• 제목/요약/키워드: laryngeal function

검색결과 95건 처리시간 0.021초

개의 성문폐쇄반사에 미치는 중추조절의 영향에 관한 연구 (Glottic Closure Reflex in an Anesthetized and Awake Canine Model)

  • 강주완;김광문;김영호
    • 대한후두음성언어의학회지
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    • 제14권2호
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    • pp.83-87
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    • 2003
  • Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

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성악전공자와 비전공자에서의 음도에 따른 성대외근의 표면근전도 변화 (Surface EMG Activity of the Suprahyoid and Infrahyoid Muscles along the Pitch Changes in Trained and Untrained Singers)

  • 윤영선;손영익;추광철;김선일
    • 대한후두음성언어의학회지
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    • 제10권1호
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    • pp.24-29
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    • 1999
  • Extrinsic laryngeal muscles are well known to be important for the classical singers. We tried to elucidate any differences in the function of above muscles between trained and untrained singers by non-invasive surface electromyography(EMG). Four trained sopranos and four untrained singers sang vowel /i/ at different pitch(E3, G3, C4, E4, G4, C5, E5, G5, C6). The EMG activities of the suprahyoid, infrahyoid and omohyoid muscles were measured using surface electrodes. In trained singers, infrahyoid muscle activities increased more than those of suprahyoid in most of pitch. To the contrary, in untrained singers, the pattern of EMG activities were variable among each subjects and the EMG activities of suprahyoid muscles were relatively greater than those of infrahyoid.

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후두운동장애 (Movement Disorders Affecting the Larynx)

  • 권택균;손희영
    • 대한후두음성언어의학회지
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    • 제21권1호
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    • pp.22-26
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    • 2010
  • Neuromuscular Disorders Affecting the Larynx are steadily important topics at laryngology. Physiology of larynx is controlled by the frame structure and neuromuscular dynamics to acting on the specialized soft tissue, Therefore, for a proper understanding of the larynx, it is needed the voice and swallowing, a series of prayers on the regulation of neurologic function and the correlation between systemic neuromuscular disease and laryngeal symptoms and clinical knowledge, We described that clinical findings and treatments of the 3 neurological diseases causing dysphonia well (Parkinson's disease, laryngeal tremor, spasmodic dysphonia) and vocal impairments for stoke patients.

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양측성 성대 마비의 치료 (Management of Bilateral Vocal Cord Palsy)

  • 류인선;최승호
    • 대한기관식도과학회지
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    • 제19권1호
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    • pp.5-10
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    • 2013
  • Bilateral vocal cord palsy (BVCP) present a challenging condition which result from various etiologies including iatrogenic recurrent laryngeal nerve injury, progressive neurological disorder, intubation, trauma, tumor and idiopathic cause. Careful history taking, laryngoscopic evaluation, laryngeal EMG, and imaging studies are helpful for providing a precise diagnosis and planning appropriate treatment. BVCP causes airway restriction and not vocal dysfunction. In patients with BVFP, treatment is directed at maximizing the airway, while attempting to limit the negative effects of treatment on vocal function. A variety of surgical procedures are available for mangement of BVCP. The most conservative, limited procedure should be selected initially, and then further surgery and more extensive surgery can be tailored to the patient's airway and voice needs. This review will address the etiology, diagnosis, and managements of BVCP.

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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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사성을 주소한 이비인후과 질환에 대한 임상적 관찰 (A Clinico-Statistical Analysis of Patient with Hoarseness in E.N.T. field)

  • 이숙자;강영;유방환
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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    • pp.6.2-7
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    • 1977
  • 사성은 후두의 정상 발성기능이 장애되있을때 생기며, 후두질환의 가장 중요하고 특유한 증상이다. 1885년 Morgagni가 최초로 후두암에 대해서 보고한 이래 최근 후두암에 대한 인식이 높아짐과 동시에 사회적으로 날로 심각한 문제가 되고 있는 공해 특히 대기오염으로 인한 기도증상으로 야기되는 후두질환증후인 사성을 호소하는 환자들이 증가되고 있는지 연구 고찰함이 의의가 있다고 생각되어, 저자들은 1970년 1월부터 1976년 12월까지 만 7년간 한일병원 이비인후과 외래에 사성을 주소로 내원한 400명의 환자에 대한 임상적 고찰을 하여 다음 몇가지 지견을 얻었기에 문헌적 고찰을 가하여 보고하는 바이다. 1. 이비인후과 신 외래환자 총 14,731명중 사성 환자가 400명으로 약 2.7%이였다. 2. 성별로는 남여비가 211 : 189로 약 1.1 : 1로써 남子가 약간 많았다. 3. 질환별로는 급성후두염 158례(39.5%). 만성후두염 103례(27.3%), 성대결절 37례(9.3%), 성대마비 34례(8.5%), 성대 polyp 32례(8%), 후두질 13례(3.25%), 후두결핵 9례(2.25%)의 순이었다. 4. 연령별로는 30세대가 113례(28.23%)로 가장 많았고 다음으로 40대, 20대, 순이였으며, 10대, 20대, 60대 이상은 비교적 저율이였다. 5. 성별질환분포는 후두암이 12 : 1, 후두polyp 27 : 5, 후두유두종 4 : 1로 남성에서 압도적으로 많았으며, 그 외질환은 남여 비슷한 율을 보였다. 6. 연령별질환분포는 50세대까지는 급만성후두염이 가장 많았고 30대에선 후두 polyp, 30대 및 40대에선 성대결절, 40대 및 50대에선 후두결핵과 성대미비, 50 대에서는 후두암이 최고율이였다. 7. 월별분포는 고루 산재되어 있었으며 그중 3월∼6월사이가 비교적 고율이었고 동절엔 비교적 낮았다. 8. 발병부터 초진까지의 기간은 10일이내가 103례(26%)로 가장 많았고 약 80%에서 발병 1년이내에 내원하였다.

