Chang Myeon Song

Hanyang University, Sŏul, Seoul, South Korea

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Publications (27)38.72 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. The purpose of this study was to evaluate the frequency and pattern of central lymph node metastasis (CLNM) in isthmic papillary thyroid carcinoma (PTC).Methods. We compared the clinical and pathological data of 45 patients with a single isthmic PTC and 149 patients with a single PTC located in the unilateral thyroid lobe, all of whom underwent total thyroidectomy and bilateral central neck dissection (CND).Results. The rates of clinical, pathologic, and occult CLNM were higher in the isthmus group than the non-isthmus group. CLNM in the pretracheal and bilateral paratracheal lymph nodes was more frequent in isthmic PTC than in the non-isthmus group. On multivariate analysis, isthmic location of tumor was an independent risk factor for CLNM.Conclusion. Complete bilateral CND should be considered for isthmic PTC due to the high rate of bilateral CLNM, especially to pretracheal and bilateral paratracheal lymph nodes. This article is protected by copyright. All rights reserved.
    Head & Neck 01/2015; · 2.83 Impact Factor
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    ABSTRACT: Genetic factors associated with susceptibility to papillary thyroid carcinoma (PTC) are not well known. We evaluated the association between single nucleotide polymorphisms (SNPs) of ataxia telangiectasia mutated (ATM) and the risk of PTC. A total of 437 histologically confirmed PTC cases and 184 cancer-free controls without thyroid nodules were recruited. Genotypes with respect to five ATM SNPs (rs189037, rs664677, rs373759, rs664143, and rs4585) were determined by the TaqMan assay, and odds ratios and 95% confidence intervals were obtained by logistic regression analysis. Linkage disequilibria and haplotypes were examined from the genotype data. When evaluated separately the genotype distributions of the five ATM SNPs were similar in the PTC cases and controls. Three ATM SNPs (rs373759, rs664143, and rs4585) were found to be in strong linkage disequilibrium (D′ = 1.00, P < 0.001). When the three haplotypes (C-A-G), (T-G-T), and (C-G-T) of these three ATM SNP sites were analyzed, ATM haplotype (C-G-T) +/− was associated with a lower risk of PTC than ATM haplotype (C-G-T) −/− (P = 0.03) after adjusting for age and gender. Our results suggest that genetic polymorphisms of ATM may play an important role in the development of thyroid cancer in the Korean population. Environ. Mol. Mutagen., 2014. © 2014 Wiley Periodicals, Inc.
    Environmental and Molecular Mutagenesis 09/2014; · 2.55 Impact Factor
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    ABSTRACT: Robotic thyroidectomies have been safely performed with early surgical outcomes comparable to conventional cervical thyroidectomies. However, health-related quality of life (HRQOL) after robotic thyroidectomy has not yet been evaluated. The aim of this study was to compare HRQOL of patients who underwent robotic thyroidectomy with that of those who received conventional thyroidectomy.
    Annals of Surgical Oncology 07/2014; · 3.94 Impact Factor
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    ABSTRACT: The relationship between the number of parathyroid glands preserved and hypoparathyroidism is not well understood. We sought to determine the number of parathyroid glands that need to be preserved to prevent hypoparathyroidism.
    World Journal of Surgical Oncology 07/2014; 12(1):200. · 1.20 Impact Factor
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    ABSTRACT: The aim of this study was to determine the technical feasibility and intraoperative safety of robotic lateral neck dissection in differentiated thyroid carcinoma (DTC). We analyzed 12 patients with DTC who underwent robotic total thyroidectomy and lateral selective neck dissection by a gasless unilateral axillobreast approach. The procedure was completed successfully in all patients. The mean console time for robotic lateral neck dissection was 54.2±21.5 minutes. Transient hypoparathyroidism occurred in 5 patients, and transient recurrent laryngeal nerve palsy and chyle leak occurred in 1 patient each. Cosmetic satisfaction was excellent in all patients. Robotic lateral neck dissection by a gasless unilateral axillobreast approach for DTC is feasible and safe and allows for excellent postoperative cosmesis in preliminary results. Further studies are needed to establish oncologic safety and surgical completeness compared with conventional neck dissection.
