• Title/Summary/Keyword: Unilateral recurrent

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The Effect of Steroid Therapy for Idiopathic Unilateral Vocal Cord Palsy (특발성 일측성 성대마비에서 경구 스테로이드 요법의 효과)

  • Bae, Jong-Won;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.107-111
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    • 2019
  • Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.

Usefullness of Injection Laryngoplasty with Calcium Hydroxyapatite in Unilateral Vocal Cord Paralysis (일측 성대마비 환자에서 Calcium-Hydroxyapatite를 이용한 성대 주입술의 유용성)

  • Lee, Jae-Hoon;Kim, Sung-Won;Oh, Jung-Ho;Kim, Seung-Tae;Lee, Kang-Dae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.119-125
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    • 2011
  • Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

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Poland`s syndrome: report of one case (폴란드 증후군 :1례 보고)

  • Park, I-Tae;Hong, Jang-Su;Suh, Kyung-Pill
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.60-62
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    • 1981
  • The Poland`s syndrome is very rare anomaly, which consists of congenital unilateral absence of the sternocostal pert of the pectoralis major muscle, with ipsilateral hand deformities. The clinical features are variable but all patients have absence of at least the sternal head of the pectoralis major muscle. The syndrome is not hereditary and is of unknown origin. Early recognition of Poland`s syndrome may give the provision of psychological and genetic counseling for anxious parents. We have encountered a patient with this entity, who showed striking paradoxical movement of the left anterior Ghest wall and recurrent pneumonia, and underwent successful surgical correction.

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Investigation about legal(civil) relationships with a carrier and a passenger (항공사와 탑승객 사이의 민사 법률관계에 관한 고찰)

  • Kim, Beom-Gu;Song, Byeong-Heum
    • 한국항공운항학회:학술대회논문집
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    • 2016.05a
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    • pp.89-94
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    • 2016
  • This paper is to investigate how each cases(recurrent cases) is to be classified and what each parties should prepare to solve their cases by civil law system and so on. We could find the increased volume (or quantity) of transportation by air recently and have to worry about the sky-rocketed cases of unfulfilled navigation management(aviation service) proportionately inevitably. So we knew that some cases of disputes are solved by unreasonable demand, unilateral concession or irrational decision without any logical or legal criterion, because both sides(passenger and carrier) do not recognize the situation correctly and have any preparation for the legal settlement. Therefore we should prepare the classification work and comprehend about the legal effect(fulfillment retardation of duty, fulfillment impossibility of duty and imperfect fulfillment in our civil law system) of each cases. We can grasp the legal relationship with a carrier and a passengers by the legal analysis more efficiently and save (or help) energy and time of concerned parties.

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A Case of Vocal Cord Abscess after Injection Laryngoplasty (성대주입술 후 발생한 성대 내 농양 1례)

  • Yi, Jong-Sook;Kim, Ji-Won;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.142-144
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    • 2010
  • Unilateral vocal cord paralysis occurs from a dysfunction of the recurrent laryngeal nerve. It causes a characteristic hoarseness, shortness of breath and swallowing disability. Prompt injection laryngoplasty is a treatment options that aims to improve these symptoms less invasively and easily than any other procedures. Cross-linked hyaluronic acid (HA) is widely used injection material. It is non-mammalian polysaccharides derived from streptococcus strain and well known for its duration in vocal cord about 3-6 months after injection. However, there were no complication reports such as infection or rejection after HA injection laryngoplasty in previous report. We present a case of patient with laryngeal abscess after transcricothyroid membrane percutaneous HA injection laryngoplasty.

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Comparison of the Voice Outcome After Injection Laryngoplasty: Unilateral Vocal Fold Paralysis Due to Cancer Nerve Invasion and Iatrogenic Injury (성대주입술 후 음향학적 분석결과 비교: 암의 신경 침윤으로 인한 일측성 성대마비 환자와 수술 후 발생한 일측성 성대마비 환자)

  • Yongmin, Cho;Hyunseok, Choi;Kyoung Ho, Oh;Seung-Kuk, Baek;Jeong-Soo, Woo;Soon Young, Kwon;Kwang-Yoon, Jung;Jae-Gu, Cho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.3
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    • pp.172-178
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    • 2022
  • Background and Objectives Injection laryngoplasty is a common method for treatment of unilateral vocal fold paralysis. Unilateral vocal fold paralysis has various causes, including idiopathic, infection, stroke, neurologic condition, surgery and nerve invasion by cancer. To the knowledge of the authors, there was no study on the relationship between the causes of vocal cord paralysis and the outcome of injection laryngoplasty. Therefore, we tried to investigate the difference in the outcomes of injection laryngoplasty between vocal cord paralysis after surgery group and nerve invasion by cancer group. Materials and Method A retrospective analysis was performed for 24 patients who underwent vocal cord injection due to unilateral vocal cord paralysis caused by surgery or nerve invasion by cancer. The objective quality of the voice was assessed by acoustic voice analysis with the Multi-Dimensional Voice Program. Results Both group showed an improvement of fundamental frequemcy (F0), jitter percent, shimmer (percent), and noise to hearmonic ratio (NHR) after injection laryngoplasty. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of F0, shimmer percent and NHR than the vocal cord paralysis due to surgery group, but there was not statistically significant. Conclusion Our study did not show a statistically significant difference in outcome between vocal cord paralysis due to cancer invasion group and surgery group, but statistically tendency was suggested. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of acoustic voice analysis than surgery group.

