• Title/Summary/Keyword: Laryngoscopy

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A Rare Case of Acute Obstructive Laryngitis in a Cat with Severe Respiratory Distress

  • Hyeona Bae;Dongbin Lee;DoHyeon Yu
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.124-129
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    • 2023
  • A 5-year-old neutered male domestic short-haired cat presented with acute dyspnea characterized by open-mouth breathing and stridor for 2 days. Direct visualization via laryngoscopy revealed diffuse laryngeal swelling and severe thickening of the vocal folds bilaterally; thus, the upper respiratory tract was obstructed owing to severe edema. Neutrophil infiltration was found on fine needle aspiration of the larynx cytology, and no discrete mass with polyp or neoplasia was identified on diagnostic imaging. The cat was diagnosed with acute obstructive laryngitis, and a tracheostomy tube was immediately installed. After 17 days of treatment with steroids, doxycycline and azithromycin, the swollen larynx gradually improved, and there was no recurrence of laryngitis or respiratory obstruction. A feline upper respiratory polymerase chain reaction panel revealed Mycoplasma felis infection; however, it could not be determined whether it was pathogenic or opportunistic. Herein, we report a case of obstructive laryngitis in a cat. When respiratory obstruction due to acute laryngitis is identified, a good prognosis is expected with rapid and appropriate treatment.

Relation between Subjective Symptoms and Rhinolaryngoscopic Findings or Sputum Eosinophilia in Chronic Cough Patients (만성기침 환자의 주관적 증상과 비후두경 소견 및 객담 호산구 증가증과의 관련성)

  • Kim, Hyun-Kuk;Choi, Eun-Young;Lee, Jae-Seung;Bae, Yun-Jeong;Song, Jin-Woo;Kim, Tae-Bum;Cho, You-Sook;Moon, Hee-Bom;Lee, Sang-Do;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.5
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    • pp.368-374
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    • 2010
  • Background: Rhinolaryngoscopy and sputum examination are popular tests for the evaluation of chronic cough. Little is known about the relationship between symptoms and rhinolaryngoscopic findings or sputum eosinophilia in chronic cough patients. Methods: One hundred patients, who had chronic cough with normal chest radiography and who also had undergone both rhinolaryngoscopy and induced sputum analysis, were reviewed retrospectively. Eleven associated symptoms of chronic cough were asked; postnasal drip (PND) and laryngopharyngeal reflux (LPR) were examined by rhinolaryngoscopy. Induced sputum analysis was performed for evaluation of sputum eosinophilia. Cross tabulation analyses with chi-square tests were used to evaluate the relationship between symptoms and objective findings. Results: The most frequent symptom was sputum (70%). The prevalence of PND and LPR on rhinolaryngoscopy were 56% (56/100) and 25.6% (22/86), respectively. Sputum eosinophilia was observed in 23 (23.7%) of 97 patients. The dyspnea (p=0.001), sputum (p=0.003), nasal obstruction (p=0.023), and postnasal drip sense (p=0.025) were related with PND on rhinolaryngoscopy. LPR on rhinolaryngoscopy was not related with any symptoms. Dyspnea (p=0.003), wheezing (p=0.005), nasal obstruction (p=0.013), and belching (p=0.018) were related with sputum eosinophilia. Conclusion: Any symptoms might not be related with LPR on laryngoscopy. Some symptoms might be related with PND on rhinoscopy or with sputum eosinophilia.

Malignant Lymphoma of the Larynx (후두악성임파종)

  • Cho Jung-Il;Kim Kwang-Moon;Kim Young-Ho;Choi Jae-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.137-144
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    • 1995
  • Malignant lymphoma affecting the larynx is uncommon, probably accounts for less than 1 percent of malignant lesion of the larynx. Malignant lymphoma of the larynx is predominantly localized to supraglottis such as epiglottis, aryepiglottic fold. Laryngoscopy reveals a irregular submucosal mass with a smooth surface and no ulceration. Most of which belongs to non­Hodgkin's lymphoma. After it has been determined that the disease is localized, radiation therapy is the choice of the treatment. Chemotherapy with or without irradiation is reserved for more advanced tumor. Then life-long follow-up is essential. This paper deals with 5 cases malignant lymphoma of the larynx to review our clinical experience and to suggest the optimum treatment in the course of the disease.

