• Title/Summary/Keyword: 후두암

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Carbon Dioxide Laser Treatment of Laryngotracheal Stenosis ($CO_2$ Laser에 의한 기관 및 후두협착증의 치험)

  • 김기령;홍원표;김광문;정명현;서장수;최은창;진종부
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.7.2-8
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    • 1983
  • Chronic laryngotracheal stenosis is becoming increasingly prevalent. Many acceptable procedures such as repeated dilation, laryngotracheoplasty and end-to-end anastomosis had been done according to it's indication, but it have given less than favorable results. Since 1972 the experimental and clinical experiences of Jako and Strong, the carbon dioxide laser has offered a valuable tool to the otolaryngologist. Mihashi (1976) and Lyons (1980) reported use of laser to the management of laryngotracheal stenosis with successful results. From April 82' to March 83', using the carbon dioxide laser, the various obstructing lesions were excised microendoscopically which include four patients considered failures from conventional surgical technique and one patient laryngeal stenosis occured after hemilaryngectomy and neoglottis formation. We concluded as follows, 1) Laser surgery is a useful method to the management of laryngotracheal stenosis in maintaining adequate airway. 2) Formation of granulation after laser surgery was less than other conventional methods.

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Hyperkeratosis of the Larynx (후두각화증에 대한 임상적 고찰)

  • 김광문;김기령;홍원표;최은창;장미숙;정우희
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.4 no.1
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    • pp.33-41
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    • 1991
  • The clinical entity referred to as epithelial hyperplasia has been called by various terms : keratosis, hyperkeratosis, pachydermia, acanthosis, leukoplakia, hyperkeratotic laryngitis. The metaplasia and keratinization of the layngeal mucosa are associated with the subsequent appearance of invasive epidermoid carcinoma. Therefore. frequent and prolonged periods of observation and histologic study on keratosis of the larynx are essential. A retrospective review of 18 patients with laryngeal hyperkeratosis seen at Department of Otolaryngology Yondong Severance Hospital during the 7 years period was completed. The results are summarized as follows : 1) The incidence was much higher in males(22 patients) than in females(4 patients) 2) The peak age of male was 4th decades and the peak age of female was 4th. 5th decades. 3) The chief complaint of the patients was hoarseness in all cases. 4) The average duration of symptoms was less than 24 months for 19 cases(73.1%). 5) 17 patients(65.4%) was smokers and duration of smoking was 10~20 years for 10 cases(38.8%). 6) On histological examination. the lesions were classified into three types: simple hyperplasia(61.5%). dysplasia(26.9%) and carcinoma in situ(2 cases). 7) The recurrence rates was 9 cases(34.6%) and transformation rate into invasive carcinoma was 1 case(3.8%).

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A Clinical Study of Hoarseness (애성을 주소로 한 후두질환의 임상 통계적 고찰)

  • 윤완규;조규모;송기준;김홍수
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.6.4-7
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    • 1983
  • Hoarseness is the most common and early symptom in laryngeal diseases. A clinico - statistical analysis was performed on 228 cases with chief complaint of hoarseness at the department of otolaryngology, Jeonbug National University during the past 3 years from January 1980 to December 1980. 1) The number of the patient with hoarseness were 228 cases (2.3 %) among total outpatient of 10110 cases. 2) Among the 228 cases with hoarseness, male were 115 cases and female were 113 cases, so sex ratio was nearly same. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 43 cases (18.9 %), chronic laryngitis 36 cases (15.8 %), vocal nodule 30 cases(13.2 %), vocal polyp 30 cases (13.2 %), vocal cord paralysis 26 cases (11.4 %), laryngeal carcinoma 18 cases (7.9 %) and laryngeal tuberculosis 15 cases (6.6 %). There were other diseases of larynx in 30 cases (13.2 %). 4) The incidence of age distribution in order of frequency were 4th decade (26.8 % ), 3rd decade (18.9%), 5th decade (17.1 %), 2nd decade (15.8 %) and 6th decade (9.6 %). 5) The duration from onset to consultation in order of frequency were 11 days-1 month (22.8 %), 1 month-3 months(19.7%), 3 months -6 months (18.9 %), within 10 days (13.6 %), 6 months-l year (13.2 % ), 1 year -3 years(7. 9 %) and 3 years over. 6) The duration from onset to consultation for underlying diseases were as follows ; acute laryngitis was within 10 days, chronic laryngitis was 3 months - 6 months, vocal nodule was 1 month-3 months, vocal polyp was 3 months -1 year, vocal cord paralysis was 11 days -1 month. 7) Associated symptoms with hoarseness in order of frequency were sore throat (25 %), sputum (8.8 %), swallowing difficulty (7.9 %) and dyspnea (6.1 %). But 84 cases (36.8 %), there were no other symptoms except hoarseness.

