• 제목/요약/키워드: Vocal Polyp

검색결과 80건 처리시간 0.028초

KTP 레이저를 이용한 외래 기반 후두 수술의 임상적 적용 (Clinical Applications of Office-Based Laryngeal Surgery With KTP Laser)

  • 조정해
    • 대한후두음성언어의학회지
    • /
    • 제32권3호
    • /
    • pp.118-123
    • /
    • 2021
  • The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

후두 미세 수술 후 양성 성대 병변 환자의 예후 (Prognosis of Patients with Benign Vocal Fold Lesions after Laryngeal Microsurgery)

  • 최병길;김병준;최효근;박범정
    • 대한후두음성언어의학회지
    • /
    • 제29권1호
    • /
    • pp.37-40
    • /
    • 2018
  • Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

성대 결절 및 후두 폴립의 수술 후 보충 치료로서 Accent Method의 유용성 (The Utility of Accent Method as a Supplementary Treatment after Surgery of Vocal Nodule and Laryngeal Polyp)

  • 박혜성;박영실;최두영;김상윤;유승주;남순열
    • 대한후두음성언어의학회지
    • /
    • 제11권1호
    • /
    • pp.39-45
    • /
    • 2000
  • Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p<0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p<0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.

  • PDF

성대폴립, 성대낭종 환자들의 Laryngeal Micro Surgery 수술 전, 후 공기역학적 비교: Running Speech 중심으로 (Aerodynamic Characteristics of Voice Disorders (Polyp, Cyst) before and after Laryngeal Micro Surgery: Focus on Running Speech)

  • 문태훈;심미란;황연신;김근전;이동현;선동일
    • 대한후두음성언어의학회지
    • /
    • 제30권2호
    • /
    • pp.95-100
    • /
    • 2019
  • Background and Objectives For patients with polyps and cysts, glottal gaps resulting from their lesions have negative respiratory effects when they vocalize. Phonatory Aerodynamic System is clinically used, but is often limited in the measurement of vowels. So the researchers attempted to verify the usefulness of Phonatory Aerodynamic System by comparing differences in respiratory characteristics and patterns which can be measured by the level of connected speech. Materials and Method Among the subjects who were diagnosed through a stroboscopy, there were 33 patients with polyps and 23 patients with cysts. Then, 36 subjects who were found to have no specific findings through a stroboscopy and perceptual test were selected to the normal group. We compared respiratory characteristics and patterns. And compared vocal polyps and cysts before and after laryngeal micro surgery (LMS). Results First, difference in respiratory patterns between the normal group and the patients with polyps and cysts were examined to show that breath groups, breath group syllables, and expiratory·inspiratory volume were significantly higher in the polyp/cyst group than those in the normal group, indicating that precision was lowered during the conversation, due to reduction in speech intelligibility and interruption of communication. Second, there were significant differences in maximum phonation time, mean flow rate, and subglottal pressure among respiratory characteristics, breath groups, breath group syllables, and inspiratory volume before and after LMS, which appeared to be similar to the normal group. Conclusion The understanding of respiratory characteristics and patterns produced by patients in connected speech which is most similar to natural speech was found to be the objective and useful method for examining characteristics of the subjects.

교사, 목사 및 교환수들의 음성발성에 대한 음향분석학적 특징 (Acoustic and Stroboscopic Characteristics in Teachers, Clergies and Telephone Operators)

  • 진성민;박상욱;이정우;이경철;이용배
    • 대한후두음성언어의학회지
    • /
    • 제9권1호
    • /
    • pp.53-58
    • /
    • 1998
  • Objectives : To compare the voice quality and voice problems of untrained professional voice user groups with that of normal control group without voice problem. Materials and Methods : The sustained vowel sounds of 13 male and 36 female teachers, 46 clergies and 15 telephone operators, and 40 normal male and 20 normal female persons were analyzed, using a videostroboscopy and acoustic analyzer. Together with these analyses, a questionnaire associated with risk factors for current and past voice problems was handed over to the patients. Results : The most common symptom in subjective groups was the voice fatigue. In stroboscopic examination, the professional voice user groups shelved functional voice disorder findings regardless of the Intensity of voice use. In the clergy and teacher using loud voice, vocal polyp, vocal nodule and hyperfunction of laryngeal muscle were frequently observed. In the clergy and telephone operator, jitter and shimmer were significantly increased. In the female teacher, the value of jitter, fundamental frequency variation and fundamental frequency were statiscally significant. However, the voice of male teacher showed no significant findings in the acoustic and aerodynamic studies. Conclusion : In the management of voice problems for untrained professional voice user groups, it is important to find the exact causes and patterns of voice problems, and to be individualized the management according to the causes.

