• Title/Summary/Keyword: Laryngopharyngeal

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The Changes of Reflux Symptoms and Laryngoscopic Findings in Treatment of Patients with Laryngopharyngeal Reflux (인후두 역류증의 치료 시 증상과 후두내시경 소견의 변화)

  • Tae, Kyung;Lee, Yong-Seop;Jeong, Jin-Hyeok;Park, In-Beom;Lee, Seung-Hwan;Kim, Kyung-Rae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.16 no.1
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    • pp.15-18
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    • 2005
  • Background and Objectives : To determine the changes of reflux symptoms and laryngoscopic findings of patients with laryngopharyngeal reflux (LPR) on the duration of proton pump inhibitor medication. Materials and Methods : From Feb 2003 to Nov 2004, 58 patients who were diagnosed with LPR by 24-hour double-probe pH monitoring were enrolled. All patients were treated with proton pump inhibitor and followed up for 8 weeks at least. The response of symptoms and laryngoscopic findings of patients were assessed with reflux symptom index (RSI) and reflux finding score (RFS) before treatment and 2, 4, 8, 12, 16, 20 weeks after treatment. Results : The symptoms of patients with LPR were improved significantly at 2, 4, 8 weeks of treatment. The laryngoscopic findings of patients with LPR were improved significantly at 4 and 12 weeks of treatment. There was no correlation between improvement of reflux symptoms and laryngoscopic findings. Conclusions : The laryngoscopic findings of LPR patients were improved more slowly than reflux symptoms. Based on our results, anti-reflux therapy might be continued at least for 3 months until the improvement of laryngoscopic findings.

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The clinical effects of Rabeprazole sodium (Pariet$\circledR$) in the treatment of Laryngopharyngeal Reflux (인후두역류질환 ( Laryngopharyngeal Reflux Disease. LPRD )에서 Rabeprazole Sodium (Pariet$\circledR$)의 임상효과)

  • 최홍식;김한수;최현승
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2002.12a
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    • pp.9-9
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    • 2002
  • 이비인후과 영역에 있어서 위산 역류에 의한 질환의 진단은 쉽지 않고 분명하지 않은 점이 많지만, 병변의 영향은 광범위하며, 실제로 역류에 의한 증상을 가지고 내원하는 환자도 증가하는 추세이다. 인후두역류질환의 치료는 크게 생활습관의 변경, 약물복용, 항역류수술로 나눌 수 있으며, 사용약제는 크게 두 부류로 나누는데, 제산제, H2 수용체 차단제, PPI(Proton Pump Inhibitor) 제제와 같은 산억제 약물군과 Prokinetic 약물군이다. Rabeprazole sodium(Pariet(R))은 PPI 제제에 해당하는 약제로 기존의 omeprazole, lansoprazole, pantoprazole과는 달리 대사 과정 중 CYP2C19에 대한 의존도가 낮아, 개체 간 차이가 적고 빠르고 일정하게 산분비 억제 효과를 나타내는 것으로 알려져 있은 약물이다. 2001년 5월부터 2002년 4월까지 32개 병원에서 Pariet(R) 를 복용한 2166명의 환자를 대상으로 분석하였다. 복용기간에 따라 4군(1군;1-14일, 2군;15-28일, 3군;29-56일, 4군:57일 이상)으로 나누었으며, 8가지 증상(Heart burn, Regurgitation, Chronic cough, Hoarseness, Globus sensation, Chronic throat clearing, Sore throat, Dysphagia)에 대한 호전 여부 및 후두내시경상 개선 정도, 의사에 의한 유용도 평가, 부작용 발생 여부에 대해 연구하였다. 증상개선율 50%이상을 치료 반응군으로 했을때 전체 2166명중 1627명(75.1%)에서 증상의 호전을 보았으며, 이는 복용기간이 길수록 증가하였다. 후두 내시경상 개선 정도는 현저한 개선이 32.9%, 중등도 개선이 38.7%로 대부분 환자에서 객관적인 병변의 호전을 보였으며, 유용도 평가에서는 매우 유용이 37.6%, 유용이 50.3%로 치료효과에 대한 만족도도 높은 것을 알수 있었다. PPI 제제의 부작용으로 보고되고 있는 두통, 오심, 설사, 복통. 변비, 어지럼증. 피곤 중. 소수의 환자가 두통을 호소하였으나, 그다지 심각한 정도는 아니었다. 인후두역류증 치료제로서 Pariet(R) 는 비교적 안전하고 효과가 높은 약물임이 임상 연구 결과 밝혀졌기에 보고하는 바이다.

