• Title/Summary/Keyword: 갑상연골

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Laryngeal trauma with thyroid cartilage and hyoid bone frachture (갑상연골과 설골 골절을 동반한 후두외상 1례)

  • Kang, Sun-Mook;Choe, Hwan;Jung, Kwang-Yoon;Baek, Seung-Kuk
    • Korean Journal of Bronchoesophagology
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    • v.13 no.1
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    • pp.51-54
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    • 2007
  • Laryngeal trauma is an uncommon injury but can be life-threatening event. So, early diagnosis is important for appropriate surgical management and better outcome. Because there have been some controversies about Initial airway management, appropriate diagnostic evaluation, operative indication and timing, operative technique, it is difficult to make a common management pathway in laryngeal trauma. A case of laryngeal trauma with thyroid cartilage and hyoid bone fracture is presented with a brief review of literature.

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A Study on the morphologic characteristics of each constitution's trunk (체간부의 사상체질별 형태학적 특징에 관한 연구)

  • Hong, Suck-chull;Lee, Su-kyung;Lee, Eui-joo;Han, Gi-hwan;Chou, Yong-jin;Choi, Chang-seok;Koh, Byung-hee;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.1
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    • pp.101-142
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    • 1998
  • 1. Objects The base of classification of Sasang Constitution was the different congenital formation of organs such as lungs, spleen, liver, kidneys, and it was expanded from the viscera region of lungs, spleen, liver, kidneys to the body shape of trunk. The researched about body shape of Sasang Constitution have had points of issues which derived by measurement with hands. But this study was measured the characteristics of body shape putting in importance of anatomical position with the computerized 3-Dimension scanner, which minimized the errors of measurement, and it was abled the cubic measurement such as volume, area of cross section as well as round length. 2. Materials & Method The examinee was healthy male 40 persons and female 20 persons from 20's to 40's, who was diagnosed by the specialist of Sasang Constitutional Medicine. The body shape was measured round length, area of cross section, and volume of 31 anatomical points and the 25 hypothesis with the Rapid 3D Color Scanner Model 3030 RGB/PS. And the characteristics of each constitution's body shape was derived. 3. Results & Concousion In female, Taeumin had the largest trunk and Soeumin had the smallest trunk compared to other constitution, but Soyangin had only the smallest neck. Soeumin has the smallest round length of nipple and the $CV_{12}$, and Soyangin has the smallest breadth of ASIS. Soyangin had the smallest volume from thyroid bone to the highest points of armpits and from sternum to nipple. Taeumin had the largest volume from sternum to the $CV_{12}$ and from sternum to xiphoid process. In male, Taeumin had the largest trunk and Soeumin had the smallest trunk from the level of thyroid bone to ASIS. Soyangin has the longest distance and Soeumin has the shortest distance from nipple to the lowest of breast. Taeumin had the largest volume of trunk and Soeumin had the smallest volume of trunk. In the ration of four-Cho, Taeumin had the longest distance from the highest points of armpits to nipple and Soyangin had the shortest distance of that. Soyangin had the smallest ratio of the height of upper middle cho. Soeumin had the smallest ratio from the $CV_{12}$ to navel among trunk. In the correlation among the four Cho, Taeumin had the negative correlation between the Upper-Cho and the Lower-Middle-Cho significantly.

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Surgical Anatomy of the Sternal Median and Paramedian Approaches on the Junction of the Veins and the Arteries of the Pig Heart (흉골 정중선 절개와 방정중선 절개 접근술에 따른 돼지 심장 대혈관들의 외과적 해부구조의 육안적 비교)

  • Mi-young An
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.95-99
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    • 1999
  • 돼지 심장의 해부학적 구조에 대해서는 많은 연구가 보고되어 있으나 흉골 정중선 절개와 방정중선 절개 후 절개선에 나타나는 돼지 심장 대혈관들의 외과적 해부구조에 대한 보고는 아직 없고 심장적출 및 수술에 외과적 해부구조의 숙지가 필수적이므로, 체중 15kg - 25kg의 돼지 12마리를 4마리씩 3군, 즉 정중선절개군, 우측방정중선절개군, 좌측방정중선절개군으로 나누어 흉골열개 후 나타난 심장 대혈관들의 육안적 외과구조를 보고하고 심장적출술을 시도해 각 수술절개 접근법에 따른 수술의 용이성을 관찰하여 더 나은 수술접근법을 선택하는데 필요한 정보를 제공하고자 본 실험을 실시하였다. 그 결과, 우측과 좌측 방정중선절개법에 의해 흉골을 완전 열개시에는 제 1흉골과 갑상연골 부위에서 정중선으로 접근하는 초승달형 절개를 통해 internal mammary artery의 절개 위험성을 피할 수 있음을 발견하였고 흉골정중선절개에서는 상행대동맥의 정 중앙부에 aortic cannula를 쉽게 장착할 수 있었고 특히 비숙련자에게 더 적절한 수술 방법임을 알 수 있었다. 한편 숙련자가 심장적출이 아닌 동맥관개존증등과 같은 심장수술의 경우에는 방 정중선절개로써 환축의 수술 후 통증을 감소시키고 조기치유가 가능하다면, 초승달형 절개법을 응용한 방정중선 절개를 권할 수 있고 이에 따른 임상적 관찰이 요구되는 바이다.

