• Title/Summary/Keyword: 후두경

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급성 후두기관손상 환자의 수술적 치료

  • Tae, Kyung;Jung, Yeon-Ki;Jung, Jin-Seok;Cho, Seok-Hyun; Lee, Seung-Hwan;Lee, Hyung-Seok
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.110-110
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    • 2003
  • 후두기관외상은 두경부 부위의 다른 외상에 비해 흔하지 않은데, 이는 연골의 유연성과 후두의 가동성, 후두가 하악과 흉골사이에 위치하여 외상시 보호 받게 되는 해부학적 특성에 기인한다. 그러나, 후두는 호흡과 발성에 중요한 기관으로 조기 진단과 정확한 평가, 적절한 치료를 못할 경우 생명을 위협 할 수 있고 삶의 질에 지대한 영향을 줄 수 있다. 이에 저자들은 급성 후두기관손상으로 수술적 치료를 받은 환자를 대상으로 손상 기전 및 임상 양상, 손상부위, 손상 정도 치료 등을 알아보고 향후 치료에 도움을 얻고자 하였다. 1996년부터 2003년까지 급성 후두기관 손상으로 수술적 치료를 받은 10명을 대상으로 후향적으로 조사를 하였다. 손상정도는 Schaefer의 분류를 따랐으며 술후 결과는 발성과 기도유지로 평가하였다. 발성의 경우 수상전과 동일하거나 유사할 경우 성공(good)으로, 수상전과는 다르지만 기능을 하는 경우는 양호(fair)로, 거의 음성이 나지 않거나 알아들을 수 없는 경우 불량(poor)로 분류하였고, 기도유지는 수상전과 동일하거나 유사할 경우 성공(good)으로, 경한 흡인이나 운동 유발성 호흡곤란이 있는 경우(fair)로 발관이 되지 않는 경우를 불량(poor)으로 분류하였다. 남녀 성비는 8대 2였고 30~40대가 4명으로 가장 많았다. 손상의 원인은 둔상인 경우(4예) 교통사고가 2례, cloth line 손상 2례, 관통상(6례)는 모두 칼에 의한 좌상이었다 증상은 피하기종이 9례, 애성이 7례, 호흡 곤란이 6례로 많았으며 손상부위는 갑상연골 골절이 5례(50%), 기도손상과 갑상선 손상이 각각 4례에서 관찰되었다. 그 외에도 윤상 연골 골절과 윤상갑상막 손상 등이 관찰되었다. 또한 점막 손상이 7례에서 관찰되었다. 성대마비는 내원시 4례에서 관찰되었다 치료는 수상 후 조기수술을 시행하였고 수상 부위를 개방하여 손상된 연조직을 일차 봉합하거나, 골절을 정복 고정하였고 3례에서 스텐트를 삽입하였다. 술후 기도유지는 모두 성공적이었고 발성기능은 6례에서 성공(good)적이었고 4례에서 양호(fair)의 결과를 보였다. 양호의 결과를 보인 모든 예가 내원시 성대 움직임의 마비나 저하를 보인 예였다. 급성 후두기관손상환자에서 조기 진단과 적절한 수술적 치료는 환자의 생명을 유지시키고 술후 발성 지능의 보존에 양호한 결과를 보였다.

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A Case of Epiglottic Epidermoid Cyst (후두개 유표피낭종 1례)

  • 이종원;김성남;김성곤;권영춘;양한모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.7.3-8
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    • 1977
  • In the ENT fields, epidermoid cysts occur infrequently in the oral region and often situated on the floor of the mouth or the submental region. Moreover, epidermoid cyst on the laryngeal surface of the epiglottis occurs rarely. Authors experienced a case of epiglottic epidermoid cyst and treated successfully by transhyoid pharyngotomy approach and marsupialization. It was 46 years old male patient who has been suffered from intermittent sorethroat for 2 years prior to admission, hoarseness for 2 months and dyspnea for 1 month. Indirect laryngoscopy revealed a pigeon egg-sized, round, smooth tumor mass on the laryngeal surface of the epiglottis which had soft consistency on digital examination. Biopsy proved epidermoid cyst. Marsupialization of the cyst by transhyoid pharyngotomy approach was performed and the postoperative course was uneventful.