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Comparison of Endotracheal Intubation in Difficult Postures by Using the SALT(Supraglottic Airway Laryngopharyneal Tube)

  • Yun, Seong-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.12
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    • pp.227-233
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    • 2020
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

Correlation studies of DSI and VHI - Focused on vocal nodule & LPR - (DSI와 VHI의 상관관계 연구 - 성대결절 및 후인두 역류환자를 중심으로 -)

  • Lee, Hoonsil;Jung, Kyunghee;Hwang, Youngjin
    • Phonetics and Speech Sciences
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    • v.8 no.4
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    • pp.123-129
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    • 2016
  • This study investigates the relationship between dysphonia severity index(DSI) and voice handicap index(VHI). Seventeen patients with a vocal nodule and twenty patients with laryngopharyngeal reflux(LPR) patients participated in this study. Results showed that there is no significant difference in either DSI or VHI between vocal nodule and LPR patients, with a weak negative correlation between DSI and VHI. Results also showed that there is significant difference only in both MPT and Fhi of all DSI parameters between vocal nodule and LPR patients. These results suggest that voice evaluation should be conducted both objectively in terms of acoustical and aerodynamic parameters and subjectively in terms of GRBAS and VHI.

Voice Rehabilitation after Total Laryngectomy (후두전절제술 후 음성재활)

  • Jang, Jeon Yeob
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.18-20
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    • 2016
  • Total laryngectomy remains as an important treatment option in selected patients with laryngopharyngeal cancers, which inevitably sacrifices naturally produced voice. Much effort has been devoted to voice restoration for these laryngectomized patients. Several ways of voice rehabilitation after total laryngectomy have been developed and utilized thus far, including tracheoesophageal shunt speech, esophageal speech, pneumatic speech aid, and electrolarynx. Of these, tracheoesophageal shunt speech appears to be the most effective voice restoration method, while other trials might also be useful in special situations. Nevertheless, each method has its own unique mechanisms of voice production, thus has its advantages and drawbacks in clinical setting. In this review, we discuss the currently available management options for the rehabilitation of laryngectomized voice.

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Clinical Analysis of Recurrence in Inflammatory Laryngeal Disease after Laryngomicrosurgery (술 후 재발한 염증성 성대 병변의 임상 양상)

  • 김영선;김진호;박문규;유홍균;오준환;최종욱
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.28-31
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    • 2000
  • Microscopic surgery of the larynx normally have a low recurrence rate. However, once they do recur, it is uneasy to manage recurrent diseases. Recurrence is often the result of inappropriate postoperative care and voice management. Out of the 764 patients operated for benign inflammatory laryngeal diseases, we have conducted a clinical analysis of 54 cases who have had at least one episode of recurrence after the initial treatment with laryngomicrosurgery (7.1% of recurrence rate). High risk groups for recurrence were determined, and they were related to cigarette smoking, alcohol intake, laryngopharyngeal reflux. From our experience and literature review, we conclude that pre- and postoperative patient education concerning these risk factors and voice usage Is of critical need to prevent recurrence of inflammatory laryngeal lesions after laryngomicrosurgery.