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성대 Bowing의 술전.후 음성기능 (Vocal Function After Surgical Correction of the Bowing Vocal Cords)

  • 정광윤;최종욱;한동수
    • 대한후두음성언어의학회지
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    • 제6권1호
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    • pp.9-15
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    • 1995
  • Bowing of the vocal cords may be due to aging. atrophy. bilateral superior laryngeal nerve paralysis. injudicious vocal cord surgery, of an idiopathic cause. The bowing usually produces a dysphonia characterized by breathiness due to air escape : however, it can produce aphonia. This report reviews vocal function after surgical correction of bowing of the vocal cords for diagnosis and management. The vocal function of 13 patients with sulcus vocalis and 12 patients with vocal cord atrophy was evaluated with the use of a test battery of multidimensional evaluation items. The voice was improved postoperatively in most patients. The voice improvement was reflected objectively in maximum phonation time, mean air flow rate during phonation, stroboscopic findings. sound pressure level range and fundamental frequency range of phonation, and results of acoustic analyses of tape-recorded voice. The vocal function after surgical correction of the sulcus vocalis and vocal cord atrophy was improved postoperatively in most patient, but the results were not satisfactory.

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β3GnT8 Regulates Laryngeal Carcinoma Cell Proliferation Via Targeting MMPs/TIMPs and TGF-β1

  • Hua, Dong;Qin, Fang;Shen, Li;Jiang, Zhi;Zou, Shi-Tao;Xu, Lan;Cheng, Zhi-Hong;Wu, Shi-Liang
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2087-2093
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    • 2012
  • Previous evidence showed ${\beta}1$, 3-N-acetylglucosaminyltransferase 8 (${\beta}3GnT8$), which can extend polylactosamine on N-glycans, to be highly expressed in some cancer cell lines and tissues, indicating roles in tumorigenesis. However, so far, the function of ${\beta}3GnT8$ in laryngeal carcinoma has not been characterized. To test any contribution, Hep-2 cells were stably transfected with sense or interference vectors to establish cell lines that overexpressed or were deficient in ${\beta}3GnT8$. Here we showed that cell proliferation was increased in ${\beta}3GnT8$ overexpressed cells but decreased in ${\beta}3GnT8$ knockdown cells using MTT. Furthermore, we demonstrated that change in ${\beta}3GnT8$ expression had significant effects on tumor growth in nude mice.We further provided data suggesting that overexpression of ${\beta}3GnT8$ enhanced the expression of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) at both the mRNA and protein levels, associated with shedding of tissue inhibitors of metalloproteinase TIMP-2. In addition, it caused increased production of transforming growth factor beta 1 (TGF-${\beta}1$), whereas ${\beta}3GnT8$ gene knockdown caused the reverse effect. The results may indicate a novel mechanism by which effects of ${\beta}3GnT8$ in regulating cellular proliferation are mediated, at least in partvia targeting MMPs/TIMPs and TGF-${\beta}1$ in laryngeal carcinoma Hep-2 cells. The finding may lay a foundation for further investigations into the ${\beta}3GnT8$ as a potential target for therapy of laryngeal carcinoma.

음성장애에 대한 임상적고찰 (Clinical Observation on Voice Disorder)

  • 이종원
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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    • pp.7.2-8
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    • 1979
  • 음성외과는 발성기능를 취급하는 기능외과이기 때문에 수술적응의 결정 수술효과의 판정 수술성적의 비교를 위하여 발성기능의 검사가 필요하다. 청력을 취급하는 수술에서 청력검사가 필요한 것과 같다. 연자는 구유미대학 이비인후과를 방문한 각종후두환자(56례 즉Recurrent laryngeal nerve paralysis, polyp. polipoid vocal cord. sulcus vocalis, Laryngeal cancer, Benign mass, Epitherial hypertrophy. 등에서 발성지적시간, 폐활량/담성지적시간, 평균호기유율 및 후두 Stroboscopy 검사를 시행하여 다음과같은 결과를 얻었다. 1) 성대의 편측성병변은 35례(62.5%)이고 양측성병변은 21례(37.5%)로 편측성병변이 많았다. 2) 성별로는 남성이 39례(69.8%) 여성이 17례(30.2%)로 남성이 많았다. 3) 발성지적시간은 10초이하가 26례(46.4%) 10초이상이 30례(53.6%)이였다. 4) 폐활양/발성지적시간은 300m1/sec이하가 33례(58.9%) 300m1/sec이상이 23례(41.1%)이였다. 5) 평균호기류율은 300m1/sec이하가 37례(66.1%)300ml/sec 이상이 19례(33.9%)이였다. 6) 후두 stroboscopy 검사에서 성대의 대칭성, 규칙성, 진폭, 점막파동 및 성문패쇄에 대해서 관찰하였다. 7) 후두수술전후의 음성검사와 stroboscopy 검사의 비교는 수술후의 성적이 매우 좋다.

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수직후두부분절제술 및 점막 피판과 지방 이식을 통한 성대 재건술 후의 음성분석 (The Analysis of Voice after Vertical Partial Laryngectomy with Mucosal Flap and Fat Graft Reconstruction)

  • 주형로;최인자;김진환;안회영;노영수
    • 대한후두음성언어의학회지
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    • 제18권2호
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    • pp.134-137
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    • 2007
  • Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

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