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성명훈,이강진,노종렬,유성호 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.1
Salivary gland. We have experienced a case of an intraductal papilloma arising from the sublingual salivary gland in a 51-year-old woman. The radiologic finding shows an unicystic mas having solid portion. The tumor was completely excised transo-rally. The histologic findings are papillary proliferation of two uniform layers of columnar epithelial and flat basal cells supp-orted by a fibrovascular core. The clinicopathologic features of this tumor is presented with a review of literature. (Korean J Otolaryngol 2002;45:99-102)
성명훈,김광현,김동영,박민현,고태용,김춘동 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1
BACKGROUND: Aspiration is defined as the laryngeal penetration of secretions below the level of the true vocal cords. Aspiration can result in life-threatening complications, such as bronchospasm, airway obstruction, pneumonia, pulmonary abscess, sepsis, and death. The patient with high vagal palsy had significant aspiration and dysphagia OBJECTIVE: To formulate a step-by-step management paradign for the patients with high vagal palsy MATERIALS AND METHODS : The medical records of 23 patients who were diagnosed as high vagal palsy from September, 1995 to April, 1998 in Seoul National University Hospital were reviewed retrospectively. Eleven patients were managed conservatively and 12 patients were operated to treat chronic aspiration. RESULTS : The main etiologies of high vagal palsy were mass lesions of the skull base such as neurogenic tumor, pseudotumor, meningioma or nasopharyngeal carcinoma. Aspiration and dysphagia improved in 7 out of 11 patients who were managed conservatively after 2.2 months on the average. The patients who were refractory to the conservative management underwent surgery and showed improvement in 10 out of 12 patients. The employed surgical modalities were vocal cord medialization combined with cricopharyngeal myotomy in 7 patients, laryngotracheal separation in 3 patients and arytenoid adduction only in 2 patients. Two patients still had gastrostomy tube due to the persistent symptoms. Two patients had improved after surgery, but died of underlying disease. CONCLUSION : The patients with high vagal palsy are recommended to be managed conservatively for the first 2 months. If aspiration and dysphagia are persisting after conservative management, vocal cord medialization combined with or without cricopharyngeal myotomy should be considered. If failed, laryngotracheal separation or gastrostomy will be the next option based on the control of the oropharyngeal secretion.