Biomedical subjects

Yeo-Hoon Yoon

Publications and source records attributed to Yeo-Hoon Yoon.

7 recordsLinked to original sources

PubMed2006

Cervical sensory preservation during neck dissection.

Although the practice of neck dissection has greatly advanced from radical to function-preserving surgery, the impact of the sensory nerve-preserving neck surgery on the pain and quality of life (QOL) of patients has received little study. We evaluated neck morbidity and its impact on QOL associated with selective or modified radical neck dissection with or without preservation of cervical root branches. We conducted a retrospective cohort study comparing 24 patients who had their cervical root branches preserved to 29 patients whose root branches were removed during neck dissection. The spinal accessory nerve was preserved and sex, age, pathologic status, side and extent of neck dissection, and radiotherapy were comparable between groups. The groups were compared based on sensory and motor functions of the neck and shoulder and questionnaires on depression and QOL at follow-up of mean 18.7 (range 12-34) months after surgery. The nerve-preserved patients showed a low incidence and severity of neck and shoulder pain compared to the nerve-removed subjects (p<.05). Loss of sensation was more frequently experienced in the nerve-removed group on the earlobe and the lateral neck of the operated side (p<.05). Depression and QOL scores were higher in the nerve-removed group and significantly correlated with pain intensity. Preservation of the cervical root branches reduces postoperative pain as well as permanent anesthetic areas of the neck. This may also improve the mental state and QOL of patients undergoing neck dissection.

Adult↗

PubMed2006

Effect of acid and pepsin on glottic wound healing: a simulated reflux model.

OBJECTIVE: To evaluate the effects of acid and pepsin on the healing of traumatized vocal folds in a simulated reflux model. Gastroesophageal reflux is related to various laryngeal manifestations. However, there is a lack of established reflux animal models that would ensure longer observation periods. DESIGN: A prospective randomized animal study. INTERVENTIONS: Forty-two rabbits underwent a stripping procedure of the unilateral glottis and catheter insertion under transoral endoscopic guidance. The animals were randomly assigned to a control group (n = 21; isotonic sodium chloride was used) or a reflux group (n = 21, acid and pepsin were used). They received intrapharyngeal catheter irrigation with 3 mL of isotonic sodium chloride or a solution of acid with a pH of 3 and pepsin, 0.3 mg/mL, twice daily for 4 or 8 weeks after surgery. MAIN OUTCOME MEASURES: Gross and histologic findings of the preinjured glottides of the 2 groups were compared. RESULTS: The catheter extrusion rate was significantly low (6%), and any catheter problems were immediately solved by reinsertion or reconnection. The extent of glottic scarring and frequency of granulation formation were higher in the reflux group compared with the control group (P<.05). Histologic inflammation scores and collagen deposition were significantly greater in the reflux group compared with the control group (P<.05). CONCLUSIONS: Our data suggest that glottic wound healing is significantly affected by acid and pepsin. Antireflux treatment can be advocated to minimize further injury caused by gastroesophageal reflux in patients who undergo laryngeal surgery.

Animals↗

PubMed2006

Prevention of hypopharyngeal stenosis with silastic sheeting following transoral resection.

Hypopharyngeal stenosis following transoral laser microresection (TLM) of hypopharyngeal carcinomas is a rare but devastating complication. Early oral intake and insertion of a nasogastric feeding tube have been thought to prevent stenosis after surgery. However, though rare, severe dysphagia can be caused by hypopharyngeal stenosis following TLM despite preventive efforts. We suggest a new way to prevent hypopharyngeal stenosis by using silastic sheeting with a feeding tube. This stent was inserted in three patients who underwent extensive TLM of hypopharyngeal carcinomas. This technique will help in the treatment and prevention of hypopharyngeal stenosis following TLM in selected patients with wide or circumferential hypopharyngeal tumors.

Carcinoma, Squamous Cell↗

PubMed2006

Removal of nonthyroidal neck masses with improved cosmetic outcomes in skin-lifting surgery.

OBJECTIVE: To evaluate the cosmetic benefit of neck skin-lifting surgery for the removal of nonthyroidal neck masses. STUDY DESIGN AND SETTING: Fifty patients with neck masses were divided into the following 2 surgical groups that were matched in age, sex, and the size, location, and pathology of lesions: skin lifting (n = 25) and conventional (n = 25). The operation time, hospital stay, complications, and subjective satisfaction with the incision scar as assessed on a visual analogue scale (VAS) were compared between the 2 groups. RESULTS: All but 2 lesions (lymphomas) were benign and were removed completely, drained, or biopsied. The surgery time, hospital stay, and complication rates did not differ significantly between the groups. The mean satisfaction score of the patients was 8.2 +/- 1.1 in the skin-lifting surgery group and 4.8 +/- 2.5 in the controls (P < 0.001). The incision scars were commonly hidden by natural hair or collars in the patients who received skin-lifting surgery. CONCLUSION: This surgical technique can be safely applied to most benign masses in the entire neck excluding the thyroid region, especially in patients who prefer neck scars to be invisible. EBM RATING: B-2b.