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A Case of Pedunculated Schwannoma of Aryepiglottic fold (피열후두개주름에 발생한 유경성 신경초종 1예)

  • Hong, Chang Eui;Park, Jun Cheol;Lee, Mi-Kyung;Shin, Hyang Ae
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.95-99
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    • 2017
  • Schwannoma, also known as a neurilemmomas or neurinomas, is benign peripheral nerve sheath tumors arising from the Schwann cells. About 25~45 % of all schwannomas are found in the head and neck region, and the majority are found in the parapharyngeal space. Schwannoma of the larynx is very rare with an incidence of 0.1~1.5% in all benign laryngeal tumors. Recently, we experienced a case of a pedunculated schwannoma arising from the left aryepiglottic fold in a 80-year-old patient. The tumor was completely excised under direct laryngoscopy with the use of a $CO_2$ laser and subsequently confirmed as schwannoma. So, we report this case with a review of the literatures.

Clinical Applications of Botulinum Toxin in Patients with Dysphagia (삼킴 장애 환자에서 보튤리눔 독소의 임상적 적용)

  • Cho, Jung-Hae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.77-81
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    • 2019
  • Dysphagia may result from dysfunction of any of the components involved in the complex neuromuscular interaction of swallowing. Hyperfunction of any of the muscles involved in swallowing is a frequent cause of dysphagia. The cricopharyngeus muscle (CPM) is a key component of the upper esophageal sphincter. Cricopharyngeus muscle dysfunction (CPD) refers to the muscle's failure to appropriately and completely relax or expand during deglutition. A variety of disease processes may cause CPD and accurate diagnosis is paramount for appropriate treatment. In appropriately selected patients, intervention at the CPM may yield significant improvement in dysphagia. Interventions include nonsurgical, pharyngoesophageal segment dilatation, botulinum toxin (BoNT) injection, and criccopharyngeal myotomy. Injections of BoNT in patients with CPD have been reported to result in marked relief of dysphagia. Different techniques for instilling BoNT into the CPM have been described. Awake, in-office CPM BoNT injection with electromyography and/or fluoroscopic or ultrasound guidance is performed transcervically or via flexible endoscopy. Operative CPM BoNT injection involves rigid laryngoscopy and esophagoscopy with direct visualization of the CPM. BoNT should be prepared in low-volume, high-concentration dilutions to minimize the potential for undesired diffusion of the toxin. The effects of BoNT occur within weeks of injection and typically last up to 5 or 6 months.

The Management of Systemic Voice Disorders (전신질환과 관련된 음성장애의 치료)

  • Woo, Joo Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.5-10
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    • 2016
  • Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

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A Case of Vocal Cord Dysfunction Masqueraded as Exercised-Induced Asthma (운동유발성 기관지천식으로 오인된 성대 기능 이상 1례)

  • Jo, Chang-Lae;Sym, Sun-Jin;Park, Sang-Hyun;Nam, Soon-Yuhl;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.265-270
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    • 2002
  • Vocal cord dysfunction (VCD) is respiratory disorder characterized by paradoxical closure of the vocal cord during the respiratory cycle leading to obstructive airway symptoms. The clinical presentation of VCD is often dramatic and its misdiagnosis as asthma or exercise-induced brochospasm(EIB) has led to inappropriate treatment including high dose corticosteroids, intubation, and tracheostomy. Many VCD patients are asymptomatic at rest and require exercise challenge to elicit symptoms and vocal cord abnormalities. The "gold standard" for the diagnosis of VCD remains laryngoscopy or bronchoscopy with direct visualization of paradoxical adduction of the vocal cords. We report a case of exercise-induced Vocal cord masqueraded as exercise-induced asthma unresponsive to corticosteroids. And bronchodilator confirmed by typical bronchoscopic findings with paradoxial adduction of the vocal cords.

