• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 2005년도 제11차 대한이비인후과학회 학술대회 초록집
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• pp.34.1-34.1
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• 2005

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 2005년도 제11차 대한이비인후과학회 학술대회 초록집
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• pp.37-42
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• 2005

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.53-62
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• 1991

기관절제술은 기도확보를 위해 다양한 임상적 상황에서 행해지는 술식으로 1546년에 Brasabola에 의해 처음 성공적으로 시행되었다. 기관절제술의 적응증으로는 상기도 폐쇄의 완화, pulmonary toilet의 촉진, dead space의 감소 및 mechanical ventilation의 장기 사용시 등을 들 수 있겠다. 그동안 term에도 변화가 있었는데, 1718년 까지는 "bronchotomy"란 term 이 사용되었고 그후 "tracheotomy"란 term 이 사용되었으나 1820년 이후에는 "tracheostomy"란 term 이 나오게 되어 현재 이 두가지 term 이 구별없이 사용되고 있다. 기도폐쇄를 야기시킬 수 있는 악안면 부위의 외상 혹은 여러가지 질병의 증가 추세로인해 구강외과의사가 기관절제술을 시행해야할 상황을빈번히 맞게 된다. 이에, 본 교실에서 기관절제술을 시행한 31 명의 환자에 대한 임상적 고찰을 통해 숙련된 기관절제술 및 그 처치능력의 중요성을 보고하는 바이다.

• 가정간호학회지
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• 제25권3호
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• pp.153-163
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• 2018

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

• 대한기관식도과학회지
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• 제6권1호
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• pp.80-86
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• 2000

Background : Stomal recurrence that occasionally follows total laryngectomy is associated with very poor prognosis regardless of treatment modality, so it is very important to identify high risk patients to prevent stomal recurrence. Objectives : We attempted to select an optimal management method to prevent stomal recurrence by analyzing risk factors in each patient who was found to have stomal recurrence following total laryngectomy. Materials and Methods : Risk factors in each of eleven patients who had stomal recurrence out of 159 patients who underwent total laryngectomy in the last ten years were analyzed retrospectively. Data were gathered on risk factors such as the presence of subglottic extension, extralaryngeal extension, thyroid gland invasion, lymph node metastasis, timing of tracheotomy, tumor stage, postoperative radiotherapy, and inclusion of the stoma in the radiotherapy field. Results : There were eight cases of subglottic extension, six cases of extralaryngeal invasion, one case of pharyngocutaneous fistula that occurred as a postoperative complication, and one case who was taken completion laryngectomy following conservation surgery. With the exception of one case who was taken tracheotomy prior to total laryngectomy, all tracheotomies were performed intra-operatively after endotracheal intubation. There was no evidence of paratracheal lymph node or prelaryngeal lymph node metastasis on preoperative neck CT scan. There were six cases of T4 tumors, four cases of T3 tumors, and one case of T2 tumor. Salvage surgery was performed following radiotherapy in three cases, and aside from one case who was not taken post-operative radiotherapy, postoperative radiotherapy including the stoma was performed in the remaining seven cases within one month after surgery. Conclusion : Total laryngectomy with wide paratracheal lymph node dissection, thyroidectomy, and tracheotomy should be performed for patients who have high risk factors such as subglottic extension and advanced stage. We believe that tracheotomy should be precede endotracheal intubation. Efforts should be made to prevent stomal recurrence by utilizing postoperative radiotherapy and by minimizing postoperative complications such as infection and fistula.

• 대한두경부종양학회지
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• 제25권1호
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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.

• 대한후두음성언어의학회지
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• 제6권1호
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• pp.5-8
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• 1995

Bilateral vocal cord palsy is uncommon but is serious because of airway obstruction. Treatments of bilateral vocal cord palsy are initially tracheotomy, vocal cord lateralization and vocal cord reinnervation. Recently, we experienced nerve-muscle pedicle reinnervation in 3 cases of bilateral vocal cord palsy, so reported it with a review of literature.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.12-12
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• 1982

기관절개술은 1649년 Fienus가 처음으로 호흡곤란 환자에게 시술하고 Tracheotomy라 명명한 이래 기도확보, 기관 및 기관지로 부터 분비물 제거 및 산소공급을 목적으로 이용되어 많은 생명을 구하고 있다. 그러나 기관절개술후 성문하부의 협착, 기관연화, 기관절개공주위의 육아조직, 기관점막의 부종, 정신적인 의존 및 제 1기관륜 상부의 절개등으로 인한기관 Cannula 발거곤란증이 수반되기도 한다. 저자들은 1980년 4월 산업재해로 인한 두개내혈종 및 다발성늑골골절등으로 진단되어 타종합병원에서 개두술과 기관절개술을 받은 21세 남자환자에서 기관 Cannula 발거곤란증을 경험하였기에 중간보고하는 바이다. 1981년 11월 본원 이비인후과에 전원시 간접후두경 검사상 성대 및 가성대에 심한 부종이 있었으며 성대는 부정중위로 고정되어 있었고 기관지경검사상 성문하부에 협착이 인지되어 Jackson 식도 Bougie를 이용하여 3차에 걸쳐 Bougination으로 기관확장을 시도하였으나 효과가 없었다. 1981년 2월 협착부위의 기관륜과 윤상연골에 수직절개를 한 후 직경 1. 2cm의 Teflon tube를 협착부위에 삽입하고 9개월간 유치시킨 후 제거하고 Corking을 하여 현재 양호한 경과를 취하고 있다.

• 대한치과의사협회지
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• 제52권10호
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• pp.602-614
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• 2014

폐쇄성 수면 무호흡증(OSAS)환자의 외과적 치료(surgical treatment)로는 다양한 방법들이 있고 수술 방법의 선택시 여러 인자들을 고려해서 선택해야 한다. 즉, 수술은 폐쇄성 수면 무호흡증(OSAS)을 조절하는데 있어 보존적 치료 (non-surgical treatment)의 좋은 대체 방안(alternative chance)이 될 수 있기에, 증상(OSAS)의 주관적(subjective), 객관적(objective), 심각성(severity)을 해부학적 이상(anatomic abnormality) 정도와 연관시켜 적절한 수술법(surgical procedure)을 선택해야 한다. 수술 방법은 한가지 방법을 사용(single-level)하는지, 여러 수술 방법을 통합하여 사용(multi-level)하는지에 따라 다양하며, 그 예후도 각각 다르다. 중요한 점은 다단계 폐색(multilevel obstruction)이 있는 경우에는 다단계 치료(multilevel treatment) 방법이 가장 추천된다는 것이며, 이는 단지 증상(OSAS)의 심각성(severity)을 기준으로만 평가해서는 안되며 경도나 중등도(mild to moderate)의 환자에서도 필요시 보존적 치료(non-surgical treatment)를 시행하기 전에 다단계 외과적 치료(multilevel surgical treatment) 방법을 적극적으로 고려해야 한다. 비록 다단계 치료(multilevel treatment)방법은 상대적으로 짧은 임상 기간을 거쳤지만, 앞으로 지속적인 연구 결과(evidence-based data)를 이어간다면, 개개 환자에 맞는 최적의 치료 방법(optimal surgical intervention)을 제시할 수 있을 것이다.

• 대한후두음성언어의학회지
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• 제33권2호
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• pp.97-102
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• 2022

Background and Objectives Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist. Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period. Results Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients. Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.