• Title/Summary/Keyword: 인두

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SURGICAL MANAGEMENT OF VELOPHARYNGEAL INCOMPETENCE USING SUPERIORLY BASED PHARYNGEAL FLAP (상부기저형 인두피판을 이용한 구개인두 부전증의 외과적 처치)

  • Ann, Jye-Jynn;Chang, Se-Hong;Park, Chi-Hee;Woo, Sung-Do
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.3
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    • pp.338-345
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    • 1991
  • Velopharyngeal incompetence (VPI) is a condition of inadequate functional valving between the oral and nasal cavities that results in hypernasal speech and nasal air escape. VPI is caused by the following factors ; cleft palate, soft palate defect, pharyngomegaly, velopharyngeal sphincter muscle anomaly and maxillary advancement surgery, etc. Velopharyngeal function is assessed by a variety of measures that include speech evaluation, cephalogram, airflow study, videofluoroscopy and nasoendoscopy. The management of VPI is classified into four main groups ; prosthesis, insertion of implant, palatoplasty and pharyngoplasty. Pharyngeal flap is the most common surgical procedure for correcting VPI since Schoenborn's report in 1875. We report seven cases of VPI which were treated by modified modified superiorly based pharyngeal flap with good results.

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ESOPHAGEAL SPEECH : MORPHOLOGICAL STUDY OF THE PHARYNGOESOPHAGEAL SEGMENT (식도발성 : 인두식도분절의 형태학적 연구)

  • 홍원표;이원상;유병문;윤주헌;김유현;정태섭
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.13.2-14
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    • 1987
  • 후두 악성종양의 치료로서 후두전적출술을 시행하는 경우 환자는 의사 전달수단인 언어의 장애를 동반하게 된다. 후두전적출술후 언어장애를 해결하기 위해 여러종류의 음성재활법이 제시되어 만족할 만한 결과를 얻고 있으나 그중 식도발성은 대부분의 학자들이 인정하는 가장 추천할 만한 방법이지만 시간이 걸리고 배우기가 어려워 환자들이 쉽게 단념할 수 있다는 단점이 있다. 저자들은 후두전적출술을 받은 10명의 환자에서 인두식도분절을 fluoroscopy로 관찰하여 다음과 같은 결과를 얻었기에 보고하는 바이다. 1) 식도발성을 잘하는 예에서는 pseudoglottis의 전후길이가 좌우길이보다 길었고 식도발성을 못하는 9례에서는 좌우길이가 전후길이보다 크거나 길었다. 2) 식도발성을 못하는 9례중 7례에서 인두식도 분절을 관찰할 수 있었다. 3) 인두식도분절에서 pseudoglottis의 모양이 식도발성을 잘하는 예에서는 정상성대와 유사하게 나타났다. 4) 식도발성을 잘하는 예에서는 pseudoglottis의 위치가 윤상인두괄약근 상방 2cm부위에서 관찰되었으며 식도발성을 못하는 9례중 6례에서는 pseudoglottis의 위치가 윤상인두괄약근 위치였으며 2례에서는 pseudoglottis가 각각 윤상인두괄약근상방 1cm, 1.5cm에 있었다.

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A Biomechanical Modeling of Human Pharyngeal Muscular Dysfunction by Using FEM(Finite Element Method) (유한요소법을 이용한 인두의 기능이상에 대한 생체역학적 모델)

  • Kim Sung Jae;Bae Ha Suk;Choi Byeong Cheol;Kim Sung Min
    • Journal of Biomedical Engineering Research
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    • v.24 no.6 s.81
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    • pp.515-522
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    • 2003
  • Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement! into the esophagus and functioning as airway passages. In this study, structural changes of pharyngeal dysfunction are analyzed by biomechanical model using CT and FEM(finite clement method). Loading condition was assumed that equal pressure was loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model. the pharyngeal dysfunctions was classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke. we assumed that a change of material property is caused by muscular tissue stiffness. A deformation of cross sectional area of the pharynx is analyzed increasing the stiffness $25\%,\;50\%,\;75\%$ in each case on the basis of stress-strain relationship. Based on three-dimensional reconstruction of pharyngeal structure using limited factor - techniques and the optimization procedure by means of inverse dynamic approach. the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

