• 제목/요약/키워드: laryngeal disease

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양성 후두 질환 환자의 후두미세 수술 전후 음성 장애 지수의 변화 (Change of Voice Handicap Index After Laryngeal Microsurgery for Benign Vocal Fold Lesions)

  • 김지희;최효근;박범정
    • 대한후두음성언어의학회지
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    • 제26권1호
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    • pp.34-39
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    • 2015
  • 후두 미세 수술을 받은 환자에서 수술 전과 후 전체적인 음성 장애 지수를 비교했을 때 모두 호전이 있는 것으로 나타났다. 영역별로는 기능적, 물리적 영역에서는 남녀간의 차이가 없었으나 감성적 영역에서는 여자보다 남자에서 수술 후 만족도가 큰 것으로 나타났다. 이번 연구를 통해 음성 장애 지수가 음성의 상태를 모두 대변할 수는 없지만 객관적인 음향, 공기역학적 검사로 평가할 수 없었던 음성 장애에 대한 환자의 인식 정도를 정량화하여 평가할 수 있는 편리한 도구임을 확인 할 수 있었다.

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소아에서 후두 마스크를 이용한 기관지이물 제거 경험 1예 보고 (A Case of Bronchial Foreign Body Removal During Trans-Laryngeal Mask Airway Fiberoptic Bronchoscopy)

  • 서지원;김종렬;박규호;강준구;최진
    • Tuberculosis and Respiratory Diseases
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    • 제44권6호
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    • pp.1433-1439
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    • 1997
  • 소아에서 기관지내 이물은 드물지 않게 접하는 질환이 나 본 예의 환자의 경우와 같이 소아에서 후두 마스크를 사용하여 기관절개술(tracheostomy)을 회피하고 기관지 이물을 제거한 경험예는 현재까지 아직 발표된 바 없고, 아직까지도 마취과의사를 제외한 다른 진료분야의 의사들에게는 후두 마스크가 널리 알려져 있지 않기에 저자들은 후두 마스크를 사용하여 굴곡성 기관지경으로 기관지 이물을 성공적으로 제거한 1례를 문헌고찰과 함께 보고하는 바이다.

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후두 근긴장이상증과 근긴장성 발성장애 (Laryngeal Dystonia and Muscle Tension Dysphonia)

  • 김지원;최승호
    • 대한후두음성언어의학회지
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    • 제25권2호
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    • pp.79-81
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    • 2014
  • Spasmodic dysphonia (SD) is a chronic, focal, speech-induced, action-specific dystonia, resulting strained voice. Muscle tension dysphonia (MTD) may also result in a strangled, strained voice quality, usually as a result of compensation for underlying laryngeal disease such as glottal insufficiency. Patients with SD and MTD were suffered from the severely limiting people's communication, especially via telephone and in noisy backgrounds. SD is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks, which is difficult to distinguish from MTD. In this review article, we present the characteritics and management of SD and MTD.

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한국인에서의 후두크기와 음성 기본주파수의 상관관계에 대한 연구 (A study of the Correlation of External laryngeal Size with the Fundamental frequency of the Larynx in Korean)

  • 이승환;김성근;이형석;김선곤
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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    • pp.69-69
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    • 1993
  • 음성 기본주파수는 성대 전체의 단순한 진동에 의해 형성되며 음성의 특징을 결정하는 가장 중요한 요소 중의 하나이다. 저자들은 후두질환의 발견과 치료의 기초로 이용하고자 20대 성인 남녀 각각 50명과 10세 내외의 소아 남녀 각각 40명을 대상으로 외후두의 크기와 기본주파수를 측정하여 다음과 같은 결과를 얻었다. 1. 성인에서 평균 외후두의 크기는 남자 37.8$\pm$3.15 mm, 여자 31.0$\pm$3.19 mm였고 기본주파수의 평균은 남자가 117.8$\pm$10.09 Hz, 여자가 220.26$\pm$13.75 Hz로 각각 통계학적으로 유의하게 차이가 있었다. (p<0.05) 3. 소아에서 평균 외후두의 크기는 남자 25.67$\pm$4.53 mm, 여자 27.28$\pm$2.77 mm였고 기본주파수의 평균은 남자가 224.88$\pm$15.89 Hz, 여자가 239.25$\pm$15.92 Hz로 통계학적으로 유의하게 차이가 있었다. (p<0.01) 5. 성인에서 외후두의 크기와 기본주파수는 서로 유의한 상관관계를 보였다. (r=0.48)