Retinoblastoma: Result of Radiotherapy (망막아세포종의 방사선치료 성적)

  • Kim, Il-Han;Kim, Jong-Hoon;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.169-176
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    • 1990
  • Radiotherapy result was analyzed in 23 children with retinoblastoma treated in Seoul National University Hospital from 1980 to 1987. Three ($17\%$) had bilateral tumor at diagnosis. Among 20 children with unilateral retinoblastoma 13 children got radiotherapy after enucleation, 2 were treated with radiotherapy alone, and 5 were delivered with radiotherapy after relapse. Of 15 non-recurrent unilateral tumors, there were 5 stage II children, 8 stage III, and 2 stage IV by staging system proposed by St. Jude Children's Research Hospital. Chemotherapy was combined when resection margin of the optic nerve was positive or when malignant cell was found in CSF. Of 12 children who completed radiotherapy, local or distant failure was not found but 2 cases of relapse at the contralateral retina were observed. Their 5 year survival rate was $82.2\%$. Another case of contralateral relapse was detected in children who was treated with radiotherapy alone. Thus overall frequency of the bilateral disease was $33\%$. Prognosis of recurrent tumors were so poor that no cases of CR was obtained and that 3 year survival rate was $20\%$. Two of 3 bilateral cases at diagnosis were in NED status. Complication were sunken orbit only. Result of radiotherapy was so good in early stage or small bulk tumor that treatment delay after diagnosis must not be allowed.

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A Case Report of Bilateral Congenital Lacrimal Sac Fistula with Cleft Ear Lobe (갈라진 귓볼과 동반된 양측성 선천성 누낭 피부누공의 경험례)

  • Lee, Han Jung;Choi, Hwan Jun;Choi, Chang Yong
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.197-200
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    • 2008
  • Purpose: A congenital lacrimal sac fistula is unusual and consists of a dimple opening below the medial canthal tendon that leads to the lacrimal sac. This anlage ducts occur when the lacrimal anlage cells proliferate and canalize rather than involute. And, the anomaly is usually not associated with any systemic abnormalities. Also congenital cleft of the earlobes is rarely seen among congenital ear anomalies. Therefore, we report rare case with symptomatic bilateral lacrimal fistula with the ear cleft. Methods: A 4-year-old boy was admitted with aggravated chronic maxillary sinusitis, recurrent chronic dacryocystitis, and epiphora. He had two minor anomalies including bilateral lacrimal fistula originated in lacrimal tear sac and unilateral transverse ear cleft. The patient had been operated with fistulectomy and perioperative antibiotics. A small vertical ellipse is made around the opening with sharp dissection. The tract is excised using the probe as the guide. Another probe is placed through the lower canaliculus to prevent the damage. A suture ligature of 6-0 Maxon is placed around the deepest point of the tract, which is then excised. Additional sutures are placed in the tissues to form a tight closure to prevent reestablishment of the fistula. The skin is closed with 6-0 Black Silk. Results: The patient recovered well without any complications such as infection, epiphora, and obstruction of lacrimal sac. Conclusion: Our case illustrates bilateral lacrimal anlage ducts in a patient with unilateral congenital ear cleft. We recommend careful evaluation of lacrimal system in these patients, especially bilateral case and other congenital anomalies. Finally, we recommend excision of the ducts when epiphora, infection, or chronic skin irritation occur.

Parry-Romberg syndrome with ipsilateral hemipons involvement presenting as monoplegic ataxia

  • Lee, Yun-Jin;Chung, Kee-Yang;Kang, Hoon-Chul;Kim, Heung Dong;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.354-357
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    • 2015
  • Parry-Romberg syndrome (PRS) is a rare, acquired disorder characterized by progressive unilateral facial atrophy of the skin, soft tissue, muscles, and underlying bony structures that may be preceded by cutaneous induration. It is sometimes accompanied by ipsilateral brain lesions and neurological symptoms. Here we present the case of a 10-year-old girl with right-sided PRS and recurrent monoplegic ataxia of the left leg. At 4 years of age, she presented with localized scleroderma over the right parietal region of her scalp; her face gradually became asymmetric as her right cheek atrophied. Brain magnetic resonance imaging revealed hemiatrophy of the face and skull base, and T2-weighted images showed increased signal in the right hemipons and hemicerebellar peduncle. Magnetic resonance angiography findings were unremarkable. She was treated with oral prednisolone, and her recurrent gait ataxia diminished within 2 months of the follow-up period. To the best of our knowledge, this is only the second case of PRS presenting with an abnormal involvement of the ipsilateral hemipons.

A Case of Perineal Hypospadias with Os Penis Deformity and Unilateral Cryptorchidism in a Boston Terrier (보스턴 테리어에서 발생한 음경골 이형성과 편측 잠복고환증을 가진 회음부 요도하열)

  • Park, Woo-Young;Bae, Chun-Sik;Kim, Hwi-Yool;Cho, Ki-Rae;Park, Woo-Dae
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.185-188
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    • 2009
  • A six-month-old Boston terrier presented with an extruded penis caudally, incompletely formed preputial sheath, bifid scrotum, retained testicle and deformity of the os penis. On physical examination, the urethral orifice was located on the surface of the perineum and a fibrous band was observed running from the grans to the urethral orifice on the perineum. The dog also had urethritis that was infected by ascending bacteria entering through the contaminated urethral orifice. Corrective surgery was undertaken to excise the external genitalia and retained testicle. The prepuce, penis and retained testicles were successfully excised. After the urethral orifice was cleaned periodically and antibiotics were administrated, recurrent urethritis disappeared. Using this therapeutic regime it is not necessary to reconstruct the anomaly located urethral orifice, if the location of urethral orifice is not the cause of recurrent urethritis and urinary incontinence.