• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.29-34
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• 2021

Background and Objectives Tracheostomy lead to persistent bacterial colonization of the respiratory tract. Surgical site infection and restenosis by the pathogenic bacteria is the most fatal complication after open airway surgery. The aim of this study is to describe the culture results of larynx and tracheostoma in patients with tracheostomy and the preoperative, intraoperative culture results in patients underwent open airway surgery. Materials and Method A retrospective review was performed on 18 patients who underwent culture between 2017 and 2019. Results Pseudomonas or antibiotic resistance bacteria were identified in 11 patients out of 18 patients (61.1%); Ceftriaxone-resistant Streptococcus (38.9%), Pseudomonas (33.3%), Methicillin-resistant Staphylococcus aureus (16.7%), extended-spectrum β-lactamases (ESBL) producing Klebsiella pneumoniae (11.1%). Among 18 patients, 6 patients showed the different culture result between larynx and tracheostoma. In 4 out of 10 patients who underwent open airway surgery, the bacteria were not identified before surgery, but the bacteria were isolated in the intraoperative culture. In one patient, the bacteria detected intraoperatively were different from those detected before surgery. Conclusion Preoperative respiratory tract culture and usage of perioperative antibiotics according to the culture are necessary. It is crucial to verify the bacterial culture in both tracheostoma and larynx. And it should be performed immediately before open airway surgery.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.6.3-7
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• 1979

During last two. decades, microlaryngeal surgery opened now era in the laryngeal surgery. In 1960, using Lynch's suspension laryngoscope, Seal co et al performed the first successful microsurgery in the treatment of polyp and other laryngeal diseases. In 1968, Kleinsasser reported a new technique of microlaryngeal surgery with a self retaining laryngoscope. Authors studied the statistic analysis of 53 cases (75 times) of the suspension laryngoscopic microsurgery at E.N.T. department of Han Yang University Hospital from May 1972 to April 1979 an reported this result. 1) sex distribution was male 1.3 : female 1. 2) age distribution was 3rd decade 14 cases (26.4%), 2nd decade 10 cases (18.7%) and 5th decade 9 cases (17%) in order. 3) chief compliant was hoarseness 48 cases (90.6%), dyspnea 16 cases (30.5%) and sore throat 8 cases (15.1%) in order. 4) diagnostic impression was polyp 18 cases (34%), nodule 12 cases (22.6%), papilloma 9 cases (17%), tumor 7 cases (13.2%), intubation granuloma 3 cases (5.7%) in order and other kinds were laryngeal stenosis with decannulation difficulty, laryngeal paralysis and hematoma. 5) histopathologic result of 48 cases was polyp 17 cases (35.4%), papilloma 11 cases (23%), nodule 9 cases (18.9%), malignancy 3 cases (6.3%), chronic inflammation 2 cases (4.2%) in order and others were hyperkeratosis, mucous retension cyst, nodule associated abscess, granuloma, hematoma and unconfirmed case. 6) in involved site, both sides 15 cases (60%), Lt.side 5 cases (19%), Rt side 3 cases (12%), anterior commissure 3 cases (12%) on the nodule and polyp (26 cases) and whole laryngeal involvement 7 cases (63.6%), one side cord involement 3 cases (23.7%), extralaryngeal involvement 1 cases (9.1%) on the papilloma (11 cases).

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.43-46
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• 2008

Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngocervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.7.4-8
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• 1982

The common causes of neck closed injuries are automobile accidents and sports troubles; open injuries are gun-shot wounds and stab wounds. Generally, the treatment of wide laryngopharyngeal injuries consists of tracheostomy for adequate airway, simple repair and, later, surgical intervention for chronic laryngeal stenosis and hypopharyngeal reconstruction. Recently, authors experienced a case of extensive communicated wound with large defect on the layngopharyngeal structures and anterior neck skin. This large defect was reconstructed with horizontal cervical skin flap after total laryngectomy.

• Korean Journal of Bronchoesophagology
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• v.9 no.2
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• pp.60-64
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• 2003

Restenosis frequently develops with granulation and overgrowth of scar following surgical treatment for laryngotracheal stenosis. Various methods such as stenting or CO2 laser application have been used to prevent restenosis, but they were seldom unsatisfactory. Mitomycin is an antineoplastic antibiotics derived from Streptomyces caespitosus; it inhibits fibroblast proliferation and acts as an alkylating agent to inhibit DNA synthesis. This study was desinged to evaluate effectiveness and determine indications of usage of topical mitomycin for laryngotracheal stenosis as a nonsurgical means of reducing postoperative granulation and scar tissue formation. Patients and Method : A retrospective study was performed on eight cases of laryngotracheal stenosis with topical mitomycin application. The author analyzed clinical outcomes of operative treatment with topical mitomycin. Patients underwent laryngotracheal reconstruction, endoscopic granulation removal, or bronchoscopic bougienage followed by topical application of mitomycin (0.4 mg/$m{\ell}$, 4minuntes) on the lesion intraoperatively. Result : Overall success rate of decannulation was 38% ($\frac{3}{8}$). Successful decannulation was possible in 75% ($\frac{3}{4}$) of laryngeal stenosis patients, 75% ($\frac{3}{4}$) of children, 60% ($\frac{3}{5}$) of the patients without previous surgery, and 75% ($\frac{3}{4}$) of bronchoscopic bougienage. Conclusion : The topical application of mitomycin in laryngotracheal stenosis was effective in untreated pediatric laryngeal stenosis which underwent bronchoscopic bougienage. Our results show that the topical mitomycin application for laryngotracheal stenosis could be a effective adjuvant treatment.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.40-45
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• 2001