The first human case of Clinostomum complanatum (Trematoda: Clinostomidae) infection in Korea (새인두흡충(Clinostomum complanatum)에 의한 인두염 제1례)

  • 정동일;문주환
    • Parasites, Hosts and Diseases
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    • v.33 no.3
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    • pp.219-224
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    • 1995
  • The authors present the first human case of Clinostomum pharyngitis in Taegu, Korea. The patient was a 56-year old male who visited an otolarlngology clinic due to foreign body sensation and pain of the pharyngeal region for 3-4 days. He used to eat raw fresh-water fish. Otolaryngological examinations revealed a living worm adhered to the right posterior pharyngeal wall. The worm removed was identified as C. complonotum after morphological observations. It is likely that more attention should be paid to eating raw fresh-water fish in Korea siC regards to Clinostomunl pharyngitis.

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A study on the biomechanical modeling of human pharynx by using FEM(Finite Element Method) (유한요소기법에 의한 인두의 생체역학모델에 관한 연구)

  • Kim, Seong-Min;Kim, Nam-Hyeon
    • Journal of Biomedical Engineering Research
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    • v.19 no.4
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    • pp.423-429
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    • 1998
  • Human pharynx is unique, acting as a complex interchange between the oral cavity and esophagus, and between the nasal cavity and lungs. It is actively involved in the transport of food and liquid, producing the forces that guide that bolus into the upper esophagus and away from the adjacent larynx and lungs. This study intended to develop a biomechanical model of the human pharynx, utilizing Finite Element Method(FEM). Within each model changes in cross sectional intralumenal area were calculated and compared with the area from the computer-generated FE model. Area matching allowed estimation of intraluminal pressure gradients during swallow. The estimated pharyngeal pressure gradient varies from one region to another. The estimated pharyngeal pressure gradients showed different patterns for upper four levels and lower four levels. The contraction velocity for upper four levels is much higher than lower four levels. The higher contraction velocities and pressure gradients in the upper levels are consistent with the bolus velocities required for efficient swallow.

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The effect of sensorimotor stimulation for ingestion in dysphagic patients who have nonprogressive brain damage - Preliminary Study - (연하장애 환자의 구강인두 기능회복을 위한 감각운동 자극의 효과)

  • Kang, Hyun Sook
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.211-219
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    • 1988
  • 운동학습이론인 감각운동 통합이론을 본 연구의 개념적 틀로하여 한방병원에 입원한 뇌졸중 환자 중 구강인두 기능이 저하된 환자를 대상으로 감각운동자극이 구강인두 기능에 미치는 효과를 조사하기 위하여 1988년 3월초부터 5월 중순까지 예비실험 연구하였다. 감각운동자극을 주기 전에 구강인두기능을 시정하고 대상자 전원에게 저하된 구강인두기능에 따라 감각운동자극을 선택하여 하루 3번 매식후 30분전에 주었으며, 이를 일주일 동안 계속하였다. 일주일 후 다시 구강인두기능을 측정하여 자극을 주기전, 후의 기능정도를 paired t-test로 비교 분석하였으며 다음과 같은 성적을 얻었다. 1. “자극을 주기 전보다 준 후에 머리와 목운동 조절점수가 높을 것이다”라는 제1가설은 지지되었다(t=-2.71, df=5, p=.042). 2. “자극을 주기 전보다 준 후에 씹는 능력이 증가되었으나, 통계적으로는 유의하지 않았다(t=-2.00, df=5, p=.102). 3. “자극을 주기 전보다 준 후에 입술운동의 조절점수는 높을 것이다”라는 제3가설은 지지되었다(t=-4.77, df=5, p=.005). 4. “자극을 주기 전보다 준 후에 혀 운동 조절점수가 높을 것이다”라는 제4가설은 지지되었다(t=-3.61, df=5, p=.015). 5. 자극을 주기 전보다 준 후에 연하능력이 증가되었으나 통계적으로는 유의하지 않았다(t=-2.24, df=5, p=.076). 이상의 결과로 감각운동자극은 연하장애환자의 구강인두기능을 증진시키는데 효과적인 방법이라고 할 수 있다.

