• Title/Summary/Keyword: Laryngeal surgery

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A Case of Mediastinal Dissection for Tracheostomal Recurrence after Total Laryngectomy (후두 전적출술 후 기관루 재발에 대한 종격동 청소술 치험 1례)

  • Lee, Seung Hwan;Tae, Kyung;Yu, Yean-Hee;Choi, Joon-Suk
    • Korean Journal of Bronchoesophagology
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    • v.5 no.1
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    • pp.62-67
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    • 1999
  • Sternal recurrence has been defined as a diffuse infiltrate of neoplastic tissue at the junction of the amputated trachea and the skin. The overall prognosis is poor, resulting from progressive tracheostomal obstruction or massive hemorrhage due to erosion of major vessels. Neither radiation therapy nor chemotherapy has demonstrated any efficacy in controlling these sternal recurrence. Surgery, especially mediastinal dissection, may benefit only an occasional patient. Recently authors experienced one case of mediastinal dissection for sternal recurrence after total laryngectomy for laryngeal cancer. We report our case with a brief review of literature.

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Unilateral vocal cord paralysis after open heart surgery -A report of 2 cases- (개심술후 발생한 일측성 성대마비 -2례 보고-)

  • 이종욱
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.522-526
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    • 1990
  • We have experienced 2 cases vocal cord paralysis after open heart surgery. One was a postoperatively developed right unilateral vocal cord paralysis after prosthetic mitral valve replacement with tricuspid valve annuloplasty. The other was a postoperative left unilateral vocal cord paralysis after prosthetic aortic and mitral valve replacement with tricuspid annuloplasty. They were intubated for forty-eight and seventy-two hours but after extubation complained of hoarseness, aphonia, anxiety, and ineffective coughing Indirect laryngoscopy performed at about postoperative one week, revealed partial paralysis and decreased mobility of the vocal cord. After active phonation therapy, symptoms were improved gradually and in the follow up indirect laryngoscopy, the vocal cord paralysis was improved. The symptoms were recovered completely at about postoperative one month in both. The cause of vocal cord paralysis after open heart surgery may be any retraction or stretching injury to the recurrent laryngeal nerve, especially right side, during median sternotomy retraction and open heart operation procedures. As a result, avoid of excessive spread of median sternotomy retractor and excessive manipulation and retraction of the heart during open heart procedures will reduce the occurrence of the vocal cord paralysis.

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Current Trends in Diagnosis and Management of Laryngopharyngeal Reflux Disease; A Survey of Korean Otolaryngologists (인후두역류질환의 진단 및 치료 경향; 이비인후과 전문의 설문조사 결과)

  • Lee, Jae-Kwon;Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.141-147
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    • 2009
  • Background and Objectives: Although laryngopharyngeal reflux disease (LPRD) is a widely recognized disease in the field of otolaryngology, controversies still exist regarding the diagnosis and treatment for it. The purpose of this survey was to find out current trends in diagnosis and management of LPRD among Korean otolaryngologists. Materials and Method: Questionnaires were obtained from 26 Korean otolaryngology specialists by electronic balloting, and 46 members of the Korean Society of Head and Neck Surgery (KSHNS) bye-mail. Survey participants were asked about their preferences in diagnostic policy, duration/dosage of antireflux treatment, and their familiarity to the reflux symptom index (RST) and the reflux finding scores (RFS). Results: The majority of the survey participants (64%) preferred empiric therapy trial with proton pump inhibitors (PPIs) based on patients' symptoms and their laryngeal findings. PPIs alone (27%) or PPIs with prokinetics (32%) were usually prescribed as a first line treatment mostly with once daily schedule in the morning before meal and for less than 4 months of duration (86%). More than 90% of participants were aware of the RSI and RFS, but less than 50% of them were actually using those items in the clinics. Conclusion: Most of Korean otolaryngologists who participated in this survey answered that they prefer starting empirical treatments with proton pump inhibitors mainly based on the patient's symptoms and their laryngeal findings.

