• Title/Summary/Keyword: contact neck

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Surgical treatment of laryngeal contact granuloma (후두 접촉성 육아종의 수술적 치료)

  • Yoo, Byung Joon;Zheng, Tao;Lee, Dong Won;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.23-27
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    • 2017
  • Background and Objectives: Gastric acid reflux is known to be the most important cause of contact granuloma. Therefore, anti-gastric acid reflux medication has been used as the first line treatment although there are other treatment methods such as surgery or steroid injections. Actually, the role of surgery in the treatment of contact granuloma has not been established clearly. The purpose of this study was to evaluate the effectiveness of surgical treatment for contact granuloma. Materials and Methods: We retrospectively reviewed the medical records of 14 patients who were diagnosed with contact granuloma and treated with surgery from 2011 to July 2016 at Hanyang University hospital. Results: Of 14 patients, 9 (64.3%) were male and 5 (27.4%) were female. The mean age was 53.8 (${\pm}6.1$) years. The main symptoms were voice change followed by globus, dyspnea, and asymptomatic. Mean Reflux Finding Score (RFS) before surgery was 13.5 and mead Reflux Symptom Index (RSI) was 10.4. The causes of surgery were inadequate response to proton pump inhibitor (PPI) in 4 cases, airway obstruction with large granuloma in 8 cases, and differential diagnosis in 2 cases. Of 14 patients, recurrence occurred in 8 (53.3%) patients after surgery. In 8 recurrent cases, 5 patients showed complete remission and 3 patients showed partial remission with PPI medication. Conclusion: The role of surgery in the treatment of contact granuloma might be limited due to high recurrence rate.

Effectiveness of Proton Pump Inhibitor in the Treatment of Contact Granuloma (접촉성 육아종에서 양성자 펌프 억제제의 치료 효과)

  • Kim, Dong Hwan;Kim, Keon Ho;Jung, Seon Min;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.123-127
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    • 2017
  • Background and Objectives : Contact granuloma is granulation tissue that occurs mainly in the vocal process of arytenoid cartilage. Among several etiological factors, gastric acid reflux is known to be an important cause. The aim of this study was to evaluate clinical characteristics of contact granuloma and analyze the effectiveness of proton pump inhibitor in the treatment of contact granuloma. Materials and Methods : We retrospectively reviewed the medical records of 40 patients who were treated with proton pump inhibitor (PPI) for contact granuloma from January 2011 to December 2015. Reflux finding score (RFS), reflux symptom index (RSI) and size of granuloma were evaluated before and after treatment serially to assess the effectiveness of proton pump inhibitor. Results : Of 40 patients, 25 patients (62.5%) and 10 patients (25%) showed improvement and partial improvement of granuloma, respectively. Five patients showed no response. The mean times of partial improvement and improvement were $2.08{\pm}2.23$ months and $4.60{\pm}2.77$ months, respectively and mean duration of PPI treatment was $6.8{\pm}5.2$ months. Conclusion : Proton pump inhibitors is effective in the treatment of contact granuloma.

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Movement Patterns of Head and Neck in Proprioceptive Neuromuscular Facilitation (고유수용성 신경근 촉진법의 두부·경부 운동 패턴)

  • Bae, Sung-soo;Kim, Sang-soo
    • PNF and Movement
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    • v.3 no.1
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    • pp.27-34
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    • 2005
  • Objective : The purpose of this study was conducted to find correct head and neck patterns, manual contact. verbal commands with proprioceptive neuromuscular facilitation(PNF). Method : This is a literature study with books, seminar note and book for PNF international course. Result : Keep the information of the biomechanics and neural science in head and neck patterns and emphasize that manual contact, verbal commands and visual stimulus. Manual contacting for movement guide and stability of the $C_0/C_1$ verbal command and visual stimulus for correcting of the $C_0/C_1$ movements. Conclusion : In reminder for PNF learning, begin with head and neck and upper trunk patterns. In that time, Knott and Voss(1968) had not enough information about biomechanic movement components and neural science movement components. But Knott and Voss(1968) emphasized that head and neck patterns relate with trunk, upper extremities and lower extremities directly. Alar ligaments are relaxed with the head in neutral and taut in flexion. Axial rotation of the head and neck tightens both alar ligaments. The right upper and left lower portions of the alar ligament limit left lateral flexion of the head and neck. Therefore, head and neck patterns has to be modify. When head moving, eye and vestibular stimulus will be change. During head and neck patterns, must be consider about stimulus of eye system and vestibular system also.