Management of laryngotracheal stenosis remains one of the most challenging problems facing the otolaryngologist. The key to success is to obtain adequate rigid circular support with normal mucosal lining. Four Patients with laryngotracheal stenosis were surgically treated in our institution in 2000. All the patients were male adults. The cause of stenosis were longterm or repeated endotracheal intubation and tracheostomy in our patients. All patients were successfully decannulated following segmental resection of the stenotic portion including the anterior arch of the cricoid cartilage and end-to-end anastomosis after suprahyoid laryngeal release. The time between treatment and decannulation was just one day in three patients. These results suggest the Possibility of early decannulation even if the cricoid cartilage was partially resected. It is better to prevent laryngotracheal stenosis rather than to treat it once it has occurred.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.651-654
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• 2007

Tracheoinnominate artery fistula (TIF) is a very rare complication that can happen after long standing tracheostomy or insertion of an endotracheal tube and its mortality is very high. This condition requires early diagnosis and urgent management because of the life threatening results from tracheal obstruction or hypovolemic shock that is caused by massive bleeding. We report here on a case of successful tracheoplasty with using the costal cartilage, including the perichondrium, in a patient with laryngeal stricture, and this was done to preserve the trachea for the following operation to relieve the laryngeal stricture.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.4.1-4
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• 1978

The foreign bodies in the food and air passages are frequently observed in the field of otolaryngology, and the foreign bodies in the air passages have much significance in clinical practice because they may cause sudden death. A statistical study was done on 95 cases of foreign bodies in the food and air passages who had visited department of otolaryngology, Chung-Ang university from June, 1968 to April, 1978. The results were as follows; 1. The total cases of foreign bodies in the food and air passages was 95; 89 cases (93.7%) were in the food passage and the remaining (6.3%) were in the air passage. The ratio between the food passage and air passage was about 14. 8 to 1.0. 2. In distribution by sex, 64 cases (67.4%) were in male patients and the remaining 31 cases (32.6%) were in female patients. The ratio between male and female was 2.1 to 1.0. 3. The kinds of foreign bodies in the food in the order of their frequency, were coin, gogame stone and pebble. In the air passages, the peanut and bean were most frequently found. 4. In distribution by age, 64 cases (67.4%) of all foreign bodies were found in children under 5 year old, and coin was the most common kind of foreign body. Except for meat, almost all of foreign bodies were found in children under 10 year old. 5. There was chronologically no significant tendency in incidence; the incidence, however, had decreased during recent 2 years. 6. In the location of foreign bodies in the food passage, 70 cases (78.7%) were found at the first esophageal narrowing. Meat was more frequently found at second esophageal narrowing associated with cicatrical stenosis. Almost all of foreign bodies in the air passage was found in bronchi; 3 cases were in the right side of bronchi, and 2 cases were in the left side of bronchi and 1 case was in glottic region. 7. In duration of lodgement, 50 cases (52.6%) visited our hospital within 24 hours, and 3 cases after 30 days. 8. Under topical anesthesia, 83 cases (93.3%) of the foreign bodies in the food passage were removed by esophagoscopy, by 6 cases (6.7%) failed to be removed. All of the foreign bodies of the air passages (6 cases) were removed by bronchoscopy. Among them, 5 cases under 5 years old were removed by inferior bronchoscopy through tracheostomy site.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.792-798
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• 1998

Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.9.2-9
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• 1977

A Statistical study was carried out on 64 cases of the foreign bodies in the food and air passages, who visited the Dept. of Otolaryng. of Korea General Hospital from Jan. 1971 to Dec. 1976. The following results were obtained. 1. The total number of foreign bodies were 64 cases, which is approximately 0.69% of the total number of new patients who visited the out patient department during the same period. Among them 55 cases were foreign bodies in the food passage and 9 cases were foreign bodies in the air passage. The ratio between the food and air passages was about 6.1 : 1. 2. The frequently encountered foreign bodies in the esophagus were coin, bone, meat and food particle in order. Bean and peanut were male and 31 case the most frequent foreign bodies in the air passage. 3. In sex distribution, 33 cases were male and 31 cases were female, and the ratio between male was 1.1:1. 4. In the age distribution, 35 cases (54.7%) of all foreign bodies were under 5-year-old, especially coin was 96.2%. 5. The most prevalent site of lodgement in the food passage was the 1st esophageal narrowing, which corresponds to 69.1%. 6. In duration of lodgement, 38 cases (69.1%) of foreign bodies in the food passage were removed within 24 hours, and the longest duration was 90 days. 7. Almost all of the foreign bodies in the food and air passages were removed under local or no anesthesia by esophagoscopy, laryngoscopy.