분화갑상선암 환자에서 치료적 측경부림프절절제술의 적절한 범위

원호륜,구본석 대한갑상선학회 2021 International Journal of Thyroidology Vol.14 No.2

Regional neck metastases in well-differentiated thyroid carcinoma (WDTC) are relatively frequent. The prognosticeffects of lymph node (LN) metastases remain controversial. However, it is well known that lateral LN metastasisis related to the recurrence of the disease. In general, when lateral neck LN metastasis is confirmed in WDTCpatients, therapeutic lateral neck dissection is recommended. However, the optimal surgical extent of therapeuticlateral neck dissection in WDTC patients with clinical lateral LN metastasis is not clearly presented. Traditionalcomprehensive neck dissection including level II, III, IV and V even in patients with minimal lateral neck metastasesmay not be reasonable when considering both oncologic safety and functional aspects. There is controversywhether it is always necessary to perform level II and V LN dissection for all WDTC patients with clinical lateralLN metastasis. This is due to the fact that the likelihood of postoperative complications by the damage of thespinal accessory nerve increases with level II and level V dissection. Therefore, many studies have been reportedon the possibility of omitting levels II (especially IIb) and V during therapeutic comprehensive lateral neck dissection. However, there have been no definite conclusions about it, and it is still debate. In this article, we reviewed tofind out optimal lateral neck dissection range for WDTC patients with clinical lateral neck metastasis.

갑상선유두암 환자에서 조직학적 림프-혈관침범이 가지는 재발 인자로서의 의의: 메타분석과 체계적 고찰

원호륜,구본석 대한갑상선학회 2023 International Journal of Thyroidology Vol.16 No.2

Conflicting research results have been reported regarding the influence of lymphovascular invasion as a prognostic factor for recurrence of papillary thyroid cancer, and thus, it is continuously discussed. This systematic review and meta-analysis identified an association between recurrence rate and histological lymphatic or vascular invasion in patients with papillary thyroid carcinoma. Clinical data and outcomes were collected from MEDLINE, Embase, the Cochrane Database of Systematic Reviews and KoreaMed. Selection criteria included studies reporting local or distant recurrence rates according to histological lymphatic or vascular invasion in patients with papillary thyroid carcinoma. Twelve observational studies were included in this study. When vascular invasion was confirmed histologically in patients with papillary thyroid cancer, the local recurrence rate was odds ratio 2.544 (95% confidence interval [CI], 1.469-4.407) compared to the patient group without vascular invasion, and the distant recurrence rate was 5.126 (95% CI, 2.853-9.212). The correlation between lymphatic invasion and recurrence rate could not be analyzed. As a result, this systematic review and meta-analysis confirmed that histological vascular invasion affects the rate of local or distant recurrence in patients with papillary thyroid cancer. Therefore, the presence of histological vascular invasion must be evaluated in patients with papillary thyroid cancer.

Recent Trends in the Surgical Treatment of Secondary Hyperparathyroidism

원호륜,Bon Seok Koo 대한이비인후과학회 2020 Clinical and Experimental Otorhinolaryngology Vol.13 No.2

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The Application of Fibrin/Hyaluronic Acid–Poly(L-Lactic-co- Glycolic Acid) Construct in Augmentation Rhinoplasty

원호륜,김유석,원종은,신유섭,김철호 한국조직공학과 재생의학회 2018 조직공학과 재생의학 Vol.15 No.2

Although many graft materials have been used for augmentation rhinoplasty, an ideal graft has not yet been developed. As the field of tissue engineering has been developing, it has been applied to the reconstruction of many organs, but its application in the rhinoplasty field is still limited. This study evaluated the utility of allogenic chondrocytes with fibrin/hyaluronic acid (HA)–poly(L- lactic-co-glycolic acid) (PLGA) constructs in augmentation rhinoplasty. Chondrocytes from rabbit auricular cartilage were isolated and cultured with fibrin/HA hydrogels and implanted into PLGA scaffolds. After 8 weeks of in vitro culture, the scaffolds were implanted in the nasal dorsum of six rabbits. Eight weeks postoperatively, the implanted sites were evaluated with gross, radiologic, and histologic analysis. In vitro, more than 90% of the seeded chondrocytes in the PLGA scaffolds survived for 2 weeks, and they produced a large amount of extracellular matrix and were well differentiated. The grafts maintained their initial shape for 8 weeks after implantation. Radiological and histological evaluations showed that the structure was well maintained with minimal inflam- matory response and appropriate elevation levels. However, the formation of neo-chondrocytes was not observed. PLGA scaffolds seeded with fibrin/HA and allogenic chondrocytes can be a biocompatible augmentation material in rhinoplasty in the future.