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The Effect of Nasal Steroid Spray on Contact Granuloma of Larynx (접촉성 육아종 치료에 비강 스테로이드 분무가 미치는 영향)

  • Lee, GilJoon;Ahn, Dongbin;Sohn, Jin Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.79-82
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    • 2018
  • Background and Objectives : Laryngeal contact granuloma is benign inflammatory disease induced by excessive mechanical contact of larynx such as endotracheal intubation, voice abuse, laryngeal microsurgery as well as laryngopharygeal reflux. Because it is caused by various risk factors, multiple treatment modalities are required. The purpose of study is to evaluate treatment effect of topical steroid through nasal cavity in contact granuloma. Materials and Method : Fifty-two patients were enrolled in this study with exception of intubation granuloma. Patients were classified with four groups (Proton pump inhibitor (PPI), Nasal steroid spray (SPR), PPI+SPR, Observation) according to treatment modality. Results : Patients who treated with PPI (Odds ratio 2.45, p=0.03) and combination of PPI and SPR (Odds ratio 2.88, p<0.01) had significantly better response than patients who not treated with medical therapy. Conclusion : Combination therapy of nasal steroid spray and PPI is effective for contact granuloma of larynx and considered as a treatment of choice rather than PPI only treatment.

Treatment Result of Proton Pump Inhibitor, Steroid Inhaler and Botulinum Tonxin Injection for Contact Granuloma (양성자펌프억제제, 스테로이드흡입제, 보툴리늄톡신 주사를 이용한 접촉성 육아종의 치료 결과)

  • Park, Hyoung Min;Oh, Na Rae;Baek, Min Kwan;Kim, Dong Young;Woo, Joo Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.32-37
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    • 2017
  • Background and Objectives : This study evaluated the efficacy of combination therapy of proton pump inhibitor (PPI) and steroid inhaler (SI), with or without botulinum toxin injection (BTX) for contact granuloma. Subjects and Methods : Fourteen contact granuloma patients were enrolled in this study. Combination therapy of PPI and SI were used for the first line treatment. When combination therapy was not effective, BTX was performed as the second method. Treatment results were recorded as responsible or non-responsible. Farwell grade, size, history of voice abuse, gender, and reflux finding score (RFS) were compared between responsible group and non-responsible group. Results : Initial response rate was 28.6% after treatment of PPI and SI. BTX was performed on three un-responsible patients. After BTX injection, three patients had complete remission of granuloma. Final response rate was 50.0%. Un-responsible group had significantly higher RFS than responsible group. Conclusion : The efficacy of PPI and SI was limited for contact granuloma in this study. Botulium toxin injection was recommended in early phase when PPI and SI did not effective for contact granuloma. Prospective studies evaluating the effects of PPI and SI are warranted.

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Damage of Car Body and Passenger at Impact Contact (충돌 접촉에 있어서의 차체와 승객의 손상)

  • Han, Moon-Sik;Cho, Jae-Ung
    • Journal of the Korean Society of Manufacturing Technology Engineers
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    • v.20 no.3
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    • pp.280-283
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    • 2011
  • This study investigates the durability of car body and the safety of passenger inside car body in the case of the impact contact at passenger and car body. In case of front impact contact, maximum von Mises equivalent stress and principal stress become 3240.7MPa and 1634MPa respectively at the rear part of car body and the neck of dummy. And maximum total deformation occurred with 14.145mm at the hand of dummy. In case of side impact contact, maximum von Mises equivalent stress and principal stress become 7687.9MPa and 1690.7MPa respectively at the front part of car body and the lap of dummy. And maximum total deformation occurred with 16.414 mm at the foot of dummy. In case of rear impact contact, maximum von Mises equivalent stress and principal stress become 2366.6MPa and 1447MPa respectively at the front part of car body and the neck of dummy. And maximum total deformation occurred with 7.548mm at the rear part of car body. As the maximum von-Mises stress at side impact is shown with more than 700MPa as over two times at front or rear impact the danger of car body is increased. The great possibility of damage is shown at neck and hand of dummy with more than total displacement of 10mm.

