부인두강 종양의 진단 및 수술적 접근법

태경,이근영,이영석,이용섭,정승원,박철원 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.5

Tumors originating in the parapharyngeal space are rare, accounting for about 0.5% of all head and neck tumors. The anatomic characteristics of the parapharyngeal space makes clinical examination of this area difficult and unreliable method for assessment of these tumor. This study was performed to evaluate the proper diagnostic and surgical approaches for the parapharyngeal space tumors with our experiences. Subjects and Method:During the period from January 1998 to December 2006, 34 patients underwent surgery for parapharyngeal space tumors. We reviewed medical records and imaging study retrospectively. Results:82.4% (28/34) of the parapharyngeal space tumors were benign;17.6% (6/34) were malignant. 41.2% (14/34) were of salivary glandular origin, 35.3% (12/34) were of neurogenic origin, and 23.5% (8/34) were of miscellaneous origin. 76.5% (26/34) of cases had been performed fine needle aspiration cytology (FNAC) before surgery. 14 of 19 patients (73.7%) who had a diagnostic sample had a correct or highly suggestive diagnostic finding. Most of the parapharyngeal space tumors were treated with transcervical (44.1%;15/34) or transparotid (44.1%;15/34) approach, and transparotidcervical approach was performed in 4 patients (11.8%). All patients with salivary gland tumor were located in the prestyloid space, and most (92.9%) of them were treated with transparotid approach. Most patients (91.7%) with neurogenic tumor were located in the poststyloid space and treated with transcervical approach. Conclusion:In our study, the origin and location of the parapharyngeal space tumors were correlated with surgical approaches (p<0.05). Preoperative FNAC showed high accuracy to diagnose the tumor in the parapharyngeal space. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:441-6)

두경부에 발생한 모기질종의 고찰

태경,금효섭,이동욱,정진혁,조석현,박동우,오영하 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.5

Background and Objectives:Pilomatricoma, also known as calcifying epitheliomas of Malherbe is uncommon, benign skinneoplasm that arise from outer root sheath cell of hair follicle or hair follicle of sebaceous glands. In more than half of the cases,pilomatricoma typically involves the head and neck followed by upper extremities and trunk, with the majority occurring inchildren. The purpose of this study is to analyze the data from the authors experience with head and neck pilomatricoma and todiscuss diagnostic and therapeutic management. Subjects and Method:A retrospective analysis of the patients of pilomatricomatreated between 1994 and 2004 revealed 21 cases of head and neck pilomatricoma. Results:The typical clinicalmanifestation of pilomatricoma was non-tender, firm, subcutaneous, and nodular mass. The age range was from 9 months to 62years (mean 17.4 years). The male-to-female ratio was 4:3. The common sites of occurrence were the neck (33%), cheek(24%), suboccipital (14%), preauricular (14%). The size of the mass ranged from 0.5 cm to 3 cm, and the mean was 1.1 cm. CTwith contrast enhancement scans revealed densely calcified, mild enhancing and well circumscribed soft tissue densities insubcutaneous tissues. Additionally, MRI with gadolinum enhancement scans revealed partially enhanced, well demarcated andintermediate signal intensity mass lesions. Surgical excision was curative in all cases. Conclusion:Pilomatricoma is cutaneousneoplasms that occur commonly in the head and neck region. Even if the preoperative diagnosis may be difficult in some cases,pilomaticoma must be considered in the differential diagnosis of a superficial head and neck mass. (Korean J Otolaryngol2006;49:549-53)

인후두역류증의 진단:식도점막 생검의 의의

태경,이용섭,김수영,정진혁,이승환,박용욱,한동수 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.1

Background and Objectives:The reflux symptoms, laryngoscopic findings and 24-hour dual-probe pH monitoring are main diagnostic tools for laryngopharyngeal reflux disease. In particular, 24-hour dual-probe pH monitoring is the most specific and sensitive test, but some patients tend to fail the test due to discomfort. Eosinophilia in the esophageal mucosa may be diagnostic of gastroesophageal reflux disease, but esophageal biopsy has rarely been studied in laryngopharyngeal reflux. In this study, to discover another or alternative diagnostic tools that might help in the diagnosis of laryngopharyngeal reflux, we investigated the significance of esophageal mucosal biopsy in patients with laryngopharyngeal reflux symptoms. Subjects and Method:The study group consisted of 110 patients with laryngopharyngeal reflux symptoms and all patients were evaluated by 24 hour dual probe pH monitoring. The results of the 24 hour dual probe pH monitoring was compared with reflux symptom index (RSI),reflux finding score (RFS), gastroesophagoscopic findings, esophagogram and esophageal mucosal biopsy. Results:In 61 of the 110 patients, laryngopharyngeal reflux were confirmed by 24 hour dual probe pH monitoring. The mean RSI and RFS of thelaryngopharyngeal reflux group was higher (7.3±2.5, 6.0±3.9) than those of the group without laryngopharyngeal reflux (6.3±3.5, 4.6±2.9). Intraepithelial eosinophils in proximal esophageal biopsy was correlated with laryngopharyngeal reflux by 24- hour dual-probe pH monitoring. Conclusion:Esophageal mucosal biopsy is a reliable diagnostic test for laryngopharyngeal reflux and it could be used for patients who tend to fail 24-hour dual-probe pH monitoring due to discomfort. (Korean J Otolaryngol 2006;49:79-84)

