• 제목/요약/키워드: Unilateral recurrent

검색결과 76건 처리시간 0.023초

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

  • 배종원;이길준
    • 대한후두음성언어의학회지
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    • 제30권2호
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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.

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

  • 이재훈;김성원;오정호;김승태;이강대
    • 대한후두음성언어의학회지
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    • 제22권2호
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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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폴란드 증후군 :1례 보고 (Poland`s syndrome: report of one case)

  • 박이태;홍장수;서경필
    • Journal of Chest Surgery
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    • 제14권1호
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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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항공사와 탑승객 사이의 민사 법률관계에 관한 고찰 (Investigation about legal(civil) relationships with a carrier and a passenger)

  • 김범구;송병흠
    • 한국항공운항학회:학술대회논문집
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    • 한국항공운항학회 2016년도 춘계학술대회
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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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성대주입술 후 발생한 성대 내 농양 1례 (A Case of Vocal Cord Abscess after Injection Laryngoplasty)

  • 이종숙;김지원;최승호
    • 대한후두음성언어의학회지
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    • 제21권2호
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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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성대주입술 후 음향학적 분석결과 비교: 암의 신경 침윤으로 인한 일측성 성대마비 환자와 수술 후 발생한 일측성 성대마비 환자 (Comparison of the Voice Outcome After Injection Laryngoplasty: Unilateral Vocal Fold Paralysis Due to Cancer Nerve Invasion and Iatrogenic Injury)

  • 조용민;최현석;오경호;백승국;우정수;권순영;정광윤;조재구
    • 대한후두음성언어의학회지
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    • 제33권3호
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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.

망막아세포종의 방사선치료 성적 (Retinoblastoma: Result of Radiotherapy)

  • 김일한;김종훈;박찬일
    • Radiation Oncology Journal
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    • 제8권2호
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    • pp.169-176
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    • 1990
  • 1980년 3월부터 1987년 8월까지 서울대학교병원 치료방사선과에서 망막아세포종으로 방사선 치료를 받았던 23예의 치료 성적을 보고한다. 20예의 편측성 종양에서, 13예는 안구적출술후 방사선치료를, 2예는 방사선치료만, 5예는 안구 적출후 동측 재발종양의 방사선치료를 받았다. 재발성 종양을 제외한 15예의 병기는 St. Jude Children's Research Hospital의 병기분류 기준에 의한 I 기(retinal)는 없고, II기(global) 5예, III기 (orbital) 8예, IV기 (cranial or metastatic) 2예였다. 양측성 종양 3예는 생후 1개월 이내에 증상이 나타났고, 진행된 종양측은 안구적출술을 시행했으며 조기 종양측은(3예 모두 I기)방사선 치료를 하였다. 시신경 절단부 또는 뇌척수액에서 종양 세포가 확인된 경우에는 항암화학치료를 병용하였다. 수술후 계획대로 방사선치료를 받은 12예의 5년 생존율은 $82.2\%$이며, 국소재발 또는 원격전이는 없었으나, 2환아(III기)의 진단시 무병상태였던 반대측 망막에서 종양이 속발하였다. 일차적 방사선 치료를 계획대로 받은 1예의 반대측 망막에서 종양이 속발하였다. 따라서 양측성 종양의 전반적 빈도는 $33\%$였다. 재발성종양 5예의 치료성적은 매우 불량하여 생존율은 $20\%$였다. 양측성 종양 3예중 2예가 무병상태로 생존하고 있다. 방사선 치료후의 변화로는 안와 연조직 위축이 관찰되었다. 방사선 치료성적은 조기 병기 또는 종양의 크기가 작은 경우에 양호하여 조기 치료가 중요하며 진단후 치료가 지연되지 않도록 함이 중요하다.

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

  • 이한정;최환준;최창용
    • Archives of Plastic Surgery
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    • 제35권2호
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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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    • 제58권9호
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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.

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

  • 박우영;배춘식;김휘율;조기래;박우대
    • 한국임상수의학회지
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    • 제26권2호
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    • pp.185-188
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    • 2009
  • 6개월령의 보스톤 테리어가 미측 음경 돌출과 불완전 형성된 포피, 이분화된 음낭, 잠복고환과 음경골 이형성을 나타내었다. 신체검사상, 요도구멍은 회음부 표면에 위치하였고 섬유성 띠는 귀두로부터 회음부에 있는 요도구멍까지 연결되어 있었다. 또한, 잘못 위치한 요도구멍을 통한 상행성 감염에 의하여 요도염을 나타내었다. 교정수술은 외부생식기 전체와 잠복고환을 절제하기 위하여 시행되었다. 포피, 음경 그리고 잠복고환은 성공적으로 절제되었다. 수술 후 요도구멍을 주기적으로 세척하고 항생제를 투여한 이후, 재발성 요도염은 사라졌다. 만약, 요도구멍의 위치가 재발성 요도염의 원인과 요실금의 주요 원인이 아니라면, 요도구멍을 재형성할 필요가 없는 이 치료법을 이용할 것을 제안한다.