정필상외 Smoking (pack-year) SL MiD MoD SeD CIS Micro SCC Group A B Fig. 3. Duration of smoking history. Fig. 1. Phot

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1 KISEP Head and Neck Korean J Otolaryngol 2003;46: 후두백반증의임상적고찰 단국대학교의과대학이비인후 - 두경부외과학교실 정필상 정신근 이진구 정용원 Clinical Analysis of the Laryngeal Leukoplakia Phil Sang Chung, MD, Shin Keun Jeong, MD, Jin Goo Lee, MD and Yong Won Chung, MD Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Dankook University, Cheonan, Korea ABSTRACT Background and Objectives:Leukoplakia is a descriptive term designating a white patch or plaque of the mucosa and must be complemented by histology. The aim of this study was to analyze the laryngeal leukoplakia clinically. Materials and Method: 48 patients were included from 1995 to All presented themselves with laryngeal leukoplakia in telescopic examination. The available medical record are age, sex, duration of smoking, histopathological finding, treatment and follow up result. Results:The patients were composed of 46 males and 2 females. There were 7 patients (15%) with specific diagnostic lesion (polyps, lymphoma, tuberculosis, chronic inflammation and papilloma), 19 patients (40%) with simple hyperplasia or hyperkeratosis, 4 patients (8%) with mild dysplasia, 2 patients (4%) with moderate dysplasia, 2 patients (4%) with severe dysplasia, 2 patients (4%) with carcinoma in situ, and 1 patient (2%) with microinvasive carcinoma and 11 patients with invasive squamous cell carcinoma. Rebiopsy was performed to 10 cases during follow up period. Conclusion:The results of our study show that the leukoplakia was presented in 15% of all cases with specific diagnostic lesion and that the patient was treated according to their specific diagnosis. Almost all of the case with precancerous conditions were cured with cord stripping, cordectomy or radiation therapy. (Korean J Otolaryngol 2003;46:1064-9) KEY WORDS:Leukoplakia Larynx Precancerous conditions

정필상외 - - - Smoking (pack-year) 50 45 40 35 30 25 20 15

Photograph showing laryngeal leukoplakia arrow at anterior portion of the left vocal cord A and cord stripping with CO2 laser B. Table 1.

etc Simple hyperplasia or hyperkeratosis without dysplasia MiD Mild dsyplasia MoD Moderate dysplasia SeD Severe dysplasia CIS Carcinoma in situ Micro

2 정필상외 Smoking (pack-year) SL MiD MoD SeD CIS Micro SCC Group A B Fig. 3. Duration of smoking history. Fig. 1. Photograph showing laryngeal leukoplakia arrow at anterior portion of the left vocal cord A and cord stripping with CO2 laser B. Table 1. Grading system of laryngeal leukoplakia Grade Description SL Any specific diagnostic lesion polyp, nodule, cyst, granuloma, tuberculosis, lymphoma, papilloma, etc Simple hyperplasia or hyperkeratosis without dysplasia MiD Mild dsyplasia MoD Moderate dysplasia SeD Severe dysplasia CIS Carcinoma in situ Micro Microinvasive carcinoma SCC Invasive squamous cell carcinoma Age (year) SL MiD MoD SeD CIS Micro SCC Group Fig. 2. Age at presentation. Fig. 4. Hperkeratosis. Squamous epithelium shows marked acanthosis and hyperkeratosis H & E, 40. Squamous epithelial layer is increased in thickness and reveals thickened layer of acellular keratin on top. 1065

후두백반증 Fig. 6. Squamous cell carcinoma. Mucosal surface reveals thickened layer of atypical squamous cells with focal irregular invasion to lamina propria H & E, 40. Fig. 5.

Treatment and re-biopsy Group Initial treatment No Re-biopsy Result Treatment SL specific treatment 07 0 Cord stripping 19 3 None None /SeD LC MiD Cord stripping 04 1 None MoD

3 후두백반증 Fig. 6. Squamous cell carcinoma. Mucosal surface reveals thickened layer of atypical squamous cells with focal irregular invasion to lamina propria H & E, 40. Fig. 5. Moderate dysplasia. The squamous cells in lower part of mucosal layer shows mild pleomorphism H & E, 40. Table 2. Treatment and re-biopsy Group Initial treatment No Re-biopsy Result Treatment SL specific treatment 07 0 Cord stripping 19 3 None None /SeD LC MiD Cord stripping 04 1 None MoD Cord stripping 02 1 SCC RT SeD Cord stripping 02 1 SCC RT CIS Cord stripping/rt 02 1 SCC RT Micro Cord stripping 01 0 SCC RT 11 2 None 1 SeD LC LClaser cordectomy, RTradiation therapy, Nonumber of patient 1066 Korean J Otolaryngol 2003;46:1064-9

4 정필상외 Micro 2% CIS 4% SeD 4% MoD 4% SCC 23% MiD 8% Fig. 7. Frequency of each group. SL 15% 40% - Fig. 8. Follow-up result of 10 patients with re-biopsy. LClaser cordectomy, RTradiation therapy. (1) (2) (3) MiD (4) MoD (5) SeD (6) CIS (7) SCC (8) SCC (9) SCC RT 2 mo 8 mo MID SeD/LD 12 mo SCC/RT SCC/RT SCC/RT 2 mo 18 mo 18 mo SeD/LC 30 mo 1067

5 후두백반증 1068 Korean J Otolaryngol 2003;46:1064-9

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CO2 레이저를 이용한 경구강 후두암 절제술 성공적인 레이저 수술을 위한 필요 사항 어야 하고 마취의사와 병리의사의 긴밀한 협조가 필요하며 CO2 레이저를 이용하여 후두암을 수술하기 위하여는 환자와 보호자의 의지와 협조가 필수적이다. 술전에 각종 집도의사가 후두암과 레

CO2 레이저를 이용한 경구강 후두암 절제술 성공적인 레이저 수술을 위한 필요 사항 어야 하고 마취의사와 병리의사의 긴밀한 협조가 필요하며 CO2 레이저를 이용하여 후두암을 수술하기 위하여는 환자와 보호자의 의지와 협조가 필수적이다. 술전에 각종 집도의사가 후두암과 레 KISEP Information Korean J Otolaryngol 2004;47:1-8 CO 2 레이저를 이용한 경구강 후두암 절제술 단국대학교 의과대학 이비인후-두경부외과학교실 정 필 상 Transoral CO 2 Laser Microsurgery for Laryngeal Carcinoma Phil-Sang Chung, MD Department of Otolaryngology-Head