• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.1
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• pp.58-62
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• 1999

Previously, laryngectomized patients can achieve speech with tracheoesophageal device. Tracheoesophageal speech is currently one of the best methods of postlaryngectomy voice rehabilitation. But, tracheoesophageal speakers have some troublesome with digital occlusion of tracheostoma in every speaking time. Therefore, the tracheostoma valve has been introduced since 1982, and this valve could eliminate the need of tracheostoma digital occlusion. Currently, couple of tracheostoma valves has been introduced and developed. In this article, we introduced the 3 representative tracheostoma valves. Also, we discussed their use and characteristics. Traditionally the tracheostoma valve is used in total laryngectomized patients. We introduced one case using a tracheostoma valve after near total laryngectomy. Advantage and disadvantage of Blom-Singer valve and BIVONA II valve during using in this patients are discussed.

• Radiation Oncology Journal
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• v.14 no.2
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• pp.167-173
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• 1996

Purpose : This analysis was to evaluate the radiation dose around a tracheostoma and spinal cord in the case of advanced laryngeal cancers in which a total laryngectomy was done before radiotherapy. Materials and Methods : The radiation dose around a tracheostoma and spinal cord was measured by thermoluminescence and film dosimetry in the phantom, Radiotherapy treatment planning was done in 12 cases of advanced laryngeal cancer and compared with the measured dose in the phantom. Results : Mean spinal cord doses in the phantom by thermoluminescence dosimetry were $86.4\%$ (with a tracheostoma), $80.1\%$ (without a tracheostoma), and the difference was $6.3\%$. Mean spinal cord doses in the phantom by film dosimetry were $84.7\%$ (with a tracheostoma), $79.0\%$ (without a tracheostoma). and the difference were $5.7\%$. Calculated spinal cord doses in the phantom were $84.0\%$ (with a tracheostoma), $78.0\%$ (without a tracheostoma), and the difference was $6.0\%$. Mean calculated spinal cord doses in 12 patients were $83.1\%$ (with a tracheostoma), $76.9\%$ (without a tracheostoma). and the difference was $6.2\%$. Measured dose of lateral and posterior wall of the tracheostoma by film was low (depth of maximum dose = 12 mm). Conclusion : In the treatment planning of the advanced laryngeal cancers, the radiation dose of the tracheostoma and spinal cord should be evaluated and be followed by an appropriate management such as a bouls or a brachytherapy boost if the dose around the tracheostoma is low.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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• pp.54-57
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• 2022

The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.246-251
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• 2001

심장 탈장은 심낭을 열고 전폐절제술을 시행 후 드물게 발생되는 합병증으로 수술이 끝날때나 수술직후 발생된, 44세 남자환자에서 심낭을 열고 좌측 폐를 전절제술 후 심낭 결손부위를 인공조직으로 봉합하였다. 수술이 종료될 때 심장탈장이 발생되어 개흉에 의한 응급 복원을 시행하였으나 심한 저 산소성 뇌 손상이 발생되었다.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.492-496
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• 1984

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. We experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 4.0 cm segmental narrowing below the tracheostoma. Before reconstruction, we tried to T-tube cannulation, but the result was not satisfactory. So we resected the narrowed segment and tracheal reconstruction was performed with uneventful result.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.73-76
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• 1982

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, among the variable complications following tracheostomy, the tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. At the Dept. of thoracic surgery, CAFGH, we have experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 2.5 cm segmental narrowing 5 cm below the tracheostoma. Before recon-struction, we tried to dilate the stenotic segment for about 2 months, but the result was not satisfactory to relieve dyspnea. So, we resected the narrowed segment and tracheal reconstruction was performed with an excellent result in postoperative periods till now.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.27-29
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• 2010

Tracheostomal stenosis after total laryngectomy is brothersome problem to surgeon and patient. To prevent tracheostomal stenosis, tension around the tracheostoma must be released. Advancement flap, V-Y inset and Z-plasty were suggested as solution to tracheostomal stenosis. But such methods need elevation of superior flap and it is very difficult when the patients received radiotherapy and has high change of developing pharyngocutaneous fistula. We suggested new stomaplasty technique which named "Modified Fish-Mouth Technique" that does not need to elevate superior skin flap.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.213-221
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• 1996

To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.

• 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.