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Combined 18F-FDG PET/CT Imaging for the Initial Evaluation of Glottic Cancer
정한신,백정환,정만기,손영익,홍상덕,복권효 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.1
Objectives. The primary aim of this study was to determine whether 18F-FDG-PET/CT (PET/CT) scans provide additional diagnostic information in addition to the direct laryngoscopic examination (L/E) and contrast-enhanced CT (CT) in patients with glottic cancer during the initial evaluation. Methods. Fifty-five consecutive patients with glottic cancer of the larynx that had L/E, CT and PET/CT were enrolled. The diagnostic value of each modality was compared for their accuracy in predicting the extent of the primary tumors on sub-site based analysis and the final tumor staging. The reference standards were either the surgical pathology findings or clinical/radiological follow-up outcome. Changes in patient care based on PET/CT results were compared with the treatment decisions based on L/E with CT. Results. For primary tumor sub-site based analysis, the sensitivity was significantly higher for L/E (92.8%) than for PET/ CT (79.4%, P=0.028). The comparisons between L/E vs. CT and CT vs. PET/CT did not reach statistical significance. As an initial tumor-staging method the L/E had a diagnostic accuracy of 76.4%, compared to 61.8% for CT and 41.8% for PET/CT. The L/E and CT were better than the PET/CT (P=0.0009 and 0.049) for the initial TNM staging. PET/CT scanning changed the clinical decision-making based on the L/E with CT results in 12.7% of cases, of whom 5.5% had no additional PET/CT related benefit. Conclusion. The results of this study showed that PET/CT imaging added no clinical information benefit compared to the L/E and CT for the initial evaluation of patients with glottic cancer. Objectives. The primary aim of this study was to determine whether 18F-FDG-PET/CT (PET/CT) scans provide additional diagnostic information in addition to the direct laryngoscopic examination (L/E) and contrast-enhanced CT (CT) in patients with glottic cancer during the initial evaluation. Methods. Fifty-five consecutive patients with glottic cancer of the larynx that had L/E, CT and PET/CT were enrolled. The diagnostic value of each modality was compared for their accuracy in predicting the extent of the primary tumors on sub-site based analysis and the final tumor staging. The reference standards were either the surgical pathology findings or clinical/radiological follow-up outcome. Changes in patient care based on PET/CT results were compared with the treatment decisions based on L/E with CT. Results. For primary tumor sub-site based analysis, the sensitivity was significantly higher for L/E (92.8%) than for PET/ CT (79.4%, P=0.028). The comparisons between L/E vs. CT and CT vs. PET/CT did not reach statistical significance. As an initial tumor-staging method the L/E had a diagnostic accuracy of 76.4%, compared to 61.8% for CT and 41.8% for PET/CT. The L/E and CT were better than the PET/CT (P=0.0009 and 0.049) for the initial TNM staging. PET/CT scanning changed the clinical decision-making based on the L/E with CT results in 12.7% of cases, of whom 5.5% had no additional PET/CT related benefit. Conclusion. The results of this study showed that PET/CT imaging added no clinical information benefit compared to the L/E and CT for the initial evaluation of patients with glottic cancer.
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홍상덕,조양선,이현석,홍성화,정원호,복권효,박신홍 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.7
Background and Objectives:The aim of our study is to analyze the characteristics and outcomes of revision surgery for chronic otitis media. Subjects and Method:December 31, 2004 (N= 208) were performed. The control group who underwent primary canal wal down mastoidectomy (CWDM, N= 51) was compared with the case group who underwent revision CWDM. Results:As a cause of revision ear sur-gery, recurent cholesteatoma comprised 38% of the cases, and granulation tisue in the unexenterated air cels were found to be 62%. Mastoid tip and perisinal air cels were most frequent sites of unexenterated air cells. CWDM was performed in 96.6% of a residual air-bone gap (ABG) of ≤30 dB. Complications after revision surgery were wound infection (3.8%) and temporary facial nerve palsy (1.9%). In the control group, disease control rate, postoperative ABG ≤30 dB, wound infection and facial nerve palsy were 90.2%, 90.5%, 5.9% and 0% of patients, respectively. Conclusion:Disease control rates and complications primary ones. Significance:This is a first report on revision ear surgery in Korean literature and a first report of revision surgery comparing with primary cases. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :584-9)
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상기도 폐색이 지속성 비강기도양압술 치료에 미치는 영향
민진영,김효열,정승규,동헌종,정영준,복권효,이우영,홍상덕 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.10
Background and Objectives:Nasal continuous positive airway pressure (CPAP) is a useful and efficient treatment modality, butthe patients compliance depends on several factors such as nasal CPAP level. The aim of this study was to evaluate the relationshipbetween upper airway obstruction and nasal CPAP level in obstructive sleep apnea syndrome (OSAS). Subjects and Method:This retrospective study (from August 1995 through May 2005) included 50 patients suffering from OSAS with a mean apneahypopneaindex of 43.78/hr, and those who underwent overnight polysomnography, laboratory nasal CPAP, and acoustic rhinometry(AR) for the measurement of minimal cross-sectional area (MCA) of the nasal cavity. We compared the nasal CPAP level withthe degree of anatomic upper airway obstruction including tonsil and palate grade, MCA, subjective symptoms, or body mass index(BMI). A single linear regression analysis and one-way analysis of variance (ANOVA) were performed to compare variables.Results:The mean nasal CPAP level was 6.32±2.17 cmH2O. We found a significant correlation between the nasal CPAP leveland BMI (p<0.01) and the degree of palatine tonsil grade (p=0.01). Furthermore, AR measurements correlated with the nasalCPAP level (p=0.025) in patients with BMI<25. The other variables such as subjective symptoms, palate grade, and anatomic nasalobstruction in obese patients (BMI>25) revealed no correlation with the nasal CPAP level. Conclusion:Upper airway obstructionincluding nasal obstruction and tonsillar hypertrophy may increase the nasal CPAP level. Correction of nasal obstructionand tonsillectomy may reduce the nasal CPAP level in nonobese patients. (Korean J Otolaryngol 2006;49:986-90)
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