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T2 후두 편평세포암종에서 단독 방사선치료와 항암방사선병합치료의 비교 연구 (The treatment outcome of T2 laryngeal squamous cell carcinoma in one institution with long term follow-up: Radiotherapy alone vs Chemoradiotherapy)

  • 진성민;김재구;박경석;정익주;정웅기;이동훈;이준규;임상철;윤태미
    • 대한두경부종양학회지
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    • 제34권2호
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    • pp.11-15
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    • 2018
  • Background/Objectives: The efficacy of radiotherapy alone versus chemoradiotherapy has been studied in patients with T2N0M0 laryngeal squamous cell carcinoma. Materials & Methods: Thirty nine patients with newly diagnosed T2N0M0 laryngeal squamous cell carcinoma were treated with either radiotherapy(RT group, 66-70Gy) or chemoradiotherapy(CRT group, cisplatin based concurrent chemoradiation with or without 2 cycles induction chemotherapy including cisplatin, $5-FU{\pm}$ docetaxel / radiation therapy same with above mentioned). The mean follow-up was 73.5 months. Results: The overall survival (OS), disease specific survival (DSS), disease free survival (DFS), and larynx preservation survival (LPS) at 5 years were 70%, 79%, 67%, and 71%. The complete response rate was 82.4% in RT group, and was 95.5% in CRT group. OS (57% vs 80%), DSS (69% vs 86%), DFS (52% vs 77%), and LPS (63% vs 77%) at 5 years were higher in CRT group than RT group, but it was not statistically significant. In subsite analysis, CRT group tends to improve DFS, compared to RT group, in glottic cancer (p=0.06). The toxicities were tolerable and no fatal case was observed in both groups. Conclusion: Chemoradiotherapy is effective as primary therapy for T2 laryngeal squamous cell carcinoma and showed manageable treatment induced toxicity.

후두 종양의 임상적 및 병리조직학적 고찰 (The Clinical and Histopathological Study of Laryngeal mass)

  • 김화성;한경수;이준기;정덕희;박재훈
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.9.1-10
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    • 1981
  • 1975년 3月부터 1980년 3月까지 애성을 주소로 하여 본원에 입원하여 수술 받은 183명의 후두 종양 환자에 대한 임상적 통계와, 그중 병리조직학적으로 확진된 88case의 성대 결절과 폴립 환자에서, 성대 결절(30case), 국한성 폴립 (48), 미만성 폴립 (10)을, 임상적인 분류하에 현미경학적 검사로 다음과 같은 결과를 얻었기에 보고하는 바이다. I. 임상적 관찰 1) 전체 183명중 성대 결절 82명 (45%), 후두 폴립 53명 (29%), 삽관후 육아종 3명 (1%), 후두 유두종 18명 (10%), 후두 결핵 2명 (1%), 후두암 25명 (14%)를 차지했다. 2) 남녀 비는 성대 결절 3 : 4, 후두 폴립은 1 : 1, 삽관후 육아종 1 : 2, 후두 유두종 3 : 2, 후두암 11 : 1.성대 결절, 삽관후 육아종은 여자, 후두암과 후두 유두종은 남자에게 많았다. 3) 연령 분포는 성대 결절 20~30대, 후두 폴립 30~40대, 삽관후 육아종 20대, 후두 결핵 10대와 40대, 후두암은 50대이었다. 4) 증상발현으로부터 내원까지의 이환기간의 분포를 보면 성대 결절과 폴립은 5개월~1년, 후두 유두종과 삽관후 육아종은 1년이내, 후두 결핵과 암은 1년~3년이었다. 5) 발생 부위를 보면, 성대 결절, 폴립 후두 유두종은 성대의 전 1/3~중 1/3경계, 삽관후 육아종은 중 1/3~후 1/3, 이었다. 6) 발생측에 있어서 후두 결절과 유두종은 성대의 양측에 오며, 후두 폴립 5 : 3, 삽관후 육아종 2 : 1로 우측에 많았다. 7) 후두 종양의 크기는, 성대 결절 1~2mm(67%), 후두 폴립 3~5mm(42%), 삽관후 육아종 6~10mm(67%), 후두 유두종 1~2mm(39%), 후두 결핵과 암은 10mm 이상의 크기로 산재해 있었다. 8) 후두 종양의 증상은 애성이 90%이상, 연하통은 후두암과 결핵, 호흡곤란은 삽관후 육아종, 후두 유두종, 결핵, 암에서 나타났으며, 그외에 후두의 이물감, 작열감, 소양감 둥의 증상이 있었다. 9) 과거력은 Smoking과 관련 있는 것이 후두 결핵 50%, 후두암 40%이었고, 후두 유두종은 빈번한 상기도 감염이 33%에서 있었다. 10) 직업에서는 어떤 특별한 통계학적 의미를 찾아볼 수 없었다. II. 병리조직학적 관찰 1) 성대 결절과 플립의 상피세포는 중층 편평 상피로 덮여 있으나, 위축, 극세포증, 이상 각화증과 과각화증의 소견을 보이며, 그중 과각화증과 극세포증이 많았다. 2) WHO classification에 의해 섬유성 점액 종양, 혈관성, 유리질성의 4가지 단계로 나누였는데, 성대결절은 점액 종양 병변 60%, 국한성 폴립은 점액 종양 병변과 함께 혈관성, 유리질성 병변이 많았고, 미만성 폴립은 혈관성 병변(80%)이었다. 3) 전 18례의 후두 유두종에서, Exophytic 형이며 편평세포형이 17례(94.5%), 역형이며 이행세포형이 1례 (5.5%)이었다. 4) 후두암은 편평세포 : 선암의 비율이 24 : 1이었다.

