• 대한후두음성언어의학회지
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• 제14권1호
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• pp.51-53
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• 2003

Amyotrophic lateral sclerosis Is an unusual pattern of distal muscular atrophy with permanent bulbar sign. Vocal fold paralysis and velopharyngeal insufficiency(VPI) due to soft palate paralysis Is occasionally associated with distal muscular atrophy. Recently we experienced a case of amyotrophic lateral sclerosis whose symptom was initially expressed with hoarseness and VPI. So we report a case with review of literature.

• Tuberculosis and Respiratory Diseases
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• 제59권2호
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• pp.209-212
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• 2005

유육종증은 침범된 기관에 T림프구와 단핵구가 축적되고, 비건락성 상피양세포 육아종이 생기면서 정상 조직의 구조가 파괴되는 원인 불명의 비교적 흔한 만성 질환이다. 저자들은 쉰목소리를 보여 기관지 내시경을 하였으나, 마비된 왼쪽 성대 자체에는 특별한 문제가 없었으며, 컴퓨터 단층촬영과 Gallium-67 스캔에서 비대해진 종격동으로 회귀 후두신경 압박에 의한 임상 양상으로 추측하였고, ACE증가와 피부 병변의 비건락성 육아종을 보였으며 또한 결핵, 진균 등의 침범은 배제할 수 있어 유육종증을 진단하였다. 해외에서는 쉰목소리의 원인으로 유육종증이 진단 된 경우가 종종 보고되고 있으나, 한국에서 드문 것으로 보여 문헌 고찰과 함께 보고하는 바이다.

• 대한두경부종양학회지
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• 제11권1호
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• pp.9-17
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• 1995

This study was retrospectively reviewed and analysis of postoperative local complication on all patient undergoing thyroid operation of 242 cases of thyroid disease, at Department of General Surgery, Chosun University Hospital from January 1988 to December 1992. The result were follow: Postoperative local complication are as follow; 52 cases of transient hypocalcemia, 7 cases of thansient hoarseness, 3 cases of permanent hypocalcemia, 2 cases of permanent hoarseness, and other local complication were postoperative bleeding with airway obstraction, hematoma, infection. In pathologic classification according to complicative patients; The most common frequency of complication in benign disease was Graves' disease with 13 cases(54.2%), and the most frequency of complication in malignance disease was follicalar adenocarcinoma with 7 cases(53.9%). The frequency of complication according to operation procedure were unilateral lobectomy in 31 cases(19.9%), subtotal thyroidectomy in 15 cases(39.5%), near total thyroidectomy in 12 cases (44.4%), and total thyroidectomy in 10 cases(55.6%). There was a significant relationship between extent of operative procedure and frequency of complication. The incidence of local complication after thyroid resection was 57 of 196(29.1%) in the benign disease that was 15 of 26(57.7 %) in the intrathyroidal carcinoma and 13 of 20(65.0%) in the extrathyroidal carcinoma. There was significant different in frequency of local complication according to invasion and malignance of pathologic lesion. The most frequent complication after thyroid resection is transient hypocalcemia ; 39 of 196(19.9%) in the benign disease, 7 of 26(26.9%) in the intrathyroida1 carcinoma, and 6 of 10(30.0%) in the extrathyroidal carcinoma. Their complication rate increased in direct relationship to the invasion and malignance of pathologic lesion, but there was no statistically significant. Transient hypocalcemia was encountered in 52 cases of the total 242 patient(21.9%) ; 29 of 156(18.6%) after unilateral lobectomy, 9 of 38(23.7%) after subtotal thyroidectomy, and 5 of 18(27.8 %) after total thyroidectomy. The relation ship between temporal hypocalcemia and the extent of surgery was not statistically significant.

• 대한후두음성언어의학회지
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• 제17권1호
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• pp.49-52
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• 2006

Background and Objectives: Vocal cord granuloma is a exophytic inflammatory mass and caused by gastroesophageal reflux, voice abuse, endotracheal intubation. There has been a controversy in the treatment of vocal cord granuloma. Our aim of study is to know the clinical characteristics and the results of surgical management for vocal cord granuloma. Materials and Methods: We have reviewed and analyzed medical records of 55 patients who were diagnosed and surgically treated as vocal cord granuloma in Asan medical center from 1997 to 2005 retrospectively. Results: 25 cases were intubation granuloma and 30 cases were contact granuloma. In intubation granuloma, the clinical manifestation was hoarseness(70%), foreign body sensation(44%), chronic cough(21%). In contact granuloma, the clinical manifestation was hoarseness(67%), foreign body sensation(60%), throat clearing(21%). The recurrence rate after surgery was 8% in intubation granuloma and 33% in contact granuloma. Mean recurrence time was 4.1months in intubation granuloma and 3.2months in contact granuloma. Conclusion: Although there is no significant difference, recurrence rate after surgery was high in contact granuloma compared to intubation granuloma(p=0.125). Although this study is retrospective, surgical management must be considered in resolving diagnostic doubt, treating airway obstruction, and failure in conservative treatments.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

• 대한기관식도과학회지
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• 제9권1호
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• pp.67-74
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• 2003

