• 제목/요약/키워드: Injection laryngoplasty

검색결과 44건 처리시간 0.023초

일측성 성대 마비의 치료에서 후두 신경재식법과 내측 후두 성형술의 선택 (The Choice of Laryngeal Reinnervation Versus Medicalization Laryngoplasty in Unilateral Vocal Fold Paralysis)

  • 김희진
    • 대한후두음성언어의학회지
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    • 제31권1호
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    • pp.1-6
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    • 2020
  • In unilateral vocal fold paralysis (UVFP) patients, we try to improve their symptoms such as hoarseness or aspiration by restoring nerve functions or medialization laryngoplasty (ML), etc. Until now, ML (thyroplasty and/or arytenoid adduction) is considered as gold standard of treatment for UVFP. However, if recurrent laryngeal nerve (RLN) is damaged and use of RLN is feasible during operation, laryngeal reinnervation (LR) would be a good option. Anastomosis with ansa cervicalis to RLN is most common reinnervation method. Delayed LR may be considered in young patients when the RLN denervation period is not long (less than 2 years) for the treatment of surgery-related UVFP. Injection laryngoplasty and laryngeal framework surgery showed great voice outcomes in UVFP. Combination therapy (neuromuscular pedicle innervation with ML) also showed good post-operative voice outcomes even in longer periods (over 2 years). In pediatric patients, LR would be considered as a good treatment option because all procedures need to general anesthesia.

최장발성폐기능저하를 동반한 일측성 성대마비 환자에서의 S/Z Ratio와 최장 발성시간(Maximum Phonation Time)의 유용성 비교 (Usefulness of S/Z Ratio and Maximum Phonation Time in Unilateral Vocal Fold Paralysis with Decreased Pulmonary Function)

  • 박준표;정고은;강병철;김성태;남순열;김상윤;노종렬;최승호
    • 대한후두음성언어의학회지
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    • 제23권2호
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    • pp.129-132
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    • 2012
  • Background and Objectives : MPT is directly related to degree of glottal closure. So it is widely used in the assessment of glottal closure with unilateral vocal fold paralysis. But MPT could be influenced not only by glottal closure but also by pulmonary function. So MPT might not reflect glottal closure in UVFP with decreased pulmonary function. The purpose of the study is to evaluate usefulness of MPT and ratio of /s/ time to /z/ time before and after injection laryngoplasty in UVCP with decreased pulmonary function. Materials and Methods : This study involved 34 patients with unilateral vocal fold paralysis : with decreased pulmonary function in group A (n=15) : with normal pulmonary function in group B (n=19). All patients underwent injection laryngoplasty. Paramters of perceptual analysis, acoustic analysis, aerodynamic analysis, videostroboscopy were compared between two groups. Results : Breathness and asthenic scale, G scale of perceptual analysis were significantly improved in both groups. Glottal gap index were significantly decreased after injection in both groups. In aerodynamic analysis, MPT was improved after injection laryngoplasty in both groups, but S/Z ratio was improved only in group B. In correlation analysis, /s/ time was not correlated with pulmonary function. Conclusion : S/Z ratio reflects neither the pulmonary function nor the glottal clousure properly. MPT is more useful indicator than S/Z ratio to evaluate vocal fold paralysis even with decreased pulmonary function.

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Effects of Injection Laryngoplasty with Hyaluronic Acid in Patients with Vocal Fold Paralysis

  • Kim, Geun-Hyo;Lee, Jae-Seok;Lee, Chang-Yoon;Lee, Yeon-Woo;Bae, In-Ho;Park, Hee-June;Lee, Byung-Joo;Kwon, Soon-Bok
    • Osong Public Health and Research Perspectives
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    • 제9권6호
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    • pp.354-361
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    • 2018
  • Objectives: The purpose of this study was to explore the effects of injection laryngoplasty (IL) with hyaluronic acid in patients with vocal fold paralysis (VFP). Methods: A total of 50 patients with VFP participated in this study. Pre- and post-IL assessments were performed, which included analyzing the sustained vowel /a/ phonation, and the patient reading 1 Korean sentence from the "Walk" passage that comprised 25 syllables in 10 words. To investigate the effect of IL on vocal fold function, acoustic analysis (acoustic voice quality index, cepstral peak prominence, maximum phonation time, speaking fundamental frequency) was conducted and auditory-perceptual (grade and overall severity), visual judgment (gap), and self-questionnaire (voice handicap index-10) assessments were performed. Results: The patients with VFP showed statistically significant differences between pre-and post-IL assessments for acoustic and auditory-perception, visual judgment, and self-questionnaire assessments. Conclusion: The patients with VFP showed positive change in vocal fold function between pre- and post-IL measurements. The findings showed that IL with hyaluronic acid is an effective method to improve vocal fold function in patients with VFP.

후두골격수술 (Laryngeal Framework Surgery)

  • 최승호;권민수
    • 대한후두음성언어의학회지
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    • 제24권2호
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    • pp.96-101
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    • 2013
  • Laryngeal framework surgery (LFS) is a unique phonosurgical concept that enables us to influence the laryngeal biomechanics by changing the shape/position of the laryngeal cartilages. LFS procedures can be favorably combined with one another but also with other phonosurgical methods, and they are usually reversible and correctable. Type I thyroplasty and arytenoid adduction are still useful in spite of the recent popularity of injection laryngoplasty. Basic surgical principles have seldom been changed since Isshiki's development, but a number of modifications have been tried and are still going on. These delicate surgeries require exhaustive training, but the reward is great to both the surgeon and the patient.

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성대구증의 형태에 따른 음향학적 분석 및 치료 결과 (Voice Analysis and Treatment Result According to Configuration of Sulcus Vocalis)

  • 양호철;정병서;김동영;우주현
    • 대한후두음성언어의학회지
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    • 제23권2호
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    • pp.119-123
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    • 2012
  • Background and Objectives : Sulcus vocalis could be classified into type I, type IIa, and type IIb. There have been a little reports about voice quality and treatment results related with types of sulcus vocalis. The authors conducted an analysis of voice and treatment according to different types of sulcus vocalis. Materials and Methods : This study was based on a retrospective chart review. The sulcus types were classified into type I and type II. Objective and subjective voice assessments were analyzed. Patients were treated individually with voice therapy, percutaneous steroid injection, and injection laryngoplasty. Comparison was performed on the voice difference between type I group and type II group, and between pre-treatment and post-treatment of each types. Results : One hundred and one patients were enrolled into this study, and 49 patients were type I and 52 patients were type II. Type I group showed longer mean maximal phonation time (MPT) than type II group, although other voice parameters didn't show any difference between two groups. Even after the management, almost all of the voice parameters didn't show improvement except MPT of type II group. Conclusion:Although the type I sulcus has been known as a non-pathologic lesion, it can result in some degree of voice change and discomfort, and thus need an active management. In this study, voice therapy, percutaneous steroid injection, and injection laryngoplasty showed limited effect to the both types of sulcus vocalis. Further studies for management of sulcus vocalis were needed.

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일측 성대마비 환자에서 Calcium-Hydroxyapatite를 이용한 성대 주입술의 유용성 (Usefullness of Injection Laryngoplasty with Calcium Hydroxyapatite in Unilateral Vocal Cord Paralysis)

  • 이재훈;김성원;오정호;김승태;이강대
    • 대한후두음성언어의학회지
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    • 제22권2호
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    • pp.119-125
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    • 2011
  • Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

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