구인두에 발생한 아니사키스증 1예

최전하,김은주,박상현,김승우 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.4

Anisakiasis is one of the fish-transmitted infections that result from the accidental ingestion of third-stage larva belonging to the family Anisakidae. A large number of cases of gastric anisakiasis have been reported in countries where the eating of raw fish is customary; however, there have been very few reports of anisakiasis involving the oral cavity and oropharynx. A 46-year-old woman complained of sore throat shortly after eating raw flatfishes. The oropharyngeal examination revealed two living tubular spinning objects in the submucosal layer of left posterior pillar. It was removed with biopsy forceps. We report a very rare and unique case of anisakiasis in oropharynx confirmed by pathologic findings. To best of our knowledge, this is the first case report involving oropharyngeal anisakiasis in Korea.

후두암의 경부 전이로 오인된 측경부 미입 갑상샘에서 발생한 유두상 암종 1예

최전하,김춘동,김은주,김승우 대한갑상선학회 2015 International Journal of Thyroidology Vol.8 No.2

The aberrant or ectopic thyroid in lateral neck is a rare developmental anomaly. Furthermore, the primary thyroid carcinoma arising in ectopic thyroid is extremely rare, only a few cases have been reported so far in English literature. We report a 64-year-old male with left transglottic cancer and primary papillary carcinoma from lateral aberrant thyroid in left lateral neck. Preoperatively, we diagnosed as transglottic cancer with ipsilateral neck metastasis. The patient underwent total laryngectomy, left selective neck dissection and left thyroidectomy. Finally, the patient was diagnosed as left transglottic cancer and papillary carcinoma from lateral aberrant thyroid. Surgeons should take into account a primary ectopic thyroid carcinoma arising in lateral neck may co-exist with another type of head and neck tumor.

이상동 종물 양상의 다발성 골전이를 동반한 갑상선 섬 암종 1예

최전하,홍석정,이미지,김승우 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.7

Thyroid insular carcinoma (TIC, poorly differentiated thyroid carcinoma) is derived from thyroid follicular cells and known to show pathophysiologic behaviors intermediate between well-differentiated and undifferentiated types of thyroid carcinoma. The estimated incidence of TIC is from 0.4% to 5% of all thyroid cancers and is rare in Asians. Moreover, the multiple bone metastases in TIC have been rarely reported so far. Clinically, there are two pathways that thyroid cancer is presented, either as a parapharyngeal or retropharyngeal mass. For the first pathway, the mass is located on the thyroid upper pole and it grows toward the anatomical defect of posterior aspect of inferior pharyngeal constrictor. The second pathway involves a pharynx directly compressed by the mass from outside to inside of inferior pharyngeal constrictor. A 66-year-old man who had a thyroid mass revealed important clinical findings: a right pyriform sinus mass from laryngoscopy and multiple bone metastases from radiology. We performed subtotal thyroidectomy with central neck dissection. The mass was confirmed as TIC from follicular thyroid carcinoma. The patient received radiation and radioactive iodine therapy, and bcause of a remnant thyroid mass, he was observed closely. We herein report a rare, unique case of TIC with a review of literatures. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(7):542-6

개방형 유양동을 가진 환자에서의 인공와우 이식술

최전하,백훈희,조현상,김춘동 대한이비인후과학회 부산,울산,경남 지부회 2016 임상이비인후과 Vol.27 No.1

Background and Objectives:Performing cochlear implantation is a difficult process for those patients who have received radical mastoidectomy due to chronic otitis media. However, we could perform a single stage operation successfully without external auditory meatus and mastoid complete obliteration. Materials and Methods:The authors performed 13 cases of cochlear implantation in open cavity mastoidectomy state patients without obliteration of mastoid or with the partial obliteration of mastoid from July 2011 to July 2015. Of these thirteen patients, eight patients received cochlear implantation in the site of open mastoid cavity and others in opposite site. The medical records and radiological findings were reviewed retrospectively. Results:Three of eight patients who had undergone open cavity mastoidectomy did not perform mastoid cavity obliteration during cochlear implantation. Another five patients with an open cavity mastoid had undergone the partial obliteration of mastoid during cochlear implantation. There were no postoperative medical complications such as infections of mastoid cavity, recurrence of cholesteatoma and necrosis of skin flap during following up periods except for 1 case of delayed electrode extrusion. Conclusions:The advantages for this procedure as the following. First, we could overcome the difficulty of radiological diagnosis for primary or recurrent cholesteatoma due to mastoid obliteration. Second, a single-stage procedure allowed the implantation as safe as two-stage procedures. At last, non-obliterative or partial obliterative procedures may replace the typical mastoid obliteration process during cochlear implantation for it allows a safe procedure for open cavity patients reducing complications such as electrode extrusion or infection.

악하 삼각에 발생한 면역글로불린 G4 연관 경화성 질환 2예

최전하,김춘동,김은주,김승우 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.3

Immunoglobulin G4-related sclerosing disease (IgG4-RD) is histologically a chronic inflammatory disorder characterized by infiltration of lymphoplasmacytes, sclerosis, and an elevated serum level of IgG4 and IgG4 positive plasmocytes. IgG4-RD is associated with autoimmune pancreatitis, sclerosing cholangitis, sialalithiasis, retroperitoneal diseases, inflammatory arotitis and Mikulicz’s disease, typically including the lacrimal glands, salivary glands, pancreas, thyroid gland, lungs and kidneys. It is important to distinguish IgG4-RD from neoplastic disease as it responses well to steroid. Because consensus for nomenclature of IgG4-RD is recently made, reports of IgG4-RD in the Head and Neck area are still rare. In the first case, a 68-year-old man presented with a recurring submandibular gland mass from 7 years ago; he underwent submandibular gland resection and was diagnosed as IgG4-RD. In the second case, a 69-year-old mass presented with a relapsing right neck mass on level Ib. He underwent an exsional biopsy and was diagnosed with the same disease entity. We experienced two cases of IgG4-RD, and so report them with a brief literature review. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(3):250-3

