of recurrence was 13.1 months (p=0.039). There was a statistical significance between the injected dose of cidofovir and post-treatment interval of recurrence (p=0.009). There were no local or systemic side effects caused by cidofovir. Conculsion : Intralesional injection of cidofovir seems to have a potential of a safe and effective adjuvant therapy of RRP. There was a positive correlation between the injected dose of cidofovir and patient clinical outcomes so that administration of higher doses and more frequency of injections should be needed to reduce recurrence. Further study regarding injection therapy regimen for RRP is required.

진행된 하인두암의 동시 항암화학 방사선 요법 후 구제 수술의 결과

류인선,한명월,노종렬,남순열,김상윤,최승호 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.10

Background and Objectives We evaluated treatment outcomes of patients with advanced hypopharyngeal cancer for whom surgical salvage was attempted after primary concomitant chemoradiation therapy (CRT) had failed as a treatment. The pre-salvage factors were assess-ed to predict the prognosis of salvage surgery. Subjects and Method A retrospective analysis was conducted from 1997 to 2006 for 22 patients with stage III-IV hypopharyngeal cancer who had undergone salvage surgery after local and/or regional CRT failures with no distant metastasis. Results Larynx-sacrificing pharyngectomy was performed in 12 (54.5%) of all patients. Postoperative complications occurred in 9 (40.9%), and carotid artery blowout occurred in two of these patients. After salvage surgery, the 2-year and 5-year overall survival rates were 52.8% and 28.9%, respectively. The 2-year disease specific survival rate and locoregional control rate were 45.5% and 60.0%, respectively. The initial N2-3 stage (p=0.038) and the concurrent local and regional failures (p=0.035) were independent predictors for decreased survival after salvage surgery. Two-year overall survival rates for patients with 2, 1, or none of these predictive factors were 23.3%, 66.7%, and 80.0%, respectively (p=0.027). Conclusion Although salvage surgery after CRT has postoperative complications and unfavorable larynx preservation, it can be considered as a viable option with acceptable oncologic outcomes for advanced hypopharyngeal cancer. The initial N2-3 stage and concurrent local and regional failures were independent predictors that can stratify patients into distinct prognostic groups for postsalvage survival.