• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.41-43
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• 2018

"Saber-sheath" trachea is a deformity of lower cervical or intrathoracic trachea. The configuration of the deformity is marked coronal narrowing associated with sagittal widening. This deformity is associated with chronic obstructive pulmonary disease. We report a case of patient with saber-sheath who underwent total laryngectomy. Although the patient had no tracheal collapse after the total laryngectomy, crusted discharge was increased. Diagnosis of the saber-sheath trachea, possible causes, and clinical implications are discussed.

• Radiation Oncology Journal
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• v.8 no.2
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• pp.199-205
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• 1990

During a ten-year period from 1978 through 1987, 44 patients with T2NOMO glottic cancer were treated with radical radiation therapy at the Yonsei University Medical Center. Forty-two patients had a minimum follow-up of 3 years, and $81\%$ had at least five years of follow-up. Patients were staged according to the AJCC system. Forty-two patients have been analyzed in detail with respect to two variables: the status of vocal cord mobility and the degree of local extension of the disease. Five-year local recurrence free survival rates were as follows: All 42 patients, $53.3\%$ patients with normal vocal cord mobility (n =18), $69.1\%$ versus patients with impaired vocal cord mobility (n=24), $43.4\%$(p<0.05); patients with subglottic extension (n=15), $36.7$ versus patients without subglottic extension (n=29), $61.9\%$ (p<0.05). The most favorable Prognostic group included the patients with normal mobility without subglottic extension (n=14), $83.1\%$. On the basis of this analysis, we confirmed the presence of heterogeneity in T2NOMO glottic cancer This study indicates that further randomized controlled trials are warranted to evaluate.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.136-139
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• 1994

Tracheal stenosis is relatively common complication after tracheal intubation or tracheostomy for a long time. We experienced 10 cases of tracheal stenosis with various causes, prolonged intubation or tracheostomy caused the tracheal stenosis in seven, one after advanced cancer of the lung, one after inhalation burn, and the other was palliative management for tracheal stenosis by Gianturco type tracheal stent. We tried to correct this stenosis applying three tracheal stent and one Montgomery T-tube as a palliative approach, but failed in two, one restenosis due to regrowing of granulation tissue with scarring or another metastatic spread of cancer to systemic organs after 3 months of placing the stent. Tracheal circumferential resection and end to end anastomosis were done in seven, and obtained one postoperative complication as subglottic stenosis was followed by Montgomery T-tube and reoperation later. With the brief review of references, we report the cases.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.217-222
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• 2006

$\underline{Purpose}$: This study evaluated the results of definitive radiation therapy and the prognostic factors that affect survival rates for T2N0 glottic cancer patients. $\underline{Materials\;and\;Methods}$: Thirty patients with T2N0 glottic cancer who were treated with definitive radiation therapy at our institution between September 1986 and June 2004 were retrospectively reviewed. All patients were pathologically confirmed as having squamous cell carcinoma and were staged as AJCC T2N0. The age of the patients ranged from 39 to 79 (median 62) years and all were male. A total dose of $66{\sim}70\;Gy$ (median 66 Gy) was delivered with a 6-MV linear accelerator in $6.5{\sim}7$ weeks. The median follow-up period was 63 months. $\underline{Results}$: The actuarial disease-free survival rate for the entire group of the patients was 79% at 5 years. The five-year disease-free survival rates for patients without and with subglottic extension were 90% and 56%, respectively (p=0.03). However, anterior commissure involvement, supraglottic extension, and impaired cord mobility were not statistically significant prognostic factors. The five-year disease-free survival rates for patients with and without concurrent chemotherapy were 86% and 69%, respectively (p=0.47). $\underline{Conclusion}$: Subglottic extension can be considered a poor prognostic factor for T2N0 glottic cancer.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.21-23
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• 2016

The aim of this report was to present a rare case of a tracheotomy site recurrence after operation and post-operative radiotherapy in head and neck squamous cell carcinoma patient. Tracheotomy site recurrence other than subglottic cancer is very rare in head and neck cancer patient. The granulation tissue around tracheotomy was a fertile "soil" for tumor cell implantation. Midline mucosal sparing block which was used to decreased acute toxicity during post-operative radiotherapy could be facilitating the tumor cell implantation. The head and neck surgeon should try every effort to reduce contamination of cancer cells during operation and consider the entire operative field should be included in post-operative radiation portals.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.105-105
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• 1993

Laryngeal cancer is the commonest of all head and neck malignancies and, in Korea, constitutes approximately 2.3% of all malignancies among males. Survival rate is rather higher than any other head and neck malignancies. Treatment results of 121 laryngeal cancer patients were analyzed. 1. Glottic region 44%, supraglottic 41%, subglottic 8%, transglottic 7%. 2. Rate of cervical metastasis according to T stage was 19% in T2 stage, 47% in T3 stage, 69% in T4 stage. 3. Overall 3-year NED survival rate was 65% and showed stage I 93%, stage II 76%, stage III 63%, stage IV 53%. 4. Glottic cancer showed much better prognosis(3-year NED 82%) than supraglottic cancer(3-year NED 58 %). 5. According to treatment modality, complication rates in surgery with postoperative radiation was higher than in surgery along and disproportionally higher in salvage surgery after failed curative radiation.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.38-43
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• 2000

