• Title/Summary/Keyword: Transoral surgery

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Simultaneous Neck Dissection in Transoral $CO_2$ Laser Surgery for Supraglottic Cancer (성문상부암에서의 경구강 $CO_2$ 레이저 수술과 동시경부청소술)

  • Kim, Sung-Won;Lee, Kang-Dae
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.18-23
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    • 2009
  • Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.

Two Cases of False Cord Schwannoma Treated with Transoral Laser Resection (가성대에 발생한 신경초종의 경구강 레이저 절제술 치험 2례)

  • Kim, Young-Rok;Kim, Sung-Won;Hong, Jong-Chul;Lee, Bong-Ju;Lee, Kang-Dae
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.58-62
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    • 2007
  • Schwannoma is a benign well-encapsulated tumors arising from the sheath of Schwann cell of the peripheral motors, sensory, and cranial nerves, but not from the optic and olfactory nerves. Since it is relatively common in the head and neck region, it should be included in the differential diagnosis of head and neck tumor. However, reports of laryngeal involvement have rarely appeared in the literature. We have experienced a 50-year old woman and 39-year old woman with history of progressive voice change. We recognized a benign mass at the false cord area with the telelaryngoscope and CT. The tumors were successfully removed by transoral CO2 laser resection without tracheotomy.

A Case of Cavernous Hemangioma Occurred in Arytenoid (피열부에 발생한 해면상 혈관종 1예)

  • Kim, Tae Hwan;Kim, So Yeon;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.1
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    • pp.54-57
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    • 2015
  • Hemangioma is one of the most common benign neoplasm, which occurs about 50% in head and neck region, but laryngeal hemangioma is relatively rare. Hemangioma occurred in larynx can be treated by surgical removal, cryosurgery, and steroid injection. Transoral CO2 laser micorsurgery has been known as useful method for the treatment of laryngeal hemangioma. We have experienced a 54-years old male patient of hemangioma originated in arytenoid area. This mass was removed via transoral approach with 'en bloc' resection by CO2 laser. We report this case regarding the treatment and prognosis of laryngeal hemangioma with review of literatures.

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A Case of Second Branchial Cleft Cyst Presenting as a Parapharyngeal Cystic Mass (부인두강 낭성 종물로 발현된 제2새열 낭종 1례)

  • Kim, Byung Ha;Do, Nam Yong;Cho, Sung Il;Park, Jun Hee
    • Korean Journal of Bronchoesophagology
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    • v.18 no.2
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    • pp.60-63
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    • 2012
  • Second branchial cleft cysts are usually present as a fluctuant neck mass along the anterior border of the sternocleidomastoid muscle. When they are found in this typical location, accurate diagnosis on initial presentation is not difficult. Parapharyngeal presence of the branchial cleft cyst is very rare. We report a case of second branchial cleft cyst presenting as a parapharyngeal cystic mass in 51-year-old male. Before coming to our clinic, the patient had been diagnosed as parapharyngeal abscess, resulting in several attempts at removal. However, symptoms and parapharyngeal abscess recurred. We performed complete surgical resection of the parapharyngeal cystic mass via transoral approach only with oropharyngeal incision. The cystic mass was located in the parapharyngeal space and did not have tract-like structure. Histopathologic examination confirmed that the excised cyst was branchial cleft cyst. Patient discharged without any surgical complication and there was no evidence of recurrence for 2 years follow-up.

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Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer

  • Yoichiro Ono;Kenshi Yao;Yasuhiro Takaki;Satoshi Ishikawa;Kentaro Imamura;Akihiro Koga;Kensei Ohtsu;Takao Kanemitsu;Masaki Miyaoka;Takashi Hisabe;Toshiharu Ueki;Atsuko Ota;Hiroshi Tanabe;Seiji Haraoka;Satoshi Nimura;Akinori Iwashita;Susumu Sato;Rumie Wakasaki
    • Clinical Endoscopy
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    • v.56 no.3
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    • pp.315-324
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    • 2023
  • Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions: Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

TRANSORAL TREATMENT OF EAGLE'S SYNDROME: 2 CASE REPORT (구내 접근을 통한 이글씨 증후군의 치험 2례)