A Comparison of Cardiovascular Effects between Orotracheal Intubation and Nasotracheal Intubation (경구기관삽관법과 경비기관삽관법의 심혈관계 영향에 대한 비교)

  • Kim, Dong-Ok;Choi, Young-Kyoo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.10-15
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    • 2001
  • Background: This prospective study was designed to compare the cardiovascular response to endotracheal insertion of either an orotracheal tube or a nasotracheal tube Methods: 120 ASA physical status I and II surgical patients requiring general anesthesia and tracheal intubation were studied and assigned to two groups: orotracheal intubation group (n = 60) and nasotracheal intubation group (n = 60). Patients were premedicated with midazolam 0.05 mg/kg and glycopyrrolate 0.005 mg/kg intramuscularly and anesthesia was induced with thiopental sodium 5 mg/kg and succinylcholine 0.1 mg/kg intravenously. Systolic blood pressure (SBP), diastolic blood pressure (DBP). mean arterial pressure (MAP) and heart rate (HR) were assessed noninvasively before induction of anesthesia and immediately after intubation, 1 min, 2 min, 3 min, and 5 min after intubation. Results: Cardiovascular responses such as SBP, DBP, MAP and HR were similar for both techniques and no significant differences between two groups were observed until 5 min after intubation. Conclusions: In healthy ASA I and II patients with normal blood pressure, induction doses of thiopental sodium 5 mg/kg and succinylcholine 0.1 mg/kg didn't attenuated the cardiovascular response to laryngoscopy and tracheal intubation. Insertion of an endotracheal tube may be the most invasive stimulus during intubation procedures. (JKDSA 2001; 1: 10-15)

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Pyriform Sinus Fistula with Recurrent Deep Cervical Abseesses Successfully Treated with Trichloroacetic Acid Cauterization and Ligation (화학 소작술 및 결찰을 이용한 이상와 누공의 치험 1예)

  • Park, Young-Hak;Lee, Jeong-Hak;Song, Ki-Young;Cho, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.16 no.1
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    • pp.85-87
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    • 2005
  • The pyriform sinus fistula can cause a recurrent abscess in the neck and the current treatment of choice involves complete excision of the sinus tract. But, because of excisional difficult, chemical cautery has been intermittently used as a successful substitute. Recently we experienced a case of pyriform sinus fistula of 9 year-old female who was successfully treated with chemocauterization with trichloroacetic acid(TCA) and ligation of the internal opening of the fistula tract on suspension laryngoscopy. So we report this rate case with review of literatures.

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Restylane Injection into the Vocal Cord of the Patient with Unilateral Vocal Cord Paralysis -A Case Report- (편측 성대마비에서 Restylane을 이용한 성대내 주입치료 1예 -증 례 보 고-)

  • Park, Tae-Joon;Lim, Jae-Yol;Seo, Hyung-Seok;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.1
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    • pp.43-47
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    • 2004
  • When a person was suffered from vocal cord paralysis or glottic insufficiency, injection materials (e.g Teflon, Bovine collagen, Autologous fat & tendon, Gelfoam) into the vocal cord have been widely used. But each injection material has some disadvantage. We introduce the Restylane which is composed of a hyaluronic acid, artificially producted. It has advantage of rate foreign body reaction, proper endurance, easy to injection. The patient was 55-year-old woman who showed left vacal cord paralysis after pneumonectomy due to aspergillosis, taken the type I thyroplasty and arytenoid adduction. The middle portion of left vocal cord has some atropic mucosal change, slight chink was noted. The restylane injection into vocal cord was done with suspension laryngoscopy under general anesthesia. In the 3 month follow-up after Restylane injection, the quality of voice has been better progressively. We report a case of Restylane injection as a new method for the improvement of quality of voice.

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