    Surgical laparoscopy, endoscopy & percutaneous techniques 04/2014; · 0.88 Impact Factor
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    ABSTRACT: Abstract Background: Although the excellent short-term cosmesis after robotic/endoscopic thyroidectomy has been reported, the long-term cosmetic outcome is not yet known. The aim of this study was to evaluate the long-term cosmetic outcome of robotic/endoscopic thyroidectomy. Patients and Methods: We compared 147 patients who underwent robotic or endoscopic thyroidectomy using a gasless unilateral axillo-breast (GUAB) approach or a gasless unilateral axillary (GUA) approach with 161 conventional open thyroidectomy patients. Subjective cosmetic outcomes were evaluated using a series of scar-specific questions as well as the Vancouver scar scale at 12-18 months after surgery. The cosmetic satisfaction score was defined as the sum of the two cosmetic satisfaction questions with a rating scale of 1-5. The scar consciousness score was defined as the sum of the four scar consciousness questions with a rating scale of 0-3. Results: The cosmetic satisfaction and scar consciousness scores were significantly better in the robotic/endoscopic group than in the open group (P<.001 in both). The cosmetic satisfaction and scar consciousness scores were the same in the robotic and endoscopic groups and were also the same in the GUA and GUAB approach groups. Patients treated by the GUA approach were more satisfied with their scarless breasts than patients treated by the GUAB approach having breast scars. Conclusions: Long-term postoperative cosmesis after robotic/endoscopic thyroidectomy using GUAB/GUA approaches is significantly better than conventional open thyroidectomy. In the robotic/endoscopic group, the scarless breasts resulting from the GUA approach lead to greater satisfaction than those after the GUAB approach.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 04/2014; 24(4):248-53. · 1.19 Impact Factor
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    ABSTRACT: The aim of this study was to compare short-term and long-term sensory disturbance and discomfort after robotic thyroidectomy versus conventional open thyroidectomy. We compared 118 patients who underwent robotic thyroidectomy by a gasless unilateral axillobreast (GUAB) or axillary (GUA) approach with 176 patients who underwent conventional open thyroidectomy from April 2009 to June 2011. Postoperative hypesthesia/paresthesia and discomfort of the neck and anterior chest were evaluated regularly for 1.5 years using a questionnaire with a scale from 0 to 4. There were no differences in neck discomfort or hypesthesia/paresthesia between the two groups. Neck discomfort and hypesthesia/paresthesia returned to preoperative levels by postoperative years 1.0 and 1.5, respectively, in both groups. Anterior chest discomfort and paresthesia/hypesthesia were higher in the robotic group than the open group. They returned to preoperative levels by postoperative year 1 in the robotic group and within 3 months in the open group. Long-term sensory disturbance and discomfort of the neck does not differ between robotic thyroidectomy and conventional open thyroidectomy. However, anterior chest discomfort and sensory disturbance are greater and require longer times to recover after robotic thyroidectomy. Minimizing dissection of the anterior chest should be considered to reduce discomfort and sensory disturbance after robotic thyroidectomy by a GUAB/GUA approach.
    World Journal of Surgery 02/2014; · 2.35 Impact Factor
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    ABSTRACT: Objective Prophylactic central neck dissection (CND) in papillary thyroid carcinoma (PTC) remains controversial. If the presence of central lymph node metastasis could be assessed preoperatively or intraoperatively, unnecessary CND could be avoided. The aim of this study was to evaluate the accuracy of intraoperative determination of central lymph node metastasis by the surgeon using palpation and inspection in clinically node-negative PTC.Study DesignProspective study.SettingUniversity tertiary care facility.Subjects and MethodsA total of 122 consecutive patients with clinically node-negative PTC were enrolled. Any suspicious lymph nodes on intraoperative palpation or inspection were sent for frozen biopsy, and then bilateral CND with total thyroidectomy was carried out in all patients. The criteria for a suspicious lymph node included palpable hardness, dark discoloration, or size exceeding 5 mm in diameter. We compared the surgeon's judgments with the final pathologic results.ResultsSuspicious lymph nodes were found in 37 (30.3%) patients, and 15 of them had metastasis on permanent biopsy. Of 85 patients with no suspicious lymph nodes, 27 (31.8%) had metastasis on permanent biopsy. The sensitivity and specificity as well as positive and negative predictive values of intraoperative determination of central lymph node metastasis were 35.7%, 72.5%, 40.5%, and 68.2%, respectively. The positive predictive values of enlarged lymph nodes, dark discoloration, and hardness were 30.4%, 50.0%, and 78.6%, respectively.Conclusion Intraoperative determination of central lymph node metastasis by the surgeon is a limited guide for CND in clinically node-negative PTC because of its low sensitivity and specificity.