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A Case of the Laryngopharyngeal Burn Caused by A Microwave-Heated Egg Bite

  • Won, Seong Jun;Woo, Seung Hoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.2
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    • pp.122-124
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    • 2013
  • Nowadays, microwave ovens are commonly used for cooking. However, the cooking certain food in microwave ovens can be hazardous. It has been reported that the heating eggs in a microwave oven can cause an explosion and injuries. The exploding eggs can cause burn injury of face, neck, eyelid, pharynx and larynx. Direct thermal damage to the larynx after swallowing microwave-heated eggs is rare. The authors report a larynx thermal injury due to microwave-heated eggs and review the cause and the prevention methods of exploding eggs.

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A Case of Total Pharyngo-laryngo-esophagogastrectomy and Colon Transposition in a Patient with Esophageal Cancer following Partial Esophagectomy and Gastic Pull-up due to Esophageal Stricture (식도협착으로 식도부분절제술과 위간치술 후 발생한 식도암에서 시행한 전인두후두식도위적출술 및 대장치환술 치험 1예)

  • 왕수건;손봉형;이병주;이형렬
    • Korean Journal of Bronchoesophagology
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    • v.9 no.2
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    • pp.69-73
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    • 2003
  • Various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the oncologic needs of the situation. If the entire esophagus or significant part of the thoracic esophagus is involved by tumor, then total esophagectomy and gastric pull-up or colon transposition is indicated. But for most hypopharyngeal tumors, laryngopharyngeal tumors, and cervical esophageal tumors, segmental resection of these area and replacement with a jejunal fee or forearm free flap has become the standard technique. The authors have experienced a case of total pharyngo-laryngo-esophago-gastrectomy and colon transposition in a patient of esophageal cancer following partial esophagectomy and gastic pull-up due to corrosive esophageal stricture. We report this case with brief review of the literatures.

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Multicenter Evaluation on the Efficacy of N-Acetyl Cystine in Relieving the Symptoms of Laryngopharyngeal Reflux Disease (인후두 역류질환에서 N-Acetyl Cysteine의 증상 개선 효과에 대한 다기관 평가)

  • Kim, So Yean;Kwon, Tack Kyun;Kim, Han Su;Son, Young Ik;Woo, Seung Hoon;Woo, Jeong-Soo;Lee, Seung Won;Lim, Jae Yol;Chung, Man Ki;Joo, Young Hoon;Cha, Wonjae;Choi, Seung Ho;Hong, Hyun Jun;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.87-93
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    • 2018
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) is relatively common disease. N-acetyl cysteine (NAC) has both mucolytic and antioxidant effect, also may be beneficial in inflammatory airway diseases. The purpose of this study was to evaluate the efficacy and safety of inhaled NAC therapy in LPRD. Materials and Method : We retrospectively reviewed the medical records of 525 LPRD patients at 12 medical centers. Finally 401 patients subjected to inhaled NAC therapy for 2 months were enrolled in the study. We analyzed the change of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) after use of NAC for 4 weeks and 8 weeks in addition to the patient's compliance of the treatment. Results : The RSI score significantly decreased from $19.87{\pm}6.34$ to $12.78{\pm}6.93$ after 4 weeks and to $10.65{\pm}7.47$ after 8 weeks. The RFS score also significantly decreased from $9.29{\pm}3.4$ to $7.17{\pm}3.41$ after 4 weeks and to $6.1{\pm}3.73$ after 8 weeks (p<0.05). During the treatment periods, 42 patients (10.4%) reported to have 80 episodes of discomfort. Throat discomfort (33%) and nausea (28%) were most common complaints, but the duration of discomfort was usually less than 4 weeks. Conclusion : Inhaled NAC treatment is highly effective for the reduction of both subjective and objective findings in LPRD patients. This study will provide the evidence of new treatment option for patients with LPRD. However, further studies will be needs to assess the real effect of inhaled NAC therapy as a standard treatment regimen of LPRD.

Analysis of High-Resolution Manometry Results in LPRD Patients Who Do Not Response to PPI Medication (양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.1
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    • pp.43-47
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    • 2012
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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