• Title/Summary/Keyword: Laryngeal surgery

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Practical Approach of Laryngeal Ultrasonography (후두초음파의 임상적 활용)

  • Cho, Woojin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.19-23
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    • 2018
  • Ultrasonography has increasingly moved from being a modality confined to the radiology department to an active diagnostic and therapeutic aid available to the head and neck at the point of patient care. However, the application of ultrasonography to the laryngeal disorder is very rare due to progressive age-related ossification of laryngeal cartilage and the presence of air in the lumen, which contribute to difficult conditions for transmission of the ultrasonic waves. The observation about the movements of larynx or surrounding structures is important to understand the physiology of phonation or swallowing and to diagnose the disease. Ultrasonography is a noninvasive and safe imaging technique that can be used to investigate the anatomic structures of the head and neck. Recently, the development of high-frequency ultrasonography makes it possible to apply the ultrasound in the evaluation of larynx.

Diagnostic Laryngeal Electromyography (진단적 후두근전도)

  • Chung, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.2
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    • pp.107-112
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    • 2008
  • Diagnostic laryngeal electromyography (LEMG) relatively evaluates the electrophysiologic status of the larynx and provides critical clinical informations that no other tests can provide. However, LEMG is still not widely applied as a routine tool in clinical practice. One reason for this is the technical and interpretative difficulties of LEMG. But if LEMG is performed by a team approach consisting of an otolaryngologist and a neurologist, the technique and the interpretation of LEMG are not difficult to master. Another reason is that there is still not exact standard guideline for clinical application of LEMG. LEMG is an essential diagnostic test in evaluating patients with neuromuscular disorders, particulary vocal fold immobility, reduced mobility of vocal fold. The more we have used LEMG, the more we have found it useful in the evaluation and treatment of voice disorders, and the role of LEMG will be extended.

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A Case of Metachronous Multiple Primary Tumor Involving the Thyroid and the Larynx (갑상선과 후두에 발생한 다발성 원발암 1례)

  • 손영익;권중근;추광철
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.164-168
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    • 1997
  • Multiple primary tumors in the head and neck are not uncommon, however those in the thyroid and the larynx are known to be very rare. In most cases of multiple primary tumors involving the thyroid and the larynx, lesions are observed usually simultaneously and thyroid tumors are found incidentally during the laryngeal tumor surgery. In rare cases, thyroid tumors are found metachronously after radiation therapy of laryngeal cancer. The authors recently experienced a case of multiple primary tumor involving the thyroid and the larynx, in which thyroid papillary carcinoma was the index tumor and the laryngeal squamous carcinoma was the meatachronous second tumor. Both tumors showed aggressive local extension and regional nodal meatastasis with tumor collision in the same node. The patient died of recurrent or of residual squamous carcinoma shortly after main surgical treatment index thyroid cancer.

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Anesthetic management in corticobasal degeneration with central sleep apnea: A case report

  • Shionoya, Yoshiki;Nakamura, Kiminari;Sunada, Katsuhisa
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.235-238
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    • 2019
  • Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by dystonia, cognitive deficits, and an asymmetric akinetic-rigid syndrome. Little information is available regarding anesthetic management for CBD patients. Our patient was a 55-year-old man with CBD complicated by central sleep apnea (CSA). Due to the risk of perioperative breathing instability associated with anesthetic use, a laryngeal mask airway was used during anesthesia with propofol. Spontaneous respiration was stable under general anesthesia. However, respiratory depression occurred following surgery, necessitating insertion of a nasopharyngeal airway. Since no respiratory depression had occurred during maintenance of the airway using the laryngeal mask, we suspected an upper airway obstruction caused by displacement of the tongue due to residual propofol. Residual anesthetics may cause postoperative respiratory depression in patients with CBD. Therefore, continuous postoperative monitoring of $SpO_2$ and preparations to support postoperative ventilation are necessary.

A Case of Laryngeal Lipoma Arising at the Free Margin of the Vocal Cord (성대의 자유연에 발생한 후두 지방종 1례)

  • Lee, Sang Joon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.107-109
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    • 2018
  • Lipomas are benign tumors and most commonly occurs in trunk, upper extremities and lower extremities. About 13-15% of lipomas are located in the head and neck area. However, lipomas of larynx are very rare and only about 100 cases have been reported. Laryngeal lipomas occur mainly in epiglottis, aryepiglottic fold and false vocal cords, which have adipose tissue. Author experienced an unusual presentation of laryngeal lipoma. Tumor seemed to be located in the supraglottis in the preoperative laryngoscopy, but it was found to be located at the free margin of the true vocal cord. To date, only one case has been reported in the world literature. We report this case with a review of the literature.

Occult Metastatic Rate of Laryngeal Cancer Predicted by Elective Neck Dissection (후두암종에서 예방적 경부청소술로 확인한 경부 잠재전이율)

  • Tae Kyung;Jeong Jin-Seok;Lee Dong-Wook;Jeong Jin-Hyeok;Lee Hyung-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.19-23
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    • 2004
  • Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

Activation and Abnormalities of Cell Cycle Regulating Factor in Head and Neck Squamous Cell Carcinoma Cell Lines: Abnormal Expression of CDKN2 Gene in Laryngeal Squamous Cell Carcinoma (두경부 편평상피세포암 세포주에서 세포주기조절인자의 활성 및 이상 : 후두편평상피세포암에서 종양억제유전자 CDKN2 유전자의 발현이상)

  • Song, Si-Youn;Han, Tae-Hee;Bai, Chang-Hoon;Kim, Yong-Dae;Song, Kei-Won
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.166-182
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    • 2005
  • Background: Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2 inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous report that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development.1) Materials and methods: We used 5 human laryngeal carcinoma cell lines whether they have deletions or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity (LOH) of CDKN2. PCR was performed by using microsatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162, D9S166, D9S171, D9S200 and D9SIFNA). For informative cases, allelic loss was scored if the signal of one allele was significantly decreased in tumor DNA when compared to the same allele in normal DNA. Results: The CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases (87.5%). Conclusion: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma.

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The Analysis of Voice after Vertical Partial Laryngectomy with Mucosal Flap and Fat Graft Reconstruction (수직후두부분절제술 및 점막 피판과 지방 이식을 통한 성대 재건술 후의 음성분석)

  • Chu, Hyung-Ro;Choi, In-Ja;Kim, Jin-Hwan;Ahn, Hwoe-Young;Rho, Young-Soo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.134-137
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    • 2007
  • Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

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