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인후두역류질환의 진단 및 치료 경향; 이비인후과 전문의 설문조사 결과 (Current Trends in Diagnosis and Management of Laryngopharyngeal Reflux Disease; A Survey of Korean Otolaryngologists)

  • 이재권;김태욱;손영익
    • 대한후두음성언어의학회지
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    • 제20권2호
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    • pp.141-147
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    • 2009
  • Background and Objectives: Although laryngopharyngeal reflux disease (LPRD) is a widely recognized disease in the field of otolaryngology, controversies still exist regarding the diagnosis and treatment for it. The purpose of this survey was to find out current trends in diagnosis and management of LPRD among Korean otolaryngologists. Materials and Method: Questionnaires were obtained from 26 Korean otolaryngology specialists by electronic balloting, and 46 members of the Korean Society of Head and Neck Surgery (KSHNS) bye-mail. Survey participants were asked about their preferences in diagnostic policy, duration/dosage of antireflux treatment, and their familiarity to the reflux symptom index (RST) and the reflux finding scores (RFS). Results: The majority of the survey participants (64%) preferred empiric therapy trial with proton pump inhibitors (PPIs) based on patients' symptoms and their laryngeal findings. PPIs alone (27%) or PPIs with prokinetics (32%) were usually prescribed as a first line treatment mostly with once daily schedule in the morning before meal and for less than 4 months of duration (86%). More than 90% of participants were aware of the RSI and RFS, but less than 50% of them were actually using those items in the clinics. Conclusion: Most of Korean otolaryngologists who participated in this survey answered that they prefer starting empirical treatments with proton pump inhibitors mainly based on the patient's symptoms and their laryngeal findings.

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HPV-Associated p16INK4A Expression and Response to Therapy and Survival in Selected Head and Neck Cancers