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Effects of Chronic Electrical Stimulation on Functional Recovery Following Laryngeal Reinnervation in the Rat (흰쥐에서 반회후두신경 손상 후 만성적 전기자극이 후두 기능 회복에 미치는 영향)

  • 김지연;조선희;한후재;박수경;신유리;정성민
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.2
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    • pp.172-177
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    • 2000
  • Background and Objectives : Until now, various attempts have been made fir reinnervating paralyzed vocal cord. Nevertheless, the most cases did not produce satisfactory outcome due to occurrence of synkinesis of larynx secondary to misdirected axonal regeneration. Accordingly, the purpose of this investigation is to learn the effect of chronic electrical stimulation on regeneration of the recurrent laryngeal nerve. Material and Methods : Using 20 healthy male Sprague-Dawley rats(250-300g) with normal vocal functions, transections were made on their left recurrent laryngeal nerves and then primary anastomosis were performed under the operating microscope and they were divided into an experimental group and a control group each having 10 rats. After the procedure, for the experimental group, chronic electrical stimulation was carried out until vocal cord movement was functionally recovered. for the control group, only chronic electrical stimulation was not given. Result : In experimental group, the number of functionally recovered rats was two and in control group, that of functionally recovered rate was same. The reorganization of posterior cricoarytenoid muscle motoneuron in nucleus ambiguus appeared in the case of directed reinnervation of recurrent laryngeal nerve. Conclusion : The chronic electrical stimulation does not a direct beneficial effect on the early functional recovery in rats with injured recurrent laryngeal nerve.

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Neurofibroma of the Larynx (후두의 신경섬유종)

  • 김종선;윤태현;노관택
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.9.5-9
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    • 1979
  • Somewhat less than 100 cases of neurogenic tumors of the larynx are reported in the literature. This is slowly growing tumor and is mostly schwannomas and neurofibromas, and could affect any age group. Since the first description of Von Recklinghausen's disease in 1882, about 20 cases of laryngeal involvement have been reported in the world literature. In this paper two cases of laryngeal neurofibroma will be presented: one congenital laryngeal neurofibroma in a 2-month-old boy, and one large laryngeal neurofibroma in Von Recklinghausen's disease in a 28 year old woman. The importance of conservative surgical procedure is discussed with. case presentation and literature review.

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A Case of Selective Laryngeal Adductor Denervation-Reinnervation Surgery for Adductor Spasmodic Dysphonia (선택적 갑상피열분지 및 측윤상피열분지의 절단과 경신경고리 신경재지배 방법을 이용한 연축성발성장애의 수술적 치료 1례)

  • Park, Young-Hak;Bae, Seong-Cheon;Lee, Seok-Eun;Cho, Seune-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.146-148
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    • 2006
  • Spasmodic dysphonia is a voice disorder characterized by involuntary voice breaks during speech. Adductor spasmodic dysphonia is most common and characterized by strained and strangled voice breaks. The current standard of treatment of therapy for adductor spasmodic dysphonia is chemodenervation of thyroarytenoid muscle with botulinum toxin(Botox). However, Botox is a temporary treatment with each injection lasting approximately 3 months on average and require repeated injections. In this study, we report our experience with surgical treatment for adductor spasmodic dysphonia. In this procedure, the thyroarytenoid branch and lateral cricoarytenoid branch of recurrent laryngeal nerve is selectively denervated unilaterally, and its distal nerve stump of thyroarytenoid branch is reinnervated with branch of the usa cervicalis nerve. And lateral cricoarytenoid muscle partial myotomy was done unilaterally. After 6 months of treatment, voice fluency had improved and no period of breathiness or dysphagia was noted.

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A Case of the Laryngeal Papilloma Observed for the Past 13 Years (13년간 경과를 관찰한 후두유두종의 1예)

  • 이양선;박윤이;이인환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.5.2-5
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    • 1983
  • It is well known that laryngeal papilloma is histopathological benign, but clinically one of the most troublesome disease in otolaryngologic department, usually seen in child age. Since Cleesmann reported papilloma of the vocal cord, 1817 first, the etiology had not been known exactly. The symptoms in children are dyspnea, dysphonia due to recurrence, and papilloma in adult can change into neoplasm. The papilloma is thought as real neoplastic lesion and there is not effective treatment, using now repeated removal and combined therapy. This report is based on the typical findings and progress of one case of laryngeal papilloma observed for the past 13 years with repeated removal and topical application of 5-FU at our department. Authors have experienced this subject is interesting that the change of the tumor region during the course than to any new therapeutic methods employed, and so report with some reviews of the literatures.

