Oncologic and Functional Outcomes of Supraglottic Partial Laryngectomy: 18 Years Experience / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Supraglottic partial laryngectomy (SPL), which provides the removal of selected tumors involving the upper structure of the glottis, shows equivalent oncologic outcome when compared to total laryngectomy with functional preservation. We report our 18-year experience of applying supraglottic partial laryngectomy in the Yonsei Head and Neck Cancer Clinic. SUBJECTS AND METHOD: We retrospectively reviewed the charts of 78 patients who underwent SPL. We divided the patients into two groups, the early and the recent, and performed Kaplan-Meier survival analysis and chi2-test on the groups. The post-operative functional outcome was assessed. RESULTS: The 3-year-disease-specific survival rate of the early and recent period was 87% and 84.6%, respectively. Decannulation and tolerability of an oral diet was possible in 93% and 95% of the earlier group, and 95% and 98% in the recent group, respectively. There was no statistically significant difference in survival rate, recurrence pattern, decannulation and tolerability of oral diet between the two groups. CONCLUSION: We achieved a satisfactory survival rate through SPL. In addition, almost all patients could be decannulated and eventually tolerated an oral diet. Our results confirm that SPL is an oncologically & functionally sound procedure for selected supraglottic tumors.

A Case of Cerebral Salt Wasting Syndrome after Surgical Excision of a Giant Acoustic Neuroma / 대한이비인후과학회지

Cerebral Salt Wasting Syndrome (CSWS) is defined as the development of extracellular volume depletion due to a dysfunction of the renal sodium transport system. Differentiation of CSWS from the Symdrome of Inappropriate Secretion of Antidiuretic Hormone in patients with intracranial disease is difficult because both syndromes include hyponatremia and concentrated urine with natriuresis. However, distinguishing between these two syndromes is very important because the treatment options differ. We report a 41 year-old Asian woman who presented initially with hyponatremia, and was finally diagnosed with CSWS after an operation for an acoustic neuroma. Based on this case, we discuss a possible mechanism and disclose insights about differential diagnosis thereof.

Postoperative Residual Juvenile Nasopharyngeal Angiofibroma Treated with Gamma Knife Surgery

Juvenile nasophayngeal angiofibroma (JNA) is a histologically benign but highly vascular, agressively expansile lesion that occurs exclusively in prepubescent or pubescent males. Traditional treatmemt strategy of JNA has included open surgical approaches for majority of tumors. However, radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of postoperative residual JNA with gamma knife radiosurgery.

Endoscopic Thyroidectomy via an Axillo-Breast Approach without Gas Insufflation for Benign Thyroid Nodules and Micropapillary Carcinomas: Preliminary Results

PURPOSE: To examine the feasibility of endoscopic thyroidectomy (ET) via an axillo-breast approach without gas insufflation for large thyroid tumors and micropapillary carcinomas. MATERIALS AND METHODS: The patients in the benign group were separated into groups 1 (n=95, or =4 cm in tumor diameter). Also, 57 patients in the micropapillary carcinoma group underwent an endoscopic hemithyroidectomy (HT) (group 3) and were compared with 60 patients who received conventional open HT (group 4). Postoperative functional outcome, local complications, surgical outcomes, and pathological outcomes were compared between the groups. RESULTS: In the benign group, there was no significant difference in mean operating time, hospital stay, or overall perioperative complications between the two groups. In the micropapillary carcinoma group, mean operating time and hospital stay in group 3 were significantly longer than in group 4 (p=0.015 and p or =4 cm and micropapillary carcinomas. Although it has the advantage of better cosmetic results over open thyroidectomy, there is room for improvement in terms of lessening its invasiveness and shortening the operative time.