A Case of Foreign Body Laryngeal Granuloma Mimicking Contact Granuloma (접촉성 육아종으로 오인된 후두 이물 육아종 1예)

  • Kim, Hye soo;Kim, Sun woo;Lee, Jin;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.27-30
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    • 2020
  • Among lesions in the larynx, laryngeal contact granuloma due to persistent tissue irritation can typically be attributed to endotracheal intubation, vocal abuse, or gastro-esophageal reflux disease. Treatment typically includes voice therapy, lifestyle changes and use of anti-reflux medication. Microsurgical removal is only indicated in cases of severe dyspnea due to mass size. Foreign body granuloma is a response of to any foreign material in the tissue. Foreign body granulomas are sometimes misdiagnosed as soft tissue tumors when the causative foreign body is not initially found. Delayed treatment of these foreign bodies may cause complications. We present a case of larynx granuloma due to impacted foreign body, probably fish bone, in the larynx that mimicked contact granuloma. We initially used anti-reflux medication, but to no avail. The laryngeal mass, observed through laryngoscopy, showed no improvement and therefore necessitated a proper pathologic diagnosis. We were able to successfully treat it via trans-oral laser CO2 microsurgery before any complications developed.

Clinical Studies for the Development of Non-contact Thermometer to Take Easily the Body Temperature of Domestic Animals (가축에서 간이 체온측정 비접촉성 체온계 개발을 위한 임상적 연구)

  • 김용준;이대영;한경호
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.357-363
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    • 2003
  • These studies were carried out to develop non-contact thermometer to take easily the body temperature of domestic animals instead of taking rectal temperature. For the studies, 86 cattle, 57 horses, 72 pigs, 43 goats, and 42 dogs were used and body parts as neck, flank, axilla, lateral abdomen, gluteus, inguinal region, or jugular groove were chosen for taking temperature according to different species. Two types of commercial non-contact thermometers were used to take the temperature of certain body part and at the same time the rectal temperature using digital thermo-meter was taken to compare the difference of temperature between rectum and certain body part. The difference of mean temperature in cattle between rectum and axilla and flank were 0.52 and $2.41^{\circ}C$, respectively, using non-contact thermometer I, whereas $3.02^{\circ}C$ between rectum and flank using thermometer II. The difference of mean temperature in horses between rectum and axilla, gluteus, and jugular groove were 0.52, 1.49, and $0.26^{\circ}C$, respectively, using thermometer I, whereas 2.28 ane $0.92^{\circ}C$ between rectum and gluteus or jugular groove using thermometer II. The difference of mean temperature in swine between rectum and flank, inguinal region, and neck were 1.23, 0.21, and $0.8^{\circ}C$, respectively, using thermometer I, whereas 1.42, 0.711, and $1.25^{\circ}C$ using thermometer II The difference of mean temperature in goats between rectum and lateral abdomen and inguinal region were 1.02 and $0.12^{\circ}C$, respectively, using thermometer I, whereas 1.96 and $1.01^{\circ}C$ using thermometer II. The difference of mean temperature in dogs between rectum and lateral abdomen, inguinal region, and neck were 3.26, 0.24, and $2.37^{\circ}C$, respectively, using thermometer I, whereas 3.45, 0.56, and $2.61^{\circ}C$ using thermometer II.

Clinical Application of Botulinum Toxin to Contact Granuloma and Vocal Nodule (보툴리눔 독소를 이용한 성대육아종과 성대결절 치료)

  • Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.82-86
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    • 2019
  • In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.