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The Effect of Laryngeal View Grade and Intraoral Bleeding on Intubation Difficulty during Fiberoptic Nasotracheal Intubation (굴곡성 내시경을 이용한 경비기관내삽관 시 후두경으로 관찰한 후두시야(Laryngeal View) 등급과 구강내 출혈이 삽관의 난이도에 미치는 영향)

  • Kim, Han-Wook;Seo, Kwang-Suk;Shin, Teo-Jeon;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.9 no.2
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    • pp.91-97
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    • 2009
  • Background: Nasotracheal intubation for general anesthesia is preferred for oral and maxillofacial procedures because it provides improved access to the operative site. Fiberopic nasotracheal intubation is a useful technique when airway management seems difficult. But, intaoral bleeding is considered as the important factor that makes fiberopic nasotracheal intubation difficult. The purpose of our study was to elucidate the effect of laryngeal view and bleeding on intubation difficulty during fiberopic intubation. Methods: We studied 461 patients undergoing nasotracheal intubation with permission. Laryngeal view grades were examined with laryngoscope and were recorded. Then, intubation time and the amounts of bleeding were measured during fibroptic nasotracheal intubation under general anesthesia. Results: There was no significant difference between laryngeal view grade and intubation difficulty (P > 0.05). But severity of bleeding increased intubation difficulty (P < 0.05). Conclusions: In this study, the significant amounts of bleeding had an effect on intubation difficulty.

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A case of prolapse of the laryngeal ventricle (후두실 탈출증 1례)

  • 권우영;손학선;백문찬;김종애;조진규
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.7.1-7
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    • 1977
  • According to Bryce and Cranston, prolapse of the laryngeal ventricle is a protrusion of the ventricular mucosa into the laryngeal cavity from inflammatory hyperplasia or edema. This 53 year old female patient was admitted to our hospital March 11, 1977 with the chief complaints of dyspnea and hoarseness. On admission, evaluation of the larynx revealed smooth surfaced round pink-reddish mass protruding bilaterally beneath the false cord. The airway was almost completely obstructed by the tumor mass, but neither ulceration nor infiltration was seen, also no lymphnode was palpable in the neck. Tracheotomy was performed for the relief of dyspnea and biopsy was done endoscopically. Histologic study showed chronic inflammation. On April 2, 1977 laryngofissure was performed under general anesthesia. Laryngeal examination revealed smooth surfaced, plate like, pinkreddish mass protruding bilaterally from both laryngeal ventricles into the laryngeal cavity and extending the whole length of the ventricle antero-posteriorly and touching each other. Biopsy was taken of the mass and the result was non-specific inflammatory hyperplasia of the larynx. Postoperatively, the air way is completely clear of obstruction but mild hoarseness still remains. No recurrent mass is visible in the larynx. In view of the symptoms, operative findings and histological findings, this case is diagnosed as "Prolapse of the laryngeal ventricle". The prolapse of the laryngeal ventricle is a very rare lesion and is reported with review of the literature.

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CROSS-LINKED COLLAGEN IMPLANT INJECTION AND REHABILITATION OF GLOTTIC INCOMPETENCE (Cross-linked collagen 주입에 의한 성문폐쇄부전의 개선)

  • 이정구
    • Proceedings of the KSLP Conference
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    • 1993.12a
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    • pp.18-18
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    • 1993
  • 성문폐쇄부전의 개선을 위해 후두내에 주입하여온 여러 재료 중 현재에는 teflon만이 가장 흔히 사용되어지고 있다. 그러나 teflon은 점막하와 가동성 성대 내에 주입할 수 없어 경도 성문 폐쇄부전의 미세 조정과 성대의 작은 결손에는 부적합하다. 성문폐쇄부전을 개선하기 위하여 9명의 환자에서 17회 cross-linked collagen을 주입한 결과 이 방법은 환자의 음성을 개선하고 성문폐쇄부전을 교정하는데 성공적이었다. (중략)

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