• Title/Summary/Keyword: 갑상연골

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Partial thyrotomy (갑상연골 부분절개술)

  • 이종원;김성남;김성곤;권영찬;양한모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.10.2-10
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    • 1977
  • Thyrotomy is very useful surgical procedure for laryngeal lesions; however, the web-formation at the anterior part of vocal cords is a frequent troublesome sequel of this procedure. Since the anterior commissure is not injured in Hayashi's hemithyrotomy, a web never results from this procedure. But the intralaryngeal exposure is too small to perform the surgery in this method. Partial thyrotomy was deviced as a new surgical technique to the glottic subglottic lesion. In partial thyrotomy, surgical procedure can be easily carried out under local anesthesia, in a wide field. This procedure has no side effects such as the web-formation at the anterior commissure, nor dyspnea after the surgery.

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재발성 흡인성 폐렴을 동반한 편측성대마비 환자의 제I형 갑상연골 성형술 1례

  • 남정권;남순열
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.85-85
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    • 1996
  • 편측성대마비에 대한 치료방법으로 외측에 위치한 성대를 수술적으로 교정하려는 시도는 최근 활발하게 진행되어 Teflon 등을 이용한 성대내 이물주입술, 제Ⅰ형 갑상연골 성형술 및 피열연골 내전술등의 시술들이 시행되어 왔다. 저자들은 최근 후두와 종양으로 개두술을 시행받은 후 발생한 재발성 흡인성 폐렴 및 애성을 주소로 내원한 49세 남자환자를 원인 미상의 우측 편측성 성대마비로 진단하고 제Ⅰ형 갑상연골 성형술을 시행한 후 흡인성 폐렴 및 애성 등의 증상의 현저한 호전을 관찰할 수 있었으며, 술전 Maximal comfortable phonation time(MPT)이 6.24초에서 술후 17초로 증가하는 등 좋은 결과를 얻은 1례를 치험 하였기에 보고하는 바이다.

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A Case of Thyroid Cartilage Fracture with Vocal Cord Paralysis (갑상연골 골절로 인한 성대마비의 치험례)

  • 조진규;차창일;안회영;조중생;홍남표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.14.2-14
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    • 1983
  • Complications and sequelae of the laryngeal trauma are respiratory difficulties, edema or swelling, cellulitis or abscess, fistula, perichondrium and chondritis, chronic laryngeal stenosis, vocal cord paralysis, decannulation difficulty, and impaired voice production etc. Generally, the treatment of laryngeal injuries consists of initial tracheostomy for adequate airway and later surgical intervention for its complications and sequelae. Recently, authors experienced a case of closed laryngeal injury with thyroid cartilage fracture, left vocal cord paralysis, swallowing difficulty and right clavicular fracture owing to automobile accident. With reconstructive surgery for thyroid cartilage fracture, we established an adequate airway, improved swallowing function and better voice production.

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Measurement of Various Dimensions of the Larynx in Korea Adult (한국인 성인의 후두계측에 관한 연구)

  • 박승훈;박성남;김미자;윤희병;정대현;장혁순;전승하;강주원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.9.1-9
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    • 1982
  • The authors have measured various dimensions of the larynx of twenty adult cadavers. (male; 13, female; 7) The result were as follows, 1) Transverse diameter between the greater horns of the hyoid bone; M.52.58mm, F.43.07mm. 2) Transverse diameter between the lesser horns of the hyoid bone; M.36.20mm, F.30.20mm. 3) Transverse diameter of the thyroid cartilage; M.50.58mm, F.42.58mm. 4) Transverse diameter of the cricoid cartlage; M.30.14mm, F.26.94mm. 5) Distance from the lower margin of the hyoid bone to the thyroid notch; M.12.83mm, F.10.92mm. 6) Distance from the lower margin of the thyroid cartilage to the lower margin of the cricoid cartilage; M.16.40mm, F.10.26mm. 7) Distance from the upper margin of the thyroid cartilage to the lower margin of the cricoid cartilage; M.34.65mm, F.34.61mm. 8) Anteroposterior diameter of the cricoid cartilage; M.25.32mm, F.20.01mm. 9) Transverse diameter of the epiglottis; M.29.32mm, F.22.08mm. 10) Vertical diameter of the epiglottis; M.35.90mm, F.27.90mm. 11) Transverse diameter between the cuneiform tubercles; M.17.69mm, F.13.52mm. 12) Length of the vocal fold; M.11.61mm, F.10.40mm. 13) Transvers diameter of the vocal fold; M.18.62mm, F.18.27mm. 14) Distance from the upper margin of the epiglottis to the vocal fold; M.42.45mm, F.34.52mm. 15) Anteroposterior length of the vocal fold; M.19.25mm, F.10.70mm.