Larygopharyngeal reflux(LPR) is one form of the Gastroesophageal Reflux Diseases(GERD). It is known to cause various kinds of otolaryngologic symptoms such as hoarseness, globus sensation in throat, chronic throat clearing, and chronic cough, Disease entities diagnosed by otolaryngologists as posterior laryngitis, globus pharyngeus and reflux laryngitis should be suspected as LPR-related diseases. The nizatidine(AXID), as a Histamine H2-receptor antagonist, reduces gastric acid secretion and improves gastric motility function. Objectives : The effect of nizatidine using 150mg b.i.d was evaluated for symptom relief and improvement of laryngoscopic findings in patients with LPR. Materials and Methods : In 30 multicenter, observational trial performed nationalwidely in Korea. 308 patients with LPR symptom were observed to evaluate their symptoms and larygnoscopic findings after 4weeks, 8weeks, 12weeks of treatment with nizatidine. Results : The symptoms of LPR including globus sensation, chronic throat clearing and hoarseness, are reduced significantly after 4 weeks, 8weeks, and 12weeks of treatment(p<0.05). The laryngoscopic findings including diffuse erythema, edema and granulation are improved after nizatidine treatment(p<0.05). and the efficacy of nizatidine on LPR-related sympoms after 4 weeks is 88.6%, and those of after 8 weeks and 12weeks were 92.6%, and 99.1% in ITT(Intent To Treatment) group(p<0.05). And PPA(Per Protocol Analysis)group showed 93.7%, 97.3%, and 99.1% of efficacy after 4, 8, and 12 weeks of nizatidine treatment(p<0.05). Conclusion : These results indicate that in patient with LPR, nizatidine 150mg b.i.d treatment very effectively reduces LPR symptoms and improves laryngoscopic findings as well as reduces gastric acid secretion and improves gastric motility function.

• Tuberculosis and Respiratory Diseases
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• 제65권6호
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• pp.532-536
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• 2008

저자들은 가래를 동반한 기침과 쉰 목소리로 내원한 68세 남자에게 흉부 전산화 단층촬영으로 우중엽 무기폐를 확인하고 기관지경 및 생검을 시행하여 후두와 기관기관지에 국한된 유전분증 1예를 경험하였기에 문헌고찰과 함께 보고한다.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.305-310
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• 2007

수술 후 인후 합병증은 통증이나 구토에 비하면 사소한 합병증이지만 흔히 환자들이 불편을 호소한다. 양 측 내시경적 부비동 수술 후에 양 코를 막아 입으로 숨 쉬게 되어 구강 건조가 더 심할 것으로 보고 환자들을 glycopyrrolate를 전투약 하고 반전시에 쓴 경우, 전투약 하지 않고 반전에만 쓴 경우, 전투약에만 쓰고 반전은 atropine을 쓴 경우, 전투약 하지 않고 반전은 atropine으로 한 경우의 네 군으로 나누었다. 마취 종료 1시간, 6시간, 12시간, 24시간, 48시간 후의 인후통과 쉰 소리 여부를 묻고, 없는 경우 0, 있는 경우에는 감기 시 목 아픈 것 보다 약하면 1, 비슷하면 2, 더 심하면 3으로 하여 심각도를 나누어 물었다. 각 군 간의 인후통 발생률은 1군에서 조금 높았으나 유의한 차이가 없었다. 심각도는 모두 1이하로 낮았다. 쉰 소리는 모든 환자에서 발생하지 않았다. 양측 내시경적 부비동 수술 후 인후 합병증은 심각도가 낮고 24시간 내에 사라지는 것으로 항콜린성 제제 사용을 피해야 할 필요성은 없을 것으로 보인다.

• The Korean Journal of Pain
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• 제19권2호
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• pp.202-206
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• 2006

Background: Stellate ganglion block (SGB) might be associated with changes in the blood pressure (BP) and heart rate (HR). The heart rate variability (HRV) shows the balance state between sympathetic and parasympathetic activities of the heart. The changes in these parameters of the HRV were studied to evaluate the possible mechanism of SGB in changing the BP. Methods: SGB was performed on 26 patients, using a paratracheal technique at the C6 level, and 8 ml of 1% mepivacaine injected. The success was confirmed by check the Horner's syndrome. The BP, HR and HRV were measured before and 5, 15, 30, 45 and 60 minutes after the SGB. Results: The increases in the BP from the baseline throughout the study period were statistically, but not clinically significant. The HR and LF/HF (low frequency/high frequency) ratio were increased at 5 and 45 min, respectively, after the administration of the SGB. In a comparison of left and right SGB, no significant differences were found in the BP, HR and HRV. A correlation analysis showed that an increased BP was significantly related with the changes in the LF/HF ratio and LF at 15 and 30 minutes, respectively, after the SGB. Dividing the patients into two groups; an increased BP greater and less than 20% of that at the baseline INC and NOT groups, respectively, hoarseness occurred more often in the INC group (P = 0.02). Conclusions: It was concluded that SGB itself does not clinically increase the BP and HR in normal hemodynamic patients. However, the loss of balance between the sympathetic and parasympathetic nerve system, attenuation of the baroreceptor reflex and hoarseness are minor causes of the increase in the BP following SGB; therefore, further studies will be required.

• 대한한방내과학회지
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• 제28권3호
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• pp.624-631
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• 2007

Hypothyroidism is a common disease of the endocrinal system, characterized by fatigue, cold intolerance, bradycardia, and so on. Subclinical hypothyroidism is a common biochemical abnormality which can be found in routine screening tests of thyroid function. It is defined as an asymptomatic state which characterized by normal free thyroxine(FT4) and elevated thyroid stimulating hormone(TSH) levels. The purpose of this study was to evaluate the effect of treatment with palmijihwang-tang and to observe the changes in triiodothyronine(T3), free thyroxine(FT4), thyroid stimulating hormone(TSH) level and VAS of cold intolerance, hoarseness, dry skin. After the treatment, triiodothyronine(T3) increased from 57.12ng/dl to 120.53ng/dl. Free thyroxine(FT4) increased from 12.59pg/ml to 14.21pg/ml. Thyroid stimulating hormone(TSH) decreased from 10.61mU/L to 1.57mU/L. Cold intolerance, hoarseness and dry skin changed for the better. These results support a role for oriental medical therapy in treating subclinical hypothyroidism. Further case studies of herbal treatment of this ailment are needed.