• Title/Summary/Keyword: Neck surgery

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Robotic Surgery in Head and Neck (두경부 영역에서의 로봇 수술)

  • Tae, Kyung;Shin, Kwang-Soo
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.27-32
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    • 2010
  • Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

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Correlation of Clinical Factors with HMGI(Y), p53 and Ki-67 Expression in Squamous Cell Carcinomas of the Head and Neck (두경부 편평세포암에서 HMGI(Y), p53, Ki-67의 발현과 임상인자와의 상관 관계)

  • Rho Young-Soo;Park Jun-Young;Park Il-Seok;Lim Young-Chang;Moon Sung-Ho;Kim Sung-Dong;Hwang Joon-Sik;Kim Duk-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.11-17
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    • 2002
  • Objectives: Expression of HMGI(Y), a nucleoprotein that binds to A/T rich sequences in the minor groove of the DNA helix, is observed in neoplastically transformed cells but not in normal cells. We have analyzed HMGI(Y), p53 expression and Ki-67 labelling index in squamous cell carcinomas of the head and neck, and evaluated its clinicopathologic significance. Materials and Methods: 40 cases of squamous cell carcinoma of the head and neck were entered on the study of immunohistochemical stains for HMGI(Y), p53 and Ki-67. We analyzed the relationship between HMGI(Y), p53, Ki-67 expression and age, sex, primary tumor site, stage, survival rate, recurrence. Results: HMGI(Y) expression evidenced by immunohistochemical staining was observed in 35 of 40 (87.5%) squamous cell carcinoma of the head and neck. But no significant correlation was observed between HMGI(Y) expression and other clinical factors such as primary site, tumor stage, differenciation, cervical lymph node, metastasis, recurrence and immunohistochemical status of p53. The Ki-67 labelling index was significantly correlated with recurrence and HMGI(Y) expression (p<0.05). Conclusion: This results suggest the Ki-67 is a good prognostic factor and the HMGI(Y) expression plays some roles in carcinogenesis and cellular proliferation of squamous cell carcinoma of the head and neck. HMGI(Y) gene can be used as a cancer marker, the correlation between the gene expression and the prognosis of the cancer patient should be proved in the future studies.

A Case of Lymphoepithelial Cyst Mimicking Cervical Plexus Schwannoma (경부신경총에서 기인한 신경초종으로 오인된 림프상피성낭종 1예)

  • Jeong Hwan Kim;Byung Jae Kang;Min Suk Kim;Hong Jin Kim;Ye Hwan Lee;HwaEun Oh;Kyung Ho Oh;Soon Young Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.49-54
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    • 2023
  • Neck masses can have various origins and diverse presentations, making accurate diagnosis challenging. Schwannomas and lymphoepithelial cysts are commonly encountered neck tumors, and it is hard to get differential diagnosis. A 50-year-old woman presented with a progressively enlarging right neck mass discovered five years ago. Upon examination, a 3 cm firm, non-tender, and mobile tumor was found in the right neck level II region. Imaging studies suggested a tumor originating from the cervical sympathetic chain. The patient underwent a resection of the tumor under general anesthesia. Postoperative follow-up showed no complications or signs of recurrence. However, contrary to the initial suspicion of a schwannoma, the final pathological examination revealed a lymphoepithelial cyst. In this paper, we present a case of a cervical lymphoepithelial cyst misdiagnosed as a schwannoma, aiming to compare the clinical and histological characteristics of these two tumors and provide insights into appropriate diagnosis and management.

Impact of anxiety on voice after thyroidectomy : a preliminary study (갑상선 수술 전 환자의 불안 정도가 수술 후 음성에 미치는 영향 : 예비연구)

  • Lee, Hyoung Shin;Lee, Sang Shin;Kim, Hwa Bin;Oh, Dasol;Kim, Ji Su;Jeon, Suk Won;Kim, Sung Won;Lee, Kang Dae
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.17-22
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    • 2017
  • Background and Objectives: Voice change after thyroidectomy may develop without injury of recurrent laryngeal nerve. Psychogenic or emotional factors related to voice change after thyroidectomy has been rarely studied. In this study, we sought to analyze the impact of anxiety on early state of post-thyroidectomy voice change. Materials and Methods: We made a retrospective chart review of 36 patients who underwent thyroidectomy for papillary thyroid carcinoma and voice exam before surgery, 2 weeks after and 1 month after surgery. All patients included in the study answered a questionnaire for State-Trait Anxiety Inventory ; STAI-KYZ (form Korean YZ). Clinico-pathologic factors and parameters of voice analysis were reviewed to analyze correlation to the anxiety index. Results: No differences were identified between clinicopathologic factors and preoperative parameters of voice analysis between patients with higher and lower level of anxiety. Noise to harmonic ratio (NHR) was higher in those patients with higher level of anxiety, 2 weeks after surgery (p=0.043). However, none of the parameters showed any difference 1 month later. Conclusion: With limited number of patients and short period of follow up, significant impact of preoperative anxiety on postoperative voice change after thyroidectomy could not be identified in this preliminary study.