경부 전이가 동반된 두경부 편평세포암종 환자에서 제3형 변형 근치적 경부절제술의 의의

태경,이근영,신광수,이용섭,박철원,이형석 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.10

두경부 편평세포암에서 Cyclin D1유전자의 증폭에 관한 연구

태경,이형석,박철원,안경성,조율희,공구 대한이비인후과학회 1997 대한이비인후과학회지 두경부외과학 Vol.40 No.8

Robotic and Endoscopic Thyroid Surgery: Evolution and Advances

태경,지용배,송창면,류준선 대한이비인후과학회 2019 Clinical and Experimental Otorhinolaryngology Vol.12 No.1

To minimize surgical morbidity and neck scarring, minimally invasive thyroidectomy and robotic/endoscopic thyroidectomy via cervical, axillary, anterior chest, breast, postauricular or transoral approaches have been developed over the past 20 years. In this article, we review the evolution of robotic and endoscopic thyroid surgery and recent advances. Among remote access approaches, the gasless transaxillary approach, bilateral axillo-breast approach, postauricular facelift approach, and transoral vestibular approach are in common use today. Each procedure has its own advantages and disadvantages. Therefore, we need to understand these advantages and limitations, and to select the appropriate method for each patient. The most significant advantage of remote access thyroidectomy is its excellent cosmesis. The complication rate is similar in patients undergoing a remote access approach and those undergoing conventional surgery if the former is performed by experienced surgeons. Operative time is significantly longer in remote access thyroidectomy. In conclusion, remote access thyroidectomy is feasible and its outcomes are comparable to those of conventional transcervical thyroidectomy in highly selected patients.

경부 지방종증의 치험

태경,이형석,권순욱,정진혁,김경래,Tae, Kyung,Lee, Hyung-Seok,Kwon, Soon-Wuk,Jeong, Jin-Hyeok,Kim, Kyung-Rae 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1

Benign symmetric lipomatosis was initially described in 1846 by Sir Benjamin Brodie. In 1888, Otto Madelung presented 33 cases of benign symmetric lipomatosis and described the classic“horse collar”cervical distribution of the lipomatous tissue. Launois and Bensaude described benign symmetric lipomatosis as a distint syndrome characterized by a diffuse, symmetric, fatty accumulation in the cervical region. This disease is rare condition affecting mostly middle aged alcoholic men and associated with many systemic diseases such as diabetes mellitus, hyperuricemia, renal tubular acidosis, liver enzyme abnormality etc. The condition does not spontaneously involute and surgical excision is the only proven method of treatment, and recurrence is frequent. We experienced six patients of benign symmetric lipomatosis who underwent surgical excision via collar incision which afford wide exposure of the entire cervical area. We report them with the review of literature.

갑상선 여포종양의 임상적 특성 및 감별진단

태경,전성하,이용섭,이형석,김동선,최웅환,안유헌,박동우 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.5

Background and Objectives:A preoperative diferential diagnosis betwen follicular adenoma and follicular carcinoma of thyroid is very dificult, and the standard basis for distinction is the presence of capsular and/or vascular invasion. In this study, the folli-cular neoplasm. Subjects and Method:A retrospective review of medical records was caried out on 104 patients who had undergone thyroid surgery and had been diagnosed with thyroid follicular adenoma or carcinoma from 195 through 204. The final pathologic diagnosis was compared to the various clinical data including the result of fine needle aspiration cytology (FNAC) and ultrasonographic findings. Results:Of total 104 cases, 82 were follicular adenoma and 22 were follicular carcinoma. The incidence of carcinoma was significantly higher in male than in female. The result of FNAC were divided into 6 cyto-diagnostic groups, namely, inadequate, colloid nodule without atypia, colloid nodule with atypia, follicular neoplasm without atypia, folicular neoplasm with atypia, or highly suspicious malignancy. The incidence of carcinoma was significantly higher in the groups with atypia such as colloid nodule with atypia, follicular neoplasm with atypia, and highly suspicious malignancy than ci-fication on ultrasonography also indicated the posibility of malignancy. Conclusion:The incidence of follicular carcinoma was significantly high in male patients, atypia in FNAC, and ill-defined margin and calcification on ultrasonography. (Korean J Otolaryngol 2007 ;50 :420-5)

이하선 종양의 보존적 이하선 부분절제술

태경,이형석,홍동균,박혜경,조석현,이승환,박철원 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.7

새성기형의 임상적 고찰

태경,정승원,이응준,이승환,김경래,박철원,이형석 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.10

Background and Objectives:The branchial anomaly is a lateral neck mas comonly sen by otolaryngologists. Although somewhat controversial, almost all surgeons agree that lateral cervical cyst, fistula and sinus are of branchogenic origin. Dep-study is to evaluate the clinical and pathologic manifestations of branchial anomaly and to determine proper diagnosis and treatment. Materials and Method:With a review of charts, we retrospectively analyzed 46 cases of the branchial anomaly who had been treated at the Hanyang University Medical Center between 1991 and 2001. Age, sex, site of lesion, classification, surgical therapy, radiologic and pathologic findings and post-operative surgical complications were reviewed. Results:The second branchial and sinuses were detected relatively at the younger age. Twenty five per cent of patients were presented in the infected state, and 45 cases were treated with complete surgical excision;there were no major post-operative complications and recurrence. Conclusion:An acurate diagnosis is crucial in the management of branchial anomaly to prevent recurrence and multiple sur-gical procedures. Although clinical examination and history are the most important factors suggesting the diagnosis of branchial anomaly, preoperative radiologic evaluation can be used to determine the nature and extent of the branchial anomaly. After (Korean J Otol-aryngol 2002;45:998-103 )