    Otolaryngology Head and Neck Surgery 01/2014; · 1.72 Impact Factor
  • Ji Hun Eom, Yong Bae Ji, Chang Myeon Song, Hyuck Kim, Kyung Tae
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 01/2014; 57(8):533.
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    ABSTRACT: Objectives The aim of this study was to investigate the feasibility and efficacy of robot-assisted neck dissection by a postauricular facelift approach in head and neck squamous cell carcinoma (HNSCC), compared with conventional neck dissection.Study DesignCase series with chart review.SettingUniversity tertiary care hospital.Subjects and Methods Thirty HNSCC patients with clinically node negative necks (cN0) who underwent robot-assisted selective neck dissection (SND) by a postauricular facelift approach (11 patients, 12 necks) or conventional neck dissection (19 patients, 21 necks).ResultsThe mean age was lower in the robotic group (P = .030). However, the distributions of gender and TNM stage did not differ between the two groups. The robotic SND was completed successfully in all patients. The mean operative time was longer in the robotic group (215 ± 56 min) than the conventional group (144 ± 43 min) (P < .001). The mean numbers of lymph nodes removed were 25.0 ± 7.4 and 28.9 ± 8.2 in the robotic and conventional group, respectively (P = .192), and the number of lymph nodes removed at each level also did not differ between the 2 groups. In addition, there was no significant difference in postoperative complications between the 2 groups, but cosmetic satisfaction was higher in the robot group (P = .002).Conclusions Robot-assisted SND by a postauricular facelift approach is comparable to conventional neck dissection in selected patients with cN0 HNSCC and results in excellent postoperative cosmesis.
    Otolaryngology Head and Neck Surgery 12/2013; · 1.72 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the surgical completeness of robotic total thyroidectomy compared with conventional open thyroidectomy. Retrospective, case-control study. We studied 245 patients with papillary thyroid carcinoma who underwent total thyroidectomy and postoperative radioactive iodine (RAI) ablation. Of these, 62 patients underwent robotic thyroidectomy by a gasless unilateral axillo-breast (GUAB) or axillary (GUA) approach, and 183 underwent conventional open thyroidectomy. We analyzed serum TSH-stimulated thyroglobulin (Tg) and RAI uptake at the time of RAI remnant ablation to compare surgical completeness in the two groups. Tumor characteristics and complications did not differ between the two groups except TNM stage. The mean TSH-stimulated Tg at the first RAI ablation was significantly higher in the robotic group (10.20 ± 9.98 ng/ml) than in the open group (3.85 ± 6.79 ng/ml) (P <0.001). In subgroup analysis of the robotic group by the period in which operations took place, TSH-stimulated Tg was significantly higher than in the open group in the first (13.28 ± 11.91 ng/ml) and second (10.45 ± 9.30 ng/ml) periods, but there was no significant difference in the third period (6.00 ± 6.26 ng/ml, P = 0.141). The RAI uptake rate at the first RAI ablation did not differ between the two groups, and TSH-stimulated Tg after RAI ablation was similar. The surgical completeness of robotic total thyroidectomy by a GUAB/GUB approach is comparable to that of open thyroidectomy, if performed by experienced robotic thyroid surgeons in properly selected patients. 3b. Laryngoscope, 2013.
