• Title/Summary/Keyword: 후두 장애

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Botox Injection for the Management of Spasmodic Dysphonia (연축성 발성장애(Spasmodic Dysphonia)에 대한 보톡스 주입치료)

  • Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.2
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    • pp.99-103
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    • 2012
  • Spasmodic dysphonia is a chronic, focal, movement-induced, action-specific dystonia of the laryngeal musculature during speech. It can have a profound effect on quality of life, severely limiting people's communication, especially via telephone and in noisy backgrounds. Spasmodic dysphonia (SD) is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks with forced-strangled voice, but it may also be abductor type or, much less commonly, mixed. Treatment options for adductor spasmodic dysphonia (ADSD) include voice therapy, surgical procedures, and botulinum toxin injections (Botox). The use of Botox injected into the laryngeal muscles remains the "gold standard" treatment for reducing the vocal symptoms of ADSD and Botox induces a temporary paresis of the laryngeal muscles and provides short-term relief of symptoms. Repeated injections of the laryngeal muscles, generally every 3-4 months, are required for continuous relief of symptoms. Improvement in vocal function has been reported after use of Botox injections, though a completely normal voice is rarely achieved. In this hospital, 1,030 patients have been enrolled for Botox injection therapy so far (May, 2012). In this review article, I'd like to present my personal experience of management of spasmodic dysphonia mainly by Botox injection.

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A Case of Selective Laryngeal Adductor Denervation-Reinnervation Surgery for Adductor Spasmodic Dysphonia (선택적 갑상피열분지 및 측윤상피열분지의 절단과 경신경고리 신경재지배 방법을 이용한 연축성발성장애의 수술적 치료 1례)

  • Park, Young-Hak;Bae, Seong-Cheon;Lee, Seok-Eun;Cho, Seune-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.146-148
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    • 2006
  • Spasmodic dysphonia is a voice disorder characterized by involuntary voice breaks during speech. Adductor spasmodic dysphonia is most common and characterized by strained and strangled voice breaks. The current standard of treatment of therapy for adductor spasmodic dysphonia is chemodenervation of thyroarytenoid muscle with botulinum toxin(Botox). However, Botox is a temporary treatment with each injection lasting approximately 3 months on average and require repeated injections. In this study, we report our experience with surgical treatment for adductor spasmodic dysphonia. In this procedure, the thyroarytenoid branch and lateral cricoarytenoid branch of recurrent laryngeal nerve is selectively denervated unilaterally, and its distal nerve stump of thyroarytenoid branch is reinnervated with branch of the usa cervicalis nerve. And lateral cricoarytenoid muscle partial myotomy was done unilaterally. After 6 months of treatment, voice fluency had improved and no period of breathiness or dysphagia was noted.

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Characteristics of the Oropharyngeal Swallowing Impairment in Stroke Patient using the Modified Barium Swallowing Impairment Profile (MBSImP에 따른 뇌졸중 환자의 삼킴 장애 양상 분석)

  • Im, Ikjae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.36-44
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    • 2019
  • Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

The Comparison of Pitch Production between Children with Cochlear Implant and Normal Hearing Children (건청아동과 인공와우 수술을 한 아동의 Pitch산출 비교)

  • 유현수;고도흥
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.144-145
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    • 2003
  • 고심도의 청각장애를 가진 아동의 음성은 높은 음도와 강도, 과비음 등 건청 아동과는 매우 다른 특성을 나타낸다. 그 중에서 초분절적인 요소에 속하는 억양은 청각장애 아동의 경우 단조롭고 높낮이 변화가 크지 않아서 의미전달에 어려움을 주는 중요한 요소이다. 청력손실이 고심도인 경우 수술을 하게 되면 청각적 수용능력을 높일 수 있어, 최근 부각되고 있는 인공 와우 이식수술을 받은 아동 또한 이러한 억양에서의 문제는 완전히 해결 받지 못하고 있다. 따라서 이 연구에서는 인공 와우 이식수술을 받은 청각장애 아동이 건청 아동과 억양에서 어떠한 차이를 드러내는지에 대해 알아보고자 하였다. (중략)

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청각장애 아동의 청각통합 능력과 언어능력과의 상관관계 연구

  • 박상희;권영주
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.239-239
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    • 2003
  • 연구목적 : 본 연구의 목적은 청각장애 아동들이 실제적으로 소리를 듣는 능력과 말소리를 이해하고 표현하는 언어 능력과 어떠한 관계가 있는가에 대해서 알아보고자 하는데 있다. 일반적으로 청각통합 능력은 청각장애 아동의 듣기 능력을 측정할 수 있는 대표적인 검사도구이며, MCDI-K는 부모가 언어능력을 평가할 수 있는 도구이다. 이 두 가지 모두 부모가 평가할 수 있는 도구이다. 따라서 본 연구에서는 청각통합 능력, 언어이해능력, 언어표현능력이 연령과 교육받은 시기와 어떠한 관계가 있는 가 알아보기 위해서 실시하였다. (중략)