  • PDF

후두 미세수술과 연관된 구강 및 후두 합병증 (Oropharyngeal Complications Associated with Laryngomicrosurgery(LMS))

  • 강진욱;최승효;남순열
    • 대한후두음성언어의학회지
    • /
    • 제14권1호
    • /
    • pp.5-9
    • /
    • 2003
  • Introduction : Laryngomicrosurgery(LMS) is frequent procedure applying to benign and early malignant larygeal disease such as vocal cord polyp, nodule and early glottic cancer. LMS has been known as safe procedure and short time consuming treatment. So few reports about complications in LMS was done. In this study, complications and problems from LMS were investigated and reported. Method : From 2000, January to 2001, December, 180 patients who were treated with LMS in Asan medical center were studied by retrograde chart review. Results : In these patients, total 9 patients(5%) were suffered from complication. 4 patients (2%) had teeth injury and 4(2%) were suffered from foreign body sensation in tongue and 1(1%) had hypoglossal nerve injury. Main mechanism of complications is thought by pressure injury by laryngoscope blade. No definite correlation between procedure and complication was observed. Conclusion : There are few neural complications with LMS such as lingual and hypoglossal nerve injury. Before operation of LMS, warning and informing of complications by mechanical stress must be done. Gentle procedure and short operation time are necessary to avoid these problems. And patients who have risk factors of oral complications such as dental disease or dental prosthesis must have dental evaluation and treatment before LMS procedure.

  • PDF

후두미세수술에서 탄산가스 레이저를 이용한 레이저 수술의 안전성 (Laser Safety in Laryngeal Microsurgery Using $CO_2$Laser)

  • 이정구;정필상;정필섭
    • 대한기관식도과학회지
    • /
    • 제4권2호
    • /
    • pp.159-164
    • /
    • 1998
  • The developmental and subsequent addition of laser technology to existing surgical techniques offered new and exciting Possibilities for improving traditional endoscopic operations and expanding the scope of the specialty of otolaryngology-head and neck surgery. Lasers were found to be Precise, but potentially dangerous, surgical instruments whose use was associated with certain distinct and unprecedented advantages, but also with many unique and potentially serious, and sometimes catastrophic complications. The Purpose of this study was to evaluate the of elation technique of $CO_2$laser, kinds of anesthesia, equipments of operating room, and education of medical staff. Four hundreds 4 cases of $CO_2$laser laryngeal microsurgery were reviewed for the safety of $CO_2$laser in laryngeal microsurgery. Vocal polyp (46,3%) was the most common pathology in our cases. The others were vocal nodule, Reinke`s edema, epiglottic cyst, laryngeal granuloma, laryngeal papilloma, intracordal cysts, laryngeal tuberculosis, laryngeal web, laryngotracheal stenosis, and laryngeal cancer. Following complete equipment controls, treatment area controls, maintenance, service and procedural controls, personel protective equipment, and warning signs, no complications were found in our cases. In conclusion, laryngeal microsurgery with $CO_2$laser could be done safely without complication if complete preoperative preparation and education of medical staff preceded.