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Quantitative Evaluation of Dysphagia Using Scintigraphy (신티그라피를 이용한 연하곤란증의 정량적 평가)

  • Park, Seok-Gun;Hyun, Jung-Keun;Lee, Seong-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.276-289
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    • 1998
  • Purpose: To evaluate dysphagia objectively and quantitatively, and to clarify the effect of neck position and viscosity changes in patients with aspiration and laryngeal penetration. Materials and Methods: We studied 35 patients with dysphagia and 21 normal controls using videofluoroscopy and scintigraphy. Videofluoroscopy was performed with barium with three different viscosity, and scintigraphy was done with water, yogurt, and steamed egg mixed with Tc-99m tin colloid. If aspiration was found during videofluoroscopic examination, patient's neck position was changed and study repeated. Videofluoroscopy was analyzed qualitatively. We calculated 7 quantitative parameters from scintigraphy. According to the videofluoroscopic findings, we divided patients into 3 subgroups; aspiration, laryngeal penetration, and no-aspiration group. Results: The result of videofluoroscopy revealed that the most common finding was the delay in triggering pharyngeal swallow. Pharyngeal transit time (PTT) and pharyngeal swallowing efficiency(PSE) in patients with aspiration were signifi-cantly different from other groups. After neck position change, aspiration could be reduced in all of 7 patients, and laryngeal penetration reduced by about 82%. PTT and PSE were also improved after position change. Aspiration and laryngeal penetration occurred more frequently in thin liquid swallowing than in thick liquid and solid swallowing. Conclusion: PTT and PSE were useful for the evaluation of dysphagia. Aspiration and laryngeal penetration could be reduced when appropriate position assumed. We could decrease the chance of aspiration by changing the patient diet consistency. Scintigraphy might be useful tool to quantitate and follow up these changes.

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A STATISTICAL STUDY ON THE CORRELATION BETWEEN THE NASOPHARYNGEAL SPACE AND THE DENTOFACIAL STRUCTURES (비인두강(鼻咽頭腔)과 안면골격간(顔面骨格間)의 상관관계(相關關係)에 대(對)한 통계학적(統計學的) 연구(硏究))

  • Oh, Sungjin;Kinoshita, Z
    • The korean journal of orthodontics
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    • v.17 no.2
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    • pp.255-277
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    • 1987
  • 부정교합(不正交合)의 발생요인(發生要因)의 하나로서 비인두강(鼻咽頭腔)의 협착(狹窄)이 거론(擧論)되어 왔다 본(本) 연구(硏究)는 안면골격(顔面骨格)의 형태결정(形態決定)에 비인두강(鼻咽頭腔)의 기여정도(寄與程度)를 파악(把握)하고자 함에 있다 연구자료(硏究資料) 및 방법안(方法安) 한국인(韓國人) 성인(成人) 남녀(男女) 156 명(名)의 측모두부X선규격사진(側貌頭部X線規格寫眞)을 사용(使用)하여 NEC PC-9801 VM2 Personal Computer와 Oscon GT-4000 Digitizer에 의한 data 입력(入力)을 행(行)한 후 통계처리(統計處理)를 행(行)하였다 통계처리(統計處理)로서는 각계측치(各計測値)에 대하여 남녀별(男女別)로 평균치(平均値), 표준편차치(標準偏差値)를 산출(算出), Student's t-test를 행(行)하고, 비인두강(鼻咽頭腔) 계측항목(計測項目)과 안면골격(顔面骨格)의 각(各) 계측치간(計測値間)의 상관관계(相關關係)의 검토(檢討)를 행(行)하였다 결(結) 과(果) 1 남녀(男女)의 성차(性差)로서, 여자(女子)보다 남자(男子)가 상악골(上顎骨)에 대해 하악골(下顎骨)이 돌출(突出)되어 있었으며, 안면고(顔面高)가 컸다 2 Ba-S-PNS와 S-PNS-Ba간(間)에 부(負)의 상관(相關)이 인정(認定)되어, 이 두 계측치간(計測値間)애 상호작용(相互作用)이 있는 것으로 판단 되었다 3 비인두강(鼻咽頭腔)의 깊이는 하악(下顎)의 전후위치관계(前後位置關係)와 유의(留意)한 상관관계(相關關係)를 보였다 4 비인두강(鼻咽頭腔)의 깊이와 안면(顔面)의 깊이와는 관련성(關聯性)이 없는 것으로 판단 되었다 5 비인두강(鼻咽頭腔)의 깊이와 안면고간(顔面高間)에 유의(有意)한 부(負)의 상관(相關)이 시사(示唆)되었다 6 비인두강(鼻咽頭腔)의 고경(高經)과 안면고간(顔面高間)에 유의(有意)한 상관관계(相關關係)가 인정(認定)되었다.

