• 제목/요약/키워드: Laryngeal surgery

검색결과 404건 처리시간 0.02초

후두초음파의 임상적 활용 (Practical Approach of Laryngeal Ultrasonography)

  • 조우진
    • 대한후두음성언어의학회지
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    • 제29권1호
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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.

진단적 후두근전도 (Diagnostic Laryngeal Electromyography)

  • 정성민
    • 대한후두음성언어의학회지
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    • 제19권2호
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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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갑상선과 후두에 발생한 다발성 원발암 1례 (A Case of Metachronous Multiple Primary Tumor Involving the Thyroid and the Larynx)

  • 손영익;권중근;추광철
    • 대한기관식도과학회지
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    • 제3권1호
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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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    • 제19권4호
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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.

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

  • 이상준
    • 대한후두음성언어의학회지
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    • 제29권2호
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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.

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

  • 태경;정진석;이동욱;정진혁;이형석
    • 대한두경부종양학회지
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    • 제20권1호
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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.

두경부 편평상피세포암 세포주에서 세포주기조절인자의 활성 및 이상 : 후두편평상피세포암에서 종양억제유전자 CDKN2 유전자의 발현이상 (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)

  • 송시연;한태희;배창훈;김용대;송계원
    • Journal of Yeungnam Medical Science
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    • 제22권2호
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    • pp.166-182
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    • 2005
  • 정상인의 말초혈액 림프구 DNA를 주형으로 사용하여 DNA PCR을 시행하였다. 그 결과 5례 모두에서 예상되는 167bp 크기의 CDKN2 genomic DNA 단편이 증폭됨을 관찰할 수 있었다. 정상인의 말초혈액 림프구로부터 분리한 mRNA를 사용하여 cDNA를 합성하고 이를 주형으로 사용하여 RT-PCR와 시행하였다. 그 결과 예상되는 355bp 및 468bp의 CDKN2 및 ${\alpha}$-actin의 mRNA 전사산물이 전례에서 발현됨을 관찰할 수 있었다. 또한 CDKN2 mRNA의 RT-PCR 산물을 Sal I 제한효소로 절단하여 252bp와 103bp의 두 단편으로 나뉘어짐을 관찰하였다. 총 5례의 후두 편평상피세포암 세포주에서 CDKN2가 발현되는지를 RT-PCR로 관찰하였으며 각 세포주로부터 mRNA의 분리가 잘되었는지는 ${\alpha}$-actin의 발현을 통하여 RT-PCR로 관찰하였다. 5례의 세포주에서 모두 ${\alpha}$-actin의 발현을 관찰할 수 있었으며 이들의 mRNA를 사용하여 CDKN2 RT-PCR와 시행한 결과 총 4례(80%)의 세포주에서 CDKN2의 발현이 상실되어 있음을 알 수 있었다. CDKN2 발현의 이상이 있는 후두 편평상피세포암 세포주 및 발현이 정상인 후두 편평상피 세포암 세포주 모두에서 CDKN2 유전자의 존재를 DNA-PCR로 관찰하여 총 5례의 세포주 중 2례(40%)에서 CDKN2 유전자의 결손을 관찰할 수 있었다. 이 2례의 후두 편평상피세포암 세포주는 CDKN2의 발현이 일어나지 않은 것으로 RT-PCR의 결과와 일치하였다. 총 8례의 후두 편평상피세포암세포들에서 CDKN2의 이종접합성의 상실이 발견되는지를 DNA-PCR로 관찰하여 7례(87.5%)에서 최소한 한 개 이상의 microsatellite marker에 대한 이종접합성의 상실이 발견되었으며, 6례(75%)에서 최소한 한 개 이상의 microsatellite marker에 대한 증폭이 발견되었다. 또한 2례에서 최소한 한 개 이상의 microsatellite marker에 대한 microsatellite의 불안정이 발견되었다. 이종접합성의 상실, 증폭 또는 microsatellite의 불안정의 세 가지 모두를 보면 전례에서 한가지 이상의 CDKN2의 이상이 발견되었다. 이상의 결과로 볼 때 CDKN2가 후두암의 발생에 중요한 역할을 하고 있을 것으로 사료된다.

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

  • 주형로;최인자;김진환;안회영;노영수
    • 대한후두음성언어의학회지
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    • 제18권2호
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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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