• 제목/요약/키워드: Laryngeal surgery

검색결과 403건 처리시간 0.023초

난치성 연축성 발성장애 환자에서 갑상피열근 절제술 및 선택적 반회후두신경 절제술 1예: 장기 추적 관찰 (A Case of Thyroarytenoid Myectomy with Selective Recurrent Laryngeal Nerve Section in Intractable Spasmodic Dysphonia: A Long-Term Follow-Up)

  • 이윤지;안유영;박기남;이승원
    • 대한후두음성언어의학회지
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    • 제31권1호
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    • pp.35-38
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    • 2020
  • Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

성문하 기관 협착증의 수술 치험 2예 (Surgical Treatment of Subglottic Stenosis -2 Cases-)

  • 김종만
    • Journal of Chest Surgery
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    • 제23권3호
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    • pp.577-583
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    • 1990
  • Subglottic stenosis is a disorder characterized by narrowing of the airway below the glottis. In children, the stenosis is usually due to scar formation secondary to prolonged airway intubation, rather than to external trauma. The location and extent of the stenosis are highly variable, consequently, corrective measures need to be selected to suit the individual problem. Conservative treatment is adequate for lesser degrees of stenosis but those with more severe scarring require external laryngeal surgery. We managed 2 children with subglottic stenosis due to prolonged intubation after open heart surgery who needed a resectional surgery of the stenotic upper airway. The preoperative evaluation and surgical technique for subglottic stenosis were reviewed.

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성대용종환자에서 후두미세수술시에 수술부위에 Triamcinolone 국소주입이 음성에 미치는 영향에 대한 연구 (The Effect of Triamcinolone Injection on the Vocal cord during Laryngeal Microsurgery in the Patient of the Vocal Polyp)

  • 유준;오경호;윤희철;이도영;우정수;백승국;정광윤;권순영
    • 대한후두음성언어의학회지
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    • 제26권2호
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    • pp.122-126
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    • 2015
  • Background and Objective : Laryngeal microscopic surgery (LMS) is popular method to treat for vocal polyp. There is not always the improvement of the voice after operation. Many methods have been developed for better outcome of the surgery. The purpose of this study is to investigate the effect of the triamcinolone injection at vocal cord during LMS. Materials and Methods : The medical records of 28 patients, received LMS under diagnosis of vocal polyp, were retrospectively reviewed. The patients were divided into two groups depending on whether triamcinolone injected or not (case group : Triamcinolone-injected group, control group : Triamcinolone-not injected group). The quality of voice was evaluated by GRBAS scale, fundamental frequency (Fo), jitter, shimmer and NHR (Noise to harmonic ratio) at previous operation, 4 weeks after operation, 8 weeks after operation. Each voice analysis factor was compared between case group and control group by Independent t-test. Results : The mean differences of each voice analysis factor. The mean difference of Jitter, Shimmer, NHR in case group were lower than in control group, and mean difference of GRBAS scale in case group were higher than in control group. These differences were not significant (p>0.05). Conclusion : Though there was a tendency of better voice outcome in patients of triamcinolone-injection, it may not be concluded that the triamcinolone injection is helpful for better voice outcome in surgery of vocal polyp due to statistical insignificance.

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후두인두절제술 및 인두재건 후 다량의 출혈을 야기한 인두누공 (Pharyngeal Fistula Causing Excessive Bleeding after Laryngopharyngectomy and Pharyngeal Reconstruction)

  • 김승범;진성민;강성훈;이준규
    • 대한두경부종양학회지
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    • 제33권1호
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    • pp.53-56
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    • 2017
  • Pharyngocutaneous fistula is one of the most common wound complications after total laryngectomy. The leakage of saliva may cause an erosion of greater vessels nearby and result in a life-threatening bleeding. 65-year-old male received laryngectomy and pharyngectomy followed by Latissimus dorsi flap reconstruction due to recurred laryngeal cancer with oropharyngeal extension after postoperative radiotherapy. Pharyngeal fistula was developed and an excessive fresh blood flowed through the oral and nasal cavity. The patient was transferred to the operating room immediately, and the causing artery was ligated. The rupture of the common carotid artery and its branches should be warned when the pharyngocutaneous fistula is developed. Prompt and proper therapy must be performed for the patients with impending or acute hemorrhage.

후두에 발생한 염증성 근섬유모세포종 1 례 (A Case of Laryngeal Inflammatory Myofibroblastic Tumor)

  • 박상규;김예슬;전현웅;송창면
    • 대한두경부종양학회지
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    • 제35권2호
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    • pp.71-75
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    • 2019
  • Inflammatory myofibrolastic tumor (IMT) is a rare borderline neoplasm. It frequently occurs in the lung but occasionally occurs in extrapulmonary sites such as the genitourinary tract, gastrointestinal tract, breast, salivary glands, sinonasal tract, orbit, and the central nervous system. Laryngeal involvement of IMT is very rare. A 61-year-old woman who complained of hoarseness persisting for 3 months visited our hospital. Laryngoscopy showed an elevated lesion in the right true vocal cord. Incisional biopsy was confirmed as larygeal inflammatory myofibrolastic tumor. We performed a transoral excision with CO2 LASER under suspension examination. Regional recurrence or distant metastasis was not observed after 9 months of follow-up. Herein we report a case of larygeal inflammatory myofibrolastic tumor that was treated with surgery alone, with a literature review.

구제수술에서 일측 복장뼈자루 절제를 통한 전종격동 기관절개술의 1례 (A Case of Creation of Mediastinal Tracheostoma with Unilateral Manubrial Resection as Salvage Operation)

  • 전석원;김창회;이해영;김성원
    • 대한두경부종양학회지
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    • 제32권2호
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    • pp.29-33
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    • 2016
  • A 65-year-old male visited hospital in the state of tracheostomal recurrence 1 year after total pharyngolaryngectomy. Extensive recurrence around stoma or paratracheal, superior mediastinal area is challenging in treatment, especially in securing airway. We performed mediastinal tracheotomy through resection of unilateral manubrium, some part of sternal side of clavicle and $1^{st}$ rib as the salvage operation for recurrent laryngeal cancer. This procedure could be risky, thus very careful patient selection is required because of a tortuous postoperative course. We would like to present the case that anterior mediastinal tracheostomy could be needed as appropriate palliative means of airway construction in the patients with recurrent laryngeal cancer with lower neck extension with literature review.

성대 주입술과 리도카인 주입술을 통해 치료한 난치성 근긴장성 발성장애 (Intractable Muscle Tension Dysphonia Treated by Injection Laryngoplasty and Lidocaine Injection)

  • 안유영;정준영;박기남;이승원
    • 대한후두음성언어의학회지
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    • 제32권2호
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    • pp.94-97
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    • 2021
  • Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy

  • Park, Seong Hoon;Kim, Joo Hyun;Lee, Jun Won;Jeong, Hii Sun;Lee, Dong Jin;Kim, Byung Chun;Suh, In Suck
    • Archives of Plastic Surgery
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    • 제44권6호
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    • pp.550-553
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    • 2017
  • Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture.