• Title/Summary/Keyword: 갑상성형술

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재발성 흡인성 폐렴을 동반한 편측성대마비 환자의 제I형 갑상연골 성형술 1례

  • 남정권;남순열
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.85-85
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    • 1996
  • 편측성대마비에 대한 치료방법으로 외측에 위치한 성대를 수술적으로 교정하려는 시도는 최근 활발하게 진행되어 Teflon 등을 이용한 성대내 이물주입술, 제Ⅰ형 갑상연골 성형술 및 피열연골 내전술등의 시술들이 시행되어 왔다. 저자들은 최근 후두와 종양으로 개두술을 시행받은 후 발생한 재발성 흡인성 폐렴 및 애성을 주소로 내원한 49세 남자환자를 원인 미상의 우측 편측성 성대마비로 진단하고 제Ⅰ형 갑상연골 성형술을 시행한 후 흡인성 폐렴 및 애성 등의 증상의 현저한 호전을 관찰할 수 있었으며, 술전 Maximal comfortable phonation time(MPT)이 6.24초에서 술후 17초로 증가하는 등 좋은 결과를 얻은 1례를 치험 하였기에 보고하는 바이다.

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The Results of Voice Assessment after Type IV Thyroplasty in a Transgender(Male to Female, MTF) - A Case Report - (갑상성형술 IV형을 시행 받은 성전환자의 수술 전후 음성검사 결과의 비교 - 증례보고 -)

  • 김한수;이성은;박태준;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.47-50
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    • 2003
  • The transgender is who has persistent discomfort with his of her sex or sense of inappropriateness in the gender role of that sex. Many transgenders have been undergone trans-sex operations after 1980's. But there were not so much experience of voice surgery for transgenders. Vocal pitch can be elevated by various surgical techniques. Type IV thryoplasty, which one of the cricothyroid approximation methods, increases tension to the vocal folds, thus increasing fundamental frequency and upper pitch range. We treated a transgender (MTF, Male to female) using this technique. Acoustic and aerodynamic measures were obtained both pre- and post-operatively. Clinically significant improvement was achieved in both study; increasing of vocal pitch, widening of pitch range, and improvement of vocal efficiency.

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Comparison of Voice Outcomes between Medialization Thyroplasty and Arytenoid Adduction with or without Injection Laryngoplasty in Unilateral Vocal Fold Paralysis Patients (일측성 성대마비 환자에서 내전형 갑상성형술, 피열연골 내전술, 피열연골내전술과 성대주입술 병행치료의 음성 결과 비교)

  • Jin, Hokyung;Won, Seong Jun;Choi, Nayeon;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.118-122
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    • 2017
  • Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

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Laryngeal Framework Surgery (후두골격수술)

  • Choi, Seung-Ho;Kwon, Minsu
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.2
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    • pp.96-101
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    • 2013
  • Laryngeal framework surgery (LFS) is a unique phonosurgical concept that enables us to influence the laryngeal biomechanics by changing the shape/position of the laryngeal cartilages. LFS procedures can be favorably combined with one another but also with other phonosurgical methods, and they are usually reversible and correctable. Type I thyroplasty and arytenoid adduction are still useful in spite of the recent popularity of injection laryngoplasty. Basic surgical principles have seldom been changed since Isshiki's development, but a number of modifications have been tried and are still going on. These delicate surgeries require exhaustive training, but the reward is great to both the surgeon and the patient.

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Type I Thyroplasty Using Prefabricated Hydroxylapatite Implant(VoCoM$^{\circledR}$) (미리 제작된 Hydroxylapatite 보형물을(VoCoM$^{\circledR}$) 이용한 제 1 형 갑상성형술)

  • 이현종;정한신;백정환;손영익
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.2
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    • pp.117-122
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    • 2003
  • Background and Objectives : $VoCoM^{\circledR}$ is a commercialized set composed of prefabricated hydroxylapatite implants and shims of various sizes which are specially designed for the type I thyroplasty. Even though a previously published preliminary report showed that $VoCoM^{\circledR}$ is a convenient and safe product for the type I thyroplasty, further investigations or experiences are yet to be reported. Authors aimed to evaluate the efficacy of $VoCoM^{\circledR}$type I thyroplasty, and its advantage and/or disadvantage. Materials and Method : Twenty three consecutive patients with unilateral vocal cord palsy enrolled for the study, who received type I thyroplasty with $VoCoM^{\circledR}$ between July 2001 and June 2003. Acoustic, aerodynamic and stoboscopic analyses were performed prior to surgery and 1 to 3 months after surgery. Speech language pathologists evaluated their voice quality by GRBAS scale, and patients themselves reported subjective changes of their voice by visual analog scale. Results : The average time for the operation was 80 min, which is about 30 min less than other methods. Preoperative jitter was 3.25$\pm$1.65% and improved to 1.94$\pm$1.79% postoperatively (p<0.05). Preoperative shimmer was 9.72$\pm$6.56% and improved to 5.61 $\pm$3.76% (p<0.05), Maximal phonation time increased from 4.41$\pm$2.99 to 7.98$\pm$4.35 sec (p<0.05) The postoperative stroboscopy revealed an effective medialization in 91.3% of the patients. The subjective phonetic improvements were reported in 21 out of 23 patients. GRBAS scale improved from 2.71$\pm$0.46 to 1.47$\pm$1.12(p<0.05). Additional medialization with $Gore-Tex^{\circledR}$ was easily performed in two revision cases. Previously inserted $VoCoM^{\circledR}$ implant was hard to remove because of the tight integration of soft tissues around the implant. Side effects such as extrusion or foreign body reaction are not observed. $VoCoM^{\circledR}$ was relatively expensive and costed more than 10 times of $Gore-Tex^{\circledR}$. Conclusion : Prefabricated hydroxylapatitie implant($VoCoM^{\circledR}$) provides a convenient, safe and efficient way of vocal fold medialization. However it is relatively expensive and hard to remove.

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New Thyroplasty Technique Using Balloon Catheter (풍선도관을 이용한 새로운 갑상성형술의 제안)

  • Yoo, Young-Sam;Choi, Chan;Kim, Heui-Ju
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.118-121
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    • 2007
  • Background and Objectives: Silicone, Gore- Tex, Gelfoam, Collagen and autologous fat are used for thyroplasty in case of vocal fold paralysis or paresis. These implants have many advantages, such as biocompatibility, low price and easy handling and accessibility. But additional voice modification is impossible using these materials. So, we design new thyroplasty technique, called balloon thyroplasty using Foley catheter. Materal and Methods: The fresh human larynx was dissected in midline posteriorly. Minithyrotomy hole was created using 5mm cutting burr in the midline of thyroid cartilage. Subperichondrial dissection was done using Duckbill elevator up to vocal process. Balloon catheter(1.5cm balloon size) was inserted through the subperichondrial tunnel. The balloon was inflated to medialize the vocal cord. Results: After ballooning, the true vocal cord medialized mimicking thyroplasty. Conclusion: The authors found that Balloon thyroplasty could be a good candidate for vocal fold medialization technique. The technical refinement and in vivo safety are reserved for the ongoing study.

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