KISEP Head and Neck Korean J Otolaryngol 2004;47:1146-50 성문암종에서수직부분후두절제술 한양대학교의과대학이비인후과학교실 이형석 김기태 민현정 박철원 태경 Vertical Partial Laryngectomy in Glottic Cancer Hyung Seok Lee, MD, Ki Tae Kim, MD, Hyun Jung Min, MD, Chul Won Park, MD and Kyung Tae, MD Department of Otolaryngology, College of Medicine, Hanyang University, Seoul, Korea ABSTRACT Background and Objectives:The surgical goals of glottic cancer should not only be to preserve life but also to preserve laryngeal functions such as airway, aspiration prevention, and voice production. Vertical partial laryngectomy preserve laryngeal functions if we carefully select surgical indications. The aim of our study was to evaluate the surgical outcome of vertical partial laryngectomy oncologically and physiologically for the treatment of glottic cancer. Subjects and Method:Forty-one glottic cancer patients were treated with vertical partial laryngectomy at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university hospital from 1993 to 2002. We reviewed the patient charts retrospectively with respect to age, sex, tumor stage, reconstruction, tracheostomy tube decannulation, oral feeding time, postoperative complication, and recurrences. Results:There were six recurrences (14.6%) in the primary site, and recurrence rate was higher in T2 & T3 stage. No patient had recurrence of the cervical lymph nodes. The average decannulation time of tracheostomy tube was 13 postoperative days. The average oral feeding time was 12 postoperative days. There were significant differences in MPT, jitter, shimmer and HNR between the normal control and the cases group (p<0.05). Conclusion:Functional outcome after vertical partial laryngectomy was relatively satisfactory. Vertical partial laryngectomy is a oncologically safe procedure for the treatment of T1 and selected T2 glottic cancer. (Korean J Otolaryngol 2004;47:1146-50) KEY WORDS:Glottic cancer Glottis Partial laryngectomy. 1146
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수직부분후두절제술 Table 1. Local recurrence according to T stage 1148 T stage T1a T1b T2 T3 0/20 00% 0/03 00% 5/16 31.2% 1/02 50% 6/41 14.6% Tabel 2. Local recurrence according to vocal cord mobility in T2, T3 lesionn18 Vocal cord mobility Normal mobility Impaired mobility 4/15 26.7% 2/03 66.7% 6/18 37.5% Table 3. Local recurrence according to surgical margin Surgical margin Negative Dysplasia Positive 3/32 09.4% 2/06 33.3% 1/03 33.3% 6/41 14.6% Table 4. Voice analysis after vertical partial laryngetomy VPL Voice paramater Normal n20 VPL n22 p value Fundamental frequency Hz 134.97 126.14 0.6300 Jitter % 000.32 001.86 0.0003 Shimmer db 001.03 012.03 0.0001 Harmonics to noise ratio db 030.67 010.87 0.0010 Maximal phonation time sec 019.2 008.3 0.0010 - Korean J Otolaryngol 2004;47:1146-50
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