• Imaging Science in Dentistry
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• 제48권2호
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• pp.121-125
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• 2018

Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

• 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.

• 대한기관식도과학회지
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• 제10권2호
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• pp.52-54
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• 2004

Esophageal foreign bodies are common problems in the part of otolaryngology department, and may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheoesophageal fisula, pneumothorax and pyothorax. Therefore, early diagnosis and intervention is needed to reduce morbidity and motality. But, calcification of the laryngeal cartilages may masquerade as foreign body in some patients with a history of foreign body ingestion. Recently, We experienced a case of calcification of thyroid cartilage which was misunderstood as an esophageal foreign body and report this case with a review of literatures.

• 대한후두음성언어의학회지
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• 제10권2호
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• pp.102-118
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• 1999

In this study, the author developed a new animal model to examine morphological changes and functional recoveries after vertical hemilaryngeal transplantation in the canine. Seven vertical hemilaryngeal transplantations were carried out in the canine. After preparing the host dog removing right sided hemilarynx, hemilarynx of the donor dog was transplanted by hooking up the arteries, veins, nerves and hypopharyngeal mucosa. Especially, recurrent laryngeal nerve was anastomosed at the branch level(anterior and posterior) respectively. After 7 days, for the first evaluation of the transplantation, four out of seven dogs were considered successful. Three dogs survived more than one month, which is the critical period to evaluate the functional recovery after transplantations. After EMG examination, two dogs(#3, #5 dog) showed some functional recoveries. The five-transplanted hemilarynges were sectioned at the arytenoid cartilage region to examine the morphological changes. The results showed that the transplanted hemilarynx appeared normal as control in #5 dog. In addition, #2 dog showed fairly good condition even though died from asphyxia after 9 days out of transplantation. The other. three dogs(#3, #6, #7) showed various levels of atrophy and disappearance of the muscles and cartilages in their larynges. It can be suggested that this model could contribute an advance to preparing human laryngeal transplantation in the future.

• Imaging Science in Dentistry
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• 제49권1호
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• pp.65-70
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• 2019

Purpose: To determine whether calcified carotid atherosclerotic plaques(CCAPs) and mineralized laryngeal cartilages (MLCs) were more frequently detected on digital or film-based panoramic radiographs. The clinical relevance of this question is that some radiopacities seen on digital radiographs may correspond to medium-density tissues that are not necessarily mineralized. Materials and Methods: Data were collected from panoramic radiographs and the respective reports issued by 2 private oral radiology centers. A total of 388 radiographs and reports were divided into film-based (group A) and digital (group D) radiographs. The frequencies of CCAPs and MLCs were analyzed using the Fisher exact test, and odds ratios were also calculated (${\alpha}=1%$). Results: The mean age of patients whose reports and radiographs showed CCAPs and/or MLCs ranged from 50.1 to 54.1 years. There was a predominance of females. A higher frequency of CCAPs and MLCs was observed in group D than in group A at both centers(P<0.01). CCAPs and MLCs were detected 4 times more frequently in group D than in group A at one of the centers. Conclusion: CCAPs and MLCs were more frequently detected on digital than on film-based panoramic radiographs. Further studies are needed to determine whether such radiopacities do indeed correspond to mineralized, rather than medium-density, tissues.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.174-179
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• 2010

Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

• 대한후두음성언어의학회지
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• 제20권2호
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• pp.126-130
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• 2009

Arytenoid motion has long been recognized as complex. Misunderstandings about the specifics of arytenoid motion remain prevalent. The resultant misunderstandings have led to erroneous or suboptimal clinical approaches to the treatment of vocal fold immobility. A thorough understanding of the anatomy of the arytenoid and cricoid cartilages, the cricoarytenoid joint, and related ligaments, muscles, and other structures is essential in order to fully understand laryngeal motion disorders. Arytenoid motion occurs in three directions. Movements involving a change anteriorly and posteriorly, as well as vertically, are due to the revolving or pitchlike motion of the arytenoid along the minor axis of the cricoid's elliptically shaped facet. The medial and lateral movements are due to the orientation of the arytenoid which in turn is determined by the forward, lateral, and inferior inclination of the cricoid-arytenoid facet. During adduction it is the outward angulation of the vocal process from the body of the arytenoid that allows the entire length of the vocal proceses to approximate one another and to have this meeting occur at the proper vertical height.