Abscess↗

PubMed2005

Prevention of anterior glottic stenosis after bilateral vocal fold stripping with mitomycin C.

OBJECTIVE: To examine the effects of immediate application of topical mitomycin C (MMC) on the prevention of anterior glottic stenosis (AGS) after microsurgical stripping of both vocal folds, including the anterior commissure, in a canine model. DESIGN: Prospective randomized experimental study. INTERVENTIONS: Twelve canine larynges were injured by a stripping procedure of both entire membranous vocal folds. The dogs were randomly divided into 2 groups for treatment with 1.0 mg/mL of MMC or with isotonic sodium chloride solution (control) for 5 minutes immediately after surgery. Three and 6 weeks after surgery, the glottic webs were lysed and repeatedly treated with MMC or isotonic sodium chloride solution. The glottic wound healing and AGS formation were examined every week. Ten weeks after the initial surgery, all larynges were collected and examined histologically. RESULTS: The stripping procedure induced AGS, affecting 58% to 86% (mean, 72%) of the length from the anterior commissure to the vocal process in the control group. The application of MMC at the time of initial surgery significantly lowered the incidence and extent of the web formation (P = .004). The AGS lesions were resolved by web lysis and treatment with MMC, without significant local adverse effects. Histological staining for collagen and elastin revealed that MMC treatment did not induce excessive fibrotic or atrophic changes in the lamina propria of the vocal folds. CONCLUSION: Bilateral stripping of the membranous vocal folds induces significant AGS, which can be minimized by use of MMC at initial surgery.

Alkylating Agents↗

PubMed2005

Effect of topical mitomycin C on the healing of surgical and laser wounds: a hint on clinical application.

OBJECTIVES: Mitomycin C (MMC) is used in otolaryngological surgery to reduce complications from postoperative scarring. However, the effects of MMC on wound healing at different doses and on different wound types have not been fully described. The aim of this study was to evaluate the effects of topical MMC at 2 different doses on the healing of surgical and laser wounds. STUDY DESIGN AND SETTING: This was a randomized study using 20 rabbits. Six full-thickness wounds were made by excision or laser vaporization on the flank skin. The wounds were randomly treated by topical MMC of 0.4 or 1.0 mg/mL or saline for 5 minutes. RESULTS: Re-epithelialization and contraction of the original wounds were significantly delayed by the use of MMC (P < 0.01). The delayed healing effect of MMC was more prominent in the laser wounds than in the excision wounds. MMC inhibited collagen deposition and fibroblast proliferation of wounds on histological analysis. The 2 different concentrations of MMC showed no difference in gross or histological wound healing characteristics. CONCLUSION: Our results showed that MMC delays the healing of wounds as a result of the inhibition of fibrosis, especially for laser wounds.

Administration, Topical↗

PubMed2005

Prevention of anterior glottic stenosis after transoral microresection of glottic lesions involving the anterior commissure with mitomycin C.

OBJECTIVE: To evaluate the effectiveness of topical mitomycin C (MMC) in preventing anterior glottic stenosis (AGS) after transoral microresection of glottic lesions involving the anterior commissure (AC). STUDY DESIGN: Prospective clinical study. METHODS: Sixteen patients with benign or malignant glottic lesions involving the AC were studied. The lesions were removed by transoral microsurgery using a CO2 laser or cold microinstruments. In all patients, the anterior glottis was treated topically with 0.4 mg/mL MMC for 5 minutes at the end of surgery. The postoperative vocal folds and voice quality of patients were evaluated using video strobolaryngoscopy and voice recordings. RESULTS: Four patients had local recurrences after surgery and were treated with repeat microsurgery. Postoperatively, five patients (31%) developed acceptable small webs in the anterior glottis; one resolved with web lysis and a second with topical MMC. Postoperative vocal quality was affected mainly by the extent of vocal fold resection and the subsequent wide glottal gaps and extensive scarring, rather than by MMC use per se. Significant local side effects or atrophy of the vocal folds owing to MMC were not found. CONCLUSION: Topical MMC may be useful for preventing AGS and subsequent dysphonia after transoral microresection of glottic lesions involving the AC.

Administration, Topical↗