  • Kim, Jae-Young;Choi, Ji-Wook;Kim, Nam-Kyun;Tae, Il-Ho;Kim, Seong-Taek;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.180-183
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    • 2009
  • Eagle's syndrome refers to a symptomatic elongation of the styloid process or calcification of the stylohyoid and stylomandibular ligaments that usually accompanies facial and pharyngeal pain, dysphagia, and foreign-body sensation in the throat. Making an accurate diagnosis is difficult as Eagle's syndrome can be accompanied with referred pain to various areas of head and neck. Treatment options for Eagle's syndrome include non-surgical and surgical methods. The surest and the most effective method for relieving the symptom is surgical removal or reduction of the elongated styloid process. The present study reports two cases of female whom were diagnosed as "Eagle's syndrome" and whose chief complain was foreign-body sensation and pain in the throat on movement. Surgical removal via transoral approach of the elongated styloid process is a safe surgical option with favorable results compared to extraoral approach.

Retromandibular reduction of medially dislocated condylar process fractures

  • Lee, Gyu Hyeong;Kang, Dong Hee;Oh, Sang Ah
    • Archives of Plastic Surgery
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    • v.45 no.1
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    • pp.23-28
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    • 2018
  • Background Condylar process fractures account for one-third of all mandibular fractures, and the distal fragment is prone to dislocate to the medial side due to the pulling of the lateral pterygoid muscle. Retromandibular approaches are commonly used, but the intraoperative view becomes limited in medially dislocated fractures. This study summarized a series of cases of retromandibular reduction for medially dislocated condylar process fractures and described our supplementary procedure to realign the dislocated condylar process. Methods Nine patients with medially dislocated condylar process fractures underwent surgical correction from January 2012 to December 2016. In 6 of them, it was possible to realign the fractures with a conventional retromandibular approach, but for 3 cases of severe dislocation to the middle cranial fossa, a supplementary transoral procedure was carried out. The angle difference between the ramus and condyle, ramus height, and maximal mouth opening (MMO) were evaluated. Results All 9 cases were restored to the proper anatomical alignment without any major complications, and postoperative images revealed successful union. The angle difference was $8.94^{\circ}{\pm}4.11^{\circ}$ preoperatively, and $0.99{\pm}0.49^{\circ}$ at the 6-month follow-up. The pretreatment ramus height difference was $6.12{\pm}6.09mm$, and the postoperative difference was $0.18{\pm}0.10mm$. These changes after surgery were statistically significant. The MMO before surgery was $11.44{\pm}3.0mm$, and the postoperative MMO was $37.2{\pm}2.9mm$, reflecting a significant increase after reduction. Conclusions Retromandibular reduction is a useful method in medially dislocated condylar process fractures, and additional transoral assistance should be considered to realign condylar processes that severely dislocate to the middle cranial fossa.

Retromandibular approach for the management of subcondylar fractures, followed by treatment of parotid gland fistulae: Case report (하악 과두하 골절시 후하악 접근법에 의한 수술 후 발생한 이하선 누공 형성과 이에 대한 치료 증례)

  • Ro, Jae-Chan;Kim, Ju-Won;Yang, Byoung-Eun
    • The Journal of the Korean dental association
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    • v.55 no.10
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    • pp.696-705
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    • 2017
  • Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

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Surgical Treatment of Cancer of Tongue and Floor of Mouth (설암 및 구강저암의 수술적 치료)

  • 홍기환;양윤수
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.270-276
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    • 1997
  • The records of 18 patients with squamous cell carcinoma of the tongue and floor of mouth treated surgically were reviewed. Surgical approaches, staging, treatment modalities, recurrence and vital status were evaluated. The distrubutions of involved sites were tongue(9 cases) and mouth floor(9 cases). Patients were treated by surgery primarily, combined chemotherapy and radiation, and by surgical salvage in the failure cases of radiation and chemotherapy. All ipsilateral necks of mouth floor cancer and advanced tongue cancer were treated with neck dissection. Cases of early tongue cancer could be excised with transoral route, and advanced cases needed transmandibular approach. Whereas, majorites of mouth floor cancer needed transmandibular approach, and other cases could be excised transoral and pull-through approaches. In the recontructions, we used primary closure, pectoralis major myocutaneous flap, forearm free flap, fibular osteocutaneous flap and skin graft. One year survival rate was 93% and 2 year survival rate was 60%.

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