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J Korean Soc Laryngol Phoniatr Logop > Volume 27(1); 2016 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2016;27(1): 30-34.
미세피판기법을 이용한 성대낭종제거술
안정민1, 최지은1, 이동근2, 장전엽3, 손영익1
1성균관대학교 의과대학 삼성서울병원 이비인후과학교실
2인제대학교백병원 의과대학 이비인후과학교실
3부산대학교병원 의과대학 이비인후과학교실
Microsurgical Extirpation of Intracordal Cyst with a Microflap Technique
Jungmin Ahn1, Ji-Eun Choi1, Dong Kun Lee2, Jeon Yeob Jang3, Young-Ik Son1
1Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
2Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
3Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
Correspondence  Young-Ik Son ,Tel: (02) 3410-3579, Fax: (02) 3410-6987, Email: yison@skku.edu
Received: 18 December 2015;  Accepted: 31 December 2015.  Published online: 30 June 2016.
ABSTRACT
Background and Objectives
Microsurgical resection of intracordal cysts is technically difficult and challenging because the wall of cysts may be tightly attached to underlying vocal ligament and/or overlying epithelium, and therefore their thin wall will easily rupture during surgical dissection. We aimed to evaluate the voice outcomes of standard microflap subepithelial resection and the recurrence rate depending on the intraoperative rupturing of the cyst.
Materials and Methods
Medical records of Samsung Medical Center, Seoul, Korea, were reviewed for sixty-four consecutive patients who received surgical resection of vocal cyst using microflap subepithelial dissection technique between the year 2004 and 2013. Meticulous dissection was performed to completely remove the cyst wall while preserving the mucosa and the lamina propria as much as possible. Voice outcomes and recurrence rates were compared according to the type, size and the intraoperative rupture of cyst.
Results
Presence or absence of cyst rupture was clearly described in the operation records of 41 patients. Intraoperative rupture of the cyst occurred in 32 of 41 (78%) patients. The recurrence was detected in 5 of 64 (7.8%) total cases and 4 of 32 (12.5%) cases of ruptured cyst, but not in 9 cases of intact extirpation. Rupture was more common in case of mucous retention cyst compared with epidermoid cyst (p=0.036). Subjective and objective voice parameters were measured at before and 3 months after surgery, which improved regardless of the cyst rupture.
Conclusion
Although complete microsurgical extirpation of intracordal cyst while keeping the cyst wall intact is technically difficult, meticulous dissection with maximal preservation of surrounding tissue may warrant the improvement of voice outcomes.
KEY WORDS: Intracordal cystVocal cystCyst extirpationVoice outcome
중심 단어: 성대 낭종표피양낭종성대낭종제거술음성분석과
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