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Repair of Tracheoesophageal Fistula under Laryngeal Microsurgery Approach: Case Report and Literature Review (기관식도 누공에 대한 후두미세수술 접근하 재건술: 증례 보고 및 문헌 검토)

  • Han, Mun Soo;Yum, Gunhwee;Oh, Kyung Ho;Kwon, Soon Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.83-86
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    • 2020
  • Patients with tracheoesophageal fistula show signs of aspiration, possibly leading to pneumonia, which could be fatal to bed-ridden patients. Tracheoesophageal fistula occurs as a complication of intubation, tracheostomy tube insertion and nasogastric tube insertion. Possible etiology is pressure and ischemic necrosis given by tracheostomy tube and nasogastric tube to trachea and esophagus; or in some cases, larynx and hypopharynx. Meanwhile, for repair of tracheoesophageal fistula, transcervical approach can be considered but takes relatively long operation time and is not appropriate for patients with underlying diseases. We report a case of tracheoesophageal fistula complicated several years after tracheostomy tube and nasogastric tube insertion who came to medical attention with signs of aspiration. Authors successfully performed repair of the fistula under laryngeal microsurgery approach without skin incision and dissection, and thereby report the experience with review of literature.

Intraoperative Nerve Monitoring during Minimally Invasive Esophagectomy and 3-Field Lymphadenectomy: Safety, Efficacy, and Feasibility

  • Srinivas Kodaganur Gopinath;Sabita Jiwnani;Parthiban Valiyuthan;Swapnil Parab;Devayani Niyogi;Virendrakumar Tiwari;C. S. Pramesh
    • Journal of Chest Surgery
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    • v.56 no.5
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    • pp.336-345
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    • 2023
  • Background: The objective of this study was to demonstrate the safety, efficacy, and feasibility of intraoperative monitoring of the recurrent laryngeal nerves during thoracoscopic and robotic 3-field esophagectomy. Methods: This retrospective analysis details our initial experience using intraoperative nerve monitoring (IONM) during minimally invasive 3-field esophagectomy. Data were obtained from a prospectively maintained database and electronic medical records. The study included all patients who underwent minimally invasive (video-assisted thoracic surgery/robotic) transthoracic esophagectomy with neck anastomosis. The patients were divided into those who underwent IONM during the study period and a historical cohort who underwent 3-field esophagectomy without IONM at the same institution. Appropriate statistical tests were used to compare the 2 groups. Results: Twenty-four patients underwent nerve monitoring during minimally invasive 3-field esophagectomy. Of these, 15 patients underwent thoraco-laparoscopic operation, while 9 received a robot-assisted procedure. In the immediate postoperative period, 8 of 24 patients (33.3%) experienced vocal cord paralysis. Relative to a historical cohort from the same institution, who were treated with surgery without nerve monitoring in the preceding 5 years, a 26% reduction was observed in the nerve paralysis rate (p=0.08). On follow-up, 6 of the 8 patients with vocal cord paralysis reported a return to normal vocal function. Additionally, patients who underwent IONM exhibited a higher nodal yield and a decreased frequency of tracheostomy and bronchoscopy. Conclusion: The use of IONM during minimally invasive 3-field esophagectomy is safe and feasible. This technique has the potential to decrease the incidence of recurrent nerve palsy and increase nodal yield.

Evaluation and treatment of facial feminization surgery: part II. lips, midface, mandible, chin, and laryngeal prominence

  • Dang, Brian N.;Hu, Allison C.;Bertrand, Anthony A.;Chan, Candace H.;Jain, Nirbhay S.;Pfaff, Miles J.;Lee, James C.;Lee, Justine C.
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.5-11
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    • 2022
  • Facial feminization surgery (FFS) refers to a set of procedures aimed at altering the features of a masculine face to achieve a more feminine appearance. In the second part of this two-part series, assessment and operations involving the midface, mandible, and chin, as well as soft tissue modification of the nasolabial complex and chondrolaryngoplasty, are discussed. Finally, we provide a review of the literature on patient-reported outcomes in this population following FFS and suggest a path forward to optimize care for FFS patients.

