• Title/Summary/Keyword: Posterior pharyngeal wall

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과대비성을 호소한 환자에 있어서 수술적 치료에 대한 임상적 고찰 (Clinical Analysis of Operative Treatment for Hypernasality)

  • 최홍식;김명상;이해성;이주형;표화영
    • 대한후두음성언어의학회지
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    • 제8권1호
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    • pp.69-74
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    • 1997
  • 과대비성의 수술적 치료에 있어서 인두측벽의 운동성이 수술 후 어느 정도 남아있는가와 측두문의 크기를 어느 정도 유지하는 것이 적당한가를 결정하는 것이 환자의 만족도를 높이고 좋은 결과를 얻는데 중요한 부분을 차지함을 알 수 있었다.

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과대비성(Hypernasality)을 호소한 환자에 있어서 수술적 치료에 대한 임상적 고찰 (A Clinical Assessment of Surgical Treaimant on Hypernasality)

  • 최홍식;김명상;이해성;표화영
    • 대한음성언어의학회:학술대회논문집
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    • 대한음성언어의학회 1996년도 제6회 학술대회 심포지움
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    • pp.97-97
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    • 1996
  • 저자들은 1994년 1월부터 1996년 8월까지 과대비성(hypernasality)을 주소로 영동세브란스병원 이비인후과를 내원하여 상저부 인두피판(superior based pharyngeal flap) 혹은 후인두벽 증대(posterior pharyngeal wall augmentation) 시행받은 환자 20명을 대상으로 수술 전후의 치료결과를 판정하였다. 수술 전후의 치료결과는 2명의 이비인후과의사와 1명의 언어치료사가 구강을 통한 내시경 적검사와 음성평가를 동시에 시행함으로써 판정하였다. (중략)

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소폭의 잔존 하인두벽을 이용한 첩포형 전완유리 피판 인두 재건술 (Patch Reconstruction with Radial Forearm Free Flap of Hypopharyngeal Cancer Using the Narrow Strip Pharynageal Wall)

  • 정희선;이원재;유대현;나동균;탁관철
    • Archives of Plastic Surgery
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    • 제33권4호
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    • pp.407-412
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    • 2006
  • Purpose: Various attempts of reconstruction for pharyngoesophageal defects after ablative surgery have been made to restore the function of the pharyngoesophagus. A fabricated tubed radial forearm free flap or free jejunal free flap was used when the width of remnant pharyngeal wall was less than 50% of the normal width. However there are many disadvantages such as stricture, saliva leakage and fistula formation on tubed radial forearm free flap. The jejunal free flap has the problem such as short pedicle, poor tolerance of ischemic time, wet voice and delayed transit of swallowed food due to the uncoordinated contraction. The authors studied the utility of patch-type radial forearm free flap using the remnant posterior pharyngeal wall of the hypopharynx. Methods: Retrospective reviews in Severance Hospital were made on 25 patients who underwent reconstruction surgery with patched radial forearm free flap because of the hypopharyngeal cancer between 1996 and 2005. The patients of Group I had the narrow posterior pharyngeal wall and its width was less than 3centimeters after the tumor was resected. Those of Group II had the partial pharyngectomy and the width of the remnant pharynx was larger than 3 centimeters. Results: Seven patients belonged to the group I and the flap of this group had 100% survival rate. One case of fistula and no swallowing discomfort due to stricture was reported. The Group II including 18 patients also had the 100% flap survival rate. Neither fistula nor stricture was seen but the lower diet grade was checked. Conclusion: The patch type radial forearm free flap using the remnant pharyngeal wall have the advantage of the radial forearm free flap, and furthermore this flap is the safe reconstructive method even if the width of the remnant pharyngeal wall is less than 30% of that of normal pharynx.