    The Laryngoscope 11/2013; · 2.03 Impact Factor
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    ABSTRACT: This study aimed to demonstrate the radiological properties of hyaluronic acid (HA) and calcium hydroxylapatite (CAHA) on serial computed tomography (CT) and positron emission tomography (PET) scan. Retrospective Case Series. Retrospective chart and imaging analysis of patients who underwent HA or CAHA injection laryngoplasty. Total of 243 patients who underwent more than one CT of PET after last injection laryngoplasty were included. Sixty-eight patients received HA injection and 175 patients received CAHA injection. In all cases HA showed hypo-density in CT and no abnormal uptake on PET. CAHA showed bright calcific density on CT scan and high uptake on PET but had disappeared with time in 18 months if injected less than 0.85 mL in amount. These findings support previous clinical studies on CAHA longevity and provide proper radiological interpretation on injection materials in the vocal folds. IV (Case series) Laryngoscope, 2013.
    The Laryngoscope 07/2013; · 2.03 Impact Factor
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    ABSTRACT: BACKGROUND: New approaches to robotic thyroidectomy help to prevent neck scarring and improve surgical ergonomics. The purpose of this study was to compare the efficacy and advantages of a gasless unilateral axillary (GUA) approach and an axillo-breast (GUAB) approach in robotic thyroidectomy. METHODS: We retrospectively reviewed the data of 131 patients who underwent robotic thyroidectomy with or without central neck dissection using a GUAB (90 cases) or GUA (41 cases) approach between September 2009 and December 2011. We excluded patients who underwent simultaneous lateral neck dissection and cases within the learning curve. We compared patient and tumor characteristics, surgical outcomes, perioperative complications, and cosmetic satisfaction between the two approaches. RESULTS: Robotic thyroidectomy was successful in all patients. There were no differences in terms of patient and tumor characteristics, extent of thyroidectomy and central neck dissection, operative time, and postoperative complications between the two approaches. Cosmetic satisfaction was excellent in both groups. There was no difference in satisfaction with the cosmetic result in the neck area, but the GUA patients expressed higher satisfaction with the appearance of the breast. CONCLUSIONS: The surgical outcomes of GUA and GUAB approaches are similar in robotic thyroidectomy. Both are safe, effective, and yield cosmetically excellent results when performed by an experienced robotic thyroid surgeon. However, a GUA approach is associated with superior cosmetic satisfaction with the appearance of the breast.
    Surgical Endoscopy 04/2013; · 3.31 Impact Factor
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    ABSTRACT: Background: The aim of this study is to report the efficacy of routine follow-up after head and neck cancer treatment. Method: Data of 520 head and neck cancer patients registered with between 2002 and 2008 were reviewed retrospectively. Results: The mean ± SD follow-up period taken into account was 34.7 ± 22.8 months. The pick- up rate for recurrence using our follow-up protocol in this cohort was one in every 79 visits (1.26%). High pick-up rates were observed in patients older than 70 years and patients with advanced T classification, while low pick-up rates were observed in patients who had received treatment including surgery. The only factor on multivariate analysis to influence follow up visits was surgical treatment (P=0.043). Conclusions. Individualized and obligatory follow-up policy is desirable considering various factors, especially age, T classification, and whether treatment modality includes surgery or not. Head Neck, 2013.
    Head & Neck 04/2013; · 2.83 Impact Factor
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    ABSTRACT: Abstract Background: Scarless and minimally invasive surgery is becoming popular in the head and neck area. We have developed a new robotic selective neck dissection procedure for head and neck squamous cell carcinoma (HNSCC) to avoid a long visible lateral neck scar. Here we report on the technical feasibility and safety of our procedure. Subjects and Methods: We prospectively analyzed 4 patients with early HNSCC who underwent transoral robotic surgery (TORS) and concomitant robotic selective neck dissection via a gasless postauricular facelift approach using the da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA). Results: Of these patients, 3 were male, and 1 was female. The mean age was 59.0±8.8 years. All patients had tongue cancer, with a clinically negative neck. Three patients were T1, and 1 patient was T2. All patients underwent partial glossectomy by TORS and elective robotic selective neck dissection including levels I, II, and III. The robotic selective neck dissection procedure was completed successfully in all patients. The mean operative time was 276±48 minutes. The mean number of lymph nodes removed was 19.3±7.3. Postoperative hematoma and transient marginal nerve palsy occurred in 1 patient each. Cosmetic satisfaction was excellent in all patients. Conclusions: Preliminary results indicate that robotic selective neck dissection via a gasless postauricular facelift approach is feasible and safe and allows for excellent postoperative cosmesis. Further studies are necessary to determine the oncologic safety and surgical completeness of this procedure compared with conventional neck dissection.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 03/2013; 23(3):240-5. · 1.19 Impact Factor
  • Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 01/2013; 56(9):569.
  • Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 01/2013; 56(3):149.
  • Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 01/2013; 56(11):706.
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    ABSTRACT: OBJECTIVES/HYPOTHESIS: To analyze the clinical features of olfactory neuroblastoma (ONB) and compare the treatment results according to various treatment modalities, and to validate various staging systems. STUDY DESIGN: Retrospective analysis. METHODS: This study included 35 patients with ONB. Treatment consisted of neoadjuvant chemotherapy and radiation therapy (seven patients), traditional craniofacial resection (TCFR, 12 patients), endoscopic craniofacial resection with craniotomy (ECFR, 11 patients), and transnasal endoscopic resection without craniotomy (five patients). The overall mean follow-up period was 64.9 months and mean disease-free survival (DFS) was 50.2 months. RESULTS: Five-year overall survival and 5-year DFS rates were 76.0% and 61.8%, respectively. Five-year DFS rates for nonsurgical treatment, TCFR, ECFR, and transnasal endoscopic resection without craniotomy group were 35.7%, 41.7%, 80.8%, and 100%, respectively (P = .01). Neck metastasis negatively affected survival (P = .03). DFS rate of patients in the endoscopic surgery group was higher than the nonendoscopic surgery group on Cox multivariate regression analysis (P = .02). The modified Kadish classification system predicted DFS more accurately than the Biller and Dulguerov classification system (P = .04). Locoregional recurrence occurred in 23% (period of recurrence after treatment, mean 49 months; range, 3-143) of patients with ONB, and distant metastasis in 26%. ECRF group showed lesser perioperative bleeding amount and shorter operation time compared with TCFR. However, the admission period was not statistically different. CONCLUSIONS: Endoscopic surgery for advanced ONB showed successful survival results compared with nonendoscopic surgery on multivariate analysis, and limited morbidities. Modified Kadish classification best predicted DFS for ONB. Long-term follow-up is necessary due to its late recurrence. Laryngoscope, 2012.
    The Laryngoscope 10/2012; · 2.03 Impact Factor
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    ABSTRACT: Genetic dysregulation may be associated with development of obstructive sleep apnea (OSA). Genetic expression was investigated in the soft palate of patients with OSA to evaluate the biomolecular characteristics of the tissue where airway obstruction actually occurs. Soft palate mucosa was obtained during uvulopalatal flap surgery. Three patients with apnea/hypopnea index (AHI) >30/h and three simple snoring patients with AHI < 5/h were enrolled. After total RNA was extracted and amplified, gene expression levels were determined by microarray analysis, and relative signal intensities for each gene were evaluated. Of the 45,034 genes analyzed, 137 were up-regulated in OSA patients compared with simple snorers and 95 were down-regulated. Gene network analysis showed that genes related to RNA interference and transcription were most commonly involved in the functional pathophysiology of OSA. In particular, genes encoding proliferating cell nuclear antigen and proteasome 26S subunit ATPase 6 were functionally connected with other genes.
    Acta oto-laryngologica 06/2012; 132 Suppl 1:S63-8. · 0.98 Impact Factor

Publication Stats

25 Citations
38.72 Total Impact Points

Institutions

  • 2014
    • Hanyang University
      • College of Medicine
      Sŏul, Seoul, South Korea
  • 2013
    • Seoul National University
      Sŏul, Seoul, South Korea
  • 2010–2012
    • Seoul National University Hospital
      • Department of Otorhinolaryngology
      Seoul, Seoul, South Korea