• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.2
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• pp.91-97
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• 2009

Background: Nasotracheal intubation for general anesthesia is preferred for oral and maxillofacial procedures because it provides improved access to the operative site. Fiberopic nasotracheal intubation is a useful technique when airway management seems difficult. But, intaoral bleeding is considered as the important factor that makes fiberopic nasotracheal intubation difficult. The purpose of our study was to elucidate the effect of laryngeal view and bleeding on intubation difficulty during fiberopic intubation. Methods: We studied 461 patients undergoing nasotracheal intubation with permission. Laryngeal view grades were examined with laryngoscope and were recorded. Then, intubation time and the amounts of bleeding were measured during fibroptic nasotracheal intubation under general anesthesia. Results: There was no significant difference between laryngeal view grade and intubation difficulty (P > 0.05). But severity of bleeding increased intubation difficulty (P < 0.05). Conclusions: In this study, the significant amounts of bleeding had an effect on intubation difficulty.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.161-167
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• 2001

Background and Objectives： Total laryngectomy is often required for advanced cases. But this operation induced the many inconvenience of basic daily life. Early diagnosis of laryngeal cancer is very important to prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening test using voice has many advantages such as simple, less interventional. Voice collection by Automatic Response System(ARS) is comfortable and easy to got acoustic sample. Thus author tried to got the acoustic parameters which can differentiate normal, benign. and malignant laryngeal diseases and also checked the availability of parameters on neural network system. Materials and Methods: Author has evaluated the voice from 17 laryngeal cancer patients and 45 benign laryngeal disease patients who visited at Department of Otolaryngology, Pusan National University Hospital from May 1998 to April 2001, and 15 normal control. Author chose the sir Parameters (Jitt. vFo, Shim, vAm, NHR, SPI) that was thought to be related with voice collected by ARS among thirty-three parameters analysed by a Multi-Dimensional Voice Program (MDVP). Two-step neural network was used for the availability of six parameters. Results: The detection rate of normal voice by ARS voice analysis is 78.5% and detection rate of abnormal voice was 97.1 o/o. Among abnormal voice, the detection rate of benign laryngeal diseases and laryngeal cancers were 82.4 o/o, 70.6% respectively. Conclusion: Author concluded that six parameters and Matlab based neural network software may be effective in development of acoustic screening system for laryngeal cancer and further study should be necessary for development of new acoustic parameters.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.35-43
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• 2014

Purpose: The purpose of this study was to establish novice user guidelines for efficient external laryngeal manipulation for intubation in difficult airway management. Methods: This study included 59 pre-qualified junior and senior emergency medical service students. The participants were instructed at random to intubate a manikin equipped with a cervical collar, thus simulating a difficult airway, using three types of external laryngeal manipulation: bimanual laryngoscopy, backward-rightward pressure, and cricoid pressure. The resultant intubation time and glottic view grade scores were estimated. Results: Intubation time was longest using the bimanual manipulation method, followed by cricoid pressure and backward-rightward pressure. A low Cormack-Lehane glottic view score was obtained regardless of the assisted compression method used. Conclusion: Backward-rightward pressure may be the most efficient method of external laryngeal manipulation on the basis of the intubation time and improvement in glottic view.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.97-100
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• 2010

After introduction of operating microscopes and laser devices in the 1960's, monumental innovation for had been achieved in laryngeal microscopic surgery. The development of high-tech operating devices made the laryngeal surgery less invasive and more precise. There were long histories until developing of the modem instruments and surgical techniques. The simple oral mirror introduced by Bozzoni in 1807 is the beginning of laryngoscope. In 1859 Green carried out the laryngeal operation under direct view of larynx. The appearance of local topical anesthesia on throat had contributed to laryngeal surgery coming into wide use. Killian and Jackson made much contribution to developing the design of laryngoscope. After that, modem laryngeal surgery have been developed with development of the stabilizing holder of laryngoscope and optical devices. We propose carefully the direction of the development of the laryngeal surgery by historical consideration of laryngeal surgery and instrumental development.

