Subglottic stenosis (SGS) and tracheal stenosis (TS) are rare conditions that can cause significant breathing difficulties and, if not properly managed, may lead to life-threatening complications. Despite their clinical importance, debate continues regarding the optimal management of adult SGS and TS, and no comprehensive guidelines have been established to date. The Korean Bronchoesophagological Society appointed a task force to develop clinical practice guidelines with the goal of providing evidence-based recommendations for managing SGS and TS in adults. The task force conducted a systematic review of the relevant literature by searching PubMed, Embase, and the Cochrane Library using predefined search terms aligned with key clinical questions. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, which also informed the formulation and reporting of the recommendations. The strength of each recommendation reflects the guideline panel’s confidence that the benefits of an intervention outweigh its risks for eligible patients. After drafting the guidelines, feedback was obtained through Delphi questionnaires completed by members of the Korean Bronchoesophagological Society. Ultimately, the committee developed 17 evidence-based recommendations across four categories: initial evaluation, medical management, surgical treatment, and postoperative management and rehabilitation. These guidelines aim to support clinicians in delivering optimal care to adult patients with SGS and TS.

Presbylarynx is a condition characterized by age-related changes in the laryngeal structures that result in altered voice quality and function. This review explores the pathological mechanisms, clinical symptoms, and treatment options for presbylarynx. Pathologically, presbylarynx involves structural changes in the vocal folds, including muscle atrophy, thinning of the vocal fold mucosa, and alterations in connective tissue, which collectively contribute to decreased vocal fold elasticity and closure. Clinically, individuals with presbylarynx often experience a weakened voice, hoarseness, vocal fatigue, and reduced voice stability. These symptoms are compounded by changes in respiratory function and neurological control of the vocal folds. Treatment strategies for presbylarynx include voice therapy to strengthen vocal fold muscles and improve voice quality, pharmacological interventions such as anti-inflammatory medications and steroids to manage inflammation, and surgical approaches like vocal fold augmentation to restore vocal fold function. Emerging technologies such as neural-machine interfaces offer potential for future advancements in treating this condition. This review highlights the need for comprehensive management approaches to improve the quality of life for individuals affected by presbylarynx.

Transoral thyroidectomy is a promising technique because of its superior postoperative cosmesis. Although tract implantation after remote-access thyroidectomy is extremely rare, it can result in poor outcomes. A 45-year-old female presented with multiple palpable nodules in the anterior neck after a transoral thyroidectomy for which thyroid function tests, CT, ultrasonography, and fine-needle aspiration were performed. The thyroid function test results were normal. CT and ultrasonography revealed multiple, well-defined nodules at levels Ia and VI along the tracks left by the endoscopic instrument inserted during transoral thyroidectomy. Fineneedle aspiration revealed a microfollicular structure derived from thyroid tissue without evidence of atypia. Wash-out fluid from the nodules revealed elevated thyroglobulin levels. Initially, the patient was hesitant about surgical removal, but the nodules grew larger, so surgical removal was performed. Final histopathological examination revealed follicular thyroid carcinoma. The patient was recommended extensive resection but was lost to follow-up.

Balloon laryngoplasty is a noninvasive procedure for managing pediatric subglottic stenosis with promising outcomes of a lower rate of tracheostomy and a higher decannulation rate. It can be applied even in a severely narrowed airway stenosis such as Myer-Cotton grade III. It is gaining popularity because, unlike the traditional rigid dilation method, it is considered an option to avoid shearing mucosal damages. Endoscopic balloon laryngoplasty may be recommended as a primary treatment option in a symptomatic pediatric subglottic stenosis before performing an invasive laryngotracheal reconstruction surgery. Herein, we introduce our institute’s balloon laryngoplasty procedure step-by-step.

Extended endotracheal intubation in infancy causes various complications. Upper airway disruption is very rare but reversible cause of respiratory insufficiency. Tracheostomy may not be avoidable in severe upper respiratory tract lesions especially in large subglottic cysts and severe subglottic stenosis; however, avoiding it is a priority when possible. A 7-month-old child who had a history of newborn respiratory distress syndrome and extended endotracheal intubation developed respiratory symptoms including stridor. A subglottic cyst was found by bronchoscopy and surginally removed with the tubeless anesthesia technique without tracheostomy. This method was successful even on infants. We report this case with a review of literature.

Background and Objectives: Parotid cancer is a rare malignancy tumor, constituting about 3% of head and neck cancers. Treatment of parotid carcinoma is challenging because of its rarity and unpredictable clinical course. Therefore, it is important to evaluate risk factors associated with prognosis and to predict adverse outcomes. In this article, we aimed to analyze risk factors associated with recurrence free survival in our 10-year single center retrospective study.Subjects and Method Retrospective medical chart review was performed for patients with parotid gland cancer who underwent parotidectomy with or without adjuvant treatment in our institute 2011 to 2020. Patient demographics, histopathologic results, operative method, treatment outcome were assessed. Results: A total of 8 patients (15%) experienced recurrence. Old age and low body mass index was associated with recurrence. Univariate analysis also revealed that high clinical stage, tumor involvement in deep lobe and facial nerve, postoperative radiotherapy or concurrent chemo radiotherapy, positive resection margin, and high histologic grade were statistically significant with recurrence. Multivariate analysis concluded that facial nerve involvement with tumor was associated with higher incidence of recurrence. Deep lobe and facial nerve involvement, postoperative radiotherapy or concurrent chemo radiotherapy, positive resection margin, clinical stage, and histologic grade were statistically significant factors associated with recurrence free survival. Conclusion Our 10-year single institute study will be helpful for predicting adverse outcomes in parotid cancer patients.

