• Title/Summary/Keyword: tracheotomy

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Tracheal Fibroma (one case report) (기관(氣管) 섬유종(纖維腫)의 1례(例))

  • Lee, Chong Kook;Lee, Sung Koo;Lee, Sung Haing
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.41-43
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    • 1976
  • Primary tumors of trachea are rather uncommon, and few cases of direct surgical excision were reported in the literature. Recently we had the opportunity to see a patient with a benign obstructing tumor of the trachea which was confirmed as fibroma. The patient has complained of intermittent dyspnea, especially during inspiratory phase, dry cough and wheezing of a strident character for last 8 years. Bronchoscopy or bronchography were not attempted because of severe dyspnea. Trachea tomogram revealed oval mass at the terminal trachea. The right posterolateral thoracotomy was performed. Tumor, $2.5{\times}1.7cm$ in size, was located at terminal trachea and removed through right lateral tracheotomy without difficulty. Postoperatively all the symptoms and signs disappeared.

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Huge Subglottic Polyp Treated with Tracheotomy and Laryngofissure (기관절개술과 후두절개술로 치료한 거대 성문하 용종 1예)

  • Hong, Yong Tae;Yeo, Cha Dong;Hong, Ki Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.52-54
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    • 2017
  • Vocal polyps are benign laryngeal lesions which arise from the Reinke's space abd hoarseness is the most common symptom. However, airway compromised is rarely presented in the vocal polyp. A rare case of large subglottic polyp causing dyspnea is reported. Tracheostomy was performed under local anesthesia and then the mass was resected under general anesthesia using a laryngofissure approach. The dyspnea and hoarseness disappeared after surgery immediately. The histopathological findings indicated a diagnosis of vocal cord polyp with chronic inflammatiuon. We consider that tracheostomy is the safest and most useful procedure to guarantee the upper airway in cases of large vocal polyp showing dyspnea. We hereby report a case of huge subglottic polyp in which a tracheostomy and laryngofissure was required for removing the subglottic mass successfully.

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Submental intubation in maxillofacial fracture: a case report

  • Akbari, Hooshang;Heidari-Gorji, Mohammad Ali;Poormousa, Rostam;Ayyasi, Mitra
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.166-168
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    • 2016
  • It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text.

Clinical Application of Endoscopic Laser Assisted Supraglottic Partial Laryngectomy in Early Supraglottic Cancer (초기 상후두암종에서 레이저를 이용한 내시경하 상후두부분절제술의 적용)

  • Choi Jong-Duck;Kwon Kee-Hwan;Oh Joon-Hwan;Han Seung-Hoon;Lee Seung-Hoon;Choi Geon
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.164-168
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    • 1998
  • Background: Supraglottis and glottis have a different embryologic origin. Supraglottic cancer is characterized by high incidence of cervical lymph node metastasis at initial diagnosis, and favored surgical management of the early supraglottic cancer was partial supraglottic laryngectomy, however the procedure resulted in frequent incidences of postsurgical aspiration and voice disabilities. Objectives: We retrospectively analyzed the problems and the advantages of the endoscopic laser assisted supraglottic partial laryngectomy as a part of surgical management for early supraglottic cancer. Materials and Methods: During the past nine years 25 cases of supraglottic cancer(Tl 10 cases, T2 15 cases) were treated by tracheotomy and laser assisted supraglottic partial laryngectomy(KTP532, 15 Watt, continuous type) and in 10 cases with cervical lymph node metastasis, they were additionally managed by neck dissection one week later, and all cases received postoperative irradiation therapy. Results: At present, 19 cases are alive with no evidence of disease. During the follow up period total of six cases(primary failure: three cases, nodal failure: three cases) were recurred. In relation to tumor staging, One of the 10 Tl cases and two of the 15 T2 cases recurred showing 88% locoregional recurrence rate for early supraglottic cancer. Postoperative com-plication included bleeding in three cases who were controlled by electrocautery under general anesthsia, one case of longstanding aspiration and two cases of laryngeal stenosis as a delayed complication. Conclusion: High control rate suggests that the endoscopic laser assisted supraglottic partial laryngectomy may be a good initial management method for early supraglottic cancer, however it is difficult to determine the resection margin, therefore, accurate tumor staging must be done prior to surgery. In order to prepare for postoperative bleeding, edema and aspiration, the tracheotomy must be performed prior to surgery.

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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.