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EXPERIMENTAL RECONSTRUCTION OF LARYNX WITH STERNOMASTOID MYOPERIOSTEAL FLAP (흉유돌근골막 피판을 이용한 후두 재건)

  • 조재식;안병현;김선태;이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.28-28
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    • 1991
  • 후두암의 수직절제 수술후의 후두 재건 목적은 기관절개를 통하지 않고 후두를 통한 호흡이 가능하도록 하면서 연하시 기도흡인을 피하기 위한 sphincter 능력의 보존, 그리고 발성이 가능하도록 성대진동 mechanism을 재건하는데 있다. 오늘날 수많은 후두학자들에 의해서 고안 개발된 다양한 재건 방법이 있다. 연자는 광범위한 후두절제에 따른 큰 결손을 메우기 위해 bulky하면서도 점막 상피의 재생이 용이한 재건 피판으로 흉유돌근골막 피판을 이용하여 후두 결손부를 재건하여 보았다. 방법은 성견 3마리를 대상으로하여 thiopental sodium 정맥주사로 전신마취를 시행한 후 설골에서부터 흉골상까지 경부 정중앙의 피부를 절개하고 후두를 노출시켜 후두 수직절제술을 시행하였다. 흉유돌근과 흉골에 부착된 골막을 박리하여 흥유돌근골막 피판을 제작한 후 골막이 후두강 안쪽으로 되도록하여 골막연과 후두점막을 봉합하였다. 그리고 3, 5, 9개월에 후두적출술을 시행하여 병리조직학적 및 수술후 경과를 관찰하였다. 3실험견 모두 기관절개술 없이 후두를 통한 호흡이 가능하였고 흡입성 폐렴이나 피하기종등의 합병증없이 창상이 치유되었으며 발성도 양호하였다. 이식된 골막위로 신생혈관의 출현과 함께 점막재생이 잘되 있었다. 단지 봉합사 주위에 소량의 육아종이 관찰되었다. 조직학적으로는 섬유조직위로 편평상피가 재생되었으며 성문하부에서는 일부 섬모가 있는 호흡기 점막도 관찰되고 골막하부에 신생골 형성은 관찰할 수 없었다. 골막 피판은 그 유연성 때문에 결손부위의 점막연에 맞춰도 tension이 없고 공기 누출이 되지 않게 봉합이 가능할 뿐 아니라 점막이 재생할 수 있는 frame-work의 역할을 하는 것으로 사료되었다. 이상과 같은 사실로 미루어 흉유돌근 자체가 견실하고 골막에 혈류공급이 잘되어 창상치유에 좋을 뿐 아니라 큰 후두결손부의 재건이 가능하리라고 사료되었다.로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실

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Channel Compensation for Cepstrum-Based Detection of Laryngeal Diseases (켑스트럼 기반의 후두암 감별을 위한 채널보상)

  • Kim Young Kuk;Kim Su Mi;Kim Hyung Soon;Wang Soo Geun;Jo Cheol Woo;Yang Byung Gon
    • Proceedings of the Acoustical Society of Korea Conference
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    • spring
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    • pp.49-52
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    • 2004
  • 본 논문에서는 켑스트럼 기반의 후두질환 음성의 자동감별시, 훈련 및 테스트 마이크 불일치로 인한 채널 왜곡을 보상하기 위한 방법에 대해 연구를 하였다. 특징벡터 영역에서의 채널보상 방법으로 기존의 Cepstral Mean Subtraction (CMS) 방법과 Pole Filtering CMS (FPCMS) 방법을 이용하였다 실험결과 FPCMS를 적용한 경우 기존의 CMS에 비해 우수한 성능을 보이고, $40\%$의 인식 오류 감소를 얻었다.

