• 제목/요약/키워드: 후두수술

검색결과 307건 처리시간 0.021초

설소대단축증의 수술적 방법에 따른 비교 (A Comparison Study of the Surgical Outcome According to the Surgical Technique)

  • 홍원표;서용석;송미현;양해동;김성수
    • 대한후두음성언어의학회지
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    • 제14권1호
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    • pp.10-15
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    • 2003
  • Background and Objectives : Ankyloglossia, commonly known as tongue-tie, is the result of a short, fibrous lingual frenulum or highly attached geioglossus muscle. This condition may cause sucking and swallowing problems, articulation disorders, interference with the tongue's cleansing action, increased the potential for caries, and inability to lick the lips, play a wind instrument, and 'french kiss' Treatment is surgical procedure. In the most cases, horizontal sectioning and mucosal suture(the conventional procedure) is preferred, but in some cases, the Z-plastic procedure is effective. This study is aimed to compare the result of the two procedures. Materials and Methods : Twenty tongue-tie patients underwent operation. Ten patients were treated with the Z-plastic procedure and ten patients were treated with the conventional method randomly. We checked preoperative mobile tongue length, postoperative mobile tongue length, operation time and postoperative wound states. Results : Among the 20 cases of tongue-tie, 2 cases are excepted due to pre-operative state, thus we compared 18 cases of tongue-tie patients. There is no statistically significant difference between the two procedures except in operation time. The Z-plastic procedure apparently needs a little more operating time. Conclusion : Patients treated with the Z-plastic procedures appeared to have better outcomes, but the data shows no statistical significance except in operating time. Consequently, the Z-plastic procedure is indicated in a limited amount of cases.

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외상성 후두 협착 치험례 (A Case of Traumatic Laryngeal Stenosis)

  • 강연섭;정재봉;변우현;조윤태;박해수
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.9.2-9
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    • 1981
  • 심한 두경부 외상은 교통사고·폭행·산업재해 등으로 인하여 나날이 증가일로에 있다. 이 때는 대개 시급한 기관절개술 및 신경외과적 치료가 필요한 경우가 많은데, 두부 외상에 대한 치료뿐 아니라 그에 상당하는 관심을 가지고 경부외상을 치료하지 않으면 후일에 심각한 합병증 및 후유증을 초래할 수 있으므로 주의를 환기 할 필요가 있다. 최근 저자들은 약 1년 6개월 전에 집단 폭행으로 두부 및 후두부에 외상을 입고 타 병원에서 두개골절제술 및 기관절개술을 받은 20세 남자 환자에서 발생한 후두 협착을 다단계 수술로써 치료하여 좋은 결과를 얻었으므로 이에 문헌 고찰과 아울러 보고하는 바이다.

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갑상선 수술 후 음성 변화에 대한 비대면 음성언어치료 증례 (A Case of Voice Therapy for Patient Who Voice Changed after Total Thyroidectomy Using Contactless Voice and Speech Therapy Service Platform)

  • 이길준;박수나
    • 대한후두음성언어의학회지
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    • 제32권1호
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    • pp.43-47
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    • 2021
  • Voice therapy is effective in many voice and speech disorders. However, patients have low accessibility to therapeutic facilities due to disease-unrelated reasons such as lack of time and pandemic of COVID-19. Contactless voice therapy could be an alternative and may helpful to all patients with voice and speech problems. We developed contactless voice and speech therapy program on the necessity of improving accessibility. Herein, we report the first case of voice therapy to 30 year-old female patient who complained voice change after total thyroidectomy using contactless voice and speech therapy service platform in Korea.

점막하구개열 수술 후 지속된 구개인두부전에 대한 수축근 구개인두성형술 증례 (A Case of Sphincter Pharyngoplasty for Persistent Velopharyngeal Insufficiency After Submucosal Cleft Palate Surgery)

  • 이윤형;최연수;김성열;최정석
    • 대한후두음성언어의학회지
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    • 제33권3호
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    • pp.188-192
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    • 2022
  • Velopharyngeal insufficiency (VPI) is a phenomenon that can occur due to anatomical or neurological causes of the soft palate. VPI can make the patient difficult to articulate through hypernasality and nasal emission. There has been needed the customized treatment, as VPI can occur for many causes. We present the case of 21-year-old male who took palate plastic surgery 20 years ago for congenital submucosal cleft palate. As he had poor contraction of both lateral side of velopharynx, he was diagnosed with coronal type VPI. Through sphincter pharyngoplasty, he can obtain improvement of articulation accuracy. We would like to share this challenged case.

