• 제목/요약/키워드: Laryngoscopy

검색결과 110건 처리시간 0.031초

술 전 분무한 10% lidocaine이 현미경 하의 후두 미세 수술 시 혈역학적 반응에 미치는 영향 (The Effects of Preoperative Sprayed 10% Lidocaine on the Hemodynamic Response during Suspension Microlaryngeal Surgery)

  • 이덕희;도현석
    • Journal of Yeungnam Medical Science
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    • 제24권2호
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    • pp.162-169
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    • 2007
  • 현미경 하 후두 미세 수술에서 10% lidocaine 술 전 분무가 혈역학적으로 어떠한 영향을 미치는 지를 보기 위하여 대상 환자 50명을 각 25명씩 두 군으로 나누어 대조군과 10% lidocaine 분무군으로 하였다. 마취 유도 후 대조군에서는 근이완제 투여 후 3분 30초에 기관내 삽관을 시행하였으며, 연구군은 근이완제 투여 2분 후 인후두 점막과 기관내에 lidocaine 1.5 mg/kg을 분무하였고 다시 1분 30초 후에 기관내 삽관을 시행하였다. 수축기 및 이완기 혈압과 심박수를 마취 유도 전에 측정하여 기준치(T0)로 삼았으며 기관내 삽관 후 1분(T1), 3분(T2), 5분(T3), 현수 후두경 거치 후 1분(T4), 3분(T5), 5분(T6), 10분(T7)에 각각 측정하여 기록하였다. 동맥압과 심박수가 기관내 삽관후 3분까지 그리고 현수 후두경 거치 후 3분까지 대조군에 비하여 10% lidocaine 분무군에서 유의하게 낮음을 보아 기관내 삽관 전 10% lidocaine 분무는 기관내 삽관과 현수 후두경으로 인한 심혈관계 자극을 효과적으로 완화시킴을 알 수 있다.

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KTP-532 레이저에 의한 성문상부 협착증 치험 (Endoscopic Management of Supraglottic Stenosis with KTP-532 Laser)

  • 최종욱;전병선;강희준;백승국;최건;정광윤;주형로
    • 대한기관식도과학회지
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    • 제5권2호
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    • pp.153-158
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    • 1999
  • Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.

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기관내삽관이 뇌압변동에 미치는 영향 (The Effect for Intracranial Pressure during Laryngoscopy and Endotracheal Intubation)

  • 김흥대;지용철
    • Journal of Yeungnam Medical Science
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    • 제2권1호
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    • pp.45-51
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    • 1985
  • 전신마취시 후두경의 사용과 기관내삽관이 혈압 및 뇌압을 상승시킬 수 있음은 잘 알려져 있으며 이는 이미 뇌압이 상승되어 있는 환자에게는 매우 위험할 수 있다. 따라서 저자들은 현재 통상 시행되고 있는 전신마취 유도방법인 thiopental, S.C.C., intubation 과정이 어느 정도의 뇌압상승을 유발시키는지를 알아보기 위하여, 뇌압측정장치가 되어있는 개두술 환자 13명에게 위와 같은 마취유도시 뇌압 및 동맥압의 변화를 측정하여 보았던바 뇌압은 $7.1{\pm}7.23mmHg$, 동맥압은 $43.5{\pm}25.46nmHg$, 뇌관류압은 $33.3{\pm}27.53mmHg$ 상승되었다. 이러한 결과로 미루어 보아, 이미 뇌압이 상승되어 있는 환자의 마취유도 시에는 필히 마취유도에 따른 뇌압상승을 예방할 수 있는 처치를 강구해야만 할 것으로 사료된다.

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기관절개술 후 발생한 기관내 육아종에 대한 십육미유기음(十六味流氣飮)의 치험 1례 : 증례보고 (A Case Report of Tracheal Granuloma Treated with Sipyukmiyuki-eum)

  • 남이랑;허기윤;강희경;김민화;김마리아;권정남;김소연;박소정;윤영주;최준용;한창우;홍진우;이인
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.973-979
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    • 2022
  • Purpose: The purpose of this study is to report the improvement of tracheal granuloma after herbal medicine treatment. Methods: A patient with tracheal granuloma was treated with Sipyukmiyuki-eum, and we checked laryngoscopy images to observe the improvement of this condition. Results: After treatment with Sipyukmiyuki-eum and Korean medicine therapy, we found that tracheal granuloma showed improvements in the laryngoscopy image. Conclusion: This case suggests that Sipyukmiyuki-eum might be effective for patients who develop tracheal granuloma after tracheostomy. However, additional studies with more patients are required to verify this finding.

Difficult airway management in a patient with a parapharyngeal tumor

  • Ji, Sung-Mi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제15권3호
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    • pp.153-156
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    • 2015
  • A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

경비삽관 시도 중 발생한 심각한 비출혈 (Massive Epistaxis during Nasotracheal Intubation)

  • 전대근;송재격;김석곤;지승헌
    • 대한치과마취과학회지
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    • 제13권2호
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    • pp.51-54
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    • 2013
  • A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and we successfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

성대폴립양상의 원발성 성문부 국균증 1예 -증 례 보 고- (A Case of Primary Laryngeal Aspergillosis -A Case Report-)

  • 김철호;강성욱
    • 대한후두음성언어의학회지
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    • 제15권2호
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    • pp.153-155
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    • 2004
  • Primary infection of the larynx with aspergillus spp. with immunocompetent patient is extremely rare, few cases have been reported in the literature. It is more commonly seen as a part of a wider infection involving the respiratory system in immunocompromised patients. We present one case of primary laryngeal aspergillosis without any other airway tract extension and without any generalized immune deficit in a 69 year-old woman with history of hoarseness. Direct laryngoscopy and biopsy confirmed the diagnosis of aspergillosis.

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후두외상 후 발생한 저음발성 여자환자에서의 라디오전파를 이용한 음도상승 유도 치료 1예 (Radiofrequency Pitch Raising Surgery of Low Vocal Pitch Female that Results from Laryngeal Trauma)

  • 김민호;송기재;최홍식
    • 대한후두음성언어의학회지
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    • 제17권1호
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    • pp.56-59
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    • 2006
  • The factors involved in controlling the vocal pitch are the tension, the mass, the length of the vocal cords and the subglottic pressure. Vocal pitch can be elevated surgically by increasing the stiffness or reducing the vibrating mass of the vocal cords. Recently, we experienced a case of 25 year-old female whose vocal pitch was elevated with radiofrequency surgery of right vocal cord on suspension laryngoscopy. Elevation of vocal pitch(134.11 to 144.73) was noted two months after operation. So we report this case with review of literature.

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역설적 성대운동을 보이는 3명의 환자에 대한 임상분석 (Clinical Evaluation of 3 patients with Paradoxical Vocal Cord Movement)

  • 최선명;임길채;한광우;남순열
    • 대한기관식도과학회지
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    • 제9권1호
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    • pp.83-86
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    • 2003
  • Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

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성대결절의 임상적 고찰 (CLINICAL ANALYSIS OF THE VOCAL NODULE)

  • 김기령;김광문;현승재;전영명
    • 대한후두음성언어의학회지
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    • 제2권1호
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    • pp.24-30
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    • 1986
  • 사성은 후두질환 환자에 있어서, 가장 초기에 그리고 가장 흔하게 생기는 증상으로 이러한 사성을 호소하는 환자에게서 가장 빈도가 높은 질환중의 하나가 성대결절이다. 성대결절은 만성 기계적 자극에 의한 성대의 조직 반응이며, 일반적으로 성대의 라인케씨 층중 특정 부위에 발생한 염증반응으로 알려져 있다. (중략)

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