• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.154-162
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• 1999

The laryngopharyngectomy for tumor ablation is the most common indication for pharyngoesophageal reconstruction in our country. Most of these cases are advanced laryngeal cancer that has spread beyond the larynx, pharynx and cervical esophagus. Such patients are obviously unable to breathe, swallow, or speak in the normal manner. The ideal reconstruction would restore normal anatomy, permitting patients to breathe and swallow without aspiration, and would not require a permanent tracheostomy. Reconstruction of the pharyngoesophageal defect traditionally been carried out with tubed local random flap, deltopectoral or musculocutaneous flap. Another approach is the pedicled enteric flap. But microsurgical reconstruction of the pharyngoesophagus, using either the free jejunal or the tubed radial forearm flap, have now become the preferred technique. Among them, we used jejunal free flap in 39 cases, tubed radial forearm free flap in 5 cases, patched radial forearm free flap in 2 cases and pectoralis major myocutaneous island flap in 2 cases from December 1990 to Febrary 1999. In this paper we illustrated that both forearm and jejunal free flap is a usful alternative in reconstruction of hypopharynx and cervical esophagus.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.87.4-88
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• 1976

The statistcal study was done on 81 cases of the foreign bodies in the food passages (73 cases) and air passages (8 cases), who had visited the Dept. of Otolaryngology of Kyung Hee Medical Center and treated endoscopically, from Nov. 1971 to Mar 1976. The results were as follows, 1) The incidence of esophageal foreign bodies (73 cases) in order of frequency was coin (61 cases; 83.6%), bone (6 cases; 8.2%), food particles (3 cases; 4.1%), discs (2 cases), and other metals (l case). The incidence of foreign bodies in the air passages (8 cases) was food particles (3 cases; 37.5%), pointed metal (2 cases; 25%), plastic pencil cap (l case), plastic ring (1 case), and wood piece (1 case) in order. 2) In sex distribution, 51 cases (62.9%) were males and 30 cases (37.1%) were females, and the ratio between males and females was about 1.7 : 1.3. In the age incidence, 69 cases (82.5%) of all foreign bodies were under 5 years of age, and especially, coin cases were 59 cases (96.7%) and the highest was 8 years of age, lowest was 11 months of age. 7 cases (87.5%) of all airway foreign bodies were under 10 years of age. 4) The ratio between the food passages(73 cases) and the air passages (8 cases) was about 9 : 1. In the location of the foreign bodies of the food passages, 66 cases (90.4%) were in the first esophageal narrowing, 5 cases (6.9%) in the second narrowing, and 2 cases (2.7%) in the third narrowing. In the air passages, the frequent sites were trachea (5 cases; 62.5%), larynx (2 cases), and bronchus (1 case) in order. 5) In duration of lodgement, 63 cases (86. 3%) of esophageal foreign bodies were removed within 24 hours, and one case was removed within 16 days. The number of cases lodged within 24 hours were 4 cases (50%). in the air passages and one case was removed within 18 days. 6) In treatment, 37 cases (50.7%) of esophageal foreign bodies were extracted by modified upper esophagoscopy, 33 cases (42.5%) by esophagoscopy under the local anesthesia, 3 cases (4.1%) by esophagoscopy under the general anesthesia. 8 cases of the coin cases were passed into the stomach during the endoscopic examination. Laryngeal foreign bodies (2 cases; 25%) were extracted by laryngoscopy under the local anesthesia. 2 cases (40%) of tracheal foreign bodies by Bronchoscopy with tracheotomy under the local anesthesia, 3 cases (60%) by Bronchoscopy under the general anesthesia, and bronchial foreign body (1 case) by open thoracotomy under the general anesthesia, at the Dept. of Chest surgery.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.11.1-11
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• 1982

Foreign bodies in the esophagus is a common problem encountered in the ENT field. Small toys were the most common type of esophageal foreign body found in Korea until the government started making coins. Although 10 won coins are most commonly found, there is a tendency for an increased percentage of 100 won coins parallel with the economic development of the country. Recently, the authors experienced a very intersting case in which a 7 year-old child had a 5 won coin lodged horizontally at a level of the third esophageal constriction portion for 4 years, which eventually resulted in esophageal dilatation. A review of the literature of this subject is included.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1392-1397
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• 1996

Over the past two years the free jejunal transfer have been used in 7 consecutive patients to restore alimentary tract continuity artier the resection of esophagus. Six patients had squamous cell carcinomas and one had esophageal stricture . The patients underwent partial esophagectomy with modified radicAl neck dissection or mediastinal Iymph node dissection. The microvascular anastomosis was performed to the neck vessels in 4 patients and to the in ercostal vessels in 3 patients. Postoperative complications were graft necrosis in one patient, and a temporary anastomotic leakage with spontaneous closure in one patient. Reconstruction of the esophagus was successful in 6 of 7 patients. We emphasize that esophagectomy followed by transplantation of a free jejunal transfer is suitable for esophageal carcinoma or intractable esophageal stricture, and involvement of the midesophagus is not a contraindication to the use of the free Jejunal transfer.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.90.4-90
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• 1976

Foreign bodies of the esophagus are frequently seen in otolaryngological fields and there are numerous reports about the cases of esophageal foreign bodies in the literatures. It is well known and agreed to most of the authors that the most common subjects of foreign bodies in the esophagus are coins in young children. The authors recently experienced a rare case of foreign body in the first narrowing of the esophagus in a l-year-old female who visited with the complaints of fever, dysphagia and imspiratory dyspnea for 5 days, complicating subcutaneous emphysema, periesophageal abscess, mediastinal emphysema, mediastinitis and lung atelectasis causing death.

