Robotic thyroidectomy: Evolution and Outcomes

송창면,태경 한양대학교 의과대학 2016 Hanyang Medical Reviews Vol.36 No.4

Recently robotic thyroidectomy has gained its popularity for the treatment of differentiated thyroid cancer and benign thyroid tumors. It has been developed to overcome the drawbacks of conventional open trans-cervical thyroidectomy, which is an apparent neck wound that is visible unless concealed with clothes. Robotic thyroidectomy provides surgeons with three-dimensional magnified view and multiarticulated robotic arms that can stabilize hand tremors. It also has advantages over conventional trans-cervical thyroidectomy that include recovery of voice symptoms and acoustic parameters along with superior cosmetic outcomes. Robotic thyroidectomy results in equivalent surgical outcomes including oncologic safety and complications compared with conventional thyroidectomy. Various approaches including transaxillary, postauricular facelift, and breast-axillary approaches have been developed for robotic thyroidectomy. Recently, the indication of robotic surgery has been extended to neck dissection of the lateral compartment. Herein we summarize the indication, procedures, and efficacy of robotic thyroidectomy, and also introduce our experience with robotic thyroidectomy.

Factors Affecting the Extrusion Rate of Ventilation Tubes

송창면,박민현,김영호,이준호 대한이비인후과학회 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.2

Objectives. The objective of this study was to determine the various factors that affect the extrusion rate of ventilation tubes (VTs), including the nature of the middle ear effusion. Methods. A retrospective chart review of 82 pediatric patients (177 ears) who received VT insertion surgery under general anesthesia was carried out to evaluate the relationship between various factors and the VT extrusion rate. The factors we analyzed included age, gender, the adenoid size, the amount and content of the middle ear effusion after myringotomy, bleeding events, associated adenoidectomy and the findings of the tympanic membrane status, the tympanometry and the audiometry of the air bone gap. Results. The mean extrusion time was 254 days (range, 11 to 809 days). The patients with no history of previous VT insertion had a longer extrusion time (mean, 279 days) than did the patients who had undergone previous VT insertion (mean, 203 days). The patients with serous effusion had the shortest extrusion time (mean, 190 days) as compared to those patients with glue (273 days) and pus (295 days) effusions. Other factors had no statistical significant relationship with the extrusion time. Conclusion. The mean VT extrusion time was 254 days. The VT extrusion time was significantly related to the characteristics of the middle ear effusion and a history of previous VT insertion. Thus, the nature of middle ear effusion can provide a clinical clue to predict the VT extrusion time.

갑상선 수술 환자의 입원 만족도를 높이기 위한 환자의 질병에 대한 이해도,관심 사항 및 회복도 조사

송창면,김희진,권택균,성명훈,김광현,하정훈 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.9

Background and Objectives Diagnosis of thyroid disease requiring surgery and subsequent thyroidectomy may affect patients’ emotion and quality of life. The purpose of this study is to evaluate the patients’ understanding and concern about the disease and recovery rate after thyroidectomy,and therefore to enhance the satisfaction of hospitalization. Subjects and Method Seventy-seven patients undergoing thyroidectomy in a tertiary hospital from April 2009 to October 2009 were enrolled. Questionnaires were filled out on the admission day, discharge day, and 2 weeks after operation. Questionnaires consisted questions regarding the understanding of the disease, details of concern, recovery rate after surgery, and satisfaction on hospitalization duration. Retrospective chart review was also performed. Results Many patients (42.9%) acquired their knowledge of thyroid cancer through the internet. The possibility of voice change was the major concern before surgery (46.8%), whereas the major postoperative concern was adjuvant therapy (37.7%). The patient group with higher understanding of the disease showed higher recovery rate than the others at the time of discharge (mean postdischarge surgical recovery 67.4% vs. 55.3%, p=0.01). The patient group with lower understanding wanted longer hospitalization than the other group at discharge (p<0.001). Conclusion Patient education about the thyroid disease may reduce patients’ anxiety and therefore may enhance subjective recovery rate and satisfaction of hospitalization. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:557-63

피부 부착 전극을 이용한 후두 신경 감시술

송창면(Chang Myeon Song) 대한신경모니터링학회 2023 Journal of Neuromonitoring & Neurophysiology Vol.3 No.1

Recently, Intraoperative nerve monitoring during thyroidectomy has gained its popularity. There are many methods to perform nerve monitoring including electromyography tube electrode, needle electrode, and skin electrode. However, using needles during thyroid surgery may lead to bleeding or unexpected injury. Herein, effectiveness and safety of skin electrode neuromonitoring and literature is reviewed.

분비성 유방암과 유사한 침샘 암종

송창면(Chang Myeon Song),정선민(Jung Seon Min),신수진(Su-Jin Shin),태경(Kyung Tae) 대한두경부종양학회 2017 대한두경부 종양학회지 Vol.33 No.2

Mammary analogue secretory carcinoma (MASC) of the salivary gland is a newly classified pathologic entity since 2010. Prior to its recognition, MASC was diagnosed as low-grade cystadenocarcinoma, acinic cell carcinoma, and mucoepidermoid carcinoma. MASC shares common histological and genetic characteristics with secretory carcinoma of the breast and has a distinct feature of the ETV6-NTRK3 fusion gene. Treatment of MASC in salivary gland is mainly wide surgical resection of the tumor. Prognosis of MASC is similar to other low-grade salivary gland carcinomas. Herein, we report a case of MASC developed in a parotid gland with a review of the literature.