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A Case of Protrusion of False Vocal Fold Resulting from the Deformed Thyroid Cartilage (변형된 갑상연골에서 기인한 가성대 돌출 1예)

  • Lim, Sung Hwan;Kim, Seung Woo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.47-50
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    • 2018
  • Trauma, congenital malformation and aging process can be a cause of the deviation of laryngeal prominence in the thyroid cartilage. Among these, the senility is the most common cause. Usually, ossification in the thyroid cartilage has occurred symmetrically, but the asymmetrical event leads to the shift of laryngeal prominence. Also, such deformity can provoke protrusion of false vocal fold. A 75-year-old man with hoarseness and globus sense in throat visited our clinic. Five years ago, he experienced a blunt trauma on left midline neck and had a concave deformity in the left thyroid cartilage lamina. Laryngoscopic findings revealed a marked protrusion in the left false vocal fold. We performed the laryngeal microsurgery to discriminate the tumorous condition. The pathology revealed non-pathologic mucosa. We report a unique and didactic case with a brief literature review.

Histopathologic study of laryngeal cancer with serial section (연속 대절편 제작을 이용한 후두암의 병리조직학적 연구)

  • 이강대;이종덕;유태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.90-90
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    • 1993
  • When illustrating the therapeutical plan of laryngeal cancer, there are difficulties in obtaining the three dimensional volume of tumor, submucosal extension of tumor, and particularly whether or not invasion on laryngeal cartilage has occurred. In particular clinical significance is the invasion to the laryngeal framework, which correlates with poor prognosis due to high frequency of local recurrence and cervical metastasis. Therefore the purposes of histopathological evaluation according to serial section study after laryngectomy are firstly, apprehension of the spread of laryngeal cancer and the pattern of invasion to laryngeal cartilage and secondly, obtaining an aid to establish direction of management to make higher the validity of preoperative clinical diagnosis. The following results were obtained : 1. The pattern of tumor invasion in cartilage 1) The tumor invades ossified cartilage chiefly and invades nonossified cartilage in extensive lesion only. 2) The tumor spread through intramarrow space at invaded ossified cartilage with intact perichondrium. 3) The perichondrium is strong barrier. 2. The incidence of cartilage invasion in order of frequency is as follow thyroid, arytenoid, cricoid, epiglottic cartilage. 3. The transglottic cancer has higher incidence(811.8%)of cartilage invasion. 4. The sensitivity, specificity, and accuracy rate of preoperative CT scan was 100%, 62.5%, 82.3% respectively.

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False Vocal Fold Hypertrophy Caused by Thyroid Cartilage Inward Bowing (갑상연골 내굴곡에 인한 가성대의 비대)

  • Kwon, Jin Ho;Choi, Byeong Il;Hong, Hyun Jun;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.1
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    • pp.51-54
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    • 2013
  • False vocal fold hypertrophy caused by diverse pathologic lesion, such as laryngeal amyloidosis, laryngeal lipidosis, laryngocele, saccular cyst and sulcus vocalis. False vocal fold hypertrophy, however, is also caused laryngeal structure deformity, irrespective of pathologic lesions. In this article, we report some cases of false vocal fold hypertrophy caused by inward bowing of thyroid cartilage. At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 male complained of hoarseness as subjects, and comfirmed of false vocal fold hypertrophy using the stroboscopy and larynx CT we checked vocal fold and laryngeal structure. Three patients with apparent hypertrophy of false vocal fold were investigated with computerized tomography (CT). In all patients, marked concavity of thyroid cartilage was revealed in CT scan at the level of the false vocal fold, and this deformity of the thyroid cartilage seemed to cause a protrusion of false vocal fold which taken as hypertrophy in stroboscopy. Careful palpation of the larynx and a CT scan taken at the level of the false vocal fold should be useful in determining whether hypertrophy of the false vocal fold is pathologic. For the next articles, It is necessary to discuss for the cause, diagnosis, treatment and prevention of inward bowing of thyroid cartilage.

