• 제목/요약/키워드: Stridor

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후두연하증의 분류와 치료 (Classification and Management in Patients with Laryngomalacia)

  • 박기철
    • 대한후두음성언어의학회지
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    • 제28권1호
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    • pp.20-24
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    • 2017
  • Laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms begin to appear after weeks of age, become worse at 4-8 months, improve between 8-12 months, and usually heal naturally at 12-18 months. Despite these common natural processes, the symptoms of the disease can be very diverse and, in severe cases, require surgical treatment. The diagnosis can be made by suspicion of clinical symptoms and direct observation of the larynx with the spontaneous breathing of the child. Typical laryngeal features include omega-shaped epiglottis, retroflexed epiglottis, short aryepiglottic fold, poor visualization of the vocal folds, and edema of the posterior glottis, including inspiratory supra-arytenoid tissue prolapse. In this review, we discuss the classification and treatment based on symptoms and laryngoscopic findings in patients with laryngomalacia.

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후두 정맥 기형에 대한 에탄올 경화치료 1예 (A Case of Laryngeal Venous Malformation Treated with Ethanol Sclerotherapy)

  • 윤민;이동준;박상현;문정환
    • 대한후두음성언어의학회지
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    • 제25권2호
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    • pp.104-106
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    • 2014
  • We describe a case of laryngeal venous malformation in 43 year-old patient, discovered incidentally. Laryngeal venous malformation is a comparatively rare condition in adults. It presents as a dark bluish mass that may cause bleeding, hoarseness or stridor, but he complained only mild throat discomfort. We found dark-bluish tumor on the right arytenoid area, and treated the lesion by Ethanol sclerotherapy. All lesions disappeared after one month without any complication. Sclerotherapy with Ethanol can be an easy and effective treatment for laryngeal venous malformations, so we present the case with a review of the related literatures.

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선천성 기관 협착환자에서 늑연골 절편을 이용한 기관성형술 1례 (Tracheoplasty with Rib Cartilage Flap for Congenital Tracheal Stenosis -A Case Report-)

  • 이형민
    • Journal of Chest Surgery
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    • 제27권5호
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    • pp.407-412
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    • 1994
  • Congenital long-segment tracheal stenosis which involves nearly entire trachea and carina is very rare disease, but leads to life threatening obstruction in infancy and childhood. Symptoms are ranged from stridor and wheezing to severe cyanosis and respiratory failure. Routine chest X-ray is somewhat helpful to diagnose it, but definitive diagnosis can be made by bronchoscopy or tracheogram for severely narrowed tracheal lumen.Recently, we experienced a case of congenital tracheal stenois, type 1 by Cantrell classification with carinal involvement. After costal cartilage was designed as oval shaped flap and covered with pericardium, anterior and posterior augmentation was done with prepared costal cartilage.This patient died of respiratory failure at 13 days postoperatively, probably due to sustaining obstruction in association in with failure to make a sufficient widening at carinal level.Important issues in the management of congenital tracheal stenosis are rapid diagnosis, selection of appropriate surgical procedure, and detailed anesthetic schedule.In the future, more biocompatible material and more effective surgical procedures should be studied to reduce the surgical mortality and morbidity of the complicated tracheal stenosis.

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PATAU 증후군에 동반된 후두연화증의 $CO_2$LASER를 이용한 수술치험례 ($CO_2$Laser Aryepiglottoplasty for Treatment of Laryngomalacia in Patau Syndrome)

  • 송영호;이동엽;안회영;김영도
    • 대한기관식도과학회지
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    • 제3권1호
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    • pp.128-136
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    • 1997
  • 저자들은 Patau증후군에 동반된 후두연화증으로 심폐정지가 유발된 환아에서 $CO_2$레이저를 이용한 aryepiglottoplasty를 시행하여 극적인 호전을 보였기에 문헌고찰과 함께 치료경험을 보고하는 바이다.

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A Case of Lobular Capillary Hemangioma at the False Vocal Cord With Intermittent Stridor

  • Park, Sang-Wook;Cho, Ki Ju;Won, Seongjun;Park, Jung Je
    • 대한후두음성언어의학회지
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    • 제32권3호
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    • pp.150-152
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    • 2021
  • Lobular capillary hemangioma (LCH) is a type of benign vascular tumor. It arises from vascular endothelial cells and contains capillaries arranged in a lobular pattern. In the head and neck, the most common presenting location of LCH is the lips, and presentation in the larynx is very rare. LCH might not be distinct from granuloma in macroscopic views. We report a 71-year-old female with LCH of the larynx that was totally resected via laryngeal microsurgery with a CO2 laser and briefly review the literature.

