• 제목/요약/키워드: Laryngeal paralysis

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타질환과 동반된 애성 (Uncommon Causes of Hoarseness)

  • 윤희병;김미자;정대현;박승훈;박옥경;목정민;전승하;강주원
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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    • pp.8.2-8
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    • 1982
  • 애성이란 음성의 질적 변화를 의미하는 것으로 이는 후두의 가장 대표적인 주 증상이다. 애성의 원인으로는 현재까지 알려져 있는것만 해도 약50 여종이 있다고 하며 그중 virus에 의한 상기도 감염증이 가장 많은 비율을 차지하고 있는 것으로 알려져 있고, 후두결절 및 풀립, 후두마비, 후두암, 후두유두종, 후두결핵등의 순으로 발생하는 것으로 알려져 있다. 최근 저자들은 본원에 입원중인 환자로서 애성 때문에 본 이비인후과로 진찰의뢰된 환자중 비교적 보기드문 질환과 동반된 애성환자 4예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 증예1. 29세 남자로서 교통사고로 후두부에 외상을 입은후 1 달만에 애성이 발생. 후두경 소견상 좌측성대의 paramedian paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예2. 53세 남자로서 clonorchis sinensis로 일반외과에서 전신 삽관마취하에 choledochostomy를 시행한 6 일후에 애성이 발생. 후두경 소견상 좌측성대의 median paralysis가 인정되었음. 증예3. 56세 남자로서 Aortic Aneurysm으로 내과에 입원한 환자로 입원전 3개월부터 애성이 발생. 후두경 소견상 좌측성대의 intermediate position paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예4. 74세 남자로서 Bronchogenic Ca.로 내과에 입원중인 환자로 입원 3년전부터 애성이 발생. 후두경 소견상 우측성대의 paramedian paralysis가 인정되었음

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반회신경마비를 동반한 갑상선 질환에서 갑상선절제술과 성대내전술 (Thyroidectomy with Vocal Cord Medialization)

  • 김광현;성명훈;최승호;강제구;노종렬;박홍주
    • 대한후두음성언어의학회지
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    • 제7권1호
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    • pp.5-10
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    • 1996
  • From October 1991 to June 1995, 4 medialization thyroplasties and I arytenoid adduction were simultaneously performed with the thyroid surgery when the unilateral recurrent laryngeal nerve was paralyzed before or during thyroidectomy. Four cases were papillary carcinoma with direct invasion to the unilateral recurrent laryngeal nerve, and one case was huge adenomatous goiter and the recurrent laryngeal nerve was incidentaly cut. Hoarseness was present preoperatively with mean duration of 15 months and aspiration was also present in three cases. After phonosurgery, voice was improved in 4 out of 5 cases and aspiration subsided in 2 out of 3 cases. In one case, hoarseness continued after total thyroidectomy and thyroplasty type I and the arytenoid adduction with planned due to posterior glottic gap of 2mm. We suggest that the thyroplasty type I or arytenoid adduction are primary phonosurgical procedures which ran be performed concomitantly with neck surgeries in the patients with paralysis of the unilateral recurrent laryngeal or vagus nerve damage during neck surgeries.

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갑상연골 골절로 인한 성대마비의 치험례 (A Case of Thyroid Cartilage Fracture with Vocal Cord Paralysis)

  • 조진규;차창일;안회영;조중생;홍남표
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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    • pp.14.2-14
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    • 1983
  • 후두외상의 손상은 그 정도나 범위에 따라 차이는 인지만 주요 후유증으로는 기도폐쇄, 부종, 주위조직의 봉와직염 및 농양, 누공, 후두연골 및 연골지막염, 만성 후두협착, 성대마비, 기관발거곤란증, 성음장애 등을 들 수 있고, 일반적인 후두외상의 치료방법은 일차적으로 신속한 기도유지를 위한 처치를 한 다음 상기각 후유증에 따르는 이차 시술을 시행하는 것이 보통이다. 최근 저자들은 교통사고로 인한 후두부 및 경부의 폐쇄적 외상으로 갑상연골 골절과 좌측 성대마비, 연하장애 및 우측 쇄골 골절을 보인 환자에게서 갑상연골 정복술을 시행 후 술후 2개월에 상기 증세의 호전을 보인 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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

  • 김희진
    • 대한후두음성언어의학회지
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    • 제31권1호
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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.