Usefulness of lateral cephalometric radiography for successful blind nasal intubation: a prospective study

  • Ito, Kana;Kamura, Ayaka;Koshika, Kyotaro;Handa, Toshiyuki;Matsuura, Nobuyuki;Ichinohe, Tatsuya
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권6호
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    • pp.427-435
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    • 2022
  • Background: This study aimed to investigate the relationship between pharyngeal morphology and the success or failure of blind nasotracheal intubation using standard lateral cephalometric radiography and to analyze the measurement items affecting the difficulty of blind nasotracheal intubation. Methods: Assuming a line perpendicular to the Frankfort horizontal (FH) plane, the reference point (O) was selected 1 cm above the posterior-most end of the hard palate. A line passing through the reference point and parallel to the FH plane is defined as the X-axis, and a line passing through the reference point and perpendicular to the X-axis is defined as the Y-axis. The shortest length between the tip of the uvula and posterior pharyngeal wall (AW), shortest length between the base of the tongue and posterior pharyngeal wall (BW), and width of the glottis (CW) were measured. The midpoints of the lines representing each width are defined as points A, B, and C, and the X and Y coordinates of each point are obtained (AX, BX, CX, AY, BY, and CY). For each measurement, a t-test was performed to compare the tracheal intubation success and failure groups. A binomial logistic regression analysis was performed using clinically relevant items. Results: The items significantly affecting the success rate of blind nasotracheal intubation included the difference in X coordinates at points A and C (Odds ratio, 0.714; P-value, 0.024) and the ∠ABC (Odds ratio, 1.178; P-value, 0.016). Conclusion: Using binomial logistic regression analysis, we observed statistically significant differences in AX-CX and ∠ABC between the success group and the failure group.

일차 구개성형술 후 발생된 지속적인 술후출혈;증례보고 (CONTINUOUS POSTOPDRATIVE BLEEDING AFTER PRIMARY PALATORRHAPHY;A CASE REPORT)

  • 심정환;김영균;채병국
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권5호
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    • pp.458-460
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    • 2001
  • A 11-month-old infancy was referred for treatment of cleft palate. The patient's congenital deformities had included oronasal fistula on the soft palate and bifid uvula. Furrow double-opposing Z-plasty was performed under general anesthesia. However, postoperative bleeding developed at ward. Despite the pressure of operative wound, venous oozing continued and hemoglobin concentration and RBC were decreased (Hb: 5.5g/dL, RBC: $1.98{\times}10^6/mm^3$). The patient was pale and confused and transferred to Surgical Intensive Care Unit(SICU) We could not keep the peripheral venous line and there was a high risk of hypovolemic shock. Emergency transfusion was performed through the central femoral venous line and emergency operation for bleeding control was carried out. We explored the operation site and found bleeding point from the posterior pharyngeal wall. Electrocoagulation and surgicel packing were carried out and bleeding was stopped.

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하인두 후벽암으로 오인된 경추 내고정 금속판 삽입 후 발생한 육아종 1예 (Granuloma Resulting from the Cervical Metallic Plate, Masquerading as Posterior Pharyngeal Wall Cancer)

  • 김승우;김영배;사대진
    • 대한두경부종양학회지
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    • 제27권2호
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    • pp.218-221
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    • 2011
  • The anterior approach to the cervical spine surgery is associated with possible complications such as dysphagia, hoarseness and granuloma formation etc. Because of orthopedic metallic plates, the increasing or focal uptake pattern may be demonstrated in $^{18}F$-FDG PET/CT scan. A 67-year-old-man came to our department, complained of dysphagia during the 4 months. He underwent cervical spine surgery three years ago. The CT and MRI findings mimicked typical posterior pharyngeal wall cancer with cervical metastasis. Furthermore, the SUV in $^{18}F$-FDG PET/CT was 10.3. But he was finally diagnosed as a granuloma resulting from the metallic cervical implants. The clinical correlation and medical history should be taken into account to avoid false-positive findings in PET/CT and to avoid many erroneous diagnostic pathways.

Nasometer 활용 바이오피드백 기법을 이용한 비인강폐쇄전환자의 치험 사례 (Speech treatment of velopharyngeal insufficiency using biofeedback technique with NM II; A case report)

  • 양지형;최진영
    • 대한구순구개열학회지
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    • 제8권1호
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    • pp.45-52
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    • 2005
  • Velopharyngeal Insufficiency(VPI); the failure of velum, the lateral wall and the posterior pharyngeal wall to separate the nasal cavity from pharyngeal cavity during speech, can be caused by congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency. Speech problems of VPI are characterized by hypernasality, nasal air emission, increased nasal air flow and decreased intelligibility. These speech problems of VPI can be treated with the surgical procedure, the application of temporary prosthesis and speech therapy. Biofeedback technique with Nasometer is a speech treatment method of VPI that commonly used as one component of a comprehensive procedure for improvement of speech in patients with VPI. In this article describes a case of VPI treated by biofeedback technique with Nasometer; which showed satisfactory result in nasalance and formant analysis after the speech therapy during 9 months.

