• Title/Summary/Keyword: 후두외상

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Traumatic Brain Injury in a Pomeranian Dog: Clinical, Computed Tomography, and Necropsy Findings (포메라니언 종에서 발생한 외상성 뇌손상 증례보고; 임상적, 전산화 단층촬영, 부검 소견)

  • Lee, Hee-Chun;Choi, Eul-Soo;Cho, Kyu-Woan;Kang, Byeong-Teck;Kim, Ju-Won;Yu, Chi-Ho;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.579-583
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    • 2010
  • An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

Laryngeal Measurement on Neck CT (경부 전산화단층촬영상에서 후두계측)

  • 유영채;오재식
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.71-81
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    • 1996
  • The normal larynx locates to the front of the neck symmetrically and the thyroid notch lies in the center of the neck, but practically the larynx is not symmetric in all people. From a clinical point of views, there are vague cases to decide whether a disordered laryngeal structure is within normal variations or a pathologic condition. The purpose of this study is to investigate the anatomy of the laryngeal framework in normal population. Authors investigate various measures of normal laryngeal framework, such as symmetry and length of the larynx, levels of the hyoid bone and vocal cord and angle of thyroid cartilage by using calipers and protractor on 45 cases of neck CT. The results are summerized as follows. 1. The laryngeal framework was asymmetric to a greater or lesser extent in most cases with directional preponderance to the right side. The degree of asymmetry did not differ among different age groups and between seres. 2. The level of the hyoid bone ranged from C2-C3 vertebrae to C5-C6 intervertebral space with most frequent level of C5. 3. The level of the vocal cord ranged from 01 vertebra to C6-C7 intervertebral space with most frequent level of C5. 4. The angle of thyroid cartilage ranged from 58 degree to 100 degree with average of 81.5 and mean angle between both thyroid alae were 77.24 degree in male and 87.88 degree in female.

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Comparison of Endotracheal Intubation in Difficult Postures by Using the SALT(Supraglottic Airway Laryngopharyneal Tube)

  • Yun, Seong-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.12
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    • pp.227-233
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    • 2020
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

A Clinical Study on Bilateral Vocal Fold Paralysis (양측성대마비에 대한 임상적 고찰)

  • 김광문;최홍식;최흥식;조정일;김세헌
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.84-84
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    • 1996
  • 1986년 10월부터 1996년 8월까지 연세대학교 의과대학 영동세브란스병원 이비인후과에 내원한 환자로서 문진, 이학적검사 및 방사선학적검사에 의하여 양측성대마비로 진단된 47례를 대상으로 성별, 연령, 주증상, 성대마비의 원인 및 치료경과에 대하여 후향적으로 분석하였다. 성별은 남자가 34례(72%), 여자가 13례(28%)였고 연령별로는 20대에서 60대에 걸쳐 비교적 고르게 분포하였으며 평균연령은 46세였다. 주증상이 호흡곤란이었던 경우가 22례(47%)로 가장 많았고 애성이 19례(40%)로 그 다음 순이었다. 성대마비의 원인별로 보면, 중추성이 4례(9%)였고, 나머지는 말초성으로 이중 비수술적 외상에 의한 경우가 15례(32%)로 가장 많았고 수술적 외상이 10례(21%), 특발성이 9례(19%), 기도내 삽관이 5례(11%)였으며, 이외에도 염증성요인에 의한 것이 2례, 갑상선종양에 의한 것이 1례, 그리고 중증근무력증에 의한 것이 1례이었다. 양측성대마비에 대한 치료로서 기관절개술이 13례(28%), 피열연골절제술이 13례(28%)에서 행해졌으며 이중 술후 완전탈관이 가능하였던 경우는 기관절개술을 시행하였던 경우에 6례(46%), 피열연골절제술을 시행하였던 경우에 9례(69%)였고 수술후 완전탈관까지의 기간은 기관절개술의 경우 평균 18개월, 피열연골절제술의 경우 평균 3개월이었다. 이외 보존적 치료가 20례(43%)에서 행해졌으며 이중 2례는 자연치유되었다.

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Treatment of an Occipital Fracture by Esquillectomy (골편적출술을 적용한 후두골 골절 치료)

  • Park, Jin-Uk;Cho, Ki-Rae;Chang, Dong-Woo;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.450-452
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    • 2010
  • A 4-year-old male Yorkshire terrier was referred to us with signs of vomiting and unconsciousness due to a blunt head trauma. Gross examinations detected facial edema, subcutaneous hemorrhage and hypersalivation. A survey radiograph located an occipital fragment which was displaced caudally. A three-dimensional computed tomographic reconstruction demonstrated that the ventral portion of the fragment was attached incompletely. Because of the instability of the fragment, it was decided to perform an esquillectomy. After removing the fragment, the defect was reinforced with a muscular flap originating from the splenius muscle. The patient's condition gradually improved except for a slightly ataxic gait. At 20 months follow-up, there was no evidence of ataxia. The neurological status did not deteriorate before starting surgical intervention, although the patient sustained a skull fracture with severe intracranial hemorrhage. It is likely that the fragment being displaced outwardly played an important role in preventing an increase in intracranial pressure which could have led to neurological deterioration.

