Treatment Results and Voice Analysis after Laser Cordectomy for Glottic T1 Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For the treatment of glottic T1 cancer, several methods such as laser cordectomy, conservative laryngeal surgery and radiation therapy are possible. This study was performed to investigate the utility of laser cordectomy in the oncological and phonetic aspects. MATERIALS AND METHOD: Eighteen patients with glottic T1 cancer, who had undergone laser cordectomy at Kosin Medical Center from March, 1997 to July, 2001, were retrospectively investigated. The method of the operation was classified according to European Laryngological Society Classification. We analysed intraoperative complication, the duration of admission, postoperative complication, and tumor recurrence. Twelve patients were phonetically analysed using MATLAB and have undergone perceptual analysis. Videostroboscopy was performed for every patient to analyze the mechanism of phonation. As a control group, six normal persons were used. RESULTS: Intraoperative complications were not found in any of the 18 patients, but 5 patients who had suspicious lesions during following up after operation, have undergone biopsy which gave negative results. Among 4 patients who had granulation tissues, 2 patients were spontaneously regressed, and the other 2 patients have undergone removal of tissue with no recurrences. The vocal parameters such as Fo, S.D.Fo, jitter, shimmer and NHR differed significantly between the surgery group and the control group. The parameters maximum phonation time, speech rate and speech intelligiblity did not differ between two groups. CONCLUSION: Laser cordectomy for glottic T1 cancer provides time-and cost-effectiveness, a low level of morbidity, excellent local control rate, and acceptable voice quality.

A Comparison of Ho's, Fourth-edition, and Fifth-edition American Joint Committee Staging Systems for Nasopharyngeal Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The incidence of nasopharyngeal carcinoma (NPC) is reported to be high in South China and Hong-Kong. For that reason, the Ho's staging system has been used in the Hong-Kong area, while the American Joint Committee on Cancer (AJCC) staging system has been commonly used in western countries. The fifth-edition staging system defines new rules for classifying NPC. The purpose of this study was to find out whether the fifth-edition of the AJCC staging system is better than Ho's and the fourth-edition AJCC staging system in predicting the prognosis of NPC. MATERIALS AND METHOD: Fifty NPC patients of World Health Organization type II and type III were restaged according to the Ho's staging system, the fourth-edition AJCC and the fifth-edition AJCC staging systems. The disease specific survival rate was calculated by T category, N category and stage grouping for each staging system. RESULTS: The fifth-edition of AJCC showed good distribution compared with other systems in stage classification and also showed statistical significance in the disease specific survival rate between early carcinoma (stage I-II) and advanced carcinoma (stage III-IV). On the survival curve of T and N categories, the fifth-edition of AJCC showed statistical significance in the disease specific survival rate between T1-2 and T3-4 group, and also between N0-1 and N2-3 group. But Ho's staging system showed similar statistical results to the fifth-edition of AJCC, except for higher concentration of patients at stage III. The fourth-edition of AJCC didn't show any statistical significance among categories of T, N and the stage groups. CONCLUSION: In considering the poorer survival rates resulting from the cranial nerve or intracranial invasion and bilateral, or lower neck lymph node metastasis, the extensive invasion to adjacent regions and lymph node metastasis may have an influence on the prognosis. As far as prognostic categories are concerned, the fifth-edition of AJCC appears to be an improvement over other system. So, we concluded that the fifth-edition of AJCC staging system is better than the fourth-edition of AJCC and Ho's staging system to predict the prognosis of NPC.

Two Cases of Presumed Fourth Branchial Cleft Cyst in Neonate / 대한이비인후과학회지

A cystic mass of the neck causing neonatal respiratory distress is usually cystic hygroma. A branchial cleft cyst, however, also can cause respiratory distress on rare cases. The fourth branchial cleft cyst is very rare entity and, until now, only 35 cases have been reported worldwide. There have been some controversial attempts to prove its anatomical route through embryological background. Some reports, however, even suggested that it might be impossible to prove its entity anatomically. Recently, reports are coming out on the diagnostic approaches using not only anatomical pathway but also pathological impression. Authors experienced in neonates two cases of lateral cystic neck mass which were pathologically presumed to be fourth branchial cleft cyst. We are reporting these two cases with their diagnostic basis and the related literature.