혀 기저부의 골성 분리종 2예

이건호,원호륜,구본석,장재원,Lee, Geonho,Won, Ho-Ryun,Koo, Bon-Seok,Chang, Jae Won 대한두경부종양학회 2019 대한두경부 종양학회지 Vol.35 No.1

Osseous choristoma is a rare, benign proliferative osseous lesion, which is defined as the growth of normal tissue in an abnormal location. The etiopathogenesis for its formation is unknown, but various hypotheses have been proposed. Treatment of choice is en-bloc resection, and no recurrence has been reported. Here, we report the two cases of osseous choristoma, presented with a mass on the base of the tongue with/without globus symptom and were treated with surgical excision.

부갑상선 선종으로 오인된 갑상설관낭 1예

이현진,원호륜,양훈식,이세영 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.1

Thyroglossal duct cysts (TGDC) are the most common congenital cervical abnormality, resulting from the remnant epithelial tissue of the thyroglossal duct, occuring in up to 70% of all congenital neck abnormalities. TGDC can be found anywhere in the midline between the foramen cecum and the thyroid gland, but are most frequently found below the level of the hyoid bone (65%), and may occur above the hyoid (20%) or at the level of hyoid (15%). Although they are commonly found near the hyoid bone, they can also be located on the base of the tongue (2%) or lower in the neck (10%). But TGDC found on the posterior surface of the thyroid, the location of parathyroid, is rare. Here, we report a case of a 43-year-old man with TGDC in the posterior of the right thyroid lobe, which was misdiagnosed as a parathyroid adenoma.

악성 경부임파선병증으로 오인된 연판화증 1예

안준영,원호륜,김동영,신유섭 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.4

Malakoplakia is usually found in the genitourinary tract; however, it occurs uncommonly as a chronic inflammatory disease and rarely in the head and neck area, having been reported in the literature only few times. Here, we report, with a review of the related literature, a case of malakoplakia on the posterior neck. A 76-year-old male patient visited our institution presenting a rapidly growing neck mass that had invaded the overlying skin for several weeks. The results of imaging studies strongly indicated a malignant tumor, but an accurate diagnosis was not made until after a fine needle aspiration biopsy was undertaken twice. The lesion was completely excised with an extended radical neck dissection including the overlying skin and scalene muscle upon consent of the patient. The pathological diagnosis was made with various immunohistochemical staining methods including Von Kossa, Periodic acid-Schiff-diastase, CD-68 and CD163. During the 24 months follow-up after the surgery, there was no sign of recurrence.

피대근 내에 발생한 전경부 신경초종 1예

이슬기,원호륜,구본석,장재원 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.4

Schwannoma, also known as neurilemmoma, is a benign neoplasm that originates from anynerves wrapped with a sheath made of Schwann cells. Schwannoma occurring in the head andneck region is not rare, but schwannomas of the anterior neck, especially ansa cervicalis, areextremely rare that only 7 cases have been reported to date worldwide. Although rare, it shouldbe considered in differential diagnosis of anterior cervical mass and may be confused with othercervical and thyroid mass. We report a case of intramuscular schwannoma in the sternohyoidmuscle. Preoperative diagnosis was established with an ultrasound-guided core needle biopsy. Although it was removed entirely without connection to any other nerves identified or any complication,clinically, the mass was thought to be derived from the nerve. To our knowledge, thisis the first case of the intramuscular schwannoma occurring from ansa cervicalis reported inthe literature.

중이강내 종물로 발견된 경동맥 동맥류

홍준형,박성윤,원호륜,문인석 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.4

Aneurysm may be classified into intracranial and extracranial according to its location. Extracranial aneurysm is relatively uncommon compared to intracranial aneurysm and it is rare in the middle ear cavity. The causes of extracranial aneurysm include atherosclerosis, dysplasia, blunt or penetrating trauma, local radiotherapy, acute dissection and infective lesions. Among the extracranial aneurysm, it is reported that carotid aneurysm in the temporal bone may be confused with glomus body tumor, which is usually larger. A typical presentation is pulsatile mass and it may accompany neurologic symptoms. We report a case with a review of literature of an external carotid aneurysm in the jugular fossa and middle ear cavity.

구제적 경부청소술 후 경부 유미액 누출 없이 발생한 유미흉 1예

김민규,장재원,구본석,원호륜 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.4

Leaks of chyle can occur during a head and neck surgery and can appear very rarely as chylo-thorax. A 62-year-old male diagnosed with Hypopharyngeal cancer was diagnosed with nodalfailure during a follow-up after radiation therapy and underwent a left cervical lymph nodedissection. Chest x-ray was taken due to dyspnea that began on the second day of surgery. Itwas diagnosed as bilateral chylothorax; absolute bed resting and fasting were maintainedalong with drainage through pleural puncture. The patient was discharged from the hospitalwith all improved symptoms on the 10th day after surgery and has been followed up for 5years without recurrence. Chylothorax is a complication that cannot be just watched but mustbe detected and treated early. Since we have experienced a case of very rare bilateral chylo-thorax without any leakage at the neck operation site, we would like to report it with a review of the literature.