• Title/Summary/Keyword: 후두성형술

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The Choice of Laryngeal Reinnervation Versus Medicalization Laryngoplasty in Unilateral Vocal Fold Paralysis (일측성 성대 마비의 치료에서 후두 신경재식법과 내측 후두 성형술의 선택)

  • Kim, Heejin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.1-6
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    • 2020
  • In unilateral vocal fold paralysis (UVFP) patients, we try to improve their symptoms such as hoarseness or aspiration by restoring nerve functions or medialization laryngoplasty (ML), etc. Until now, ML (thyroplasty and/or arytenoid adduction) is considered as gold standard of treatment for UVFP. However, if recurrent laryngeal nerve (RLN) is damaged and use of RLN is feasible during operation, laryngeal reinnervation (LR) would be a good option. Anastomosis with ansa cervicalis to RLN is most common reinnervation method. Delayed LR may be considered in young patients when the RLN denervation period is not long (less than 2 years) for the treatment of surgery-related UVFP. Injection laryngoplasty and laryngeal framework surgery showed great voice outcomes in UVFP. Combination therapy (neuromuscular pedicle innervation with ML) also showed good post-operative voice outcomes even in longer periods (over 2 years). In pediatric patients, LR would be considered as a good treatment option because all procedures need to general anesthesia.

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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Carbon Dioxide Laser Treatment of Laryngotracheal Stenosis ($CO_2$ Laser에 의한 기관 및 후두협착증의 치험)

  • 김기령;홍원표;김광문;정명현;서장수;최은창;진종부
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.7.2-8
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    • 1983
  • Chronic laryngotracheal stenosis is becoming increasingly prevalent. Many acceptable procedures such as repeated dilation, laryngotracheoplasty and end-to-end anastomosis had been done according to it's indication, but it have given less than favorable results. Since 1972 the experimental and clinical experiences of Jako and Strong, the carbon dioxide laser has offered a valuable tool to the otolaryngologist. Mihashi (1976) and Lyons (1980) reported use of laser to the management of laryngotracheal stenosis with successful results. From April 82' to March 83', using the carbon dioxide laser, the various obstructing lesions were excised microendoscopically which include four patients considered failures from conventional surgical technique and one patient laryngeal stenosis occured after hemilaryngectomy and neoglottis formation. We concluded as follows, 1) Laser surgery is a useful method to the management of laryngotracheal stenosis in maintaining adequate airway. 2) Formation of granulation after laser surgery was less than other conventional methods.

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A CASE OF LARYNGEAL STENOSIS TREATED WITH $CO_2$ LASER ($CO_2$ Laser에 의한 후두협착증의 치험예)

  • 김영숙;이종욱;강경화;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.19.3-20
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    • 1987
  • 후두협착증은 그동안 여러 치료방법에도 불구하고 이비인후과영역에서 가장 어려운 문제 중의 하나로 남아 있다. 1979년 McGee등이 후두 및 기관협착증에 처음으로 $CO_2$ laser를 사용한 이래 미세현미경술과 조화되어 후두의 상흔 및 육아조직을 제거하는 정교하고, 쉽고, 지혈이 우수한 방법으로 대두되고 있다. 또한, 주기적인 후두 및 기관확장술, 국소 steroid주입법, stenting등의 보조요법과 병행하여 사용될 때 개방성형술의 빈도를 훨씬 줄일 수 있다. 최근 저자들의 상흔성 비후에 의한 후두협착 환자에서 $CO_2$ laser를 사용하여 협착을 제거하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