Clinical Study of Patient with Traumatic Temporal and Occipital Bone Fracture (외상성 후두골과 측두골 골절에 대한 고찰)

  • Park Min Cheol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.5
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    • pp.1533-1537
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    • 2004
  • This study shows that oriental medical treatment affected a patient with headache, dizziness, dim eyes, facial palsy and hard-of-hearing caused by traumatic temporal and occipital bone fracture. Traumatic facial palsy mainly occures by temporal bone fracture. Facial palsy caused by traumatic temporal bone fracture corresponds to gu-an-wa-sha (口眼?斜)of oriental medicine. Functional disorder of an auditory organ corresponds to yi-rong(耳聾) and hyun-hoon(眩暈) of oriental medicine. In general, everyone consider surgical operation first of all, in the case of having traumatic facial nerve paralysis. But, this case shows that oriental medical treatments(acupuncture and herbal medicine) have a good effect on a patient with traumatic temporal and occipital bone fracture.

상부기도 협착의 나선식 CT를 이용한 3차원 영상의 진단적 의의

  • 김승현;김현웅;노영수;임현준;윤대영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1997.04a
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    • pp.119-119
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    • 1997
  • 상부기도 협착의 원인은 장기간의 기관 삽관, 외상, 감염, 종양, 및 선천적인 결함등에 의해 존재하며, 이에 대한 진단은 단순 촬영이나 전산화 단층 촬영술 등으로 쉽게 진단은 가능하나, 적절한 치료 계획을 세우기 위해서는 그 범위 및 정도를 정확히 파악하는 일이 중요하다 최근 방사선 촬영기술의 발달로 현재의 2차원적 단면 영상에서 3차원적 영상으로 발전해왔으며 상부기도 협착 또한 3차원적 영상으로 진단하려는 노력이 시도되고 있다. 이에 저자들은 최근에 경험한 기관 협착증 7례에서 3D CT를 시행하여 협착 부위의 상태를 기존의 단순 촬영 영상 및 2D CT 영상과 비교하였고, 7례의 기관 협착증 중 4례에서 기관 단단 문합술 및 후두 기관 문합술을 시행한 바 수술시 확인된 협착 상태를 3D CT 영상과 비교하였다.

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Subglottic transection of larynx with right pneumothorax One case Report (외상후 발생한 성문하후두의 완전절단 치험 1례)

  • 김학제
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.812-816
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    • 1985
  • In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.

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Advanced airway management for the prehospital traumatic patient (병원 전 환경의 외상성 응급환자를 위한 전문기도관리)

  • Shim, Gyu-Sik;Kim, Eun-Mee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2360-2367
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    • 2013
  • The purpose of this study was to improve the paramedics skills to manage advanced airway by comparing speed and success rate between endotracheal intubation and laryngeal mask airway(LMA) insertion in a moving ambulance. Sixty subjects were randomly recruited and samely divided into control group and experimental group. And they were asked to join a practical experiment using dummy model. Data analysis was done by SPSS WIN 14.0 Version. As a result of this research, in terms of difference in speed according to patient's intubation posture, the speed of control group was indicated to be good in sniffing position(t=-4.038, p<.001). There was no difference in speed between two groups in neutral position. In the neutral posture given the endotracheal intubation, tooth fracture occurred in 16 people(53.3%). There was no difference in success rate between two groups. As for a change in self-confidence before and after experiment, the post self-confidence was indicated to have been enhanced in both groups. In conclusion, it is effective to use LMA in the traumatic patient who is unable to receive endotracheal intubation in sniffing position. It is very important for the paramedics to receive the continuous training of the airway management skills.

Pre-hospitalization Advanced Airway Management Using The KING LTS-DTM and the LMA ProSealTM (LTS와 LMA를 이용한 병원 전 전문 기도 관리 연구)

  • Choi, Uk-Jin;Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5893-5900
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    • 2012
  • It is very critical to promptly maintain airway of cardiac arrest cases or serious traumatic cases. The purpose of this study is to compare intubation rate, successful rate and pre-/post-education self-confidence between laryngeal tube (LTS) and proseal laryngeal mask (PLMA), so that it may contribute to improving the ability of 119 emergency team - a pivotal role in pre-hospitalization process - to carry out advanced airway management. In order to achieve the purpose, total 60 paramedics (Class I) who worked for incumbent 119 emergency team were asked to join a practical experiment and were also divided into two groups (LTS group: 30 people, PLMA group: 30 people). In details, they were all asked to take 3 sessions of practice (5 minutes per session) using dummy model to quantitatively measure the time and success/failure of intubation and the change of their self-confidence. As a result, it was found that there were statistically significant differences in the time of intubation between LTS and PLMA group (p=.000), but there was no significant difference in the rate of successful intubation between these two groups, and self-confidence of two groups tended to significantly increase after experiment (p=.000). Conclusively, if it is necessary to promptly apply intubation to traumatic cases with immobilized cervical vertebral and lingual edema, LTS can be useful as an effective means of intubation. And it is expected that continuing intubation training using LTS will improve the ability of emergency team to perform advanced airway management for traumatic cases.