Simultaneous Occurrence of Medullary and Papillary Thyroid Carcinoma with Lymph Node Metastasis: A Case Report (림프절 전이를 동반한 갑상선에 동시 발생한 수질암과 유두상 암종 1례)

  • Joo, Young-Hoon;Yun, Chang-Hyun;Sun, Dong-Il;Kim, Min-Sik
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.31-34
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    • 2006
  • Simultaneous occurrence of medullary and papillary thyroid carcinomas in the same gland is very rare. In fact. there are only 18 cases of simultaneous occurrence of medullary and papillary thyroid carcinomas in the literature. We report a case of simultaneous medullary and papillary carcinoma of thyroid gland. A 67-year-old woman was diagnosed with medullary carcinoma of right lobe of thyroid gland and papillary carcinoma of left lobe of thyroid gland by fine needle aspiration cytology. Total thyroidectomy, anterior neck dissection, bilateral modified radical neck dissection and tracheotomy was undertaken. The tumor metastasized to regional lymph node and extrathyroidal muscle invasion of left papillary carcinoma was also revealed by pathological report. This report describes a case of thyroid carcinoma that demonstrated both medullary carcinoma and papillary components in the thyroid with lymph node metastasis.

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A Case of Bilateral Vocal Fold Paralysis from Acromegaly (말단 비대증 환자에서 발생한 양측성대마비 1예)

  • Park, Min-Woo;An, Soo-Youn;Roh, Dong-Hwan;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.68-70
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    • 2009
  • Acromegalic patients can develop mild upper airway obstruction. However, the limitation of both vocal folds mobility developing dyspnea is rare. We report a case with bilateral vocal cord paralysis associated with acromegaly. The patient visited our clinic presenting dyspnea showing bilateral vocal cord hypomobility in laryngoscopy. The patient underwent a tracheostomy and a transsphenoidal resection of the pituitary adenoma. Thereafter, laser cordotomy with medial arytenoidectomy was done for the permanent treatment of glottal obstruction. The tracheotomy canula was successfully removed one month after the surgery.

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Medial Partial Arytenoidectomy by $CO_2$laser for Bilateral Vocal Cord Paralysis (양측 성대마비 환자에 대한 $CO_2$레이저 피열연골 내측부분절제술)

  • 최홍식;최영준;이용훈;박헌이
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.219-224
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    • 1998
  • Bilateral vocal cord paralysis can result in severe airway compromise. Over the years a variety of arytenoidectomy procedures have bee described, and one or more of these have been the gold standard for many years. A widely accepted treatment is endoscopic laser total arytenoidectomy. However, vocal results are usually poor. Objective : To evaluate the effect of treatment of endoscopic laser medial partial arytenoidectorny for bilateral vocal cord paralysis Material and Methods : We performed endoscopic medial partial arytenoidceomy with $CO_2$laser for 3 patients with bilateral vocal cord paralysis. The $CO_2$laser is operated with a continuous 7-watt beam in superpulse mode. We compared degree of dyspnea and glottic area of pre-operation with those of post-operation for 3 patients. We analysed aerodynamic study pre-operatively and post-operatively for 1 patient. Results The symptom of dyspnea was improved markedly and the glottic area was widened from 34% to 50% compared with that of pre-operation. The voice quality was slightly decreased. Tracheotomy was not necessary for not-tracheotomized patient and decanulation was possible for tracheotomized patient post-operatively. Cunclusion: The endoscopic laser medial partial arytenoidectomy is a convient and effective method for opening the posterior glottic airway.

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Clinical Analysis of Cervical Necrotizing Fasciitis (경부 괴사성 근막염의 임상적 고찰)

  • Park, Byung Kuhn;Lee, Do-Joon;Lee, Sang Joon
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.46-49
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    • 2011
  • Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.

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4 cases of laryngotracheal stenosis treated with end-to-end anastomosis (단단문합술로 치료한 후두기관 협착 4례)

  • Tae, Kyung;Hong, Dong-Kyun;Lee, Hyung-Seok;Park, Chul-Won
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.40-45
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    • 2001
  • Management of laryngotracheal stenosis remains one of the most challenging problems facing the otolaryngologist. The key to success is to obtain adequate rigid circular support with normal mucosal lining. Four Patients with laryngotracheal stenosis were surgically treated in our institution in 2000. All the patients were male adults. The cause of stenosis were longterm or repeated endotracheal intubation and tracheostomy in our patients. All patients were successfully decannulated following segmental resection of the stenotic portion including the anterior arch of the cricoid cartilage and end-to-end anastomosis after suprahyoid laryngeal release. The time between treatment and decannulation was just one day in three patients. These results suggest the Possibility of early decannulation even if the cricoid cartilage was partially resected. It is better to prevent laryngotracheal stenosis rather than to treat it once it has occurred.

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