Experiences of the Treatment of Laryngeal Cancer in Yongdong Severance Hospital / 대한이비인후과학회지

BACKGROUND AND OBJECTS: Laryngeal cancer is a significant disease in the head and neck malignancy in the aspect of incidence. But, an accurate statistical analysis of long term results is insufficient in Korea. To improve the results of treatment in laryngeal cancer, we evaluate the survival rates according to the primary site, stage and investigating factors. MATERIALS AND METHODS: The study group was made up of 132 patients with squamous cell cancer. They had been treated for laryngeal cancer in our hospital for 11 years from 1985 to 1995. The distribution rates of patients were obtained by the discriptive statistical method according to the sex, age, pathology, primary site and stage. Survival rates were obtained by the Kaplan-Meier method according to the primary site and stage. The AJCC (1992) staging system was used. RESULTS: With respect to the primary site, the survival rate for 5 years was 52.8% in supraglottis and 71.6% in glottis. With respect to the stage, the survival rate was 82.4% in the stage I, 60.3% in the stage II, 53.8% in the stage III and 28.6% in the stage IV. The 5-year survival rate for patients who had taken radiotherapy in T1 glottic cancer was 73.5% for the group involved with anterior commissure and 96.2% for the group not involved. In the advanced laryngeal cancer, treatment failure was influenced by nodal and stomal recurrence. CONCLUSION: For those patients with T 1 laryngeal cancer and who recieved radiotherapy, a significant prognostic factor was whether or not the patients were involved with anterior commissure. Another important prognostic factor for the advanced laryngeal cancer patients was the complete neck management after the operation and prophylactic neck dissection.

Effects of Arytenoid Adduction and Type I Thyroplasty Combined Surgery for Unilateral Vocal Cord Paralysis / 대한이비인후과학회지

Type I thyroplasty, we know, could not overcome the large posterior glottal chink and arytenoid adduction have been proved to be uneffective in the cases of unilateral vocal cord paralysis with vocal cord atrophy or bowing deformity. So we performed type I thyroplasty in conjunction with arytenoid adduction and tried to compare the postoperative results with that of arytenoid adduction. We experienced 8 cases of arytenoid adductions and 6 cases of combined operations in the cases of unilateral vocal cord paralysis. All 14 patients had large posterior glottal chink. In order to compare the postoperative voice results of two groups as objective as possible, we performed preoperative and postoperative videoimage analysis(chink size, interarytenoid distance) and computer-assisted voice analysis(MPT, Jitter, Shimmer, S/N ratio). As a results, the postoperative voice outcome is superior with the combined operation than with the arytenoid adduction only in the cases of unilateral vocal cord paralysis with large glottal chink.