Supracricoid partial laryngectomy in recurrent or advanced laryngeal cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Advanced or recurrent laryngeal cancers after chemoradiotherapy were mainly treated by total laryngectomy because of inadequate surgical margin, multifocal recurrent site, and delayed diagnosis. Recently, voice preservation through conservative laryngeal surgery in case of advanced or recurrent laryngeal cancer with strict application of surgical indication became possible. In this study, authors studied the usefulness of surpracricoid partial laryngectomy (SCPL) for advanced or recurrent laryngeal cancers is discussed. MATERIALS AND METHOD: Twenty-five laryngeal cancer cases of cricohyoido-epiglottopexy (CHEP) or cricohyoidopexy (CHP) from May 1996 through April 2001 were analysed retrospectively. In recurrent cases after radiotherapy, there were 8 cases with glottic T1, 6 with T2, 3 with T3, one with T4, one with supraglottic T2 and T3. In advanced cases without radiotherapy, there were 3 cases with glottic T3 and 2 with supraglottic T3. Evaluation of oncological and functional results were conducted. The mean follow-up period was 29.1 months. RESULTS: Local recurrence occurred in 1 patient (4.3%) and cricoid perichondritis in 5 patients (21.7%), laryngocutaneous fistula in 1 patient (4.3%) after the operation. Four patients (17.3%) had to be treated with completion laryngectomy. Voice function was preserved in 19 patients (82.7%). CONCLUSION: Our experience with supracricoid partial laryngectomy with CHEP or CHP suggests that this technique can be a valuable alternative to the total laryngectomy in the recurrent or advanced laryngeal cancer.

The Comparative Study of Mucociliary Clearance with Long-term Hypertonic Saline versus Normal Saline Nasal Wash of Normal Person and Patients after Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nasal irrigation, a conventional therapy for both surgical and nonsurgical patients with a history of chronic rhinosinusitis, aids in the clearance of secretions, debris, and intranasal crusts. This is important in the postoperative period to reduce the risk of adhesions and to promote ostiomeatal patency. The objective of this study was to compare the effects of a long-term nasal irrigation with hypertonic saline (3.0%) versus isotonic saline (0.9%) in the normal and postoperative group. MATERIALS AND METHODS: We studied the transit time of nasal mucociliary clearance with a saccharine test. In the normal control group I (n = 20), the mean transit times (MTTs) were measured before and after the irrigation with atomized saline of 0.9%, 2%, 3%, 4% and 5% concentrations. In the normal control group Il (n=19), MTTs were measured before and after the atomized 0.9%, 3% saline irrigation for two months. In the postoperative group (n=10), MTTs were measured after the irrigation with saline of 0.9% (right nasal cavity) & 3% (left nasal cavity) for one month. The symptom scores about nasal stuffiness, rhinorrhea and the amount of nasal lavage contents were recorded daily. RESULTS: In the normal control group I, MTT of 3% saline irrigation was significantly shortened than those of isotonic and other hypertonic saline irrigation. In the normal control group II, MTT of 3% saline irrigation was gradually and significantly shortened compared with those of isotonic saline for two months. In the postoperative group, 3% saline irrigation had a significantly shorter MTT for one month and had a significantly more nasal lavage contents during 1st week than isotonic saline irrigation. CONCLUSION: A 3% hypertonic saline would be useful as a long-term nasal washing solution in both surgical and non-surgical patients with a history of chronic rhinosinusitis.