  • PDF

애성을 주소로 한 후두질환의 임상 통계적 고찰 (A Clinical Study of Hoarseness)

  • 윤완규;조규모;송기준;김홍수
    • 대한기관식도과학회:학술대회논문집
    • /
    • 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
    • /
    • pp.6.4-7
    • /
    • 1983
  • 애성은 후두의 발성기능 장애로 생기는 후두질환의 대표적인 주 증상이고 또한 초기에 나타나는 증상이기도 하며 문화가 발달하고 경제수준이 높아짐에 따라 환자자신들이 각종 후두질환에 대한 관심이 커지고 특히 암에 대한 의심 때문에 내원하는 경우가 많아지고 있다. 최근에 각종 후두질환에 대한 연구가 활발해지고 있으며 특히 음성 자체의 질에 대한 관심도가 증가하고 있다. 이런 점에 비추어 저자들은 애성을 주 증상으로 하는 후두질환의 실태를 파악하고 정확한 진단을 내리는데 도움이 되고자 1980년 1 월부터 1982년 12월까지 만 3년간 애성을 주 증상으로 본 교실 이비인후과 외래로 내원한 환자에 대해 다음과 같은 임상통계적 결과를 얻었다. 1) 이비인후과 외래 신환 총 10110명 중 애성을 주소로 내원한 환자는 228명으로 약 2.3 %였다. 2) 애성환자 228 명 중 남자는 115명, 여자는 113명으로 남녀 비는 거의 비슷하였다. 3) 원인질환 별로는 급성후두염이 43예(18.9%)로 가장 많았으며 만성후두염 36예(15.8%), 성대결절 30예(13.2%), 후두폴립 30예(13.2%), 성대마비 26예(11.4%), 후두악성 종양 18예(7.9%) 및 후두결핵 15예(6.6%) 의 순이었다. 기타 후두질환들로는 30 예로 13.2 %를 차지하였다. 4) 연령별 빈도는 40대에서 26.8 %로 가장 많았고 30대 18.9 %, 50대 17.1 %, 20대 15.8% 및 60대 9.6 %의 순이었다. 5) 발병부터 초진까지의 기간은 11일∼1개월(22.8 %)이 가장 많았으며 1개월∼3개월(19.7 %), 3개월∼6개월 (18.9 %), 10일이내 (13.6 %), 6개월 ∼1년(13.2 %), 1년∼3년(7.9 %)및 3년이상(3.9 %) 순이었다. 6) 각질환에 따른 발병부터 초진까지의 최다기간은 급성 후두염이 10일 이내, 만성후두염은 3개월∼6개월, 성대결절은 1개월∼3개월, 후두폴립은 3개월∼1년, 성대마비는 11일∼1개월, 악성암은 3개월∼1년 및 후두결핵은 11일∼1개월 등이었다. 7) 애성과 동반하여 나타나는 증상들로는 인두통이 25 %를 차지하며 가장 많았고 객담 8.8 %, 연하운동장애 7.9 %, 기침 6.6%, 호흡곤란 6.1% 순이었으며 애성 만을 호소했던 경우는 84예로 36.8%를 차지하였다.

  • PDF

음성 Sample의 길이 변화에 따른 MDVP 측정치와 GRBAS 척도간의 상관관계 변화 비교 (The Change of the Correlation between GRBAS Scales and MDVP Parameters according to the Different Length of Voice Samples for MDVP Analysis)

  • 표화영;심현섭;임성은
    • 음성과학
    • /
    • 제7권2호
    • /
    • pp.71-81
    • /
    • 2000
  • The present study was performed to find efficient and useful length of voice sample for MDVP analysis, by investigating the correlation between perceptual GRBAS scales and objective MDVP measurements, with the five different lengths of voices of 20 patients with vocal polyp: 0.5, 1.0, 1.5, 2.0, 2.5 seconds. The results are following: (1) 1.5-second sample of MDVP showed the highest correlation between the perceptual judgement and objective measurement, and 1.0-second sample showed the lowest. The difference between the two samples was found in the number of the statistically significant correlated pairs of MDVP parameter-GRBAS scale. (2) The two extreme edges of the lengths, 0.5-second and 2.5 second showed no statistically significant difference.

  • PDF

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

  • Hyeona Bae;Dongbin Lee;DoHyeon Yu
    • 한국임상수의학회지
    • /
    • 제40권2호
    • /
    • pp.124-129
    • /
    • 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.