Foreign bodies in the upper airway and the esophagus are common and often removed in the outpatient setting using the rigid or flexible laryngoscope. Although most esophageal foreign bodies are removed from the digestive tract, in some cases, surgical intervention is required due to its difficult location. Esophageal foreign bodies often removed by esophagogastroduodenoscopy, but when they penetrate the esophagus and move to deep neck spaces, other approaches should be taken into consideration. We report a rare case of a 13-year-old patient whose esophageal foreign body moved to a deep neck compartment, which was embedded in the anterior vertebral muscle. We decided to perform neck exploration under C-arm guidance, successfully targeted and removed the foreign body.

BACKGROUND: Long segmental tracheal repair is challenging in regenerative medicine due to low adhesion of stem cells to tracheal scaffolds. Optimal transplantation of stem cells for tracheal defects has not been established. We evaluated the role of hyaluronic acid (HA) coating of tracheal scaffolds in mesenchymal stem cell (MSC) adhesion and tracheal regeneration in a rabbit model. METHODS: A three-dimensionally printed tubular tracheal prosthesis was incubated with dopa-HA-fluorescein isothiocyanate in phosphate-buffered saline for 2 days. MSCs were incubated with an HA-coated scaffold, and their adhesion was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. HA coated scaffolds with or without MSC seeding were transplanted at the circumferential tracheal defect in rabbits, and survival, rigid bronchoscopy, radiologic findings, and histologic findings were compared between the two groups. RESULTS: HA-coated scaffolds showed better MSC adhesion than non-coated scaffolds. The HA-coated scaffolds with MSC group showed a wider airway and greater mucosal regeneration compared to the HA-coated scaffolds without MSC group. CONCLUSION HA coating of scaffolds can promote MSC adhesion and tracheal regeneration.

BACKGROUND: Long segmental tracheal repair is challenging in regenerative medicine due to low adhesion of stem cells to tracheal scaffolds. Optimal transplantation of stem cells for tracheal defects has not been established. We evaluated the role of hyaluronic acid (HA) coating of tracheal scaffolds in mesenchymal stem cell (MSC) adhesion and tracheal regeneration in a rabbit model. METHODS: A three-dimensionally printed tubular tracheal prosthesis was incubated with dopa-HA-fluorescein isothiocyanate in phosphate-buffered saline for 2 days. MSCs were incubated with an HA-coated scaffold, and their adhesion was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. HA coated scaffolds with or without MSC seeding were transplanted at the circumferential tracheal defect in rabbits, and survival, rigid bronchoscopy, radiologic findings, and histologic findings were compared between the two groups. RESULTS: HA-coated scaffolds showed better MSC adhesion than non-coated scaffolds. The HA-coated scaffolds with MSC group showed a wider airway and greater mucosal regeneration compared to the HA-coated scaffolds without MSC group. CONCLUSION HA coating of scaffolds can promote MSC adhesion and tracheal regeneration.

Purpose: Malignant gliomas are aggressive spinal cord tumors. In this study, we hypothesized that combination therapy using an anti-angiogenic agent, bevacizumab, and hypoxia-inducible glioblastoma-specific suicide gene could reduce tumor growth. Materials and Methods: In the present study, we evaluated the effect of combination therapy using bevacizumab and pEpo-NI2-SV-TK in reducing the proliferation of C6 cells and tumor growth in the spinal cord. Spinal cord tumor was generated by the injection of C6 cells into the T5 level of the spinal cord. Complexes of branched polyethylenimine (bPEI)/pEpo-NI2-SV-TK were injected into the spinal cord tumor. Bevacizumab was then administered by an intraperitoneal injection at a dose of 7 mg/kg. The anti-cancer effects of combination therapy were analyzed by histological analyses and magnetic resonance imaging (MRI). The Basso, Beattie and Bresnahan scale scores for all of the treatment groups were recorded every other day for 15 days to assess the rat hindlimb strength. Results: The complexes of bPEI/pEpo-NI2-SV-TK inhibited the viability of C6 cells in the hypoxia condition at 5 days after treatment with ganciclovir. Bevacizumab was decreased in the cell viability of human umbilical vein endothelial cells. Combination therapy reduced the tumor size by histological analyses and MRI. The combination therapy group showed improved hind-limb function compared to the other groups that were administered pEpo-NI2-SV-TK alone or bevacizumab alone. Conclusion This study suggests that combination therapy using bevacizumab with the pEpo-NI2-SV-TK therapeutic gene could be useful for increasing its therapeutic benefits for intramedullary spinal cord tumors.