부인두강 종양의 진단 및 수술적 접근법

태경,이근영,이영석,이용섭,정승원,박철원 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.5

Tumors originating in the parapharyngeal space are rare, accounting for about 0.5% of all head and neck tumors. The anatomic characteristics of the parapharyngeal space makes clinical examination of this area difficult and unreliable method for assessment of these tumor. This study was performed to evaluate the proper diagnostic and surgical approaches for the parapharyngeal space tumors with our experiences. Subjects and Method:During the period from January 1998 to December 2006, 34 patients underwent surgery for parapharyngeal space tumors. We reviewed medical records and imaging study retrospectively. Results:82.4% (28/34) of the parapharyngeal space tumors were benign;17.6% (6/34) were malignant. 41.2% (14/34) were of salivary glandular origin, 35.3% (12/34) were of neurogenic origin, and 23.5% (8/34) were of miscellaneous origin. 76.5% (26/34) of cases had been performed fine needle aspiration cytology (FNAC) before surgery. 14 of 19 patients (73.7%) who had a diagnostic sample had a correct or highly suggestive diagnostic finding. Most of the parapharyngeal space tumors were treated with transcervical (44.1%;15/34) or transparotid (44.1%;15/34) approach, and transparotidcervical approach was performed in 4 patients (11.8%). All patients with salivary gland tumor were located in the prestyloid space, and most (92.9%) of them were treated with transparotid approach. Most patients (91.7%) with neurogenic tumor were located in the poststyloid space and treated with transcervical approach. Conclusion:In our study, the origin and location of the parapharyngeal space tumors were correlated with surgical approaches (p<0.05). Preoperative FNAC showed high accuracy to diagnose the tumor in the parapharyngeal space. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:441-6)

이하선 종양의 보존적 이하선 부분절제술

태경,이형석,홍동균,박혜경,조석현,이승환,박철원 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.7

구강 편평세포암종에서 예방적 경부청소술

태경,이윤서,금효섭,정진혁,김경래,이형석 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.5

Background and Objectives:The status of cervical lymph node is important factor influencing the prognosis of patients with oral cavity squamous cel carcinoma. There has been some controversy regarding the treatment of clinical N0 neck in oral cavity Subjects and Method:Authors analyzed outcomes of elective neck dissection by a retrospective study with a review of medical records of 41 oral cavity squamous cell carcinoma patients who had clinical N0 neck. Results:The overall rate of occult neck metastasis was 27%, and the rate of occult metastasis beyond T2 stage was 45%. The occult metastasis rates of the primary sites occult metastasis and other thre had nodal recurence after elective neck dissection. Conclusion:Because there were high occult neck metastasis rate but no significant postoperative complications in using the elective neck dissection, it could be used in T2, T3 or T4 oral cavity squamous cell carcinoma with clinical N0 neck.

유두상 갑상선 암종에서 경부 림프절 전이의 양상 및 치료

태경,전성하,이현창,김경래,이형석,박용수,안유헌,김태화 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.12

Background and Objectives:Cervical lymph node metastasis develops in approximately 30% to 80% of patients with papillary thyroid carcinoma. In papillary thyroid carcinoma, lymph node metastasis at presentation do not seem to adversely affect survival, but do increase the risk of loco-regional recurrence. The management of cervical metastasis in thyroid papillary carcinoma ranges from selective removal to a formal comprehensive neck dissection. In this study, we analyzed the pattern of cervical lymph node metastasis and the impact of prognostic variables in oder to plan how to manage the cervical lymph node metastasis in patients with papillary thyroid carcinoma. Subjects and Method:The clinical records and pathological reports of 114 patients who underwent surgery for thyroid papillary carcinoma at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university from 1996 to 2002 were analyzed retrospectively. Results:Cervical nodal metastasis was found in 57 (50.0%) patients. Occult metastasis was found in 26 (22.8%) patients. Cervical lymph node metastasis was most frequently noted in the level VI (38.6%). The size of primary tumor and extrathyroidal invasion were associated with cervical metastasis. Conclusion:Based on our results, it might be suggested that elective central neck dissection is needed for patients with papillary thyroid carcinoma which is larger than 35mm or has extrathyriodal extension.