Postoperative Hypoparathyroidism and the Viability of the Parathyroid Glands During Thyroidectomy

지용배,송창면,성의석,정진혁,이창범,태경 대한이비인후과학회 2017 Clinical and Experimental Otorhinolaryngology Vol.10 No.3

Objectives. To prevent hypoparathyroidism after thyroidectomy, preservation of the parathyroid glands and their vascularity are essential. The aim of this study was to determine the association between postoperative parathyroid function and the viability of the parathyroid glands during thyroidectomy. Methods. We prospectively analyzed 111 patients who underwent total thyroidectomy and in whom all 4 parathyroid glands were preserved in situ during the operation. The surgeons scored the viability of each parathyroid gland from 0 (normal) to 3 (severely compromised viability) based on its gross appearance and vascularity intraoperatively. The index of parathyroid viability score (IPVS) was defined as the sum of the viability scores of the 4 parathyroid glands. We evaluated the relationship between postoperative parathyroid function and IPVS. Results. Transient hypoparathyroidism occurred in 25 patients (22.5%), and permanent hypoparathyroidism in 4 patients (3.6%). The IPVS were significantly different in the three groups: 2.87±1.46 in the normal group, 3.68±1.41 in the transient hypoparathyroidism group and 7.50±1.00 in the permanent hypoparathyroidism group. The rates of transient hypoparathyroidism were 13.6% in patients with IPVS 0–2, 23.8% in patients with IPVS 3–4, and 42.9% in patients with IPVS 5–6. All the patients with IPVS of 7 or more had permanent hypoparathyroidism. Conclusion. IPVS is correlated with the incidence of hypoparathyroidism. It could be a good quantitative indicator of the probability of hypoparathyroidism after thyroidectomy.

Significance of the Extracapsular Spread of Metastatic Lymph Nodes in Papillary Thyroid Carcinoma

박창호,송창면,지용배,표주연,이기정,송영수,박용욱,태경 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.3

Objectives. The extracapsular spread (ECS) of metastatic lymph nodes is associated with aggressive tumor behavior, and is regarded as a major risk factor for local recurrence in patients with head and neck squamous cell carcinoma. However, the significance of ECS of metastatic lymph nodes has not been well established in well-differentiated thyroid carcinoma. The purpose of this study was to examine this question. Methods. A retrospective review was performed of 335 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lymph node dissection from April 2001 to December 2009. We analyzed various clinical characteristics, pathologic factors, and the size, number, and ECS of foci in metastatic lymph nodes. Results. On pathologic review, 201 of the patients (56.6%) had lymph node metastasis. This was significantly related to age and tumor size. ECS was noted in 64 of these 201 patients (31.8%), and was significantly related to male gender, tumor size, presence of extrathyroidal extension, metastatic lymph node size, and focus size. Recurrence occurred in 13 patients (3.9%), and the presence of ECS was significantly related to recurrence. Conclusion. ECS of metastatic lymph nodes is an important prognostic factor for loco-regional recurrence in papillary thyroid carcinoma.

코성형술과 동시에 시행하는 미끄럼 절골 턱성형술

조성우,송창면,진홍률 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.4

Chin retrusion and micrognathia are deformities that are commonly encountered in patients desiring rhinoplasty. Augmentation genioplasty in these patients improves the profile and enhances cosmetic result of rhinoplasty. For chin augmentation, either sliding osteotomy or implant insertion can be used. In alloplastic chin augmentation, rejection, infection of the materials, or resorption of the mandible can be a major problem. Horizontal sliding osteotomy of the mandibular symphysis with advancement of the mobilized segment can be the technique of choice to avoid these disadvantages. Here we report 2 cases of acquired nasal deformity and chin retrusion treated with simultaneous rhinoplasty and sliding genioplasty with a brief literature review.

성대마비를 동반한 갑상선에 발생한 원발성 림프종 1례

정재영,송창면,지용배,태경 대한갑상선학회 2023 International Journal of Thyroidology Vol.16 No.2

Primary thyroid lymphoma is defined as a lymphoma involving either the thyroid gland alone or both the thyroid gland and neck lymph nodes, without contiguous spread or distant metastases from other areas of involvement at the time of diagnosis. Despite its rarity, prompt recognition of primary thyroid lymphoma is essential due to its distinct management, which differs significantly from the treatment approaches for other neoplasms of the thyroid gland. Herein, we report a 64 years old female patient who complained of hoarseness, and was diagnosed as thyroid lymphoma with unilateral vocal fold paralysis. After chemotherapy, vocal fold paralysis was relieved and the patient’s hoarseness improved.

Intrathyroidal Parathyroid Carcinoma in Chronic Kidney Disease: A Case Report and Review of Literature

김무건,송창면,태경,지용배 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.12

When parathyroid carcinoma occurs in the thyroid gland, it is very difficult to diagnose beforesurgery because imaging studies and aspiration cytology cannot distinguish parathyroid carcinomafrom thyroid nodule or benign parathyroid disease. A 53-year-old male was referred toour hospital for assessment of hypercalcemia. He had suffered from chronic kidney diseasefor 13 years. A 2.5×1.5 cm hypoechoic nodule was noted in the left thyroid gland on ultrasonography,and it showed increased uptake on the sestamibi scan. Fine needle aspiration biopsyrevealed it to be a parathyroid lesion, which was confirmed by surgery as parathyroid carcinomacompletely surrounded by normal thyroid parenchyme. Because ultrasonography and aspirationcytology have only a limited role in distinguishing parathyroid carcinoma from thyroidneoplasm, suspicion of parathyroid carcinoma before or during surgery through carefulexamination can lead to complete resection at the initial surgery.