기도 폐색을 유발한 성문부 거대 소엽성 모세관 혈관종 1예

최전하(Jeon Ha Choi),임성환(Sung Hwan Lim),이미지(Mi Ji Lee),김승우(Seung Woo Kim) 대한두경부종양학회 2016 대한두경부 종양학회지 Vol.32 No.1

The lobular capillary hemangioma (LCH) was previously known to pyogenic granuloma and is benign vascular lesion which grows rapidly on skin and mucosa. It arises from whole body, but oral and nasal cavities are most predilection sites in the head and neck area. The laryngeal LCH looks like a granulomatous lesion of posterior glottis and its common etiology are tracheal intubation and laryngopharyngeal reflux disease etc. The LCH in larynx can cause blood tinged sputum and lump sense. The lesions refractory to medical therapy or causing dyspnea may require surgical excision. A 74-year-old man who presented gradually aggravated dyspnea, lump sensation and hoarseness of one month came to our hospital. The stroboscopic examination revealed large well-margined glottic mass. It was excised with CO2 laser and finally diagnosed as LCH. We present a rare unique case of glottic LCH with a review of literatures.

유두상 암종과 병발하며 갑상선과 동측 기관주위 림프절에 발생한 결핵 1예

사대진,최전하,김윤정,김승우 대한갑상선학회 2013 International Journal of Thyroidology Vol.6 No.2

There are relatively rare cases concerning about concurrent papillary thyroid cancer and thyroid tuberculosis with cervical tuberculous lymphadenitis in English literature so far. Cervical lymphadenitis (scrofula) is a common manifestation of extra-pulmonary invasion of the tuberculosis. A cervical tuberculous lymphadenitis could be confused with metastatic lymph node from the thyroid cancer. A 49-year-old woman with multiple right thyroid nodules of Bethesda category VI referred our department for surgery. We performed the right thyroid lobectomy with anterior compartment neck dissection. The histopathology revealed concurrent papillary thyroid carcinoma and thyroid tuberculosis with cervical tuberculous lymphadenitis. We report a unique case of concurrent papillary thyroid cancer and tuberculosis involving the thyroid gland and ipsilateral paratracheal lymph node with literature review. To our best knowledge, such case has not been reported earlier.

노인 언어습득 후 고도난청 환자의 인공와우이식 후 말 지각 능력 변화

사대진,최전하,김춘동 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.1

Objective:To assess changes in the speech perception ability of patients (≥65 years) with cochlear implantation. Subjects Methods:26 patients with cochlear implantation at the Seoul Veterans Hospital; all patients suffered from profound hearing loss. Cochlear implant users were recorded before implantation and after operation with speech processor. The speech assessment of patients (monosyllabic word, bi-syllabic word and sentence test) were done at the 1, 3, 6 and 12 months postoperative follow-up intervals. Results:The significant improvement in speech understanding was demonstrated in performance scores using bi-syllabic words and sentences at 1, 3, 6, and 12 months after cochlear implantation, compared with pre-implantation. Especially Bi-syllabic word perception score was higher than other test score at all time. Conclusions:The elderly population showed significant improvement in auditory performance tests following cochlear implantation compared to their pre-implantation, and the improvement appeared remarkably within 6 months with speech processor.

A Case of Bilateral Peripheral Tapia’s Syndrome Subsequent to Coronary Artery Bypass Graft

김승우,김민석,최전하,김춘동 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.8

The Tapia’s syndrome means symptom complex that result from unilateral vago-hypoglossal nerve paralysis. This syndrome is rare disease entity, bilateral attack is extremely rare. Only three cases have been reported in English literature. A-66-year-old man received the coronary artery bypass graft in our hospital. After the operation, he complained of severe dyspnea, voice change and drooling. The laryngoscopic findings showed the bilateral vocal cord palsy. He could not move the tongue toward any directions. We diagnosed as bilateral Tapia’s syndrome. Usually, unilateral Tapia’s syndrome is related to the complications of anesthesia and position of the patient’s head during surgery. Otherwise, our case may be associated with the complications of operation and anesthesia. The patient’s recovered three months later, but the right vocal cord palsy is persistent. We report the very unique disease entity with literature review.

무통성 결절 양상의 갑상선에 발생한 만성 육아종성 염증 1예

곽슬기(Seul Gi Kwak),최전하(Jeon Ha Choi),김윤정(Yoon Jung Kim),김승우(Seung Woo Kim) 대한두경부종양학회 2013 대한두경부 종양학회지 Vol.29 No.2

Some clinical diseases, such as granulomatous thyroiditis, tuberculosis, and sarcoidosis can cause granuloma-tous inflammation in thyroid, and theses have various clinical presentations. Granulomatous thyroiditis is an in-flammation of thyroid gland, and may be painful and tender in case of infection, radiation, or trauma. Otherwise, autoimmune conditions, medications, or an idiopathic fibrosis may cause to be a painless thyroididtis. It is self-limited, possibly viral, inflammatory thyroid disorder usually presented with thyroid pain and systemic symp-toms. Tuberculosis of the thyroid occurs only rarely and the patient may be asymptomatic. In thyroid sarcoidosis, most common findings are painless, progressive enlargement of the thyroid with normal function. We have expe-rienced a case of chronic granulomatous inflammation of thyroid gland presenting as a painless thyroid nodule and report it with a review of literature.