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Three Cases of Submucous Cleft Palate with Hypernasality Treated with Double Opposing Z-plasty

  • 최홍식;이승수;김성국;김태만;김현준
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.189-189
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    • 1998
  • 점막하 구개열(submucous cleft palate)은 특징적인 임상적 해부학적 기형을 나타내는데 이분 구개수(bifid uvula), 근육의 분리(muscular diastasis), 경구개 후연의 절흔(frank notching of the posterior hard palate)등이다. 결국 이러한 기형을 교정하지 않으면 과비음과 공명장애로 인한 조음장애는 사회생활에 중요한 영향을 미치고, 사람의 인상에 나쁜 영향을 주게되어 개인의 인성 형성의 장애와 삶의 질의 저하를 초래하게 된다. (중략)

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MAGNETIC RESONANCE IMAGING FINDINGS OF THE BRAIN IN AUTISTIC CHILDREN (자폐장애 아동의 뇌자기공명영상 소견)

  • Park, Pil-Sang;Jung, Chul-Ho;Choi, Sang-Yong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.113-122
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    • 1997
  • The purpose of this study was to examine brain structural abnormalities in autistic children. Magnetic resonance imaging(MRI) findings in 22 male children with a DSM-Ⅲ-R diagnosis of autistic disorder and 17 non-autistic male control children were investigated. The ratio measures by lineometry was used to examine the cerebrum, midbrain, cerebellum, brain stem and ventricular system. The left to right ratio of the lateral ventricle was larger in autistic children than in controls. The pons was significantly larger in autistic children than in controls, and the cerebellum was smaller in autistic children. There were no significant differences between autistic children and controls in the symmetricity of the fontral lobe, parietal lobe, occipital lobe and temporal lobe, and in the size of the midbrain and 4th ventricle. These findings suggest that autistic disorder may be related to structural impairment of the brain.

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A Case of Mutational Dysphonia Treated with Type III Thyroplasty (제3형 갑상연골성형술에 의한 변성발성장애의 치험 1례)

  • 최홍식;조창현;김광문
    • Proceedings of the KSLP Conference
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    • 1994.06b
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    • pp.90-90
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    • 1994
  • 변성발성장애(Mutational dysphonia)는 원인이 확실히 밝혀져 있지는 않지만, 변성기에 성호르몬의 작용에 의한 정상적인 후두의 발육이 제대로 이루어지지 않아서 발생되는 것으로 추정되고 있다. 임상 양상은 대개 성인 남자임에도 불구하고 병적으로 음성의 기본주파수(fundamental frequency)가 높아서 여자 목소리에 가깝게 들린다는 것을 주 증상으로 하고 있으며, 이학적 검사상 성대의 움직임은 정상이나, 성대의 두께가 얇거나, 성대의 길이가 짧고 긴장도가 증가되어 있는 것 같이 보인다. 음성치료를 시도해 볼 수 있으며, Isshiki가 제 3형 갑상연골성형술로 효과적으로 치료될 수 있다고 보고한 이래, 다수의 보고자들에 의해 시도되어 왔다. (중략)

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Peri-Treatment Evaluation of Swallowing in Head and Neck Cancer Patients (두경부암 환자의 치료 전후 연하 평가)

  • Kim, Jin Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.14-18
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    • 2018
  • Head and neck cancer patients are prone to dysphagia and aspiration, which are usually neglected due to treatment of the cancer itself. However, dysphagia and aspiration could cause malnutrition, dehydration, pneumonia, and moreover, have negative impact on the quality of life, morbidity, and mortality. Due to its multifactorial etiology, thorough clinical and instrumental evaluation are necessary. In managing head and neck cancer patients, it has become very important to identify the possibility of dysphagia and aspiration, and to start management as early as possible.

Neurodegenerative Disease and Speech Rehabilitation (퇴행성질환과 말언어장애 재활)

  • Yoon, Ji Hye
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.79-83
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    • 2017
  • Neurodegenerative diseases such as Parkinson's disease and amyotrophic lateral sclerosis may induce impairment of speech motor system. This review discusses the characteristics of dysarthria and symptom management for these conditions. Given the progressive nature of the neurodegenerative diseases, speech-language pathologists must be aware of appropriate augmentative and alternative communication equipment at the early stage of the disease course. Patients with neurodegenerative diseases can maintain functional communication with augmentative and alternative communication supports.

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