• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.110-113
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• 2018

Tracheal cancer is rare and accounts for approximately 0.03% of all malignancies. Because of atypical symptoms, tracheal cancer can be misdiagnosed as obstructive lung disease, or tumors of thyroid or lung. Among patients of previous head and neck cancer, other primary cancer may accompany which called "econd primary cancer". We report a case of patient with tracheal cancer 3 years after definite radiation therapy of laryngeal cancer with a review of related literatures.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.61-64
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• 2018

Malignant lesion of the trachea predominantly results from direct spread of adjacent tumors, whereas primary tracheal malignancies are rarely observed. Tracheal tumors are usually diagnosed late on account of delayed specific symptoms: dyspnea, stridor, coughing and hemoptysis. Primary tracheal tumors, although very rare, may extend into the thyroid gland and present as a thyroid mass. Surgery, followed by adjuvant radiotherapy, is the treatment of choice. A case of primary tracheal cancer with thyroid invasion is reported, and a review of the literature is presented.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.153-160
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• 1983

Adenoid cystic carcinoma is a rare primary tracheal tumor and this tumor behave slow growth, low-grade ma!ignancy, locally invasion and long-term host survival. Operation with the primary goal of complete excision is the treatment of choice but this tumor require excessive margins at surgical removal because of locally invasive cancer. A 45-years-old male patient had complained paroxysmal coughing from 1 year ago prior to admission and was diagnosed pre-operatively as endotracheal adenoma. He had been treated by operation, and combined with radiotherapy by 4 MeV. Lineal Accelerator. The tracheal mass was removed by tracheo-bronchotomy transpleurally and right total pneumonectomy was performed. There was post-operative course uneventfully and no post-operative complication. The patient Is free from cancer until post-operative 1 year clinically and alive with good healthy.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.454-460
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• 2020

Tracheo-gastric conduit fistula is an extremely rare but severe complication that is difficult to manage. Conservative care, esophageal or tracheal stent placement, or cutaneomuscular flaps have been suggested; however, no definite treatment has been proven. We report a case of tracheo-gastric conduit fistula that occurred after a minimally invasive radical three-field esophagectomy. Following the primary surgery, the diagnosis was made while evaluating the patient's frequent aspiration and coughing. Conservative management failed, and a surgical correction was undertaken to identify the multifocal mucosal defect and exposed tracheal ring. A sternocleidomastoid muscle rotation flap and subsequent Histoacryl injection into the remaining fistula were performed, and the fistula was successfully managed.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.267-272
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• 2003

Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1998.11a
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• pp.198-198
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• 1998

Muc1 mucin is found in a variety of epithelial tissue and is overexpressed in several epithelial cancer. Recently it is alsol reported that primary Hamster tracheal surface epithelial(HTSE) cells express Muc1 protein and cDNA encoding HTSE muc1 protein has been cloned. Although numerous monoclonal antibodies (mAbs) to human muncins, particularly Muc1 have been produced, no such antibodies to murine Muc1 have been described. We now describe monoclonal antibody, called mAb M1CT, produced to C-terminal region of HTSE Muc1 protein by immunising mice with a glutathion-s-transferase linked fusion protein. In this study, using this antibody(mAb M1CT) we investigated the effect of RA on the expression of Muc1 in HTSE cells. Retinoic acid(RA) plays an essential role in maintaining normal differentiation of tracheal epithelial cells. With RA-deficiency tracheocytes undergo squamous metaplasia, an abnormal differentiation that can be reversed by RA. We had primary culture of HTSE cells under different concentrations of RA. Culture was maintained until the direction of differentiation was determined. Then Western blot analysis with mAb M1CT was performed with the cell lysates from the culture. The expression of Muc1 protein was decreased in dose-dependent manner as the concentration of retinoic acid was decreased. Our result indicates that the expression of Muc1 protein is coordinately regulated with airway mucous cell differentiation by RA pathway. And the antibody, mAb M1CT, produced in this study should provide useful tool to study the expression of Muc1 mucin in differentiation process or disease.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.177-180
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• 2000

Backgrounds： Patients with respiratory failure may require prolonged mechanical ventilation. The purpose of this study was to determine the optimal time for tracheostomy and complications of tracheostomy. Methods : All medical records of 27 patients who underwent tracheostomy in department of thoracic & cardiovascular surgery at Yondong Severance hospital between January 1, 1990 and December 31, 1998, were reviewed. Variables analyzed include underlying disease, primary indication of tracheostomy, interval from 1st intubation to tracheostomy, duration from tracheostomy to weaning ventilator, duration of decannulation, and complication. There were 18 men and 9 women. Mean age at the time of the tracheostomy was 54 years (rage, 11 to 64 yeras). Results : Underlying diseases included lung cancer in 14 patients (51.9%), trauma in 8 patients (29.6%), and TE fistula in 2 patients. The indication for tracheostomy were as follows: prolonged mechanical ventilation in 13 patients, purpose of bronchial toilet in 9 patients, and tracheal stenosis in 5 patients. The mean interval between the first intubation and tracheostomy was 8.1 days. The mean duration from tracheostomy to weaning ventilator was 10.1 days. Conclusions : Timing of tracheostomy Is very important. Tracheostomy may benefit patients because it can accelerate the process of weaning and thus lead to a reduction in the duration of ventilation, length of hospitalization, and cost.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.