• 대한미세수술학회:학술대회논문집
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• 1997.10a
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• pp.126.1-126.1
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• 1997

• Archives of Plastic Surgery
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• v.43 no.6
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• pp.538-543
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• 2016

Background Cutaneous squamous cell carcinoma (SCC), which occurs in keratinocytes of the epidermis and is the second most common skin cancer, has a more invasive growth pattern and higher potential to metastasize than basal cell carcinoma. Total excision of the primary tumor is the treatment of choice. For clear excision of the tumor, invasion depth is one of the most important factors. This study was conducted to clarify the relationship between the size and the invasion depth of cutaneous SCC. Methods Twenty-six cases were collected for this prospective study. Frozen biopsies were examined after complete resection of the tumor, followed by histological confirmation by pathological examination. The major and minor axis lengths of the tumor, the invasion depth, and the level of invasion were measured. Recurrence or metastasis was recorded through regular follow-up. Results The Pearson correlation coefficient was used for statistical analysis. Significant results were observed for the relationship between the major and minor axis lengths and the invasion depth of the tumor (0.747, 0.773). No cases of recurrence or metastasis were observed. Conclusions In head and neck cutaneous SCC, the invasion depth of the tumor is closely related to the major and minor axis lengths of the tumor. Therefore, the invasion depth of the tumor can be estimated by measuring the size of the tumor, and a standard vertical safety margin for head and neck cutaneous SCC can be established, which could be helpful in the development of a preoperative reconstruction plan.

• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.37-43
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• 2017

Background: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. Methods: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. Results: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. Conclusion: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.40-45
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• 2011

Background and Objectives Detailed information about the impacted esophageal foreign body is essential for safe extraction. Three dimensional reconstruction technique was applied to know shape, size and location of the simulative foreign bodies of stone, hyoid bone and endotracheal tube. Materials and Methods Submandibular gland stone, hyoid bone and endotracheal tube were used to simulate impacted foreign bodies. Axial CT, multi-planar reconstruction, volume of interest and virtual camera of Rapidia software were used to get information about the simulative foreign bodies from CT data. Shape and size were compared with the real materials. Exact locations were measured in appropriate modes of Rapidia. Results Shapes of the simulative foreign bodies matched well with the real materials. Size and location could be measured in various modes with some variable results. Conclusion 3D technique can be applied to get information about the simulative foreign bodies. This technique could be applied to the impacted esophageal foreign body.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.138-144
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• 2010

Background: Tracheal deviations are encountered frequently in head and neck tumors especially in thyroid cancer. Dyspnea and stridor are symptom calling for surgery. The method of evaluation in tracheal deviation is not well established yet. This paper is aimed to suggest objective tools to evaluate tracheal deviation in relation to cervical vertebra. Material and Method: Ten cases of thyroid cancers were recruited retrospectively. Tracheal inner shadow and shape of cervical vertebra were reconstructed three dimensionally using 3D-doctor to compare position of trachea in relation to vertebral body. Extent of deviation was scored in relation to both lateral borders of vertebral body. Angles between trachea and spinous process were measured in axial CT and compared between study group and control group. Results: Deviation scores were statistically significant between study group (mean=1.1) and control group (mean=0) (p=0.0008). Deviation angles at maximal tumor size in study group (mean=160.3 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0007). Angles at maximal deviation of three dimensional images ages in study group (mean=162.6 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0089). Conclusion: Tracheal deviation can be evaluated using scoring of three dimensional images and measuring angle between trachea and vertebral spine.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.2
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• pp.118-125
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• 2009

Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.41-44
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• 2023

Mucinous Eccrine carcinoma (MEC) is a rare malignant tumor related to the eccrine sweat gland and is commonly located on the face, especially around the eyelids and scalp. Most of these tumors are diagnosed at age 40's to 60's and exhibit a wide variety of patterns in addition to the general appearance previously reported. MEC is difficult to diagnose clinically, but can be diagnosed by accompanying biopsy. We present the case of a 75-year-old man who complained of a gradually growing Left lower lid tumor of duration one year. Initially, the tumor was mistaken for an epidermal cyst and treated by surgical resection. However, biopsy findings resulted in a diagnosis of Mucinous Eccrine carcinoma. Therefore, we performed wide excision and flap reconstruction surgery. In a one year follow-up examination, the patient achieved successful functional and aesthetic results without regional or distant metastasis and recurrence.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.198-204
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• 2001

Background and Objectives: As the laryngopharyngeal cancer is usually found at a advanced stage, it is difficult to get a wide surgical margin that preserves functional aspect and that is oncologically safe simultaneously. There were many operative technique to fulfill this principle, but none were satisfactory. Recently there were some reports about glottic and pharyngeal reconstruction using radial forearm free flap(RFFF) with palmaris longus tendon, which provided satisfactory oncologic and functional results. We attempted to perform this technique and to test usefulness at patients of laterally localized laryngopharyngeal tumor. Materials and Methods: Three patients were reconstructed glottis and pharynx using radial forearm free flap with palmaris longus tendon. Two hypopharyngeal cancer (T2N0M0) patients were performed wide vertical hemilaryngopharyngectomy and one supraglottic cancer(T2N0M0) patient was performed horizontovertical laryngopharyngectomy. Deglutitional function was evaluated with modified barium swallow and speech function was evaluated by speech pathologist. Results: Mean follow-up time was 29.3 months. There were no cancer recurrence. Their speech was satisfy-actory at social communication and oral feeding. They all have a complete oral nutrition from 26 days to 53 days. Decanulation time was from 71 days to 30 months. Conclusion: Glottic and pharyngeal reconstruction with radial forearm free flap could be accepted as a promising technique which offers a wide resection margin but satisfactory functional result in lateralized laryngohypopharyngeal cancer patients.

• Korean Journal of Head & Neck Oncology
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• v.25 no.1
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• pp.33-35
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• 2009

Purpose : Granular cell tumour(GCT) is a rare benign tumour that can arise in anywhere throughout the body. Histopathological diagnosis of malignancy is difficult. We report a case of a granular cell tumor which developed on lower lip. Methods : A 58-year-old male had a palpable mass and whitish plaque in the oral mucosa for three months. Results : Under local anasthesia, the tumor was removed through wide excision including normal skin margin. Immediate reconstruction using local flap was done. Pathologic observation showed nests of polygonal cells with abundant granular, eosinophilic cytoplasm and round nuclei. Immunohistopathologic staining showed positive reaction on S-100 protein Conclusion : The results support the hypothesis that granular cell tumor is derived from Schwann cells. We report here on a case of granular cell tumor of lower lip that was successfully treated with radical resection.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.178-184
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• 1995

Melanoma of the scalp is rare condition and seems to be to have a poor prognosis than melanoma of other portion of the body. We had 2 patients suffering from malignant melanoma of scalp. Their charts were reviewed for epidemiologic data, location, Breslow thickness, lymph node involvement and outcome. The therapeutic treatment was wide excision and skin grafting or free flap reconstruction. The early recognition of all the nevi at scalp and proper follow-up of the lesion are key stones to eradicating the changing mole and to preventing this thread to life.