두경부 영역에서의 로봇 수술

태경,신광수,Tae, Kyung,Shin, Kwang-Soo 대한기관식도과학회 2010 大韓氣管食道科學會誌 Vol.16 No.1

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

액와접근법을 이용한 무기하 내시경 갑상선 절제술(예비보고)

태경,김수영,이용섭,이형석 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.3

Background and Objectives:Surgical treatments for thyroid diseases require skin incisions that can result in prominent scars in the anterior neck. For a reduction in scar size or the elimination of scar in the neck, the various kinds of minimally invasive thyroi-dectomies were reported. In this study, we report our early experience of endoscopic thyroidectomy by the axillary approach. Subjects and Method:Between February 2005 and October 2005, 12 patients underwent endoscopic thyroidectomy by gasless axillary approach. We assessed pathologic diagnosis, duration of operation, size of thyroid tumor and complication of our experi-ment of endoscopic thyroidectomy. Results:Endoscopic procedures were performed successfully in 11 cases (3 total lobectomy, 5 subtotal lobectomy and 3 lumpectomy). Conversion to conventional thyroidectomy was required in one patient because of recur-rent laryngeal nerve injury and tracheal laceration. Final histopathologic diagnoses were 7 cases of adenomatous hyperplasia, 4 follicular adenoma, 1 papillary carcinoma. The mean operating time was 302 minutes and it gradualy became shorter. Conclusion:Gasless endoscopic thyroidectomy via axillary approach may be a safe and technically feasible procedure that leads to an improved cosmetic result. (Korean J Otolaryngol 2007 ;50 :252-6)

갑상선 수술후 저칼슘혈증 및 반회후두신경의 손상

태경,이형석,정연기,김기태,이승환,박용수,안유헌 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.11

Background and Objectives:The main indication for thyroidectomy are thyroid cancer, multinodular goiter, and Graves disease. Most important complications of thyroidectomy are recurent laryngeal nerve injury and hypoparathyroidism. The risk of com-plication depends on the extent of the operation, and skill and experiences of surgeon. The purpose of this study is to determine the incidence and predictive factors for complication after thyroidectomy. Materials and Method:We examined the records of 233 patients who underwent thyroidectomy at the Department of Otolaryngology, Hanyang University from 1994 to 2001. The The rate of recurent laryngeal nerve palsy was calculated on the number of nerve at risk of injury. There were 135 unilateral and 98 bilateral procedures. Nerves at risk is 329. The hypocalcemia was defined as a ionized calcium fell below 1.01 mEq/L. Results:Among 233 patients, 3 patients (1.3%) had permanent hypocalcemia and 57 patients (24.5%) had transient hypocal-cemia. According to surgical procedure total thyroidectomy with neck dissection was associated with an increased risk of transient hypocalcemia (63.6%) (3/329) and 0.3% (1/329), respectively. The postoperative hematoma occured in 7 patients (3% ). Conclusion:The most frequent complication after thyroidectomy is transient hypocalcemia. Based on our results, thyroidectomy is a relatively safe procedure. Complications can be kept to a minimum by a through knowledge of the anatomy, by understanding thyroid pathology, and by meticulous he-mostasis and delicate surgical technique.(Korean J Otolaryngol 202 ;45 :1092-7)

인후두역류증의 치료

태경,이용섭 대한이비인후과학회 부산,울산,경남 지부회 2009 임상이비인후과 Vol.20 No.1

인후두 역류증의 치료 시 증상과 후두내시경 소견의 변화

태경,이용섭,정진혁,박인범,이승환,김경래,Tae, Kyung,Lee, Yong-Seop,Jeong, Jin-Hyeok,Park, In-Beom,Lee, Seung-Hwan,Kim, Kyung-Rae 대한후두음성언어의학회 2005 대한후두음성언어의학회지 Vol.16 No.1

Background and Objectives : To determine the changes of reflux symptoms and laryngoscopic findings of patients with laryngopharyngeal reflux (LPR) on the duration of proton pump inhibitor medication. Materials and Methods : From Feb 2003 to Nov 2004, 58 patients who were diagnosed with LPR by 24-hour double-probe pH monitoring were enrolled. All patients were treated with proton pump inhibitor and followed up for 8 weeks at least. The response of symptoms and laryngoscopic findings of patients were assessed with reflux symptom index (RSI) and reflux finding score (RFS) before treatment and 2, 4, 8, 12, 16, 20 weeks after treatment. Results : The symptoms of patients with LPR were improved significantly at 2, 4, 8 weeks of treatment. The laryngoscopic findings of patients with LPR were improved significantly at 4 and 12 weeks of treatment. There was no correlation between improvement of reflux symptoms and laryngoscopic findings. Conclusions : The laryngoscopic findings of LPR patients were improved more slowly than reflux symptoms. Based on our results, anti-reflux therapy might be continued at least for 3 months until the improvement of laryngoscopic findings.

두경부 편평세포암에서 Cyclin D1유전자의 증폭에 관한 연구

태경,이형석,박철원,안경성,조율희,공구 대한이비인후과학회 1997 대한이비인후과학회지 두경부외과학 Vol.40 No.8