• Title/Summary/Keyword: 후두 미세 수술

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Principles of Microflap Surgery in Laryngomicrosurgery (후뒤세수술에서 미세피판술의 원칙)

  • Kwon, Tack-Kyun;Son, Hee-Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.105-111
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    • 2010
  • The vibratory or phonating surface of the human vocal folds is a complex layered structure. Benign vocal fold lesions arise primarily within the lamina propria of the vocal folds and produce dysphonia by disrupting the normal layered architecture of the phonating surface. Therefore, treatment is aimed at excision of the lesion with restoration of the normal layered architecture. The core principle of the Microflap approach is that conservative removal of submucosal pathology with preservation of overlying normal epithelium and superficial lamina propria. Microflap approach is an essential component of most phnomicrosurgical procedures and is a challenging surgical task that requires patience, appropriate instrumentation, surgical skill, and experience. The authors reviewed surgical principles of Microflap technique, instrumentation and surgical tips that could be useful for the beginners who tried to try Microflap technique for the treatment of benign vocal fold mucosal lesions.

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Complications in Microsuspension Laryngoscopy (현수 후두미세수술과 관련된 합병증)

  • Son, Hee-Young;Woo, Seung-Hoon;Kim, Jin-Pyeong
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.23-29
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    • 2011
  • Laryngomicrosurgery is common procedure applying to benign laryngeal lesion. Suspension of the laryngoscope is a vital component of Laryngomicrosurgery. Suspension laryngoscopy allows for bimanual surgery and a stable operating platform. Little information is known about oropharyngeal & vocal fold complications of suspension laryngoscopy. Because laryngomicrosurgery is dependent upon suspension laryngoscopy, surgeons should fully understand the risks of suspension laryngoscopy to properly educate and care for patients undergoing suspension laryngoscopy. That is problem to allow otolaryngologist is embarrassing, for voice restoration surgery are not satisfied with the results. The authors reviewed mechanical and phonological complications after laryngomicrosurgery.

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General Principles in Phonomicrosugery (후두미세수술의 기본 원칙)

  • Jin, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.101-104
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    • 2010
  • The origin and growth of laryngology is inseparably linked to the development of endoscopic surgery of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. Phonomicrosurgery has developed from convergence of micro laryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

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Principles of Laser Laryngeal Microsurgery (레이저 후두미세수술의 원칙)

  • Moon, Jeong Hwan;Lee, Sang Joon;Chung, Phil-Sang
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.1
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    • pp.13-17
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    • 2013
  • Laser laryngeal microsurgery is currently the primary method of treatment of various laryngeal diseases. The development of laryngeal microsurgery came from the introduction of a small spot $CO_2$ laser micromanipulator and more precise microlaryngeal instruments. $CO_2$ laser laryngeal microsurgery has enabled very precise surgery because it has small focus size and hemostatic effect. There are some limitations to the use of the $CO_2$ Laser such as adjacent tissue damage and vocal fold scarring. These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under a surgeon's control. We should also recognize the safety of $CO_2$ laser for the surgeon to precisely perform the procedure.

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A New Surgical Technique of the Larygeal Web (후두격막의 새로운 치료법)

  • 안회영;여승근;박창식;이동엽;차창일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.77-77
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    • 1993
  • Laryngeal web is formed from various causes, and it is a scar tissue covered with epithelium on both sides. The purpose of the laryngeal web surgery is to cover the vocal cords with healthy epithelium and to achieve the normal or near normal function of respiration and phonation. Until now, a lot of surgical procedures were introduced, but have some merits and disadvantages. Recently authors tried this new surgical technique on 6 patients using the suspension laryngomicroscope under the intubation general anesthesia, which was to suture the upper and lower edges of the severed web. This new approach has several advantages; 1) familiar instruments and visual field 2) no unnecessary surgical trauma beyond the operation field 3) one stage operation 4) shorter operation time 5) no serious complications 6) short hospitalization, etc.

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Oropharyngeal Complications Associated with Laryngomicrosurgery(LMS) (후두 미세수술과 연관된 구강 및 후두 합병증)

  • 강진욱;최승효;남순열
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.5-9
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    • 2003
  • Introduction : Laryngomicrosurgery(LMS) is frequent procedure applying to benign and early malignant larygeal disease such as vocal cord polyp, nodule and early glottic cancer. LMS has been known as safe procedure and short time consuming treatment. So few reports about complications in LMS was done. In this study, complications and problems from LMS were investigated and reported. Method : From 2000, January to 2001, December, 180 patients who were treated with LMS in Asan medical center were studied by retrograde chart review. Results : In these patients, total 9 patients(5%) were suffered from complication. 4 patients (2%) had teeth injury and 4(2%) were suffered from foreign body sensation in tongue and 1(1%) had hypoglossal nerve injury. Main mechanism of complications is thought by pressure injury by laryngoscope blade. No definite correlation between procedure and complication was observed. Conclusion : There are few neural complications with LMS such as lingual and hypoglossal nerve injury. Before operation of LMS, warning and informing of complications by mechanical stress must be done. Gentle procedure and short operation time are necessary to avoid these problems. And patients who have risk factors of oral complications such as dental disease or dental prosthesis must have dental evaluation and treatment before LMS procedure.

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History and Instrumental Development of Laryngeal Micro-Surgery (후두미세수술의 역사와 기구의 발전)

  • Woo, Joo-Hyun;Kim, Dong-Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.97-100
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    • 2010
  • After introduction of operating microscopes and laser devices in the 1960's, monumental innovation for had been achieved in laryngeal microscopic surgery. The development of high-tech operating devices made the laryngeal surgery less invasive and more precise. There were long histories until developing of the modem instruments and surgical techniques. The simple oral mirror introduced by Bozzoni in 1807 is the beginning of laryngoscope. In 1859 Green carried out the laryngeal operation under direct view of larynx. The appearance of local topical anesthesia on throat had contributed to laryngeal surgery coming into wide use. Killian and Jackson made much contribution to developing the design of laryngoscope. After that, modem laryngeal surgery have been developed with development of the stabilizing holder of laryngoscope and optical devices. We propose carefully the direction of the development of the laryngeal surgery by historical consideration of laryngeal surgery and instrumental development.

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A Study of Voice Improvement According to the Onset Time of Voice Therapy after Laryngomicrosurgery (레이저를 이용하여 후두미세수술을 시행한 환자에서 음성치료를 시작한 시기에 따른 음성 호전 결과에 관한 연구)

  • 김한균;정필상;오양희;김영훈
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.12 no.1
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    • pp.22-27
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    • 2001
  • Backgrounds and Objectives : There have been reported many studies which evaluate the effectiveness of combined laryngomicrosurgery(LMS) and voice therapy for the patients with benign vocal cord lesions. But the difference of voice improvement by onset time of voice therapy has not been reported. The purpose of this study is to analyze the differences of voice improvement by voice analysis test between the two groups with different onset time of voice therapy. Materials and Methods : Two groups, each of which comprises 15 patients, were analyzed. For the one group, the voice therapy was initiated 1 day after LMS. For the other, the therapy was initiated 1 week after LMS. Voice analytic parameters of the two groups were statistically analized to identify difference in voice improvement. Results : All measured parameters improved after voice therapy in two groups and showed no significant difference between two groups. Conclusions : The onset time of voice therapy after LMS has no significant impact on post-operative voice quality in the patients with benign vocal cord lesions. Early onset of post-operative voice therapy may serve as treatment modality for patients with benign vocal cord lesions.

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