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The Structures of the Pharyngeal Bones and Teeth in Two Korean Ricefishes (Pisces, Adrianichthyidae), Oryzias latipes and O. sinensis (한국산 송사리속 Oryzias 어류 2종의 인두골과 인두치 구조)

  • Kim, Hyun-Tae;Park, Jong-Young
    • Korean Journal of Ichthyology
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    • v.25 no.1
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    • pp.33-37
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    • 2013
  • A study on the structures of the pharyngeal bones and teeth in two Korean ricefishes, Oryzias latipes and O. sinensis, was carried out to find out interspecfic differences. In the pharyngeal bones, both two species have a pair of upper pharyngeal bone (stilliform shape) and lower pharyngeal bone (rectangular shape). In the lower pharyngeal bones, in particular, the number of the row was 6 to 7 in O. latipes and 5 to 6 in O. sinensis. The pharyngeal teeth also showed different types in two species: O. latipes of a top-hooked type and O. sinensis of a conical type. Through this study, we confirmed that the two Korean ricefishes show distinctive characteristics in the structure of the pharyngeal teeth.

Comparison of Two Rapid Antigen Detection Tests for Diagnosis of Group A Streptococcal Pharyngotonsillitis (A군 연쇄구균성 인두편도염 진단을 위한 두 종류 신속항원검사법의 비교)

  • Song, Seung Kyu;Hong, Mi Ae;Oh, Kyung Chang;Ahn, Seung In;Tae, Mi Hyon;Shin, Hye Jung;Chang, Jin Keun;Cha, Sung Ho
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.973-979
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    • 2002
  • Purpose : Recently, a number of rapid antigen detection tests have been available to diagnose group A streptococcal pharyngotonsillitis. The purpose of this study was to determine the sensitivity, specificity and consistency of the two rapid antigen detection tests. Methods : Among the patients who visited our clinic from November 2001 to February 2002, 61 patients who had clinical findings of pharyngeal erythema or edema, pharyngeal exudates and soft palatine petechiae were enrolled in our study. A total of 61 patients were tested with rapid antigen detection tests and throat culture. BD $LINK2^{TM}$ Strep A(Becton, Dickinson & Company, U.S.A.) and $QuickVue^{(R)}$ $In-Line^{TM}$(Quidel Corporation, U.S.A.) were selected for rapid antigen detection tests. Results : Of the 61 patients tested, 22 patients were confirmed as group A streptococcal pharyngotonsillitis by throat culture. The BD $LINK2^{TM}$ Strep A had a sensitivity of 81.8% and a specificity 89.7%. The positive and negative predictive values were 81.8% and 89.7%, respectively. The $QuickVue^{(R)}$ $In-Line^{TM}$ had a sensitivity of 77.3% and a specificity of 100%. The positive and negative predictive values were 100% and 88.6%, respectively. The kappa values of BD $LINK2^{TM}$ Strep A and $QuickVue^{(R)}$ $In-Line^{TM}$ were 0.72 and 0.81, respectively. Conclusion : In addition to high sensitivity, specificity and consistency, both kits are easy to use and simple to interpret, and therefore have the potential to be used with backup throat culture for diagnosis of acute pharyngotonsillitis.