제 20 회대한두경부외과연구회증례토론회 일시 :2006 년 5 월 27 일 ( 토 ) 오후 2 시 50 분 장소 : 강원도사북강원랜드 증례발표및토의 자유연제 I 자유연제 II - 2 -

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1 일시 :2006 년 5 월 27 일 ( 토 ) 오후 2 시 50 분 장소 : 강원도사북강원랜드 증례발표및토의 자유연제 I 자유연제 II - 2 -

2 목차 의대 5 의대 6 의대 7 의대 8 9 의대 10 의대 11 의대 13 의대 의대 16 의대 17 의대 18 의대

3 Myxoid Liposarcoma of Epiglottis 가천대학교의과대학이비인후과학교실 김동영 * M/41 C.Cglobus senseduration2 P.I 2 P/HxHTN/DM/Tbc/asthma/hepatitis Pulmonary Tbc 20. Left pneumonectomy. Operation Hx 20. Left pneumonectomy. P/ExEar, Nose, Oral cavity, Neckfree Larynxyellowish smooth surface mass on vallecular surface of epiglottis LabW.N.L Chest X rayw.n.l Abdominal SonoW.N.L Neck CT Operationmass excision Pathologic ReportMyxoid Liposarcoma Whole body bone scanno evidence of bony metastasis Neck MRI OperationSupraglottic Partial Laryngectomy POD # 2 koken change POD # 7 oral feeding try POD # 20 Panperitonitis d/t ulcer perforation OperationTrunkcal Vagotomy and Pyloroplasty POD # 24 Expire - 5 -

4 설기저부암수술후추적관찰중심한출혈로인한사망 1 예 고려대학교의과대학이비인후 - 두경부외과학교실 권순영 * 백승국 우정수 정광윤 - 6 -

5 인두암수술후발생한흡인성폐렴 1 례 한양대학교의과대학이비인후과학교실 태경 이용섭 * - 7 -

6 설암수술후발생한폐색전증 1 례 연세대학교원주의과대학이비인후과학교실 봉정표 김성일 * - 8 -

7 ARDS Caused by Intraoperative Volume Overload 서울대학교의과대학이비인후과학교실 김광현 하정훈 차원재 *

8 하인두암수술후발생한혈소판감소증으로인한사망 1 례 인하대학교의과대학이비인후 - 두경부외과학교실 김재원 * 김영모

9 A Case of Pericarditis After Rigid Esophagoscopic Bougination 성균관대학교의과대학이비인후과학교실 손영익 * 정규환 Chief ComplaintDysphagia onset Brief History Gastirc cancer Subtotal gastrectomy Dysphagia, Weight loss Diagnosed as esophageal cancer Neoadjuvant CCRT 2 cycles Esophago-colono-gastrostomy Stenosis of E-C anastomosis area Repeated balloon dilatation and bougination Restenosis & failed balloon dilatation ENT consult Hospital course Rigid esophagoscopic evaluation, scar release & bougination Good oral intake SBD Sudden dysphagia during lunch EGD-Food materials & granulation tissue at anastomosis site Rigid esophagoscopic granulation removal & L-tube insertion General weakness & chest tightness developed. V/Slow BP 80/60, fever 3738C, SpO2 91% ECGnon-specific findings MICU contactr/o hypovolemic shock & dopamine started L-tube feeding started with clear water 50 ml then SFD 200 ml PR90110, BPuncheckable, SpO296% PR 8090, BP 90/60 with dopamin increase & NS full drip The possibility of non-cardiogenic shock was suggested Chest CT to R/O mediastinitis L-tube in pericardial space Transferred to TS Segmental resection & End to end anastomosis, VATS irrigation of pericardial space Esophageal perforationsize 5 mm, 1 cm above anastomosis area at the posterior wall of esophagus Esophagographyleakage Pneumonia developed

10 Ventilator care at MICU due to 1 Pneumonia, ongoing pulmonary fibrosis 2 Sustained E-C junction leakage 3 Uncontrolled mediastinitis 4 Constrictive pericarditis ARDS developed Peumothorax chest tube insertion Tracheostomy recommended refused by pt. s family Transferred to the other hospital

11 Two Cases of Perioperative Mortality due to Acute Myocardial Infraction 연세대학교의과대학이비인후과학교실 최은창 김세헌 이진석 * 증례 1: - 증례 2:

12 Tracheotomy Complications-Tracheal Tube Dislocation 단국대학교의과대학이비인후과학교실 이상준 *

13 Airway Compromised Case Caused by Crust in the Tracheostomy Tube 부산대학교의과대학이비인후과학교실 왕수건 이병주 이진춘 *

14 Postoperative Rupture of External Carotid Artery after Extended Radical Neck Dissection in Tonsil Cancer 순천향대학교의과대학이비인후과학교실 고윤우 * 이승원 장혁순

15 조기설암환자에서술후급격히진행된경부림프절전이 영남대학교의과대학이비인후과학교실 송시연 *

16 경부에서재발한설암 가톨릭대학교의과대학이비인후과학교실 주영훈 * 김민식 58/M 1st admission C/CRt. Lateral tongue ulceration for several years P/I Rt. Lateral tongue ulceration Bx SCC, moderately differentiated check ImpressionSCC, Tongue, Rt.T1N0M0 OperationRt. Partial glossectomy c sentinel node Bx. 2nd admission C/CRt. Neck mass for 2 months P/I SCC, Tongue, Rt. T1N0M0 imp Rt. Partial glossectomy c sentinel node Bx. OPD F/U Sx FNA SCC op adm ImpressionMetastatic neck mass, Rt. OperationRt. MRND preserving SCM, SAN Post-OP RT cGY/ 33Fx/ 45days 3rd admission C/C poor oral intake for 3 weeks Hopital courseconservative care HD #6 D/C 4th admission C/CRt. Neck mass for 1 months P/I Rt. MRND preserving SCM, SAN OPD F/U Sx FNA SCC check op adm ImpressionMetastatic neck mass, Rt. OperationWide excision, Rt. Hemithyroidectomy, Rt. Paratracheal dissection Medial dissection via median sternotomy, Reconstruction c PMMCF, Rt. 5th admission C/CConcurrent ChemoRTx 6th admission C/C Concurrent ChemoRTx

17 7th admission C/C Painful neck swelling & dyspnea for 1week 9/24 Transfer to hospice 10/5 Expired on AM

18 하인두암수술후발생한기관괴사 한림대학교의과대학이비인후과학교실 김진환 * 노영수 안회영

19 대한두경부외과연구회회원가입신청서 신ᄏ청 ᄏ자 추천정회원 추천정회원

20 대한두경부외과연구회 ,

내시경 conference

내시경 conference 부울경소화기내시경학회 6월집담회 고신대학교복음병원소화기내과전임의서광일 F/63 CASE C.C) epigastric pain for 2 wks P. I) 2014.04.16 EGD at LMC adm via OPD for further evaluation. P. Hx) CASE HTN/DM/Hepatitis/Tbc (+/+/-/-) S. Hx) N-S ROS)