• Korean Journal of Bronchoesophagology
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• v.16 no.1
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• pp.64-67
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• 2010

Congenital esophageal stenosis due to tracheobronchial remnants is a rare anomaly, resulting in dysphagia and recurrent pneumonia, We have experienced three cases of csophageal stenosis due to ectopic tracheobronchial remnants and performed operative correction. Two patients were 20 months and five year old male with a chief complaints of swallowing difficulty from birth and the other was a twenty three year old female with a slowly increasing symptom of dysphagia for twenty years. Esophagogram of the patient with tracheobronchial remnants shows abrupt narrow segment at distal esophagus with marked proximal dilatation, and linear barium collections perpendicularly projecting from the stenotic esophagus. All of them were performed surgical correction by esophagectomy of the stenotic portion and esopahgo-gastrostomy with anti-reflux procedures, The resected specimens of these patients showed ectopic tracheobronchial chondroepithelial tissue within the esophageal wall histopathologically. Postoperative course was uneventful and have been in good condition without any problems.

• Advances in pediatric surgery
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• v.16 no.1
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• pp.37-42
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• 2010

Tracheal injury is a rare complication of endo-tracheal intubation. However in neonates, the rates of morbidity and mortality are high. Recommendations for treatment are based on the several reports of this injury and are individualized. Conservative management can be effective in some cases. We describe the case of a neonate who presented with subcutaneous emphysema after intubation in a neonatal intensive care unit. This patient suffered full VACTERL syndrome and had 1.7 mm diameter subglottic stenosis. Conservative management resulted in no further increase in subcutaneous emphysema and after 10 days the patient was stable.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.87-91
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• 2009

The surgical management of complete transposition of the great arteries, ventricular septal defect, and pulmonary stenosis still remain a significant challenge. The Rastelli (REV procedure) remains the most widely applied procedure for surgical repair of these lesions. Although the Rastelli procedure can be performed with good early results, the intermediate- and long-term results have been less than satisfactory because of deterioration of the hemodynamic performance of the LVOT or RVOT. We performed a modified Nikaidoh procedure as an alternative surgical procedure in a 19-month-old boy weighing 10.4 kg with this anomaly. Aortic translocation with biventricular outflow tract reconstruction resulted in a more "normal" anatomic repair and postoperative echocardiography showed straight, direct, and unobstructed ventricular outflow.

• Advances in pediatric surgery
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• v.1 no.2
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• pp.140-148
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• 1995

To study the clinical profiles and outcome of surgery in infants with esophageal atresia, we reviewed 96 esophageal atresia cases who were treated from April, 1978 to June, 1995. There were 51 male and 45 female infants, a ratio of 1.1:1. The low birth weight(<2500g) patients were 32%. Clinical findings at the time of diagnosis included drooling in 57%, choking in 50%, cyanosis in 38%, respiratory distress in 27% and swallowing difficulty in 20%. Gross classification included 6 cases of type A esophageal atresia(6%), 79 cases of type C(82%), 3 cases of type E (3%) and 8 cases of type F(8%). Associated anomalies occurred in 34 infants(35%). Among them, cardiac anomalies were most common(60%). A primary repair of the defect was carried out in 76 patients with type A or C. A staged operation comprising a repair or gastric tube interposition after gastrostomy was performed in 8 patients. In all 3 infants with H-type, a division of fistula was performed. Esophageal resection and anastomosis was done in 8 infants with esophageal stenosis. In one infant, a gastrostomy was performed and he expired before staged operation. Anastomotic complications included leakage in 16 cases(17%), stricture in 37 cases(39%) and recurrent tracheoesopohageal fistula in 3 cases(3%). The mortality rate was 14% and the leading cause of death was pneumonia. The overall survival rate was 86%, and according to Waterston criteria, the survival rates were 93%, 85% and 58% in class A, Band C, respectively. 75 patients were followed up with median follow up 6.4 years. Among them, 93% were uneventful and 7% had frequent pneumonia.

• Radiation Oncology Journal
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• v.5 no.2
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• pp.111-117
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• 1987

From March, 1983 to March, 1987, 16 patients with esophageal steno-obstruction due to nonesophageal tumors were treated in the Division of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. The patient characteristics, effect of radiotherapy (XRT) on esophageal steno-obstruction and survival were evaluated. The most common primary tumor was lung cancer (14/16) and the middle third of the esophagus was most frequently involved (14/16). Improved clinical response was observed in $80\%$ of the patients who finished the planned courses of XRT. The mean radiation dose evoking the improvement of dysphagia was 2,993 cGy given over a period of 3 to 4 weeks. The Kaplan-Meier estimates of survival at 15 and 30 weeks of follow-up were $60\%$ and $46\%$, respectively. In the completed group who finished the whole planned courses of XRT, survival rates were $77\%\;and\;51\%$, respectively. Four patients were alive over 90 weeks with normal passage of food.