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Effect of Radiation Therapy on Voice Parameters in Early Glottic Cancer and Normal Larynx (방사선 요법이 초기 성대암 및 정상 후두의 음성 지표에 미치는 영향)

  • 김민식;박한종;선동일;박영학;조승호
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.7 no.1
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    • pp.32-38
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    • 1996
  • The preservation of the voice-producing mechanism is an important feature in the management of laryngeal cancer by radiotherapy. But, radiation therapy has certain side effects such as mucositis, tissue edema, necrosis and fibrosis which could effect on normal voice production. Several subjective studies that used questionnaires and auditory perceptual judgements of voice have been interpreted to mean that radiation results in a normal or near-normal voice. Objective evidence of the status of vocal function after radiation treatment, however, is still lacking. We analyzed the changes that occur in voice parameters in a group of patients undergoing radiation therapy, in order to determine the effect of radiation on voice quality. In this study acoustic, aerodynamic measures of vocal function were used to determine the characteristics of voice production. We found that voice parameters in early glottic cancer changed meaningfully comparing to normal larynx with or without radiation and radiation therapy has an little effect on normal larynx.

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하인두 및 경부식도의 재건술;인두위문합술, 전박유리피판술 및 유리공장이식술의 비교

  • 김영호;최은창;홍원표;김은서
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.92.2-92
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    • 1995
  • 후두암 및 하인두암의 광역절제후 결손된 하인두 및 경부식도의 재건방법에는 여러 근피판, 인두위 문합이나 유리공장이식술과 같은 소화장기의 이용 및 전박유리피판술 등이 있다. 저자들은 1985년부터 1994년까지 10년간 세브란스병원에서 후두 및 하인두암으로 수술적 치료를 받은 예중 인두위문합술로 재건한 7례, 유리공장이식술로 재건한 9례, 전박유리피판술로 재건한 7례의 치료성적을 후향적으로 고찰하여 하인두 및 경부식도의 재건에 사용할 수 있는 술식들의 치료결과 및 장단점을 알아보고자 하였다. 피판의 생존은 세가지 술식 모두에서 양호하였으며 구강을 통한 식이섭취가 전례에서 가능하였다. 발생한 합병증으로는 인두피부누공, 문합부위의 협착 등이 있었으며 보존적인 방법으로 치유가 가능하였다.

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Influence of Total Laryngectomy on Spinal Cord Dose in Advanced Laryngeal Cancers (진행된 후두암 환자에서 후두전절제술에 의한 척수선량 변화)

  • Kim, Jae-Cheol;Kim, Sung-Hwan;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.167-173
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    • 1996
  • Purpose : This analysis was to evaluate the radiation dose around a tracheostoma and spinal cord in the case of advanced laryngeal cancers in which a total laryngectomy was done before radiotherapy. Materials and Methods : The radiation dose around a tracheostoma and spinal cord was measured by thermoluminescence and film dosimetry in the phantom, Radiotherapy treatment planning was done in 12 cases of advanced laryngeal cancer and compared with the measured dose in the phantom. Results : Mean spinal cord doses in the phantom by thermoluminescence dosimetry were $86.4\%$ (with a tracheostoma), $80.1\%$ (without a tracheostoma), and the difference was $6.3\%$. Mean spinal cord doses in the phantom by film dosimetry were $84.7\%$ (with a tracheostoma), $79.0\%$ (without a tracheostoma). and the difference were $5.7\%$. Calculated spinal cord doses in the phantom were $84.0\%$ (with a tracheostoma), $78.0\%$ (without a tracheostoma), and the difference was $6.0\%$. Mean calculated spinal cord doses in 12 patients were $83.1\%$ (with a tracheostoma), $76.9\%$ (without a tracheostoma). and the difference was $6.2\%$. Measured dose of lateral and posterior wall of the tracheostoma by film was low (depth of maximum dose = 12 mm). Conclusion : In the treatment planning of the advanced laryngeal cancers, the radiation dose of the tracheostoma and spinal cord should be evaluated and be followed by an appropriate management such as a bouls or a brachytherapy boost if the dose around the tracheostoma is low.

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