외상성 성문하 기관 협착증의 수술 치험 1례 (Surgical Treatment of Traumatic Subglottic Stenosis; A Case Report)

  • 최필조
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.409-412
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    • 1993
  • We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

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일측성 성대 마비에서 운동단위 활동전위를 이용한 정량적 후두 근전도 분석 (Quantitative Measurement of Laryngeal Electromyography Using Motor Unit Action Potential in Unilateral Vocal Cord Paralysis)

  • 하륜;김동영;김동현;우주현
    • 대한후두음성언어의학회지
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    • 제30권1호
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    • pp.28-33
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    • 2019
  • Background and Objectives : Laryngeal electromyography (LEMG) is valuable to evaluate the innervation status of the laryngeal muscles and the prognosis of vocal fold paralysis (VFP). However, there is a lack of agreement on quantitative interpretation of LEMG. The aim of this study is to measure the motor unit action potentials (MUAP) quantitatively in order to find cut-off values of amplitude, duration, phase for unilateral vocal fold paralysis patients. Materials and Method : Retrospective chart review was performed for the unilateral VFP patients who underwent LEMG from March 2016 to May 2018. Patient's demography, cause of VFP, vocal cord mobility, and LEMG finding were analyzed. The difference between normal and paralyzed vocal folds and cut-off values of duration, amplitude, and phase in MUAP were evaluated. Results : Thirty-six patients were enrolled in this study. Paralyzed vocal fold had significantly longer duration (p=0.021), lower amplitude (p=0.000), and smaller phase (p=0.012) than the normal. The cut-off values of duration, amplitude, and phase in MUAP for unilateral VFP were 5.15 ms, $68.35{\mu}V$, and 1.85 respectively. Conclusion : An analysis of MUAP successfully provided quantitative differences between normal and paralyzed vocal folds. But, additional research is needed to get more available cut-off value which is helpful to evaluate the status of laryngeal innervations.

컴퓨터단층촬영술을 이용한 수술 후 편측 성대마비의 진단보고 (Finding Report of Unilateral Vocal Cord Paralysis Using Computed Tomography)

  • 김민수;성현호;강성식;손희정;김태형;정유선
    • 대한방사선기술학회지:방사선기술과학
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    • 제41권5호
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    • pp.505-509
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    • 2018
  • VCP (Vocal Cord Paralysis) is rare but one of most serious complications related to endotracheal intubation. This report is a clinical experience of radiography and laryngeal EMG (Electromyography) assessment for the VCP. A 50-year-old woman with hoarseness, which was occurred after urethral diverticulum excision was examined by laryngoscopy. As a result of laryngoscopy, VCP was observed in left side of her vocal cord, and then recurrent laryngeal nerve damage was detected with additional CT (Computed tomography) scan and laryngeal EMG. After that, the vocal cord movement was recovered as normal state with regular conservative treatment for the 6 months.

개심술후 발생한 일측성 성대마비 -2례 보고- (Unilateral vocal cord paralysis after open heart surgery -A report of 2 cases-)

  • 이종욱
    • Journal of Chest Surgery
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    • 제23권3호
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    • pp.522-526
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    • 1990
  • We have experienced 2 cases vocal cord paralysis after open heart surgery. One was a postoperatively developed right unilateral vocal cord paralysis after prosthetic mitral valve replacement with tricuspid valve annuloplasty. The other was a postoperative left unilateral vocal cord paralysis after prosthetic aortic and mitral valve replacement with tricuspid annuloplasty. They were intubated for forty-eight and seventy-two hours but after extubation complained of hoarseness, aphonia, anxiety, and ineffective coughing Indirect laryngoscopy performed at about postoperative one week, revealed partial paralysis and decreased mobility of the vocal cord. After active phonation therapy, symptoms were improved gradually and in the follow up indirect laryngoscopy, the vocal cord paralysis was improved. The symptoms were recovered completely at about postoperative one month in both. The cause of vocal cord paralysis after open heart surgery may be any retraction or stretching injury to the recurrent laryngeal nerve, especially right side, during median sternotomy retraction and open heart operation procedures. As a result, avoid of excessive spread of median sternotomy retractor and excessive manipulation and retraction of the heart during open heart procedures will reduce the occurrence of the vocal cord paralysis.

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부갑상선 선종 수술시 관찰된 비회귀성 반회후두신경 (Non-Recurrent Recurrent Laryngeal Nerve) 1례 (A Case of NRRL(Non-Recurrent Recurrent Laryngeal Nerve) in a Patient with the Parathyroid Adenoma)

  • 한수진;임재열;박헌이;최홍식
    • 대한후두음성언어의학회지
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    • 제11권2호
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    • pp.188-191
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    • 2000
  • In thyroid and parathyroid surgery, damage to the recurrent laryngeal nerve(RLN) is the most common iatrogenic cause of vocal cord paralysis. Identification and preservation of the BLNs and meticulous technique can siginificantly decrease the incidence of this complication. We experienced one case of NRRLN in a patient with the parathyroid adenoma. During the dissection, there was no branch to be considered as RLN in tracheoesophageal groove. While searching for the RLN, We found a white structure coursing horizontally at the level of cricoid cartilage directly arising from the vagus nerve in the carotid sheath. That structure was nonrecurrent recurrent laryngeal nerve(NRRLN) and NRRLNs are exceedingly rare. Awareness of the possibility of NRRLN will prevent the surgeon from accidentally severing one if it is encountered during surgery.

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