전기극 뇌자극과 광시각 유발전위 검사를 통한 인간의 시각 피질에서의 기능적 분화 양상 (Functional Mapping of the Human Visual Cortex Using Electrical Cortical Stimulation and Flash Visual Evoked Potentials)

  • 이향운;홍승봉;서대원;태우석;홍승철
    • Annals of Clinical Neurophysiology
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    • 제1권1호
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    • pp.10-18
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    • 1999
  • 연구배경 및 목적 : 시각 인지 과정은 영장류 실험을 통하여 다소 정보를 얻을 수 있었으나 인간에서는 아직 완전하게 이해되지 않고 있다. 이 연구의 목적은 뇌자극과 시가유발전위 검사를 토대로 인간의 시각피질의 기능적 분화와 시간 순으로 활성화되는 양상을 보고자 한 것이다. 연구방법 : 간질 수술을 위하여 후두엽과 인접 부위에 광범위하게 피질하전극을 넣은 22명의 환자를 대상으로 전기적 뇌자극과 시각유발전위 검사를 시행하였다. 뇌자극시 나타나는 반응은 형태, 색, 및 움직임의 세 가지로 크게 나누고 형태는 다시 단순, 중간 및 복잡한 형태로 세분하였다. 시각유발전위는 P1 혹은 IV파의 latency를 측정하였다. 결과 : 단순 혹은 중간 형태는 흔히 occipital pole과 striate cortex에서 발생하였다. 색반응은 후두엽의 기저부 즉, fusiform, lingual, inferior occipital gyri를 자극할 때 관찰되었다. 움직임 반응은 내측기저부 및 외측의 측후두엽 혹은 측두정후두부의 경계부에서 주로 나타났다. 결론 : 이러한 결과는 인간의 시각피질이 시각의 여러 가지 구성성분 즉, 형태, 색, 및 움직임에 대해서 각각 별도로 분화되어 있다는 것을 보여준다. 도한 시각자극이 전해지면 striate cortex와 occipital pole이 가장 먼저 활성화되고 이어서 내측 및 외측 후두엽 부위가 활성화된다는 것을 알 수 있다. 이러한 사실을 종합하여 보면 인간의 시각피질은 시각의 여러 구성성분별로 별도로 발달된 해부학적 경로를 통하여 각각의 기능에 대하여 특수하게 분화된 뇌세포에서 시각정보를 각각 분석하되 일정한 시간순서에 의한다는 것을 시사하는 것이다.

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음성인식프로그램을 이용한 무후두 음성의 말 명료도와 병적 음성의 수술 전후 개선도 측정 (Speech Intelligibility of Alaryngeal Voices and Pre/Post Operative Evaluation of Voice Quality using the Speech Recognition Program(HUVOIS))

  • 김한수;최성희;김재인;임재열;최홍식
    • 대한후두음성언어의학회지
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    • 제15권2호
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    • pp.92-97
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    • 2004
  • Background and Objectives : The purpose of this study was to examine objectively pre and post operative voice quality evaluation and intelligibility of alaryngeal voice using speech recognition program, HUVOIS. Materials and Methods : 2 laryngologists and 1 speech pathologist were evaluated 'G', 'R', 'B' in the GRBAS sclae and speech intelligibility using NTID rating scale from standard paragraph. And also acoustic estimates such as jitter, shimmer, HNR were obtained from Lx Speech Studio. Results : Speech recognition rate was not significantly different between pre and post operation for pathological vocie samples though voice quality(G, B) and acoustic values(Jitter, HNR) were significantly improved after post operation. In Alaryngeal voices, reed type electrolarynx 'Moksori' was the highest both speech intelligibility and speech recognition rate, whereas esophageal speech was the lowest. Coefficient correlation of speech intelligibility and speech recognition rate was found in alaryngeal voices, but not in pathological voices. Conclusion : Current study was not proved speech recognition program, HUVOIS during telephone program was not objective and efficient method for assisting subjective GRBAS scale.

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성대 결절 및 후두 폴립의 수술 후 보충 치료로서 Accent Method의 유용성 (The Utility of Accent Method as a Supplementary Treatment after Surgery of Vocal Nodule and Laryngeal Polyp)

  • 박혜성;박영실;최두영;김상윤;유승주;남순열
    • 대한후두음성언어의학회지
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    • 제11권1호
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    • pp.39-45
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    • 2000
  • Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p<0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p<0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.

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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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레이저 성문절제술 후의 음성수술 (Phonosurgery after Laser Cordectomy)

  • 소윤경;손영익
    • 대한후두음성언어의학회지
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    • 제19권1호
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    • pp.11-15
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    • 2008
  • Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

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골편적출술을 적용한 후두골 골절 치료 (Treatment of an Occipital Fracture by Esquillectomy)

  • 박진욱;조기래;장동우;최석화;김근형
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.450-452
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    • 2010
  • 4년령의 수컷 요크셔테리어가 두부의 둔상에 의한 구토와 무의식을 주증으로 내원하였다. 육안검사에서 안면 부종, 피하 출혈, 과유연을 확인하였다. 방사선 검사에서 후두골편이 뒤쪽으로 변위되어 있음이 확인되었다. 3차원으로 재구성한 컴퓨터단층촬영 영상에서 골편의 배쪽 부분이 불완전하게 부착되어 있음을 보여주었고, 골편의 불안정성 때문에 골편적출술을 실시하기로 결정하였다. 골편의 제거 후, 결손부는 널판근을 이용한 근육판으로 보강하였다. 환자 상태는 약간의 실조성 보행을 제외하고, 점차 개선되었다. 술 후 20개월째 추적조사에서 운동실조는 더 이상 관찰되지 않았다. 심한 두 개 내 출혈과 두개골 골절에도 불구하고, 수술적인 중재를 시작하기까지 환자의 신경학적인 상태는 심하게 악화되지는 않았다. 이는 바깥쪽으로 변위된 골편이 신경학적 악화를 야기할 수 있는 두개내압의 증가를 방지하는데 주요한 역할을 했기 때문이라고 사료된다.