발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석 (Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor)

  • 임성용;서지영;경선영;안창혁;박정웅;이상표;정성환;함형석;안영미;임시영;고원중;정만표;김호중;권오정
    • Tuberculosis and Respiratory Diseases
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    • 제61권1호
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    • pp.34-40
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    • 2006
  • 연구배경: 발관 실패와 관련된 위험 인자를 살펴보고, 기관내 삽관의 합병증으로 인한 후두부 폐쇄와 PES로 인한 재삽관의 위험성을 발관 전에 미리 예측하기 위한 CLT 검사의 의의 및 제한점을 알아보고자 하였다. 방 법: 24시간 이상 삽관과 인공 호흡기 치료 후 발관을 시도한 34명의 연속적인 환자들을 대상으로 발관 실패군에서 성공군과 차이를 보이는 인자를 살펴보고 CLT 를 시행해서 PES와 재삽관을 예측하는 CLV, CLP의 기준값을 구하였다. 결 과: 총 34명중 발관 실패는 6명(17.6%), PES는 3명(8.8%) 이었고 PES가 있던 3명은 모두 재삽관을 받았다. 발관 실패 환자에서 삽관 기간이 길었고, SAPS II score가 컸으며, 삽관 기간은 CLV, CLP와 역상관관계를 보였다. PES 양성 환자의 평균 CLV은 $22.5{\pm}23.8ml$로 음성 환자의 $233.3{\pm}147.1ml$보다 낮았고, CLP도 양성군에서 $6.2{\pm}7.3%$로 음성군의 $44.3{\pm}24.7%$보다 유의하게 낮았다. 가장 신뢰성 있는 CLV, CLP의 기준값은 50 ml, 14.7% 였고 CLV의 민감도는 100%, 특이도 93.5%, 양성예측도 60%, 음성예측도 100% 였고, CLP의 민감도는 100%, 특이도 87.1%, 양성예측도 42.9%, 음성예측도 100% 였다. 결 론: 삽관 기간이 길고 중증 질환 환자에서 발관 실패의 가능성이 높다. CLV, CLP가 감소되어 있을 경우 PES로 인한 재삽관 위험이 높아지므로 발관 시 주의가 필요하지만 발관의 불필요한 연기나 시도 자체에 대한 기준은 아닐것으로 생각된다.

양측성 성대 마비의 치료 원칙 (Management Principles of Bilateral Vocal Fold Immobility)

  • 김태욱;손영익
    • 대한후두음성언어의학회지
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    • 제20권2호
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    • pp.118-125
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    • 2009
  • Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

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구강내 치료시 연하나 흡입된 이물질의 처치에 관한 치험례 (A CASE REPORT OF THE MANAGEMENT OF AN INGESTED OR ASPIRATED IATROGENIC FOREIGN BODY DURING INTRAORAL TREATMENT)

  • 류수장;전종후
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권3호
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    • pp.428-434
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    • 1996
  • The practice of oral surgery or other dentistry possesses the danger of causing the loss of foreign bodies used within the oral cavity. If such foreign bodies would be lost, they could enter the viscera through the esophagus or tracheobroncheal tree. Ingestion is four times as frequent as aspiration and 80% to 90% of ingested foreign bodies will pass through the body spontaneously. Once the aspiration or ingestion of foreign bodies is happened, a dental procedure should be discontinued immediately. If symptoms of respiratory distress, including coughing, wheezing, or stridor, are present, a patent airway should be maintained, oxygen administered, and ventilation supported if necessary. The PA chest radiograph will identify the objects in the lung, esophagus, or stomach. Ingested gastrointestinal foreign bodies may be managed by observation, endoscopy, and or surgical intervention and aspirated tracheobroncheal foreign bodies may be managed by bronchoscopy, and or surgical intervention. This case report describes the management of ingested or aspirated foreign bodies happened to the three patients during intraoral treatment. we recommend that the preventive method of ingestion or aspiration of the dental foreign bodies should be performed prior to intraoral treatment and the immedieate measures should be carried out after ingestion or asipiration of it.

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종양에 의한 성대마비 29예에 대한 임상적 고찰 (A Clinical Study on 29 Cases of Vocal Cord Paralysis caused by Neoplasm)

  • 김광문;김영호;최홍식;홍원표;김창규;권오휘
    • 대한후두음성언어의학회지
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    • 제5권1호
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    • pp.59-63
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    • 1994
  • The authors observed the clinical status of 29 patients with vocal cord paralysis caused by tumor from April, 1983 to September, 1993 at Department of Otorhinolaryngology, Yongdong Severance hospital, Yonsei University College of Medicine. The results were as follows: 1) In the kinds of neoplasms, the most frequent were lung Ca. with 13 cases(44.8%), followed by 8 cases by thyroid Ca., 3 cases by neurogenic tumor, 2 cases by mediastinum tumor, cervical esophagus Ca., tracheal Ca., glomus jugulare were 1 case each. 2) In sex distribution, there were 18 cases of males and 11 cases of females with the male to female ratio being 1.8:1. In age distribution, most of the cases(10 cases ; 34.5%) were in the 7th decade. 3) In chief complaints, most of the cases(17 cases : 58.6%) had hoarseness only and aspiration, stridor, dyspnea, cough, dysphagia were present in some cases. 4) In site of the paralysed vocal cord, 21 cases were in the left cord. 5 cases in the right cord and 3 cases in the both cords. 5) In the position of paralysed vocal cord, most of the cases(23 cases : 79.3%) were in the parmedian position.

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