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Anesthesia for Office Based Vocal Fold Injection (외래 시행 성대주입술을 위한 마취 방법)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.56-60
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    • 2020
  • Vocal fold injections are usually performed with a patient wake in an office under local anesthesia. For comfortable and safe office-based procedures, thorough anesthesia and premedication should be provided to the following three regions; nasal cavity, oropharynx, and larynx. Topical lidocaine is most widely used anesthetics on office based procedure. Lidocaine has a low to intermediate potency, 45 minutes to 60 minutes' duration of action, and onset of sufficient anesthesia within 90 seconds of topical administration. Tetracaine, prilocaine, ropivacaine, and bupivacaine also have been used in the office-based procedures. Nasal decongestant, oxymetazoline, is also used for widening nasal cavity by constriction of nasal mucosa. The amount of topical and local anesthetics used in vocal fold injection rarely exceeds toxic doses. The physician should know proper anesthesia techniques and must be familiar with the safe dose and complication of all anesthetics used.

Soft Tissue Response of Rabbit Larynx to Implanted Foley Catheter for Short Duration (토끼 후두내 삽입한 풍선도관에 대한 단기 조직 반응)

  • Yoo, Young-Sam;Choi, Chan;Kim, Dong-Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.34-39
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    • 2011
  • Objectives : This study was aimed to investigate soft tissue reaction such as inflammation, immune reaction of rabbit larynx to implanted foley catheter. Methods : After 8 rabbits were anesthetized, their thyroid cartilage and trachea were exposed through a skin incision and a 6 French foley catheter was inserted into the thyroid cartilage via cricothyroid membrane and ballooned with normal saline (0.1 mL). The other end of catheters were ligated and cut. The wound was closed keeping catheter under the skin. Two rabbits were used as normal control Larynges were removed for pathologic examination at 4weeks and 8 weeks of the study respectively, Results : Ten rabbits were euthanized for gross and pathologic examination (5 rabbits after 4 weeks and 5 rabbits after 8 weeks). All rabbits survived the study periods and inflammations or foreign body reactions were minimally found on pathologic examinations. Conclusions : Foley catheter could be useful and safe material for vocal fold medialization in rabbit models.

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Preliminary Reports of Injection Laryngoplasty with Plasma Gel (Plasma Gel을 이용한 성대 주입술의 예비적 보고)

  • Ahn, Seong-Yong;Lee, Hong-Kyoung;Kim, Jin-Pyeong;Park, Jeong-Je;Joo, Yeon-Hee;Lee, Eun-Jae;Woo, Seung-Hoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.32-36
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    • 2010
  • Background : Vocal fold injection using autologous material (fat or collagen) is very useful. However, Autologous material have variable resorption times and results, Plasma gel is a new injection material. The purpose of this study is to introduce a new injection material and discuss the effectiveness and complications. Subjects and Method: Eleven cases with vocal cord paralysis were analyzed after plasma gel injection, The plasma gel was acquired from patient's own blood. The preoperative and postoperative parameters including maximum phonation time (MPT) and subject aspiration score were analyzed. Results: There was a significant improvement in MPT and aspiration score in the case of vocal cord palsy. There was only one laryngeal complication. Conclusion : According to these preliminary results, the injection laryngoplasty with Plasma gel is a simple, safe, cheap procedure for temporally vocal fold palsy.

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Tracheoplasty with using the Costal Cartilage, Including the Perichondrium, for Treating a Tracheoinnominate Artery Fistula - Surgical experience of one case - (기관절개술 후 발생한 기관무명동맥루에서 연골막를 포함한 늑연골을 이용한 기관성형술 - 수술치험 1예 -)

  • Cho, Seong-Ho;Kae, Yoe-Kon;Kim, Jong-In;Cho, Sung-Rae
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.651-654
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    • 2007
  • Tracheoinnominate artery fistula (TIF) is a very rare complication that can happen after long standing tracheostomy or insertion of an endotracheal tube and its mortality is very high. This condition requires early diagnosis and urgent management because of the life threatening results from tracheal obstruction or hypovolemic shock that is caused by massive bleeding. We report here on a case of successful tracheoplasty with using the costal cartilage, including the perichondrium, in a patient with laryngeal stricture, and this was done to preserve the trachea for the following operation to relieve the laryngeal stricture.