  • Kanyilmaz, Gul;Ekinci, Ozgur;Muge, Akmansu;Celik, Sevinc;Ozturk, Furkan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.253-258
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    • 2015
  • Background: Development of squamous cell cancer of head and neck (SCCHN) is associated with human papillomavirus (HPV) infection, which in turn is closely related with expression of $p16^{INK4A}$. Loss of $p16^{INK4A}$ expression by deletion, mutation, or hypermethylation is common in SCCHN. We here evaluated $p16^{INK4A}$ as a prognostic marker of treatment response and survival in our SCCHN patients with laryngeal, hypopharyngeal or nasopharyngeal cancers. Materials and Methods: 131 patients diagnosed with SCCHN between January 2,2006 and July 17, 2010 were examined for $p16^{INK4A}$. The median age was 60 years (15-82 years). Fifty one patients were stage I-II and 80 were stage III-IV. Immunohistochemical expression of $p16^{INK4A}$ was analyzed in pretreatment paraffin-embedded tumor blocks. The influence of $p16^{INK4A}$ status on disease-free survival, and overall survival after treatment was evaluated. Results: $p16^{INK4A}$ positivity was found in 58 patients (44%). Tumor-positivity for$ p16^{INK4A}$ was correlated with improved disease free survival (70.1 months vs 59 months) and improved overall survival (2, 3 and 5-year values; 77% vs 72%, 70% vs 63% and, 63% vs 55%; respectively). On multivariate analysis, stage was determined as independent prognostic factor for disease-free survival. Conclusions: Stage was the major prognostic factor on treatment response and survival in our patients. $p16^{INK4A}$ status predicts better outcome in laryngeal, hypopharyngeal or nasopharyngeal cancer cases treated with surgery plus adjuvant radiochemotherapy as well as with definitive radiation therapy and/or chemotherapy.

후두전적출술 후 장기적인 삶의 질에 대한 평가 (Long Term Assessment of Quality of Life in Laryngectomee)

  • 권순영;유홍균;정광윤;최정철;한승훈;최종욱
    • 대한두경부종양학회지
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    • 제16권2호
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    • pp.191-195
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    • 2000
  • Objectives: Despite various attempts to preserve the normal voice in advanced laryngeal cancer, it is inevitable for many advanced laryngeal cancer patients to undergo total laryngectomy and thus making a trade off between quality and quantity of life. Laryngectomees are faced with voice loss, change in physical appearance and health deterioration which hinder their efforts to rehabilitate back into their family and employment leading to poor quality of life. The objectives of this study were to evaluate the quality of life in long term surviving laryngectomees to, define the factors which are most important in determining their present quality of life and to propose a theoretical model for quality of life after laryngectomy in Korea. Materials and Methods: From 1986 to 1995, 120 laryngectomees with no evidence of disease were followed up for at least 3years were evaluated. Each of 15 quality of life domains with a total of ten points were given for a quality of life score. Results: There was no significant difference in the physical-mental adaptation index such as general health and mental health between the laryngectomees and control group(p>0.05). However, social adaptation index such as social activity, occupational status and economic status for laryngectomees were significantly lower with 2.3, 3.5, and 4.4 points compared to control group with 8.5, 7.6, and 7.1 points respectively(p<0.05). Conclusion : Vocational and social rehabilitation should be emphasized with highest priority for improving their economic status and thus improving their quality of life.

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전방 접근법을 통한 경추 수술 후 성대 마비의 임상양상 (Clinical Features of Vocal Cord Paralysis after Anterior Cervical Spine Surgery)

  • 김일우;김범규;김용복;노영수;안회영;박일석
    • 대한후두음성언어의학회지
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    • 제17권2호
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    • pp.111-114
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    • 2006
  • Objective : The anterior approach to the cervical spine now selves as the surgical across of choice for cervical spine disease. Vocal cord paryalysis(VCP) follow the procedure as a complication, and it is most common complication of this procedure. However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the clinical features of vocal cord paralysis in anterior cervical spine surgery(ACSS). Material and Method : Retrospectively, medical records of patients who underwent ACSS at Hallym university medical center, Hangang Sacred Heart Hospital between January 2000 and March 2006 were reviewed. Further detailed review of the patients with documented VCP after surgery was then performed. Results : 242 ACSSs were performed and 9 patients with VCP were identified (3.71%) In 9 patients with VCP, 8 patients had right-sided approaches (6.01%) and 1 patient had left-sided approach (0.91%). All 9 patients had VCP on ipsilateral side and 8 patients were recovered completely on follow up period. Duration of ACSS, multilevel exposure and low-level (below the C6 level) exposure have been found to be associated with higher risk. Conclusion : For avoiding the recurrent laryngeal nerve injury, surgeon have to understand the clinical features of VCP in ACSS. As right-sided approach has a greater risk of recurrent laryngeal nerve injury, we suggest that the left-sided approach be given more consideration.

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