Endoscopic Laser Cordectomy for Early Glottic Cancer (초기 성문암종에서 레이저를 이용한 성대절제술의 효과)

  • Choi Jong-Ouck;Park Jung-Soo;Min Hun-Ki;Jung Kwang-Yoon;Choi Geon;Yoo Hong-Kyun
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.201-205
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    • 1996
  • Early detection of glottic cancer, facilitated by rigid telescopes or flexible fiberoptic laryngoscope in addition to sparse true vocal cord lymphatics, makes this a highly curable tumor in its early stage. Early glottic cancer has a high cure rate with only radiotherapy or conservative surgery. However complications such as mucositis with radiotherapy and voice complications with conservative surgery has raised recent interest in endolaryngeal laser cordectomy. Laser cordectomy can preserve phonatory function and avoid the complications such as mucositis of radiotherapy. To determine the effectiveness of laser cordectomy, the authors made a two year retrospective study of 23 early glottic cancer cases. Fourteen cases(60.9%) who underwent 1 to 3 endoscopic laser cordectomy with KTP-532 laser were cured with this procedure alone. Seven cases needed an additional radiotherapy and three cases needed therapy with salvage operation. We conclude that the endoscopic laser surgery is a good strategy for the properly selected glottic cancer.

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Relationship between Chronic Rhinosinusitis and Blood Pressure (비부비동염과 혈압의 상관관계)

  • Seo, Youn Tae;Kim, Deok Su;Kil, Bu Kwan;Shin, SeungHeon;Ye, Mi Kyung
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.182-189
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    • 2018
  • Background and Objectives : There were few literatures about the relationship between upper airway disorders and cardiovascular risk factors such as hypertension, although an association between impaired lower respiratory function and cardiovascular alterations was often reported. Our purpose was to assess the relationships between chronic sinusitis and hypertension. Materials and Methods : Three hundred subjects with bilateral chronic sinusitis who underwent functional endoscopic sinus surgery between 2015and 2017 were evaluated. Six hundred forty subjects without any nasal diseases were enrolled as a control group. Blood pressure and body mass index (BMI) were measured using a standardized method, and subjects were asked about current use of any antihypertensive medication, history of diabetes, smoking and alcohol drinking habits.Sinusitis group was assessed by nasal endoscopic examination, paranasal sinus CT scan and allergy test. Results : Average systolic and diastolic blood pressures were statistically significantly higher in subjects with sinusitis than control group. Chronic rhinosinusitis was associated with a 1.415-fold (95% confidence interval 1.053-1.930) increased hazard of hypertension after multivariate adjustment. Conclusions : These results suggest that sinusitis is associated with high blood pressure. Therefore patients with sinusitis may need special attention for blood pressure control. Further studies need to be performed to elucidate the pathogenesis behind such associations.

Predictors of Distant Metastasis in Adenoid Cystic Cancer of Salivary Gland (타액선 선양낭성암종의 원격 전이 예측인자에 관한 연구)

  • Kim, Kang Woo;Kim, Yeon Soo;Oh, Kyoung Ho;Park, Min Woo;Cho, Jae-Gu;Baek, Seung-Kuk;Woo, Jeong-Soo;Jung, Kwang-Yoon;Kwon, Soon Young
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.1-4
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    • 2014
  • 배경 및 목적 타액선 선양낭성암종은 느린 성장 속도와 늦은 원격 전이를 특징으로 하는 드문 상피성종양이다. 본 연구는 다양한 임상 병리학적 변수를 통해 선양낭성암종의 원격 전이에 영향을 주는 인자를 조사하고자 하였다. 대상 및 방법 1999년 10월부터 2011년 12월까지 본원 이비인후과에서 타액선 선양낭성암종으로 진단되어 치료 받은 44명(남자 19명, 여자 25명)을 대상으로 원격전이를 유발하는 위험 인자를 조사하였다. 8명의 환자는 배제 기준에 따라 제외하였다. 환자의 평균 연령은 54세였다. 환자의 병리 보고서, 종양의 크기, T 병기, 수술 절제연의 종양 존재 유무, 신경 조직 침습, 림프절 전이가 조사되었다. 결 과 15명의 환자가 원격전이가 있었으며 21명은 원격 전이가 없었다. 원격 전이를 유발할 수 있는 여러 인자들을 비교하였을 때, 원격 전이는 수술 절제연의 종양 세포 잔존(p=0.014), 종양의 크기(p=0.038), 진행된 T 병기(p=0.024)가 통계적으로 유의하게 연관성이 있었다. 림프절 전이와 신경 조직 침습은 원격 전이와 연관이 없었다. 결 론 종양의 크기, 진행된 T 병기, 수술 후 절제연의 종양 세포 잔존은 원격 전이의 예측 인자로 생각된다. 따라서 이에 해당하는 환자의 경우 더욱 철저한 관리 및 경과 관찰을 요한다.