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Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case (전위를 동반한 갑상연골 골절의 자연 치유 치험 1례)

  • Ryu, Hyun-Ho;Lee, Byung-Kook;Jeung, Kyung-Woon
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

Comparison of Fundamental Frequency Control Between Thyroarytenoid Muscle and Cricothyroid Muscle: In Vivo Canine Model (생체 발성 모형에서 갑상피열근과 윤상갑상근의 기본주파수 조절 기능의 비교)

  • ;Gerald S. Berke
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.70-70
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    • 1993
  • Fundamental frequency is controlled by contraction of both TA and CT muscle. While activity of the CT is known well, little is known regarding the effect of the TA muscle on vocal fold vibration. To study this, a previously developed in vivo canine laryngeal model was modified. Isolated TA muscle activation was obtained by stimulating sectioned terminal TA branches through small thyroid cartilage windows. The results indicated that TA muscle activation is a major determinant in vocal register shift from falsetto to modal phonation. F0 increased with increasing TA activation in modal register, On the other hand, the F0 decreased with TA activation when the evoked voice belonged to falsetto register. Subglottic pressure increased gradually and OQ decreased gradually with TA activation.

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Esophageal Reconstruction for Hypopharyngeal Stricture After Severe Corrosive Injury (부식성 하인두 협착시 식도재건술)

  • 변정욱;구본일
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.48-54
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    • 1997
  • Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

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A Case of Thyroid Cartilage Calcification which was Misunderstood as an Esophageal Foreign Body (식도 이물로 오인된 갑상 연골의 석회화 1예)

  • Kang Mu Hyun;Jang Min Hee;;Ju Young Min
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.52-54
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    • 2004
  • Esophageal foreign bodies are common problems in the part of otolaryngology department, and may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheoesophageal fisula, pneumothorax and pyothorax. Therefore, early diagnosis and intervention is needed to reduce morbidity and motality. But, calcification of the laryngeal cartilages may masquerade as foreign body in some patients with a history of foreign body ingestion. Recently, We experienced a case of calcification of thyroid cartilage which was misunderstood as an esophageal foreign body and report this case with a review of literatures.

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HYOID BONE POSITION IN CLASS I, II AND III MALOCCLUSIONS (I급.II급.III급 부정교합환아에서의 설골의 위치)

  • Song, Yun-Ju;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.3
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    • pp.564-571
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    • 1999
  • The importance of the hyoid bone lies in its unique anatomic relationships. It has no bony articulations but provides attachment for muscles, ligaments, and fascia of the pharynx, mandible, and cranium. Various studies have documented a variability of hyoid bone position in relation to changed mandibular position or head posture. The aim of this study is to investigate the hyoid bone position and inclination on cephalometric radiographs of three groups of patients exhibiting Class I, II, and III malocclusions. The conclusions obtained from this study can be summarized as follows ; 1. Class III malocclusion patients show a more anterior position of the hyoid bone and also less steep inclination of the hyoid bone. 2. The anteroposterior position of the hyoid bone relative to the cervical vertebra and mandible was very constant. 3. The hyoid bone represented the anterior bony boundary of the pharynx at a lower level than PNS.

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Results of Pharyngocolostomy in Intractable Caustic Pharyngeal Stricture (난치성 식도협착에서의 인두-대장 문합술의 결과)

  • 박충규;심영목;김진국;김관민
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.561-566
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    • 1999
  • Background: It is not easy to surgically correct caustic pharyngeal strictures and a lot of effort is required to restore normal swallowing after the surgery. The authors reviewed the course in patients who underwent pharyngocolostomy. Material and Method: From August 1995 to March 1998, 6 patients with caustic stricture underwent esophageal reconstruction surgery. The time of injury to the replacement of the esophagus was from 3 months to 2 years and 4 months. The left colon was used in all patients. The surgical route was used under the sternum in 5 patients and through the esophageal hiatus in 1 patient. In the cervical anastomoses, the cervical pharyngocolic anastomosis was performed on the left pyriform sinus after a partial resection of the thyroid cartilage in 3 patients and on the posterolateral aspect of the inferior pharyngeal constrictor in 3 patients. Result: Postoperative complications consisted of a dysphagia in 3 patients and left vocal cord palsy in 1 patient. There was no cervical anastomotic stricture. Revisional procedures consisted of an esophageal dilation and free jejunal graft in 1 patient, supraglottic scar band resection in 1 patient, and colonic mucosal resection in 1 patient. Swallowing training was required in the 3 patients with dysphagia. Restoration of normal swallowing was obtained in all patients between the 9th and the 303rd day. Conclusion: Pharyngocolostomy is a satisfactory method of treatment for patients with intractable caustic stricture. Pharyngocolojejunostomy is an effective alternative for esophagocologastrostomy in cases where gastric outlets are involved.

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The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation (기관내 삽관이 힘든 경우에서 Bonfils Intubation Fibrescope 사용의 임상적인 효과)

  • Lee, Deok-Hee;Kwon, Il-Chi
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.154-161
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    • 2007
  • Background : This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. Materials and Methods : For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. Results : The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a $SpO_2$<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). Conclusion : In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.

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