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인두위문합술과 유리공장이식술을 이용한 하인두 및 경부식도 재건술 (Reconstruction of Hypopharynx and Cervical Esophagus using Gastric Pull Up and Jejunal Free Graft)

  • 정동학;김영모;이원영;김대식;노병선
    • 대한기관식도과학회지
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    • 제2권1호
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    • pp.63-70
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    • 1996
  • Reconstruction for hypopharynx and cervical esophagus after wide resection of extensive hypopharynx and larynx cancers have been used various methods including myocutaneous flaps, gastric pull up, md jejunal or large bowel free graft. Recently, the authors had experienced hypopharynx and larynx cancers with extension to the posterior hypopharyngeal wall and thoracic esophagus. Of course, these reconstructive methods should be selected in accordance with the patient's age, physical status, extend of prim.:W lesion, and defect after on block resection, however, gastric pull up was performed in hypopharynx cancer which had skipped lesion in the thoracic esophagus and jejunal free grafts were performed in case 2, 3 which had a extended lesions to the posterior pharyngeal wall. Some complications were noted, which were successfully stabilized by conservative managements. The gastric pull up and jejunal free graft were considered suitable methods for reconstrunction of hypopharynx and cervical esophagus, however, further studies are necessary about it.

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

  • 정동일;문주환
    • Parasites, Hosts and Diseases
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    • 제33권3호
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    • pp.219-224
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    • 1995
  • 새인두흡충에 의한 인체감염 제1례를 보고한다. 환자는 56세 된 남자로서 3-4일간의 인후부 이 물감과 염증성 증상으로 이비인후과의원을 방문하여 오른쪽 인두 후벽에 흡착한 충체를 제거하였다. 충체는 Clnostoumum complanatum으로 동정되었다. 환자는 평소 담수어의 생식을 즐겼으며 의원 방문 4일전에도 낚시로 포획한 담수어를 생식한 적이 있었다. 우리 나라에서도 이 흡충에 의한 인두염의 예방을 위해 담수어의 생식에 더 깊은 주의가 요망된다고 생각된다. Clinostomum complanatum의 우리 말 이름을 새인두흡충으로 제안한다.

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구개열환자에서 비인두공간과 비인강폐쇄부전과의 연관성 (RELATIONSHIP BETWEEN NASOPHARYNGEAL SPACE AND VELOPHARYNGEAL INCOMPETENCE IN CLEFT PALATE)

  • 조준희;최병재;심현섭;손흥규
    • 대한소아치과학회지
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    • 제27권4호
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    • pp.517-523
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    • 2000
  • 비인강폐쇄는 연구개, 인두측벽 그리고 인두후벽간의 움직임이 서로 조화되어 구강과 비강을 나누어주는 괄약근 기전으로서 연하, 호흡 및 발음 등의 생리적 기능에 중요한 역할을 한다. 이 기능에 문제가 생긴 경우를 비인강폐쇄부전이라하며 그 원인으로는 (1) 연구개의 길이 및 움직임이상, (2) 비인두강의 해부학적 공간문제, (3) 인두후벽과 측벽의 기능이상 등이 있다. 본 연구는 구개열 환자의 측면두부방사선 사진을 통해 비인두강을 해부학적으로 분석하고 동시에 산출된 각 모음의 과비음 정도를 평가하여 비인강폐쇄부전과의 연관성을 비교해 본 것이며, 얻어진 결과는 다음과 같다. 1. 연구개 길이는 정상인에 비해 현저히 짧았다. 2. adequate ratio는 정상인에 비해 작게 나타났다. 3. adequate ratio가 감소함에 따라 모음 조음시 anatomic mVPI가 점차 증가하였다. 4. 각 모음 조음시 anatomic VPI는 과비음정도와 비례관계를 보였다. 5. 고모음(/u/, /i/)의 과비음정도가 저모음(/a/)에 비하여 크게 나타났다. 결론적으로, 구개열환자에서 측면두부방사선 사진은 비인강폐쇄부전의 진단 및 평가에 유용하게 사용될 수 있으며, 비인두강의 해부학적 구조는 산출되는 과비음정도와 밀접한 연관성이 있었다.

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