• Title/Summary/Keyword: Laryngoscopy

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

  • Lee, Deok-Hee;Do, Hyun-Seok
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.162-169
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    • 2007
  • Purpose : It is well known that suspension microlaryngeal surgery produces marked increases in arterial blood pressure and heart rate. In this study, we evaluated the effects of 10% lidocaine preoperatively sprayed for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery. Materials and Methods : Fifty American Society of Anesthesiologists (ASA) class 1 patients scheduled for excision of a vocal polyp by suspension laryngoscopy were randomly divided into two groups (n=25 for each group). They were intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites 90 sec prior to intubation (10% lidocaine group). Anesthesia was maintained using desflurane in $O_2/N_2O$ 50%. The arterial blood pressure and heart rate were measured at preinduction (T0), 1 min (T1), 3 min (T2), 5 min (T3) after tracheal intubation, and 1 min (T4), 3 min (T5), 5 min (T6) and 10 min (T7) after the suspension laryngoscopy. Results : In the 10% lidocaine group, the arterial blood pressure and heart rate at 1 (T1), 3 (T2) min after tracheal intubation and 1 (T4), and 3 (T5) min after suspension laryngoscopy were lower than the same measurements in the control group. Conclusion : 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites before intubation was an effective method for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery.

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

  • Choi, Jong-Ouck;Jun, Byung-Sun;Kang, Hee-Joon;Baek, Seung-Kuk;Choi, Geun;Jung, Kwang-Yoon;Chu, Hyung-Ro
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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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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The Effect for Intracranial Pressure during Laryngoscopy and Endotracheal Intubation (기관내삽관이 뇌압변동에 미치는 영향)

  • Kim, Heung-Dae;Chi, Yong-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.45-51
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    • 1985
  • It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and It may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylcholine injections. Intracranial pressure and MAP were measured in 13patients who underwent cramotomy. All the patients were monitored cerebral epidural ICP and intra-arterial pressure pre-operatively. The results were as follow: 1. Intracranial pressure was increased of $7.1{\pm}7.23mmHg$. 2. Arterial pressure was increased of $43.5{\pm}25.46mmHg$. 3. Cerebral perfusion pressure was increased of $33.3{\pm}27.53mmHg$. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.

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

  • Nam, Irang;Heo, Gi-yoon;Kang, Hee-kyung;Kim, Min-hwa;Kim, Mariah;Kwon, Jung-nam;Kim, So-yeon;Park, So-jung;Yun, Young-ju;Choi, Jun-yong;Han, Chang-woo;Hong, Jin-woo;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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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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    • v.15 no.3
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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.

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

  • Jeon, Dae-Geun;Song, Jaegyok;Kim, Seok-Kon;Ji, Seung-Heon
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.2
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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.

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

  • Kim, Chul-Ho;Kang, Sung-Ook
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.2
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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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Radiofrequency Pitch Raising Surgery of Low Vocal Pitch Female that Results from Laryngeal Trauma (후두외상 후 발생한 저음발성 여자환자에서의 라디오전파를 이용한 음도상승 유도 치료 1예)

  • Kim, Min-Ho;Song, Ki-Jae;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.1
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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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Clinical Evaluation of 3 patients with Paradoxical Vocal Cord Movement (역설적 성대운동을 보이는 3명의 환자에 대한 임상분석)

  • 최선명;임길채;한광우;남순열
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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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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CLINICAL ANALYSIS OF THE VOCAL NODULE (성대결절의 임상적 고찰)

  • 김기령;김광문;현승재;전영명
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.2 no.1
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    • pp.24-30
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    • 1986
  • The vocal nodule is one of the major causes of hoarseness. The patholphysiologic mechanism of the vocal nodule is relatively well-known. Chronic mechanical stimuli, such as vocal abuse, causes vocal nodule by a tissue reaction of the vocal cords. Among the 841 patients, who visited the Vocal Dynamic Laboratory at Severance Hospital complaining of the dysphonia between the period of May 1981- May 1985, 169 patients were selected who were diagnosed as vocal nodule by indirect laryngoscopy and a series of phoniatric examination. (omitted)

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