Clinical Menifestation and Anaylsis of Thyroid Follicular Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy after papillary thyroid carcinoma. We performed this study to obtain further understanding and more supporting ideas for the diagnosis and treatment of thyroid follicular carcinoma. SUBJECTS AND METHOD: Over a 12-year period, 126 patients surgically treated for FTC with an average follow-up of 57.5 months were retrospectively studied. RESULTS: Eighteen (14.3%) patients had distant metastasis at presentation and completion thyroidectomy was performed for 58 patients (46%) after partial thyroidectomy. This implies how difficult it is to diagnosis this type of cancer at the preoperative or intra-operative stage of treatment. Fine-needle aspiration cytology has been shown to be an ineffective method for the diagnosis of FTC. Five patients developed recurrent distant metastasis 6 month after their initial treatment and 3 patients died of persistent distant metastatic disease. The 10-year overall survival rate were 97.6%, and 10-year disease free survival rate was 82.5%. The patients with minimally invasive follicular carcinoma (n=92) and low risk group according to AMES classification, stage IV in TNM classification had more favorable prognosis. But the results showed no statistically significant difference. CONCLUSION: Several staging systems can be applied specifically to patients with FTC. The distinction of FTC in minimally invasive and widely invasive carcinoma, analysis of prognostic factor (recurrence, local invasion, distant metastasis, age, tumor size) is important in identifying low risk patients for a more conservative treatment.

An Unusual Case of Tonsillar Lymphangiomatous Polyp / 대한이비인후과학회지

Tonsillar lymphangiomatous polyp is an uncommon hamartomatous lesion that generally arises from the tonsillar surface. Due to the uncommon clinical and pathological features of these polyps, pathologist and clinician may experience difficulty in correctly classifying them. Although this is a rare clinical and pathologic entity for pathologists and clinicians, the diagnosis is not so difficult if one has a bit of experience about that. Recently, we experienced a 37-year-old women with a pale lymphangiomatous polyp of 3x1.5 cm size, which was treated by tonsillectomy. We report this case with a review of literature.

Endoscopic Guided Power-Assisted Adenoidectomy Using Proper Combination of Endoscope and Microdebrider ; 6 Years of Surgical Experience / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Because of its advantage over the conventional method, power-assisted adenoidectomy has become an increasingly popular procedure in adenoidectomy. The purpose of this paper is to find the best combination of endoscope and microdebrider to achieve the most successful outcome in patients with various configuration of adenoid vegetation. SUBJECTS AND METHOD: One hundred ninety-one patients who underwent adenoidectomy in the department of Otolaryngology at Inje University Seoul Paik Hospital from January 2000 to February 2006 were reviewed by charts and recorded video tapes for the techniques that we applied to these patients. RESULTS: Four different combinations can be created from two different angles of endoscope and microdebrider ; transnasal 0degrees endoscopic guided transnasal adenoidectomy using straight microdebrider (TNTN), transnasal 0degrees endoscopic guided transoral adenoidectomy using curved microdebrider (TNTO), transoral 70degrees endoscopic guided transnasal adenoidectomy using straight microdebrider (TOTN) and transoral 70degrees endoscopic guided transoral adenoidectomy using curved microdebrider (TOTO). TOTO was the most frequent combination for simple adenoid vegetation. However, it is not suitable for removal of adenoid located high in the pharyngeal roof. In this case, we added TNTO to TOTO. The least frequent combined technique was TNTN, which has inherent limitation to use in small sized nares and younger age. In this situation, TOTN is a better alternative to use. CONCLUSION: From six years of experience, we confirmed that endoscopic guided powerassisted adenoidectomy should be performed with proper combination of endoscope and microdebrider based on the location and configuration of adenoid vegetation. The most ideal combination we consistently applied for removal of adenoid is as follows ; first, TNTO, secondly, TOTO. Lastly, TOTN could be useful in selected cases.