The reconstruction for the pharynx and cervical esophagus after wide resection in essential procedures and the several methods have the reported. Each method has advantages and disadvantages relatively. Five cases of free jejunal graft were analyzed retrospectively for the reconstruction of pharynx and cervical esophagus at Chungbuk National University Hospital from May 1996 through December 1998. Primary sites were one oropharyngeal cancer, three hypopharyngeal cancers and one subglottic cancer involved the cervical esophagus. Two grafts had necrosis. Postoperative minor complications were dysphagia, fistula, stricture of anastomosis site, and pneumonia in the order. There were not possible voice rehabilitation in three success cases.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.87.3-87
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• 1976

The authors experienced a case of a difficult decannulation in a 4 years old boy, in which. case decannulation was possible 2 years later a tracheostomy. Some immunoglogical phenomena could be considered in this case as though cancer can remiss spontaneously. Such complications of tracheostomy as subglottic edema and perichondritis could become relatively less troublesome to breathing during his aging process. And another reason for the easy decannulation is considered as the patient could be accustomed to breathing through natural air pathway by continual cannula corking training.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.128-132
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• 2004

Objectives : The total laryngectomy for laryngeal cancer has made patients be afraid of voice loss. Early staged glottic or supraglottic cancer can be treated with conservative laryngeal surgery which preserve voice, though which was not normal voice comparing before. Voice analysis is used to evaluates objectively the quality of the voice in pre- and postoperation, 4 different types of conservative laryngeal surgery : laser cordectomy, supracticoid partial laryngectomy, vertical partial laryngectomy, and supralottic laryngectomy. Materials and Methods : The patients who received conservative laryngeal surgery(laser cordectomy : 23 cases, vertical partial laryngecotmy : 9cases, supracriocoid partial laryngectomy : 6cases, supraglottic laryngectomy : 8cases) from 1995 to 2001 in the Asan medical center. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum comfortable phonation time and subglottic pressure were used as parameters for voice analysis. Results : The patients who received laser cordectomy(shimmer : 5.26${\pm}$1.12%, jitter : 3.33${\pm}$0.42%, NHR : 0.47${\pm}$0.02, MPT : 9.32${\pm}$3.59sec) and supraglottic laryngectomy(shimmer : 4.39${\pm}$1.03%, jitter : 1.49${\pm}$0.14%, NHR : 0.51${\pm}$0.06, MPT : 8.9${\pm}$0.59sec) showed better results than other two procedures, but differed from normal value. Especially the patients who received supracricoid partial laryngectomy(shimmer : 9.23${\pm}$1.56%, jitter : 5.81${\pm}$1.23%, NHR : 5.89${\pm}$1.13, MPT : 6.3${\pm}$1.18sec, MFR : 632${\pm}$89ml/sec) had poorer quality of voice but presented fast functional recovery time, and the subjective symptom was improved as time goes by slowly. Conclusion : The appropriate conservative laryngeal surgery for each cancers and stage can preserve the acceptable voice for patients. Supracricoid partial laryngectomy for T1b glottic cancer can be used for acceptable voice despite its poor voice analysis.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.163-168
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• 2006

Purpose: Incidence of lung canter in patients with idiopathic pulmonary fibrosis (IPF) is known to be higher than that in general population. However, it is difficult to discriminate pulmonary nodule in patients with IPF, because underlying IPF can be expressed as lung nodules. We evaluated the diagnostic performance of FDG PET in discriminating lung nodule in patients with IPF. Methods: We retrospectively reviewed 28 lung nodules in 16 subjects (age; $67.53{\pm}9.53$, M:F=14:2). Two patients had previous history of malignant cancer (small cell lung cancer and subglottic cancer). The diagnostic criteria on chest CT were size, morphology and serial changes of size. FDG PET was visually interpreted, and maximal SUV was calculated for quantitative analysis. Results: from 28 nodules, 18 nodules were interpreted as benign nodules, 10 nodules as malignant nodules by histopahthology or follow-up chest CT. The sensitivity and specificity of FDG PET were 100% and 94.4%, while those of CT were 70.0% and 44.4%, respectively. Malignant nodule was higher maxSUV than that of benign lung nodules ($7.68{\pm}3.96\;vs.\;1.22{\pm}0.65$, p<0.001). Inflammatory lesion in underlying IPF was significantly lower maxSUV than that of malignant nodules ($1.80{\pm}0.43$, p<0.001). The size of malignant and benign nodule were $23.95{\pm}10.15mm\;and\;10.83{\pm}5.23mm$ (p<0.01). Conclusion: FDG PET showed superior diagnostic performance to chest CT in differentiating lung nodules in patients with underlying IPF. FDG PET could be used to evaluate suspicious malignant lung nodule detected by chest in patients with IPF.