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Laryngeal Measurement on Neck CT (경부 전산화단층촬영상에서 후두계측)

  • 유영채;오재식
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.71-81
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    • 1996
  • The normal larynx locates to the front of the neck symmetrically and the thyroid notch lies in the center of the neck, but practically the larynx is not symmetric in all people. From a clinical point of views, there are vague cases to decide whether a disordered laryngeal structure is within normal variations or a pathologic condition. The purpose of this study is to investigate the anatomy of the laryngeal framework in normal population. Authors investigate various measures of normal laryngeal framework, such as symmetry and length of the larynx, levels of the hyoid bone and vocal cord and angle of thyroid cartilage by using calipers and protractor on 45 cases of neck CT. The results are summerized as follows. 1. The laryngeal framework was asymmetric to a greater or lesser extent in most cases with directional preponderance to the right side. The degree of asymmetry did not differ among different age groups and between seres. 2. The level of the hyoid bone ranged from C2-C3 vertebrae to C5-C6 intervertebral space with most frequent level of C5. 3. The level of the vocal cord ranged from 01 vertebra to C6-C7 intervertebral space with most frequent level of C5. 4. The angle of thyroid cartilage ranged from 58 degree to 100 degree with average of 81.5 and mean angle between both thyroid alae were 77.24 degree in male and 87.88 degree in female.

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급성 후두기관손상 환자의 수술적 치료

  • Tae, Kyung;Jung, Yeon-Ki;Jung, Jin-Seok;Cho, Seok-Hyun; Lee, Seung-Hwan;Lee, Hyung-Seok
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.110-110
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    • 2003
  • 후두기관외상은 두경부 부위의 다른 외상에 비해 흔하지 않은데, 이는 연골의 유연성과 후두의 가동성, 후두가 하악과 흉골사이에 위치하여 외상시 보호 받게 되는 해부학적 특성에 기인한다. 그러나, 후두는 호흡과 발성에 중요한 기관으로 조기 진단과 정확한 평가, 적절한 치료를 못할 경우 생명을 위협 할 수 있고 삶의 질에 지대한 영향을 줄 수 있다. 이에 저자들은 급성 후두기관손상으로 수술적 치료를 받은 환자를 대상으로 손상 기전 및 임상 양상, 손상부위, 손상 정도 치료 등을 알아보고 향후 치료에 도움을 얻고자 하였다. 1996년부터 2003년까지 급성 후두기관 손상으로 수술적 치료를 받은 10명을 대상으로 후향적으로 조사를 하였다. 손상정도는 Schaefer의 분류를 따랐으며 술후 결과는 발성과 기도유지로 평가하였다. 발성의 경우 수상전과 동일하거나 유사할 경우 성공(good)으로, 수상전과는 다르지만 기능을 하는 경우는 양호(fair)로, 거의 음성이 나지 않거나 알아들을 수 없는 경우 불량(poor)로 분류하였고, 기도유지는 수상전과 동일하거나 유사할 경우 성공(good)으로, 경한 흡인이나 운동 유발성 호흡곤란이 있는 경우(fair)로 발관이 되지 않는 경우를 불량(poor)으로 분류하였다. 남녀 성비는 8대 2였고 30~40대가 4명으로 가장 많았다. 손상의 원인은 둔상인 경우(4예) 교통사고가 2례, cloth line 손상 2례, 관통상(6례)는 모두 칼에 의한 좌상이었다 증상은 피하기종이 9례, 애성이 7례, 호흡 곤란이 6례로 많았으며 손상부위는 갑상연골 골절이 5례(50%), 기도손상과 갑상선 손상이 각각 4례에서 관찰되었다. 그 외에도 윤상 연골 골절과 윤상갑상막 손상 등이 관찰되었다. 또한 점막 손상이 7례에서 관찰되었다. 성대마비는 내원시 4례에서 관찰되었다 치료는 수상 후 조기수술을 시행하였고 수상 부위를 개방하여 손상된 연조직을 일차 봉합하거나, 골절을 정복 고정하였고 3례에서 스텐트를 삽입하였다. 술후 기도유지는 모두 성공적이었고 발성기능은 6례에서 성공(good)적이었고 4례에서 양호(fair)의 결과를 보였다. 양호의 결과를 보인 모든 예가 내원시 성대 움직임의 마비나 저하를 보인 예였다. 급성 후두기관손상환자에서 조기 진단과 적절한 수술적 치료는 환자의 생명을 유지시키고 술후 발성 지능의 보존에 양호한 결과를 보였다.

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