• Journal of Veterinary Clinics
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• v.22 no.3
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• pp.214-219
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• 2005

This experiment was conducted in order to identify the effect of the laryngeal mask airway and it's clinical utility on cardiovascular system, intraocular pressure and stress reaction at the time of anesthesia care. The heart rate, systolic arterial pressure, diastolic arterial pressure and intraocular pressure were significantly reduced in the experimental group to be compared with the control group. But, there were no significant differences in mean arterial pressure, central venous pressure and blood cortisol concentration between both groups. In view of the above results, it is thought that the airway management using the laryngeal mask airway will be useful to reduce the stress condition in the induction of anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.77-78
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• 2017

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.122-125
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• 2016

Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.293-301
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• 2020

Background: The success rate of intubation under direct laryngoscopy is greatly influenced by laryngoscopic grade using the Cormack-Lehane classification. However, it is not known whether grade under direct laryngoscopy can also affects the success rate of nasotracheal intubation using a fiberoptic bronchoscpe, so this study investigated the same. In addition, we investigated other factors that influence the success rate of fiberoptic nasotracheal intubation (FNI). Methods: FNI was performed by 18 anesthesiology residents under general anesthesia in patients over 15 years of age who underwent elective oral and maxillofacial operations. In all patients, the Mallampati grade was measured. Laryngeal view grade under direct laryngoscopy, and the degree of secretion and bleeding in the oral cavity was measured and divided into 3 grades. The time required for successful FNI was measured. If the intubation time was > 5 minutes, it was evaluated as a failure and the airway was managed by another method. The failure rate was evaluated using appropriate statistical method. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were also measured. Results: A total of 650 patients were included in the study, and the failure rate of FNI was 4.5%. The patient's sex, age, height, weight, Mallampati, and laryngoscopic view grade did not affect the success rate of FNI (P > 0.05). BMI, the number of FNI performed by residents (P = 0.03), secretion (P < 0.001), and bleeding (P < 0.001) grades influenced the success rate. The AUCs of bleeding and secretion were 0.864 and 0.798, respectively, but the AUC of BMI, the number of FNI performed by residents, Mallampati, and laryngoscopic view grade were 0.527, 0.616, 0.614, and 0.544, respectively. Conclusion: Unlike in intubation under direct laryngoscopy, in the case of FNI, oral secretion and nasal bleeding had a significant effect on FNI difficulty than Mallampati grade or Laryngeal view grade.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.79-80
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• 2017

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.7.1-7
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• 1977

According to Bryce and Cranston, prolapse of the laryngeal ventricle is a protrusion of the ventricular mucosa into the laryngeal cavity from inflammatory hyperplasia or edema. This 53 year old female patient was admitted to our hospital March 11, 1977 with the chief complaints of dyspnea and hoarseness. On admission, evaluation of the larynx revealed smooth surfaced round pink-reddish mass protruding bilaterally beneath the false cord. The airway was almost completely obstructed by the tumor mass, but neither ulceration nor infiltration was seen, also no lymphnode was palpable in the neck. Tracheotomy was performed for the relief of dyspnea and biopsy was done endoscopically. Histologic study showed chronic inflammation. On April 2, 1977 laryngofissure was performed under general anesthesia. Laryngeal examination revealed smooth surfaced, plate like, pinkreddish mass protruding bilaterally from both laryngeal ventricles into the laryngeal cavity and extending the whole length of the ventricle antero-posteriorly and touching each other. Biopsy was taken of the mass and the result was non-specific inflammatory hyperplasia of the larynx. Postoperatively, the air way is completely clear of obstruction but mild hoarseness still remains. No recurrent mass is visible in the larynx. In view of the symptoms, operative findings and histological findings, this case is diagnosed as "Prolapse of the laryngeal ventricle". The prolapse of the laryngeal ventricle is a very rare lesion and is reported with review of the literature.