Clinical Features and Factors Affecting Prognosis of Papillary Thyroid Carcinoma in Male Patients (남성 갑상선 유두암 환자의 임상 특징과 예후에 미치는 인자에 관한 연구)

  • Kim, Nam Young;Kim, Kyoung Hun;Park, Sung Ho;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung-Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.1-4
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    • 2016
  • Background and Objectives: National cancer center institute reports that male patients of papillary thyroid carcinoma (PTC) are annually increasing. This study aimed to analyze the features of the male patients with PTC. Materials and Method: We retrospectively reviewed and analyzed clinical records of 170 patients who were treated for PTC in male patients between 2000 and 2010. Clinical features, size, pathologic type, extrathyroidal extension, recurrence, multiplicity, extent of surgery, and lymph node metastasis were retrospectively evaluated.Univariate and multivariate analyses of various clinical factors were performed. Results: Total 4145 patients received surgery for papillary thyroid carcinoma. The number of male patients was 170 (4.1%) among them. Of170 male patients, only 16(9.4%) patients underwent the recurrence of PTC. The size of tumor, central neck node metastasis, lateral neck node metastasis, extrathyroidal extension and RAI ablation therapy were associated with recurrence(p< 0.05) in univariate analysis. However, only the extrathyroidal extension [p=0.03, Odds ratio=3.58(95% CI. 1.09~14.24)] was related to the recurrence in multivariate analysis. Conclusion: Re-estimation of clinical features in male PTC patients should be concerned. The recurrence of PTC in male patients was 16(9.4%) and nearly same as the other studies. The extrathyroidal extension was revealed as an associated factor for the recurrence. Evaluation of regional or distant metastasis should be considered in patients with the extrathyroidal extension in male PTC patients during long-term follow-up.

Synchronous Primary Cancer in Hypopharyngeal Cancer (하인두암에 병발한 동시성 암종)

  • Hur Kyung-Hoe;Lee Sung-Hoon;Jung Kwang-Yoon;Choi Jong-Ouck
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.173-177
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    • 1995
  • Multiple primary malignant neoplasms occur relatively frequently today and are important especially in the head and neck area for they usually carry a bad prognosis. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. The first case was a T1 hypopharyngeal cancer with a mid-esophageal second primary who complained of a huge neck node. The second case was a T3 hypopharyngeal cancer who was initially seen by the chest surgeons for a large lower esophageal tumor. The third case was a patient previously operated for stomach adenocarcinoma three years ago, who had newly developed symptoms like dysphagia and hoarseness, and was diagnosed as hypopharyngeal T3 with oropharyngeal second primary cancer. Three cases were all heavy smokers and had histories of heavy alcohol consumption. They were all treated at the same sitting by en-block resection of the involved organs and postoperative radiation therapy. The authors have recently experienced 3 cases of synchronous second primary cancers in association with hypopharyngeal cancer and a report is made.

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A Case of Non Hodgkin's Lymphoma of Parotid Gland (이하선에 발생한 비호지킨스 림프종 1예)

  • Hwang, Jun-Yeon;Kim, Heui-Jong;Mun, Seog-Kyun;Lee, Sei-Young
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.170-173
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    • 2007
  • About 20% of non-Hodgkin' lymphoma occur in the extra-nodal region in the head and neck area and more than half of extra-nodal lymphoma in the head and neck area involves the Waldeyer' ring. Malignant lymphoma arising in the parotid glands are relatively rare, although 90% of all salivary gland lymphomas, appear in parotid gland and are classified as extranodal non Hodgkin' lymphoma. We experienced one rare case of non-Hodgkin' lymphoma in the right parotid gland, with a painless swelling of the cheek region as the chief complaint. We treated with CHOP(cyclophosphamide, $750mg/m^2$ i.v. day1 ; doxorubicin, $50mg/m^2$ i.v. day 1 ; vincristine, $1.4mg/m^2$ i.v. day 1;prednisone, $50mg/m^2$ orally days 1 to 5. repeat every 21 days) and Rituximab combination therapy. We aimed to report here one case of non-Hodgkin' lymphoma in the right parotid gland with review of literature.