Clinicostatistical Analysis for 53 Cases which were performed Microlaryngeal Surgery under Suspension Laryngoscope (Suspension Laryngoscope 하에 후두미세 수술을 시행한 53명에 대한 임상통계학적 고찰)

  • 전하동;최인환;추광철;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.6.3-7
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    • 1979
  • During last two. decades, microlaryngeal surgery opened now era in the laryngeal surgery. In 1960, using Lynch's suspension laryngoscope, Seal co et al performed the first successful microsurgery in the treatment of polyp and other laryngeal diseases. In 1968, Kleinsasser reported a new technique of microlaryngeal surgery with a self retaining laryngoscope. Authors studied the statistic analysis of 53 cases (75 times) of the suspension laryngoscopic microsurgery at E.N.T. department of Han Yang University Hospital from May 1972 to April 1979 an reported this result. 1) sex distribution was male 1.3 : female 1. 2) age distribution was 3rd decade 14 cases (26.4%), 2nd decade 10 cases (18.7%) and 5th decade 9 cases (17%) in order. 3) chief compliant was hoarseness 48 cases (90.6%), dyspnea 16 cases (30.5%) and sore throat 8 cases (15.1%) in order. 4) diagnostic impression was polyp 18 cases (34%), nodule 12 cases (22.6%), papilloma 9 cases (17%), tumor 7 cases (13.2%), intubation granuloma 3 cases (5.7%) in order and other kinds were laryngeal stenosis with decannulation difficulty, laryngeal paralysis and hematoma. 5) histopathologic result of 48 cases was polyp 17 cases (35.4%), papilloma 11 cases (23%), nodule 9 cases (18.9%), malignancy 3 cases (6.3%), chronic inflammation 2 cases (4.2%) in order and others were hyperkeratosis, mucous retension cyst, nodule associated abscess, granuloma, hematoma and unconfirmed case. 6) in involved site, both sides 15 cases (60%), Lt.side 5 cases (19%), Rt side 3 cases (12%), anterior commissure 3 cases (12%) on the nodule and polyp (26 cases) and whole laryngeal involvement 7 cases (63.6%), one side cord involement 3 cases (23.7%), extralaryngeal involvement 1 cases (9.1%) on the papilloma (11 cases).

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The Comparison of Glottal Area Waveform between Normal Person and Patient with Vocal Lesions (정상인과 후두질환 환자에서 Glottal Area Waveform의 차이에 관한 연구)

  • Yoo, Young-Sam;Rosen, Clark A.
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.16 no.1
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    • pp.5-9
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    • 2005
  • Background and Objectives : Glottal area waveform(GAW) shows the plot of glottal area versus time through the 1 cycle. This study is designed to see how it can be applied to laryngeal patients. Material and Methods : A GAW analysis was peformed on 11 patients before and after surgery and 22 persons without laryngeal problems were recruited for control. Acoustic and aerodynamic analysis with VHI(voice handicap index) evaluation were performed. Results. Significant changes in baseline offset, gross closing rate and VHI were observed postoperatively. Other parameters were changed but insignificant. Conclusion : GAW maybe used to evaluate patient with voice problems.

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Robotic Surgery in Head and Neck (두경부 영역에서의 로봇 수술)

  • Tae, Kyung;Shin, Kwang-Soo
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.27-32
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    • 2010
  • Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

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Pathophysiology of Functional Dysphonia (기능성 음성장애의 병태생리)

  • Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.75-78
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    • 2014
  • Functional dysphonia refers to a voice disturbance that occurs in the absence of structural or neurologic laryngeal pathological characteristics. Poorly regulated activity of the intrinsic and extrinsic laryngeal muscles is cited as the proximal cause of functional dysphonia (FD). Recently, the term functional dysphonia has been replaced in some clinical circles by diagnostic label muscle tension dysphonia (MTD), which serves to highlight excess, dysregulated, or imbalanced activity of the intrinsic and extrinsic laryngeal muscles as proximal cause of the observed dysphonia. And recent research evidence points to specific personality traits as important contributors to its development and maintenance. However, the origin of this dysregulated laryngeal muscle activity has not been fully elucidated. Further research is needed to better understand the pathogenesis of functional dysphonia, and factors contributing to its successful management.

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